Excerpt: 'Ask Dr. Marie,' by Marie Savard

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Yet in spite of the fact that I'm a doctor married to a doctor, at times I've been as guilty as the next woman of suffering in silence either because my complaints didn't seem important enough to mention—or because they seemed, well, unmentionable. I've gotten over that as you'll find out when I come forward with my problems in some of the chapters of this book. The point is, though, that even I kept these "female troubles" to myself for decades. I have long told each of my patients that whatever questions she has, she is not alone. Yet I had a blind spot when it came to myself. Believe me, opening up has been liberating. I'll also admit that when I was a young woman, I used to be influenced by the old patriarchal "yes, doctor" model of the physician as an all-knowing authority figure whose wisdom was not to be questioned. That era has long since passed and I've followed my own advice about taking charge of one's health and establishing a doctor-patient relationship based on mutual respect and clear communication. Yet I have become well aware that this is not always easy to put into practice, given the constraints of the health-care system in the United States today. For obvious reasons, office managers and group practice administrators are not pleased with physicians who spend as long with each patient as she truly deserves. (Nor are many physicians themselves, who worry they can't cover their expenses if they see too few patients.)

Consequently, the ideal picture I painted about our long and in-depth consultation in my office would be all but impossible to achieve in reality. That was my impetus for writing this book for you, as an alternative. The idea first came to me back when I was one of four physicians in a group practice with "panels" of thousands of patients. If you had been one of my patients, your visits with me in my office would have been limited to a mere fifteen minutes, which translates to about seven minutes of face time with the doctor, unless you had been scheduled for your annual full physical exam. Even then, we would have had a scant thirty minutes together to cover not only medical issues but everything else you might have liked to confide to me.

If you had been given enough time to relax and open up to me, you might have talked about your sex life, or lack thereof. Or perhaps you would have been honest about the moodiness you had been experiencing at the mercy of hormonal fluctuations, whether as a teenager, a new mother, or a woman entering menopause. If you hadn't felt so rushed, you might even have gotten up the courage to tell me about troubles with your "private parts" that you've been too embarrassed to talk about, such as wetting your pants when you sneeze or cough, straining to have your bowel movements, feeling fat and bloated, or leaking through pads and tampons so that you stain your clothes and sheets. Usually, however, the visit would have been over all too quickly and you would almost certainly have left my office feeling frustrated because only your most urgent or immediate concerns and conditions had been addressed whereas what impacts the day-to-day quality of your life was probably not even considered. I was frustrated, too, when I was forced to do the medical version of speed dating with my real-life patients. That's why I eventually limited my practice in order to devote most of my working hours to bringing my message of health empowerment to women everywhere.

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