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Indian Express
17 hours ago
- Health
- Indian Express
Too young, too female: At 25, all I want is a doctor who listens
The smell of hospital disinfectant, unsettled nerves and a sense of impatience hung in the consultation room as I sat in front of the 60-something-year-old doctor. But I was prepared to be a good patient. I had a mental list of all my symptoms and was ready to answer the 'whys' and the 'hows'. 'Fever, sore throat, body ache, excessive fatigue. Worse after…' 'Did you have a long day out recently?' The doctor cut me off, already reaching to jot down the prescription. 'Yes, we were out in the sun right at noon; it was very, very hot. It became even worse because I got my period the same day—' 'Yeah, that doesn't make a lot of difference. It is exhaustion and vitamin D deficiency,' the doctor interrupted again. 'Very common in young people, especially those who spend all day working indoors on their laptops,' he continued. He took a beat to look at my father, almost seeking approval for his diagnosis-cum-judgement on a whole generation. The consultation at a prominent Delhi hospital's Outpatient Department lasted barely five minutes. I walked out feeling sicker, hopeless, and angry. Medically, I was later diagnosed with a viral fever for which I ended up taking an extended antibiotic course, just because I didn't start my medication soon enough. The outcome would have likely been different had I been heard during the consultation. A 2016 essay, published in the National Medical Journal of India, states that of all the communication strategies available to medical professionals, they are most likely to dismiss 'listening' as 'passive and weak'. The essay cites a book titled Skills for Communicating with Patients, which was first published in 1998, and explores strategies for effective doctor-patient interaction. 'Doctors have traditionally controlled the interview via closed questions that limit patients' contributions and render them more passive,' the third edition of the book (2013) notes. At 25, I belong to a generation that expects to be heard. We seek healthcare that is collaborative, not judgmental and exclusionary. The dawn of the internet democratised knowledge, even around health and medicine, which were previously locked up in medical textbooks and journals. So, we grew up Googling our symptoms. Many healthcare practitioners seem to view informed (younger) patients as those looking to question their authority rather than partners with a common aim. The concern isn't entirely unfounded. When bordering on self-diagnosis, an Internet search does more harm than good and can lead to wrong or improper remedies. But I wasn't trying to play doctor. I just wanted to explain my condition as clearly as possible, present all the relevant facts, for the expert to help me better. This was lost in the shotgun approach to communication. The dismissal I faced has a name in academic circles. In 2007, Miranda Fricker first described 'epistemic injustice' or the injustice inflicted on someone 'in their capacity as a knower'. In the context of healthcare, the National Institutes of Health uses this broad concept to define 'testimonial injustice'. It's when a patient explaining their experience of a certain illness is 'dismissed or under-played' by the specialist. This leads to the selection of only parts of the patient's testimonial, which the specialist considers 'useful', for diagnosis or treatment options. When age meets gender The communication gap deepens when you are both young and female. My 28-year-old friend in Chennai, dealing with a persistent toothache and consequent headache, swung between various dentists and doctors, unable to understand the cause behind her problems. It took her several weeks and a gracious doctor who inquired enough to deduce that she needed a root canal. All this could have been avoided had she been advised to get an X-ray on the first visit itself. But her symptoms remained largely unheard and, worse, dismissed. She bore the double burden of being seen as too young to understand the intricacies and too female to trust her own body. Dr Rageshri Dhairyawan, in her 2024 book titled Unheard: The Medical Practice of Silencing, chronicles how 'not listening to patients' has been ingrained in medical science since its inception. 'All patients are silenced to some extent, but some — notably, people of Black, Asian, and minority ethnicity, women, and people who are sick or disabled — are more severely and consistently silenced than others,' Dr Dhairyawan, who is also a UK-based consultant physician, writes. Neither my friend nor I were asked what triggered our symptoms, or the severity and the duration of the discomfort. The immediate dismissal mostly came wrapped in the language of generic concern: 'Beta, it happens in this age', 'resting well should do it', or 'you are too young to have these problems'. Variations of these phrases exist across doctors, specialists, and even cities. It's harder to challenge them when family members resort to 'doctors know best, trust them'. While nobody would describe a visit to the doctor as inviting, these unpleasant encounters create barriers to seeking medical help. Self-doubt creeps in. Maybe the pain isn't so bad. Maybe it means nothing. Those who listen It takes one step from both sides to make things better. For me, the step was witnessing a balanced doctor-patient interaction. 'Tell me all that you have been feeling' — just watching another doctor sit across from my cousin and patiently ask him questions that nudged him to delve into details was reassuring and encouraging. It emphasised how the dynamics and the experience change when doctors view listening as a clinical skill. As the 2016 essay notes: 'Through active listening that recruits the emotions as well as the intellect of the listener, the doctors could move from defensive planning to empathic understanding.' The many doctors who already embody the art of listening genuinely ease the discomfort of hospital visits. Their conversations break free from the tired scripts where patient voices get lost between symptoms and treatment plans. These doctors remind us: even if consultation rooms still smell of disinfectant, they don't have to reek of dismissal. Vibha B Madhava is a sub-editor at the news desk for She is interested in writing about gender, culture and politics of ableism. Having specialised in digital journalism, she is keen to explore various forms of interactive, multimedia storytelling. Apart from that, she also likes to experiment with social media. Qualification, Degrees/other achievements: Bachelor's degree in Media and Communication from Manipal Institute of Communication, Manipal Academy of Higher Education. PG Diploma in Integrated Multimedia Journalism from Asian College of Journalism, Chennai. With The Indian Express, this is Vibha's first stint in pursuing journalism in a full-time capacity. Previous internship experience: Deccan Herald, Bengaluru; The News Minute, Bengaluru; The Mojo Story; Radio Indigo 91.9 and Fever FM 94.3 (Hyderabad) You can find her on Twitter as @VibhaBMadhava , on LinkedIn (Vibha B Madhava), or write to her at ... Read More
Irish Examiner
07-05-2025
- Politics
- Irish Examiner
Grace is not a victim of unfortunate oversight, but a citizen whose rights were repeatedly violated
Living as a disabled woman in Ireland means being underestimated, having your capacity constantly questioned regardless of your impairment, being infantilised, silenced, excluded, and rendered a nuisance. As women, we are marked by difference. Cultural and institutional memory often omits us, except for moments of public shame; even then, we are not centred — merely exposed. The story of Grace, a non-speaking, intellectually disabled woman left in an abusive 'foster' home for decades, is not just one of personal harm. Like many wrongdoings in Ireland, it is cloaked in euphemism, delayed accountability, and procedural malpractice. As a nation, we are culpable of collusion and cultural dissonance. In 1989, Grace was placed by the State in a 'foster' home that was never assessed or registered for foster or respite. The placement wasn't an oversight; it was a bureaucratic gamble with a disabled child's life. For decades, the State looked away. Reports of abuse circulated for years. The first real public conversation about vulnerability and disability emerged much later, amid outrage sparked by the Ryan Report (2009) and the Áras Attracta scandal (2014). These moments should have created a lasting national transformation, but outrage without structural change is merely a performance of eloquent rhetoric claiming shock and disgust. There is an inertia surrounding the abuse and mistreatment of disabled children and adults in this country. The Farrelly Commission and the State's decision not to proceed with the second phase has left 47 children unaccounted for. Ireland has signed the UN Convention on the Rights of Persons with Disabilities (UNCRPD). However, it has still not ratified the Optional Protocol to the Convention Against Torture (OPCAT), which would allow for independent monitoring of settings where people are deprived of liberty. Ireland's discourse surrounding disabled lives is reductionist, patronising, and insulting in its reporting of Grace; this insulates systemic actors from critique. News coverage of her situation often fails to centre her as a person with rights. Cultural ableism thrives when language strips disabled people of our complexity, autonomy, and dignity. Philosopher Miranda Fricker describes this phenomenon as epistemic injustice — when someone is denied credibility or recognition as a knower of their own life. Grace, through her legal team, submitted extensive materials to the Farrelly Commission, but none were included. The result was a 2000-page report about her, from which her mediated voice was excluded. The Farrelly Commission, established in 2017, arrived late and left early. Phase two — which was intended to explore the experiences of 47 additional children placed in the same abusive home — was abandoned. Officially, this was deemed 'too complex.' The omission of the second phase is not merely a policy gap but an ethical failure. It denied others like Grace - such as Frances O'Keeffe, featured in these pages yesterday - the opportunity to name their harm and be heard. Here, we encounter profound cultural dissonance: policies, practices, and procedures treat disabled lives, voices, and experiences as inconvenient. The disability lens is rarely included as a perspective in public inquiry and never as the central framework. We are not considered worthy of an easy-to-read format or an executive summary. Grace's status as a ward of court meant she had representation and a right to speak; yet, the inquiry into her treatment refused to include her submissions. Throughout the Farrelly Report, there is no trace of her as a legal subject, no evidence of her, and no formal communication with her by the Commission. Grace, through her legal team, submitted extensive materials to the Farrelly Commission, but none were included. The result was a 400-page report about her, from which her mediated voice was excluded. File picture: iStock Grace's narrative is gendered. Most abuse cases in institutional care, such as Áras Attracta, involve disabled women. Misogyny, like ableism, is embedded in the perception of harm as minimal. Disabled women often experience multiple forms of erasure: we are deemed too dependent to consent, too marginal to protect, and too complex to be believed. This erasure is linguistic as much as legal. Reports often use the passive voice — 'mistakes were made,' 'oversight failed.' When the language of bureaucracy overtakes the moral clarity required to name harm, disabled women like Grace become collateral damage in the pursuit of institutional self-preservation. The facts of the case are not ambiguous. Grace was placed in an un-inspected foster home. She remained there for 20 years despite a documented history of abuse concerns. The State had multiple opportunities to intervene — and chose not to. In 2017, the Farrelly Commission was formed. In 2024, it issued its report — over 2000 pages, €13m spent — and Grace's voice was still absent. Grace is not a singular failure but a symbol of systemic neglect. Her story is one chapter in a broader narrative that Ireland has yet to confront: the persistent, patterned erasure of disabled people from our histories, protections, and safety. If justice is to mean anything, it must begin with truth. That means revisiting the Farrelly Report—not with neutrality but with moral clarity. It means reinstating phase two. It means recognising Grace not as a victim of unfortunate oversight but as a citizen whose rights were repeatedly violated. Like so many others, Grace's voice will remain silent in the public record until we rewrite it—not posthumously, but now, while we still have time to act. Dr Rosaleen McDonagh is a playwright from The Traveller community.
