‘All in Her Head’: A Doctor Reckons With Sexism in Women’s Health Care

Six years ago, Dr. Elizabeth Comen, a breast cancer specialist at Memorial Sloan Kettering Hospital in Manhattan, held the hand of a patient who was hours from death.

As Dr. Comen leaned in for a final goodbye, she pressed her cheek to her patient’s damp face. “Then she said it,” Dr. Comen recalled.

“‘I’m so sorry for sweating on you.’”

In her two decades as a physician, Dr. Comen has found that women are constantly apologizing to her: for sweating, for asking follow-up questions, for failing to detect their own cancers sooner.

“Women apologize for being sick or seeking care or advocating for themselves,” she said during an interview in her office: “‘I’m so sorry, but I’m in pain. I’m so sorry, this looks disgusting.’”

These experiences in the exam room are part of what drove Dr. Comen to write “All in Her Head: The Truth and Lies Early Medicine Taught Us About Women’s Bodies and Why It Matters Today.” In it, she traces the roots of women’s tendency to apologize for their ailing or unruly bodies to centuries of diminishment by the medical establishment. It’s a legacy that continues to shape the lives of women patients, she argues.

Today, women are more likely to be misdiagnosed than men are and take longer to be diagnosed with heart disease and some cancers; they may be less likely to be offered pain medication; their symptoms are more likely to be written off as anxiety — or, as the book title suggests, as being all in their head.