Yet another healthcare rant...

Transcript

Courtney: Hello, everyone, and welcome back. My name is Courtney. I am here with my spouse Royce, and together we are The Ace Couple. And today we’re going to talk about health care. This might just go in a few different directions. It might just end up turning into Courtney rants about US health care, which, to be fair, a good handful of you have specifically been requesting more Courtney rants about health care. So perhaps this can serve that purpose for you all, but essentially, I have been in and out of the doctor a lot more often than I usually am, and that is saying a lot for me.

Courtney: I have far too many doctor’s appointments. Going to the doctor is a part-time job for me and has been for my entire adult life, if not longer. So, naturally, when you have to see doctors so often, there are going to be little irritations, little things here and there. So, I’ve just been generally frustrated with healthcare, just all the time, passively in the background, I’m just fuming about healthcare.

Courtney: So, in the midst of all of these doctors’ appointments and frustrations, some old, some new, I have been sent some videos and articles recently, which has been appreciated because I have not been on the internet much of my own volition as it is. But I want to start this conversation by talking about the good old-fashioned intake questions. I know I have had some criticisms of these in the past already, but given our current political climate in this country, given the fact that Roe v. Wade has been overturned, given the fact that we have staunch pronatalists and Christian nationalists in our current White House administration, little changes like this do need to be taken note of. And the first place we are really seeing this is the VA.

Courtney: See, these videos and articles that have been sent to me are about new questions that have been added to the intake form for women who are being seen at the VA. Now, we all know it is pretty standard despite my concerns to ask people, oh, when was your last period? Is there a chance you could be pregnant? Those are fairly normal questions that we’ve been dealing with for a very long time.

Courtney: And anytime people critique those questions, or ask if they’re necessary, or ask if you can abstain from answering those, there are always some people who are going to chime in and say, no, this is actually incredibly important, in women’s health, you know, for people who do menstruate, like having normal periods is a very important part of your health. And if things aren’t normal, it could be indicative of greater issues. So yes, of course doctors need to know about these things. It’s so important for your overall health.

Courtney: People will say that to me and I’m gonna call bullshit. We’ll talk more about that. We’ll talk more about why I’m calling bullshit, but If that’s the reason, then tell me why. Tell me why these new questions in the VA intake are asking: “Is there anything physically preventing you from getting pregnant?” Followed by: “Are you physically capable of getting pregnant and bearing a child?” Like, these are questions that are now being added. And I will link in the show notes so you can see from the veteran who initially posted this video complaining about this so you can see directly from the person who is shedding light on this.

Courtney: But the fact that this is showing up in the VA, you know, government funding, government oversight, I don’t think it’s long before it will be more normal in other places or required or expected or mandatory in other places. And I just think personally, if you are not actually seeing a doctor for anything related to family planning, reproductive health, or any chances that you are pregnant, whether or not it is a wanted pregnancy, I feel like most of the time doctors don’t need to know those things. Most of the time they do not need to know those things.

Courtney: Because also in my experience, I’m thinking about all the things you could answer if you were just to answer that question at face value. Is there anything physically preventing you from being pregnant? You know, perhaps various forms of birth control could be an answer to that question. Had my tubes tied could be an answer to that question. Had a hysterectomy could be an answer to that question. In my experience, even if you answer any of those things, they’re just gonna disregard your answer to that anyway. Because I have literally spoken to a recently post-menopausal lesbian who has had a hysterectomy, and she was like: “hey still make me take pregnancy tests before I get an x-ray. They still made me take a pregnancy test before this surgery.” That’s so silly. It is ridiculous.

Courtney: So it’s very hard to take at face value that these are important questions to medical history if they’re already going to assume what they’re going to assume anyway. But that question gets so much more nefarious in red states where abortions are now banned. Like, even when was your last period, if you answer that can be a really scary question. And justifiably, a lot of people do not want those documented in their medical charts right now, if ever. And whenever people who are concerned about this express those concerns, there’s always someone who comes out of the woodwork and goes, but HIPAA! They’re all like, Doctors are safe. You can tell your doctor anything. Anything you tell your doctor is confidential. This will never get in the hands of the federal government or any bad actors because we have HIPAA.

Royce: Anyone who has worked on the software side of medical industries can tell you that that is not reliable. A lot of medical infrastructure is aging and not kept up to date.

Courtney: Yeah, well, we talked in a previous political, vaguely medical episode about how the reason why we were all of a sudden able to do more telehealth when the pandemic started wasn’t because all of a sudden these medical companies had better, more private, secure means of doing this. It’s because the federal government said, hey, we won’t prosecute you if you aren’t holding up to these standards right now. For one, there’s that. There is the software side of things. But also, if the federal government all of a sudden decides that abortions and/or miscarriages could be a prosecutable thing, HIPAA doesn’t protect against subpoenas.

Courtney: And prosecuting pregnancy loss is a thing that does happen in this country and has happened in this country. This is not a theoretical worst-case scenario that might happen down the line. This is a thing that is happening and has happened, and I anticipate is likely to get worse before it gets better. But there is also largely, I think amongst the average population, I think a lot of people just inherently trust doctors and medical institutions in a way that I’m often deeply uncomfortable with.

Courtney: But the problem is, if like the average American just really trusts doctors and everything they’re asking must be for a reason and they know what’s best, they’re probably people who believe in science but are generally very healthy. That’s normally who that demographic is. Because of course you’ve got like the conspiracy theorists who are like anti-vaccination, anti-medical care. But then you got the people over here like me who do trust in and believe science but don’t trust individual doctors and definitely definitely don’t trust the medical institution in the way it has been set up.

Royce: Have you been keeping a running tally of how many medical professionals you’ve encountered in your lifetime that were later found to be running some kind of illegal kickback scheme?

Courtney: [laughs] At least like three? At least like three? But listen, so on the note of pregnancy tests, I have heard women in red states right now who are actively trying to get pregnant, who are still afraid to tell their doctors that, or report when their last period was, or answer the question: “Is there a possibility you could be pregnant?” Because they are aware that pregnancy loss prosecution is a possibility. And even if they want a child, even if they’re trying for a child, they don’t want it documented on their charts early on that they could be pregnant if an early miscarriage happens, which is a lot more common than most people give credit to.

Courtney: But I have taken a stance toward doctors where I am no longer going to be a pushover, mostly because I have proven to myself and my doctors time and time again that I can know what is wrong with my own body so much sooner and faster than they can. Like, for all the heat that like, don’t mistake your Google search for my medical license. Like, it happened again recently where you and I sat down and diagnosed myself and then basically had to go to the doctor and be like, this is the problem, do the test you need to prove it. Again. And have you kept track of how many times that’s happened just in the 11 years we’ve been married?

Royce: It’s a lot. And it’s not even like we went into a hole and did days of research. We spent like five minutes on our phones and we’re like, this seems to be the direction all the arrows are pointing.

Courtney: Yeah. Yes. And so I got a bit inspired recently. We talked about this not too long ago when we were talking about medical care where you went to the doctor for the first time in a long time and I was also long for the ride and they were like, Here’s an optional form and you’re like, I don’t fill out optional forms, and they’re like: “Great, no problem. Have a seat.” I was like, Wow, you can just refuse to do something they’re asking you to do? So I took a new lease on life. I’m like, I’m not doing anything at the doctor that I don’t think is necessary. I’m the one in control now.

Courtney: Well, how the fuck did that work out for me, you might ask. This has been one of the most baffling, like, few months of medical care that I think I’ve ever had. Not necessarily the hardest, not the most intense, not the most complicated, but the most baffling. Because it started when I went to who was my primary care doctor first for like yearly checkup stuff, nothing in particular.

Courtney: Although I did mention a couple things that were going on. I was like, yeah, I’ve had, you know, some odd, very short periods of extreme abdominal pain. It’s short, it’s few and far between, but it’s like bad. It is so bad. I am like hardly able to talk, writhing on the ground in a cold sweat, like can’t move my body. About to have my spouse drive me to the ER, it’s so bad. Which, again, in the US, if you’re prepared to go to the ER, If you’re prepared to pay that bill, that is saying something. Especially with someone like a pain tolerance like me and as many chronic issues as I have, like, I have to basically assume I’m dying before I will go to the ER.

Courtney: So I’m like, yeah, that’s been pretty weird. And also, I’ve had a couple of migraines lately. I had chronic migraines when I was a kid, but these are also very few and far between. But I’ve had a couple more recently. You know, when I was young, migraine medication didn’t work. Is there anything new that’s gotten better that I should try and keep on hand in case these things happen? Well, this is already the doctor that I was thinking of firing because this is the doctor I was seeing when they put in my charts: “Is the patient sexually active? Yes.” In parentheses: “Patient says no.” That was in my chart and I could see that myself. I would go onto my portal and I would just think, what the hell? That is so blatant. That is disturbing.

Courtney: So I was already thinking of firing this doctor. But she saw me for like five minutes and was like, yeah, we’ll run some blood tests. That’s about it. Okay, great. Well, something came back on my blood test and she’s like, your bilirubin level is high. And I’m like, okay, what does that mean? And she said, It means we will retest you in six months to see if it’s still high. Okay, and if it’s still high, what does that mean? They were like, oh, it means we might do other tests. What other tests? Tell me the things. And they just would not. So, also for how much doctors tell you not to Google things, they sure as shit do not tell you a lot of information. Like if you just answered my question satisfactorily, maybe I wouldn’t be turning to Google. But this was around the time oh, doctors, or Royce is seeing a doctor for the first time ever. Let’s see who this new doctor is. This doctor, do you know how long you were in front of this doctor? Because it was like longer than any doctor’s ever sat with me with my complicated ass medical history.

Royce: I don’t know, but it was a different office within the same chain, and so I don’t know how much of it is to chalk up to scheduling issues or workloads or staff differences. But we got in to see the doctor much faster. And I mean, I wasn’t looking at the clock, but it wasn’t rushed or anything. We had time to go through the whole list.

Courtney: And I swear he talked to you for like 20 minutes. And it wasn’t diagnostically. It was like, oh, tell me about what your diet is. And you’re like, oh, well, we’re vegan. We have a garden at home. We eat a lot of fresh like fruits and veggies from our garden. And I’ve started making seitan recently, and we got to a point where he’s like, I don’t even know what those words are, but he was like, you know, a good, well-rounded vegan diet, probably the best diet you could possibly have. Good job on that. You’re probably healthier than, you know, 99% of the people I talk to. And so he was like giving you a like A+ report card on just like, good job making good health choices.

Courtney: And I’m sitting here in the corner like, are you kidding me? No doctor has ever spent this much time going through my medical history. So I was like, maybe I wanna see this doctor, actually. Because before I did, I had one more of these little, like, extreme pain episodes. So I called my doctor’s office and I was like: “Hey, this thing happened again.” And they wanted me to talk to a triage nurse. They’re like, you need to speak to a triage nurse right away. Who did no triage. I don’t know what the point of the triage nurse was with no triage.

Royce: I think what you wrote in the chart just made them panic and it got you sent into another workflow that also didn’t go anywhere.

Courtney: Exactly. Well, I sent them a message in my portal that I was like, this pain was so bad that if it lasted longer than 25 minutes, I was going to go to the ER. But it stopped at like exactly 25 minutes. And then they were like calling me and they’re like, you need to speak to a triage nurse immediately. And I was like, hey, triage nurse, I already talked to my doctor about this. And they tested my blood and said my bilirubin is high. And they said, they’ll test that again in six months. And then they were just like, that’s fine. What do we do with that? And she’s like, you should come into the doctor right away.

Courtney: And I was like, for why? If you can tell me why and what they will do differently, I will do that. But I already explained this problem to the doctor. And she was like, well, you’ll just have to come in again. And I was like, are they gonna run any different tests than they’ve already done? And the triage nurse says, I don’t know what the doctor will do. So I said, screw that. I’m going to Royce’s doctor now.

Courtney: So I called and I was like, hey, give me another doctor. And they have been flabbergasted by this every time. Cause now every time I go into the doctor, they’re like, the poor women at the front desk are like looking and they’re like, which doctor are you here to see? I see you’ve been seeing this doctor, but you have an appointment with this doctor? And that seems wrong. And I was like, just take the old doctor out. I’m firing that doctor. I’m seeing a new doctor on purpose. Right?

Courtney: So then I come in and see your doctor now, and he spends like a little more time with me than usual, but not as much time as you got. And I was like, by the way, also, I’ve been getting these migraines sometimes, and I have this really extreme abdominal pain that just happens like every so often. And at this time, it had happened like four times. And me being a professional sick person, I know what the doctors are kind of looking for, so I’m like, I tried seeing if there was any commonalities that triggered this. I did not have any similar foods on these days. They were not at the same time of day. X, Y, Z, like I have been trained to track these things about myself. And I couldn’t figure it out. And he looks at the chart and he’s like, oh, I see the former doctor wanted to test your bilirubin levels in six months. Why don’t we just go ahead and retest it now? And this was like a couple weeks later. So I was like, okay, great. Let’s do that.

Royce: He was also going to look for something that they probably should have looked for in the initial test. Like, there was something else about bilirubin that was detected.

Courtney: It was like the type of bilirubin. He’s like, oh, is it mostly indirect or direct bilirubin? Which at the time, I only had a very vague grasp of what bilirubin was. But I was just trying to get to, like, what could this mean? What could this do? But meanwhile, and here’s the thing about charts and them believing you, like, I am 100% convinced that most doctors don’t even look at your charts. Because I told them in like the first of all, like sometimes it’s just outright wrong. Sometimes they ask if you’re sexually active and you say no and they put yes in your charts anyway. Rude.

Courtney: Sometimes you talk about family medical history and you tell them, yes, this is my family’s medical history. I told them twice that my mother had her gallbladder removed when she was my age. And also, every single person on her father’s side of the family also had to get their gallbladders removed. And that somehow did not get put in my charts. I told two different doctors that. Two totally different doctors that. And it’s not even in my chart right now. So then every time I come in and I’m like, hey, could this be a gallbladder attack? I think maybe this could be a gallbladder attack. Can we check for gallstones? I think that’s the problem. He’s like, no, let’s test your bilirubin again.

Courtney: And then I get a note back like the next day that’s like, yeah, your bilirubin is still elevated. So I am diagnosing you with Gilbert Syndrome. And I’m like, great, what is Gilbert Syndrome? And he’s like, it’s totally benign. No additional symptoms. Just, you know, a goofy little thing. Like, okay, but what about this, like, bad pain that I’ve been having? Well, let us know if it happens again. Okay, what about the migraines I asked you about? Can I have medication for that? You’ll have to come back into the office to talk about migraine medication.

Courtney: Are you kidding me? I’ve already asked two doctors for this. So they made me set up another appointment to come in. To the same doctor, and I’m like, hey, remember when I told you about those migraines? Same thing. What now? He’s like, okay, here’s a prescription. Great. What about this extreme abdominal pain I’ve been having? Let us know if it happens again. Okay, well it happened again. So I called the doctor and I was like, hey, it happened again. Can I please be checked for gallstones? That’s what I would like. They’re like, okay, we’ll set up another appointment for you to see the doctor. I was like, if I come into the doctor again after now having explained this like four different times to two different doctors, five if you count the triage nurse, will you actually give me an ultrasound to check for this thing? And the woman on the phone is like, oh, well, we don’t actually do ultrasounds in this office.

Courtney: It’s like, okay, so if I come into the office, what are you gonna do? Well, we can’t tell you that. We don’t know what the doctor is going to do. It’s like, the doctor already knows the problem. The doctor already knows all of the information. I gave him a calendar. I was like, these are the days this has happened. Here are the times of day this has happened. Here’s how long each one has lasted. Here’s what it’s been on a pain scale. Like, these two I ended up vomiting on. Like, I was giving everything. So I was like, please, I don’t want to waste my time. Again, I just want to be checked for gallstones because he diagnosed me with a benign syndrome called Gilbert Syndrome and then just said, great, nothing’s wrong with you, you’re fine.

Courtney: So I come into the doctor again. Because then when I was talking this woman on the phone, she’s like, let me get you over to the nurse, maybe you can explain this to her. So I explained to the nurse who has also heard this already, I’m like, hey, what’s gonna be different if I come in, just please help me. And she’s like, yeah, we don’t do those tests here, but just the doctor wants to see you anyway. Okay, so I come into the doctor.

Courtney: And I sit here, I’m like, hey, remember when I told you that I have a family history of gallbladder problems? And I think maybe I have one now. Can we please check for that? And he did nothing different. He just talked to me for like five minutes and then said, okay, I will refer you somewhere to get an ultrasound. Because we don’t do those here. Which also means if I don’t get work done in this office, it means everything outside of the office costs a lot of money.

Courtney: So then he takes me over to like the, the care guide who’s gonna refer me to get an ultrasound. And she’s like, all right, it’s probably gonna cost you 200 bucks. I was like, oh geez, yikes. Okay, I guess if we have to do this. And she’s like, they can get you in tonight. But, and this was early morning. She’s like, have you eaten yet? I was like, no, I haven’t. She’s like, great, because you need to fast for this. So don’t eat for the rest of the day until you’re so I was like dying, not prepared for this, but I was like, okay, I’ll go get this ultrasound. And what do you know? The next day they come back and they’re like, hey, you have gallstones. It’s like, wow, you don’t say.

Royce: By the way, Gilbert Syndrome is not always benign. It has a small chance of increased risk of various things, including gallstones.

Courtney: Oh, great. See, I don’t even know if I even have Gilbert Syndrome. Maybe I do. Maybe it runs in the family. Maybe everyone on my grandfather’s side of the family has Gilbert Syndrome, and that’s why we all get gallstones. But you know what? It still to this day does not say that there is a family medical history of this, despite how many times I have told them this. So the charts are bad, and they don’t care.

Courtney: Meanwhile, there are like two specialists I see regularly, like, every single month. Both of them, I just happened to mention this to while I was in the midst of these far too many doctor’s appointments for this one thing, and both of them were like, yeah, it’s probably gallstones. You should probably get tested for that. And I’m like, I’m trying. I am trying so hard. But where this is wrapping back around to was I have stopped doing things that I don’t think are necessary. Now, sometimes they actually make me come in, but I will fight it. I will be like, if you are not going to do anything new or different, just refer me where you want me to go. Because I don’t want to sit here and explain the same thing to you half a dozen times. It’s a waste of time for you and for me.

Courtney: But sometimes they make you anyway, all right, fine. But when I went to get that ultrasound, they passed a paper my way and they were like, here, sign this. But at the top of the page, right? It said: “you can refuse to sign this form.” It literally said that at the top, in bold, with like an asterisk on either side of it, for emphasis. And I saw that, and I said, oh, if I don’t have to sign this, I’m not going to. And I pushed it back to them. And here I’m like, oof, I’m pulling a power move like Royce. Look at me taking control in a medical institution. It was not so easy for me. [laughs] Royce, I see you grinning.

Royce: I have heard this story before.

Courtney: Well, because I came home fuming about it. It was the weirdest thing. She looked at me with the weirdest look on her face and she’s like, you have to sign it. And I pointed at the top of the page that says, you can refuse to sign this. And I was like, no, it says you can refuse to sign this. So I refused to sign this. And in hindsight, it was not actually that big of a deal. I could have just signed the form because all it was was the HIPAA disclosure, turns out.

Courtney: But she’s like, no, you can’t. This is a legal document. You have to sign the legal document. I said, well, if I have to sign it, then why does it say that I can refuse to sign it? And then she’s like, that doesn’t mean you can’t not sign the form, it just means you don’t, you can you can refuse to actually see the HIPAA regulation. Like we can either give you the HIPAA information or you can refuse to see it. But then I looked at the form and there’s like a place to sign that says, yes, I want the HIPAA information. No, I don’t need to see the HIPAA information. But then at the bottom of the form, there’s a section that’s like, if a patient signature is not obtained, what is the reason it wasn’t obtained? And the first checkbox on that was “patient refused to sign.”

Courtney: So I, it, it’s, it’s like the people at the desk have never read these forms before, but I’m actually reading them, and probably no one they’ve ever passed it to has ever read them either. But I point at the checkbox, and I was like, can’t you just check the box that says I refuse to sign? And then she’s like, big exasperated sigh, picked up the paper, walked away, went into a back room, closed a door, and then I got like a full shakedown. It was so weird and intimidating.

Courtney: A new woman comes out and this was at a sitting desk, so I was sitting down. This new woman doesn’t sit down. She stands over me and she leans over me. She had like Both hands slapped down on the table, leaning over me, and her lips were pursed so tight. I don’t think I’ve ever seen a stranger look at me with this much disdain. And she just says, I heard you’re refusing to sign the form. And I was like, yup. She’s like, you can’t refuse to sign the form. I said, well, the form begs to differ. And I pointed at it again because she had it in front of her and I was like, it says, you can refuse to sign this form. So if I can’t, maybe you should remove that from the form. And then she just stared daggers at me silently for a very long time.

Courtney: And then she said, do you even want to be seen here today? Do you even want treatment? I was like, I would like that. Yes, please. And she’s like, then why won’t you sign the form? I was like, because it says I don’t have to. And this final one, I swear it was like a solid minute, because I thought I broke her. She was just staring silently at me, glaring down from above, pursed lips, and got to a point where I was like, what do I do? What do I do in this situation? This woman is just glaring at me. And she snatches up the paper and walks back and shoves it at the other woman who is originally at the desk, and she’s like: “she’s not gonna sign the form.” I was like, why are you so mad at me? And then that woman’s like, okay, well she’s not gonna sign the form, what can she do? And she’s like, oh, because then before she left, she’s like, I’m gonna have to document that you refused to sign the form. And I said, perfect. That’s what I want you to do. Yes.

Royce: That’s what the form says.

Courtney: Yeah. And so then she’s like, she’s not gonna sign the form. Hands this back to this other woman, and she’s like, well, then what do I do? And she’s like: “check the box that says she refuses to sign the form.” And I was like, what is happening? So then I’m sitting after finally doing this, they’re like, all right, go have a seat. And so now I’m like Googling HIPAA, even though I know so many things about HIPAA already. And I’m like: “HIPAA refused to sign.” And I’m seeing like, the doctor’s office is legally required to show you this form, but you are not legally required to sign it. And it said that, like, on the HIPPA website. So I was like, I don’t know what the deal was with that. So of course I come home and I’m like: “Royce, how do you do it? How do you refuse to sign forms and not get people trying to intimidate you into signing it?” Like, in a court of law for things that are obviously way more serious than this, don’t they, like, ask you, like, has anybody tried to intimidate you or sway, like, it was so goofy.

Royce: I mean, honestly, if that identical thing happens again, the moment someone like that comes over and tries to lean over you, just stand up because you are taller than the average woman. And-

Courtney: Power move.

Royce: -you’ve been practicing your press energy.

Courtney: Oh no. I’ll be like, ma’am, I know Tai Chi.

Royce: Ma’am, you don’t know what I do every day.

Courtney: You don’t know what I do every day. I have a sword in this cane. I did not have my sword cane with me that day, actually. But I could have. Maybe that’s the answer. Every time I go to the doctor, it has to be the sword cane, just so I feel a little more powerful. But I was like, I don’t understand. I was not being disrespectful at all. I was just saying, this form says I don’t have to sign it, so I’d rather not. And I didn’t want it to be a big thing. It didn’t have to be. It was silly. I wouldn’t have morally objected to signing that form, but they made it such a big deal that now I was like, well, now it’s that’s the principle of the thing. But the thing that’s really funny to me, like when we’re sitting here discussing this, you’re like, yeah, just stand up, assert dominance over them. But like, you are so not that way in real life. Like, you will not go to doctor’s appointments with me if you think I’m gonna fight someone.

Royce: Yeah, I would prefer not to. But also, I’ve never been in a situation where someone has aggressively tried to make me sign a form that clearly was marked as optional.

Courtney: I know, it’s so goofy, but like, what would you actually do? Because you’re very conflict-averse, but you also get really frustrated when people are so clearly wrong about something.

Royce: Well, I don’t know now, because now that this story is in my mind, I’ve thought about it and my action would probably change.

Courtney: But when you’re not expecting it, when it just sneaks up on you-.

Royce: I mean, the only reason I didn’t sign that optional form before was because it came like a week or two after a story of yours where you were complaining about how you were filling out a form that was clearly marked optional. So the next time I got a form, I just looked at the top and it said optional and I said, oh, this form is optional. I’m not going to sign it or I’m not going to fill it out and passed it back.

Courtney: Well, and you know, my optional form where they were asking for sexuality and I was writing in the margin saying asexual needs to be an option. I am asexual. Put that in my chart. They didn’t put it in my chart. Asexual is not in my chart. So they can say they care about sexuality, but they do not.

Courtney: So yeah, so that was already super goofy, but also in the midst of this, I have not answered the like when was your last period question in an extremely long time, mostly because I haven’t had to. Back when I was having periods, they were bad, they were irregular, sometimes they were like two weeks long. So, in order to correct that, I actually have an IUD and that has stopped my periods completely. And that is ideal for me. That is a good medication that I had an issue, it got solved.

Courtney: But for how often they’re like, it’s so important to know when your last period was, ’cause it could be indicative of other health issues. When I was actually seeing doctors back in the day, a long time ago, about these period specific issues being like these are bad, this is irregular, it was the same thing as with like my migraine and my abdominal pain here today. They’re just like, alright, good to know. Are you gonna do anything about it? No. Like, I have been in a place in my life at one point where I was like, I have issues with my period. And for a very long time, it was just a footnote in my charts that no one was actually paying attention to at all.

Royce: The other thing for, for doctors, diagnostics, just asking when the last menstrual period was isn’t helpful unless you’re tracking them consistently throughout the year. Like one or two data points taken out of context don’t show a pattern.

Courtney: Exactly.

Royce: So it’s either irrelevant or it needs to be tracked consistently.

Courtney: Which is a great point, really great point, because a lot of people only see a doctor once a year. But that was another one where I never even had a doctor suggest, oh, here’s a medication to help with your menstruation. Like that was another one where I was talking to a friend of mine who had had an IUD for many years, and she was like, you should ask about this if this is a thing you’d consider doing, ’cause I haven’t had a period in a really long time. And I was like, wow, that actually sounds pretty good.

Courtney: Maybe I’ll ask my doctor about that. So I asked my doctor about that, and they’re like, yeah, sure. And I haven’t had a period since, and it’s been lovely. However, so goofy thing happened where my my IUD was technically expired for like a couple of years, but my main use of it isn’t for birth control, so every doctor would be like, oh, well, you see, your IUD isn’t actually approved to help prevent pregnancy past this year, and I was like, well, I’m still not having periods, and that’s the reason why I have this. So do I have to get it replaced, or can I wait? And then they’ll act a little confused, but then they’ll be like, yeah, I guess we can wait a little bit.

Royce: Is that like a... The expiration date on a lot of medicines is where the efficacy starts to drop, like where it can’t be a reliable dosage. But it’s not like past the date the medicine just immediately spoils. It’s just like slightly less effective.

Courtney: And it falls off faster and stuff.

Royce: It falls off faster with different medications. But is it that kind of thing where you were still getting the dosage of hormones, but it was maybe like slightly lower.

Courtney: Well, I also had a really horrible experience when I got an IUD once, which is like another thing that no one ever tells you about. Like, I ended up having like full-on labor contractions and I like nearly passed out. It was so painful and lasted for like a while in the office, like the nurses were like bringing me juice and things. But one of the nurses was just like, oh yeah, you know, this is like a pseudo labor and she’s like, it’s rare, but it happens sometimes. I was like, nobody ever told me that this happens sometimes.

Courtney: So of course, like, that was deeply unpleasant, worried about that happening again, not actually needing it for the birth control angle and like still not having periods, so for the last couple years I’ve been like, are we good? Is there any medical reason why we can’t wait until next year and usually they’re like, yeah, I guess we can wait a little longer.

Courtney: So it has now been long enough where I’m like, maybe I should just actually get the next one. But also there was one that was approved for even more years than the one I had. So I was like, maybe that one, if I have to do this again. And here’s where I once again was not disrespectful, but I really wanted an outright answer. I wanted an answer that made sense to me. But of course, this also had to be two appointments.

Courtney: First of all, they’re like, okay, let’s do an appointment that’s just a consultation for this. So I see this doctor, and she explains, okay, we’ll do X, Y, and Z. And she says, when you come into the office, first thing is we’ll give you a pregnancy test. And I said, not necessary. And she was like, what? I was like, Not necessary. I’m not pregnant. There’s no possible way I could be pregnant. We can skip that. And she’s like, are you not sexually active? And I was like: “nope.” And she was like: “oh, okay. I guess we don’t have to do that then.” I was like: “great.”

Royce: This was over the phone?

Courtney: Yeah, it was like a video call. Yeah. Yeah, it was telehealth. So when I actually get into the office that day, they like check me in and then the woman at the front desk Is like, okay, we are going to need a UA from you first. And I said, no, the doctor said I don’t need that. And she’s like, but I see here in the notes that you do need that. I was like, no, told the doctor I don’t need it. And she said, okay, so you can just show me to the room. And she’s like, oh, okay. So she did. And so I’m sitting here, I’m waiting, and then the doctor comes in first. And I was like, this is unusual. Where’s the intake nurse to ask all the usual questions? And probably misrepresent them. And she comes in standing over me also. I was sitting down again and she was standing, so now I know I should have stood up. But she’s like, why won’t you give us a urine sample? I was like, because we talked about this, I don’t need it. And she’s like, it’s our policy though. I said, that’s not what you said during our consultation. And she’s like, but it’s our policy though.

Royce: For next time. The next time someone says it’s our policy, just say change your policy. I’ve said that at work before. Like not at this company, but at a previous company.

Courtney: Change your policy. I’m gonna use that next time. But yeah, so and then she kept saying protocol after that. She’s like, it’s just protocol.

Royce: Same thing. Change your protocol.

Courtney: Change your protocol. And I said, we specifically discussed this. I told you there is no chance that I am pregnant. And you said, okay, we don’t need to do that then. That’s what you said during our consultation. She’s like, I recall having that conversation. Yes, but this is just protocol. And I said, why? She’s like, because it just is. I was like, but why? I was like, can you give me an answer why that is? And then she’s like, well, this is just a thing I would do for anyone getting an IUD. This is something I would do even if a 13-year-old was getting an IUD and, you know, sitting here with her, you know, mom or whatever, and I’d be like, I’m not a 13-year-old sitting with my mom. I’m a full-grown woman here telling you not sexually active, there’s no possible way I’m pregnant. Also, I just had an ultrasound like last week. full abdominal ultrasound because they checked everything. And I was like, not pregnant, skip, unnecessary.

Courtney: And she’s like, but I’ve been doing this for so many years and every time we do this we have to get a urine sample. I said, why do you have to get a urine sample? She said, because we have to document on your chart that you’re not pregnant. I said, do you though? I said, I will sign something. If this is a liability thing, I will sign something saying I’m refusing this test and I guarantee that I am not pregnant. Like, I’m willing to sign that if that will suffice to put in my charts. And then she’s like, you just don’t understand. We do this even if you were just coming in for an x-ray. I said, I also disagree with that. I’ve also complained about that. And she also stared at me silently for a while.

Courtney: And then she’s like, why are you being so difficult about this? She’s like, I just want to know, what is the problem? Is the problem that I’m testing you? What is the actual problem with this? And I said, well, if you really want to know, and I went into how right now on my chart, when I have told the doctors that I am not sexually active, they put yes in parentheses, patient says no. I was like, you can look on my chart right now and see that this medical facility does not believe me when I tell you something. And I said, that is humiliating.

Courtney: And she said, we’re not doing this to humiliate you. And also, did I put that in your charts? I was like, no, but it was someone else who works in this and she’s like, well see, I wouldn’t put that in your chart. I was like, that doesn’t mean that I trust you. And I said, and then she just kept saying protocol again, it’s protocol, it’s protocol. And she’s like, well I don’t know what to do because it’s protocol. And so I said, so are you telling me that you’re going to refuse to do this procedure if I do not give you a urine sample? And she didn’t say yes or no, she said, it’s just protocol. So I asked her again, probably three times.

Royce: That is probably a dangerous question to answer definitively, no to. Or yes to in this question, in this circumstance.

Courtney: That’s sort of the problem though, when people can’t actually give you a yes or no to that. Because there’s so many unspoken things. You go into a doctor’s office and people say like, just do what the doctor says. Like, if they want this test, do this test. If they want you to sign this form, sign this form. Like, it’s the same thing with police, right? Like, people tell children, like, mind the police officer. Like, at least white and middle class families are like, respect the police, do everything they say, and police also break protocol and do illegal things all the time.

Royce: Yeah, that’s why there’s so much counter education of, here are the actual laws, here are your rights.

Courtney: Exactly, yes, exactly. So I had to ask her multiple times, like, are you telling me that you are not going to do this without a urine sample. Because if she said yes, I probably would have done it. I’d be upset, but I needed this done at some point. And then she started asking me a series of other questions. She was like, why do you say you couldn’t possibly be pregnant? I was like, I have not had any sexual activity that could possibly lead to pregnancy in a lot more than nine months. And I had an ultrasound last week for unrelated reasons, but they also checked to that area. And on top of that, I have an IUD. Like, none, none. Like, it’s not possible.

Courtney: And then she said, when was the last time you were sexually active? And I said, why do you need to know that? And she’s like, I just need to know. And that question really, really bothered me because A) sexually active, like, are we talking with a woman, with a man? Like, like, I’ve had these gripes, I’ve had these rants with, like, lesbian friends of mine also, right? Where they’re like, doctors always ask me when, like, are you sexually active? But when I say yes, they assume it’s sexual activity that could lead to pregnancy. They always assume that. So that’s already a bad question.

Courtney: For as important as they think these questions are, they are inherently incomplete questions, or they’re designed to lead to an assumption that may not be accurate. Because I also understand there could be other reasons for asking about sexual activity. It could be like, is there a risk of STIs? Like, there are other reasons why you could ask that, but just are you sexually active does not paint the whole picture of health. It’s an incomplete question. But also, I know this has been a thing at my point in my life. I have talked to other women where this has also been an issue in their life, where they, you know, of their own volition were not sexually active but may have been a survivor of sexual assault. And a lot of doctors do not understand that sometimes that’s actually the question you’re asking someone.

Courtney: Like, it’s very unspoken, but if that’s someone’s only sexual activity in the past was an assault, you could essentially be asking like, when were you raped? When was that last time? And there is so much like, I would like doctors to be trauma informed, but they are not. I’ve never even had a gynecologist where I’m like, you,’re handling these issues with the utmost of sensitivity. And to them it really is just, this should be a straightforward question. I already assume the answer and it’s just a tick box that I have to do to check off my list and put it on this chart. I really, really do believe that because this doctor also, aside from the actual procedure in front of us, is not my normal doctor. She’s not looking at the picture of my health either, but she’s also asking, when was your last period? And I was like, I don’t know, like, 12 years ago.

Courtney: And she’s like, ah, you really don’t know at all? You’ve never had even a little bit of spotting? I’m like, I have at some point, probably, but it’s been so minor, so few and far between, I haven’t tracked it. I don’t know. And she’s like, well, estimate for me. Give me the date. So now she’s asking theoreticals. Estimate for me when the last time was that you had spotting, like, no, anything I tell you is not accurate because I’ve never tracked that. And I don’t want it in my charts anyway, so I’m not going to tell you that. And then she was very, very adamant. She’s like, I need to know when was the last time you were sexually active? And I said, I don’t think you do. I said, why isn’t it enough to tell you it’s been more than nine months? Why isn’t that enough? And she’s like, I just need to know. She’s like, I need to know. Are we talking one year? Are we talking five years? Are we talking 10 years. Tell me when the last time was that you were sexually active.

Courtney: And at first she was asking for a date. And I was like, even if we say, like, let’s say a single person who isn’t currently sexually active, but maybe they were, like, five years ago, and you’re asking them, give me the date of the last time you were like, that’s so weird. I was like, I don’t like. We are so outside of protocol now. And I was like, she finally, after this conversation, this back and forth, for this is actually how I get doctors to pay attention to me. This was like a 20 minute conversation with her before I even saw the nurse, which is wild. I was like, wow, this is the most a doctor’s ever paid attention to me, and she’s grilling me. Great. I finally asked her again. I was saying, are you going to make me take this urine test in order to see me today. And she said, I’m going to have to put in your chart that you’re refusing this test. And I said, thank you. That’s what I want. Yes. And then she left the room. It’s okay.

Courtney: But then when the nurse came in, the nurse was acting, like, afraid of me. I feel like the doctor caught the nurse in the hallway and was like, she’s a major bitch, she’s impossible to work with. Because the, the energy on this nurse was wild when she came in to, like, take my blood pressure and take my weight, which since they take your weight every single time you come in, I’m like, you, have all taken my weight nine times in the last month and a half. This is silly. Because another issue I have, and I explained this to her also, because she’s like, what is the issue? What’s the problem? I said, well, you’re not believing me. You’re also not treating me like an individual, which doesn’t give me a lot of confidence that you actually care about my personal health.

Courtney: And this was the one that really, really got me, because I was like, do you believe me when I tell you I’m not sexually active, and I have an IUD, and I don’t remember the last time I had a period, and I had an ultrasound last week? Do you believe me when I tell you all these things? And I’m asexual, I mentioned that too. I was like, and I’m asexual. So like, I know it says I’m married in there and I know some nurse said I am sexually active, however, do you believe me? And she said, yes, but this isn’t a matter of me not believing you. I said, so you’re saying you believe me, but you want to give me a pregnancy test just in case I’m lying? And she looked at me and said, I don’t know what to say. That was her response. And so I said, well then I don’t either. And I think that was the moment where she was like, I am going to have to put in your charts that you’re refusing this. I was like, yep, thank you.

Royce: Did you warn the nurse that your blood pressure may read a little high because of the conversation you just came out of?

Courtney: I did not say anything to the nurse, no. But then when they actually came in for the procedure, she was also like doubling, tripling down and getting really, really weird. I felt like someone like had a microphone on them. Like they had a wire taped to their chest.

Royce: This room is bugged.

Courtney: Truly, because she, this was how she phrased it. She was like, I need you to say this out loud because I need my nurse over here to also hear when the last time was that you were sexually active. I need you to say it so not only I hear it, but also my nurse hears it. And I was like, what? It was so weird. And then she was also getting all concerned. She’s like, I also don’t have any information about when your last period was. I was like, yep, I don’t either. So we’re in the same boat there. And then she was kind of threatening. She’s like, well, maybe I won’t be able to do the procedure today, but maybe we should take out the IUD, wait until you get another period, and then you can call us back. So that we can confirm when your period is so we can put this new one in. And I was like, no, not gonna play that game.

Courtney: And then she was like, well, what’s the issue with that? What’s the problem? Why are you so afraid to have your period? And I was like, well, it seems unnecessary. And also, I’ve had some really bad ones. And she’s like, I’m not gonna leave you to suffer. Even if you have really bad periods, call us the first day it starts, and we’ll try to get you in that same day if we can. I can’t guarantee, I mean, maybe we’ll have scheduling differences, or maybe you won’t be in available, but we’ll try to get you in right or away. We won’t like let you languish for, like, an entire month or anything. And I was like, how about you just do the procedure that we had a consultation for? Like, that’s what also gets me. I had a whole appointment with her a month before this to discuss all these things.

Royce: Weren’t you saying that she was sort of, like, catastrophizing, like, because you’re not in a certain stage of your, because you’re supposedly not in a certain stage of your menstrual cycle, the IUD they were going to put in might not fit. And so she was like, maybe we wait until the exact best day. Just in case.

Courtney: Well, for people who do menstruate regularly, they do try to schedule this for when you’re on your period, just because everything is like a little bit looser. Yeah, but like she measured, they have measuring tools, which are deeply unpleasant, by the way. But she’s like, I’ll measure before I put this bigger one in. And because that was another thing. During our consultation, she was like, I’ll measure to see if we can get this bigger one in. But if not, we’ll just put in the same one you already have. And I was like, that sounds like a good plan. Great, let’s do that.

Courtney: And then she gets in and she’s like, we don’t have one of the smaller ones. So if this doesn’t fit. And I was like, what do you mean? We talked about this during the consultation too. What was the point of the consultation? She’s like, well, sometimes we have some extra, but we just don’t have any extra right now. And then the nurse who is being wildly uncomfortable this whole time, who I’m needing to get interviewed for so they can pick it up on their wires, was like, I can go check. And she’s like, I mean, we don’t have any extra, but you can double check if you want. And then the nurse comes in totally empty handed and the doctor’s like, we don’t have any, do we? And the nurse was like, no, we do have one. And so we both just looked at her dumbfounded. She’s like well then go get it.

Courtney: So turns out, like, she was having this whole issue because she’s like, I just don’t feel comfortable with the state of our relationship right now. I was like, we do not have a relationship. I just need you to do the procedure I got a consultation for. It’ll be fine. And she’s like, I just feel like if you leave this office today without a new IUD, you’re gonna be unhappy. I was like, yeah, I will be unhappy if that’s the case, correct, but like, I won’t hold it against you if you try your best.

Courtney: It was wild. It was quite a time. And then after the procedure, and this is the thing too, because I know people aren’t used to getting challenged and I’m not trying to give people a hard day at work, I’m really, really not. But I am very much over these rules that are just, it’s the way it is. And like, I want to challenge and push back against them. I wish people could see that I’m not trying to be difficult, but they absolutely do. Because I’ve never seen a doctor run out of the room so fast before in my life. After the procedure, after everything was done, I sincerely said, thank you very much. And she did not respond. She just turned around and left the room faster than I’ve ever seen a doctor run out of a room.

Courtney: You would think someone next to us was like coding and like it was wild. She didn’t say a word to me. She just left. I was like, oh my goodness. And then nobody like showed me out. Normally like the nurse will like walk you out to the desk, especially at this office, because they’re very into their nurses and care guides and their checkout policy. So I just walked out of the office alone and it was wild.

Courtney: And anytime people talk about like, oh, all of the pregnancy tests, there are always people, sometimes in the medical field, sometimes not, who will be like, well, people lie all the time. People lie all the time. So we have to know because they lie all the time. And though that may be true, the other answer we always get is, well, it’s for liability. Because if you are actually pregnant and something goes wrong, you can sue the hospital. It’s all about liability. Those are the two big answers you get. And I feel like there are ways around that where we can still keep our own bodily autonomy and make our own choices about what gets tested, what gets documented.

Courtney: I feel like this could all be handled with an optional form. Why can’t I just sign a form saying this is my statement. I’m refusing this test. If I’m lying and I am actually pregnant, I will not sue the hospital for this. Well, it’s because there are some states where it is illegal to cause harm to a fetus. That is really what a lot of it comes down to. And sometimes it’s because it’s a religious institution. Also, our former doctor before this one was, like, exclusively a Christian practice.

Courtney: But I just really, really like there is something so systemic about tracking and recording and obsessing over sexual history in a way that even where it may be applicable in a healthcare setting, I do think goes overboard. Because like you said, Royce, with the like one dot, like one anecdote does not paint a full picture. Like knowing when the last period was doesn’t actually tell anything about overall health. It does not. But they don’t ask you other questions that are also important to general health. They don’t ask you what’s the last meal you ate, unless you’re literally getting a procedure where you need to be fasting. They don’t ask you that. They don’t ask you so many things that are also very integral to bodily health.

Courtney: And half the time, I feel like when people have an answer saying like, well this is why they asked that question, half the time I think it really is just protocol and people have retroactively found their own reasons for why they ask those questions. Because the sexually active question, when I’m like, what you’re actually trying to ask isn’t, am I sexually active or when’s the last time I’m sexually active? I know you’re trying to ask me if I could possibly be pregnant. That is what they’re asking me. Nine times out of ten, if not ten times out of ten, that is why you’re asking that question. So ask the actual question. And if you’re not going to take my answer for it, don’t ask me the question anyway. It’s unnecessary. But some people will be like, oh, it’s also for STIs and stuff. I don’t think it is. The doctor didn’t ask you if you were sexually active.

Royce: Yeah, and it wasn’t applicable in this setting anyway. This was not your general practitioner.

Courtney: And I guess, like, these kind of feel like two different stories, but first of all, like, these have both been happening to me, recently consistently, like I’ve been dealing with these things for a very long time. And I think one just really proves like the arguments for the other when people will say these are actually very important health questions, they do need to know these for your charts. If I sit here and tell a doctor four different times, plus if I tell two different doctors at least half a dozen times, hey, I have a family history of having gallstones, and that never once made it into my chart.

Courtney: It was early April, I first started having these issues. It was probably May that you and I thought this is probably gallstones. And it wasn’t until August that I actually like got my diagnosis and a referral to talk to a surgeon. And in all that period of time, all they did was test my blood twice before referring me to actually get an ultrasound. And I do think family medical history is important, but apparently the doctor doesn’t.

Courtney: Why is the doctor more concerned about me saying when the last time I was sexually active was, tell me exactly, tell me the date, how many years has it been? I need to know every single detail, even though it’s completely irrelevant to this right now. I need to know this to put it in your charts. And I need you to say it out loud so my nurse can hear it and it’s going in your charts, when no one put my family medical history that I’ve been impressing upon, being like, this is why I need this test, please check for this.

Courtney: And I was right. I was right. I diagnosed myself with that, and I had to fight my doctor to do what I wanted to do. If I just dropped it and didn’t go back and insist that they refer me to get this test done, my chart would still just say Gilbert Syndrome, benign, no symptoms. That would be it. That would be it. So that’s our healthcare system for you.

Courtney: Also, it cost me $200 for the ultrasound. It cost me $200 to have a 10-minute conversation with a surgeon. And also, I need to prepay what insurance won’t for the actual surgery, which is gonna be $8,600. So in total, that’s $9,000 so that I have to pay out of pocket for this damn gallbladder, even though we have insurance and we pay for insurance every single month. And that doesn’t include the anesthesiologist, ’cause the anesthesiologist is going to get billed separately after the fact. But hey, it’s okay, ’cause our insurance is paying $3,000. Healthcare in this country is such a racket. It’s such a racket. Do you know off the top of your head what we actually pay for health insurance every month.

Royce: I do not.

Courtney: It’s not cheap, but we have here for all of the non-Americans we have here what is called a high deductible plan where you pay for insurance, but insurance doesn’t want to pay for pretty much anything until you pay a certain amount upfront. And a lot of these high deductible plans are like $12,000. They’re like until you pay $12,000 in medical care for the year, we don’t want to pay anything. Certain things they have to, like some aspects of primary care they now have to pay for, we’ll see how long that lasts with the current administration.

Courtney: But if you’re seeing specialists outside of your network, outside of the approved list of doctors that insurance will allow you to see, that medical care, anything you might be paying out of pocket, doesn’t actually go toward your deductible either. And like the two specialists I see every single month to keep me functioning as a human are out of network, not covered by insurance. So even though like my regular prescriptions and my regular health care that I need costs us over a thousand dollars a month, none of that goes towards our deductible. None of that goes towards our deductible. So that means we have to pay an extraordinary amount for this surgery of mine, and once that deductible is met, they still charge you some co-pays.

Courtney: So even after you pay like 12,000 out of pocket for medical care, they’re like, oh, now you only need to pay for like, say, 10 or 20% of every procedure thereafter, and insurance will cover the rest. Until you meet your out of pocket maximum, which is normally at least double your deductible amount. So, that’s cool, and that only lasts for the calendar year. So, even when we meet our out-of-pocket maximum from the surgery that’s going to happen, it’ll be like, great, now your healthcare is free for the next two months until January hits again, then it starts all over again. So, I hate it. I hate it all so much. I hate it so much.

Courtney: And now I’m sure they’re going to require a pregnancy test before the surgery. Even though I’m like hey, I just had an ultrasound and definitely haven’t had any sexual activity since then, can I not do the pregnancy test? I’m sure they’ll say no, I’m sure they will. But yeah, also just like with insurance and paying for things, because like we have to have health insurance, like we get financially penalized in this country if we don’t have health insurance. And there are some very healthy people who like never need to see the doctor that gripe about that, right? They get upset, they’re like why do I have to pay for insurance. And why is insurance so expensive? And they essentially feel like they are subsidizing less healthy people who need more medical care. And that was kind of the political justification, like back during, you know, Affordable Care Act, they’re like, yes, if we do have more, you know, healthy people in this pot, that should distribute the wealth a little better to take some of the burden off of things.

Courtney: If it actually worked that way, I wouldn’t actually be opposed to that. But I actually heard this rant just not too long ago where someone was like, why do I have to pay for health insurance? I’m just paying for some other person’s health care. And it’s like, you aren’t. They don’t pay for my shit either. You are not paying for me because the insurance company is not even paying for me. So all this to say, like, I kind of said at first that I was approaching this as I’m not going to do anything that I think is unnecessary. But I think really my main mentality toward the doctor now is what do I want my charts to look like?

Courtney: If I think it is important to be in my chart, I am going to make sure it is said at every step necessary, and I think I’m going to sit here and say put that in my chart. Let me watch you put that in my chart. Because it still doesn’t say my family medical history in there. It still doesn’t say that I’m asexual, even though they asked and gave me an optional form that I filled out, and that’s not on there. And yet they insist on having much less necessary and important things in my chart. So I think that’s really what it comes down to for me personally. Of course, everyone’s health journey is different, but... and like, do you know this has never happened to me, but I have read many reports of this where there have been women who have been like force catheterized in hospital settings and like ERs for the purpose of getting urine for a pregnancy test. Like, that is a thing that has happened. I’ve talked to people about this, and that feels like assault to me. It really does.

Courtney: If it is not a procedure that has been consented to, and it’s not even like a life-saving procedure. I don’t know. I think in a post Roe versus Wade world with pronatalists and Christian nationalists running our country, I think we all need to be a little more skeptical of who we give information to, why people are asking the questions they’re asking, and we just need to protect ourselves. Or we can all just be stubborn bitches because it’s the principle of the thing.

Courtney: So on a much lighter note, we will end, as per the usual, with today’s featured marketplace vendor: Professional Fangrrl. This one is for certain fandoms out there. There is Taylor Swift inspired merch. There is Hunger Games inspired merch. Oh, this is actually a lot of the Hunger Games sequel. What was that called? Like, Ballad of Songbirds and Snakes? Yes, I did actually read that, but it was a minute ago.

Courtney: This artwork is so beautiful. So if you are a fan of either of those things, definitely, definitely check that out. But there are a couple of more general things here. There’s a stand up to hate pin, which is something I think we all need to be doing a bit more of. And some general book merch, like the book is always better, which I tend to agree with myself. Links as always to find our featured Marketplace vendor will be in the description box on YouTube as well as the show notes on our website.

Courtney: You are all almost certainly hearing this episode after I have had my surgery, so if you are listening to this and there are more episodes after this, I probably lived. It was probably fine. But no, I’m told it should be a very routine procedure, but I’m a little nervous to be honest. I’ve never had a surgery like this before and I’ve encountered a lot of shady, scummy doctors, and there have been many people in my family who have had poor surgery outcomes, so we shall see. Thank you all, as always, so much for being here, and we’ll talk to you all next time. Bye bye.