This Is Woman's Work with Nicole Kalil - A Terrible Strength: How Medical Bias Is Costing Women Their Lives with Dr. Kemi Doll | 408

Starting point is 00:00:00 Grownups, if there's a child in your life who is interested in, curious about, or fascinated by people in places from history, then my podcast, The Past and the Curious, might just be a hit in your home. From the invention of microscopes to world-traveling dogs to fashions of the 1890s, gold rush ghost towns, and audiences going wild for walking competitions, we've got a little bit of it all. Hosted by Children's Author and Museum educator Mick Sullivan, that's me, the show is, fun, funny, engaging, honest, and beloved by kids and parents alike. Find the past and the curious at all the usual podcast places. I am Nicole Khalil and you're listening to the This Is Woman's Work podcast.

Starting point is 00:00:53 We're together. We're redefining what it means, what it looks and feels like to be doing women's work in the world today. And if we're serious about redefining it, if this isn't just talk, if it's more than just a cute tagline, then we need to acknowledge that it's complex and we're not all on the same thing. page. And maybe we don't need to be on everything, but we do need to get clear about what we refuse to tolerate. And listen, I know we have different perspectives and we all have things that just don't compute. Perspectives that don't just challenge us, they flat out do not make sense to us. Some of them are trivial, like how tamales aren't a Christmas Day staple in every household,

Starting point is 00:01:35 which just feels wrong to me. And there are some that are not trivial at all, like how any woman could vote for Donald Trump. I just can't make sense of it. I intellectually can understand that people have different experiences, different influences, different priorities, and different information streams. I can understand the context, the influences, the arguments, and still not agree, still not see it, still not want to. And then there are perspectives that I won't ever fully understand because I haven't lived them. And the work isn't to debate or interpret or even relate It's to listen, to believe, and to witness. And this topic is both. I don't know what it is to be a black woman. I don't know what it is to be a black woman navigating pain in a health care system

Starting point is 00:02:23 that has a long documented history of ignoring it, minimizing it, and denying it. I can never fully understand because I have not lived that experience. But what I can also not understand is how anyone, especially anyone who claims to advocate for women isn't outraged by it. Because every once in a while I catch myself thinking, well, we've made progress. Maybe we're in a different place. Maybe I'm just seeing inequality because I'm looking for it. And then I look at the data, the stories, the lived experiences of black women when it comes to gyneological health and have all the evidence I need to know that we are not even close.

Starting point is 00:03:04 Most of us agree women's health is broken. But we need to be clear, women's health isn't equally broken for all of us. We cannot look at the experiences of white women, especially rich white women, and use that as the benchmark for what's working or whether progress is being made or not. And we can't look at black women being systematically denied care, believed less, diagnosed later, and dying at higher rates from conditions we know how to treat and think anything other than this. We still have a fuck ton of work. to do. Not performative work, not convenient work, real work, because our health, our autonomy, and being believed, those are the hills I'm willing to die on. And if redefining woman's work means anything, it has to include that. So if you're with me, not in theory, but in commitment to women, we're going to get into it. Today, we're joined by Dr. Kemmy Dahl, a physician, surgeon, researcher and advocate working in the intersection of health justice, reproductive equity, and gyneological cancer. She's a professor at the University of Washington, a double board

Starting point is 00:04:12 certified gynecologic oncologist and OBGYN, the founding director of the Grace Center, and the author of A Terrible Strength, The Hidden Crisis of the Black Womb and Your Survival Guide to Healing. Dr. Kimmy, thank you for being a guest. And I'd like to start to start. by asking you to explain the systemic crisis happening in gynecology and what you call womb health and why that experience is not equal for all women. Nicole, thank you so much for having me on the show. From that intro alone, I know we're going to be friends. I feel like I was just nodding and putting my fist up like, yes, all of the ways. But I truly appreciate being here because, you know, my entire perspective on this is that it's not,

Starting point is 00:05:00 it's not a niche issue and it completely intersects with women's work, with how we are show up in the world and our livelihood and how we are able to express this energy that we have and whatever we want to do here on the planet together. So I'm just really, really happy to be here. The gynecologic crisis, as I think of it, is absolutely systemic. It's really important to understand in this world of like wellness and individual agency, which all matters, that we are here because there are multiple layers of influence that have gotten us here to feeling like we're the only ones who can save ourselves in terms of womb health. So for me, the way I think of it is it starts with the fact that we really devalue women outside of their ability to reproduce and to get

Starting point is 00:05:46 pregnant. And when I say we, I mean medicine. I mean the biomedical industrial complex. I mean that less than 1% of the NIH research budget goes to researching a condition that 70 to 80% of women have, which is fibroids. So when I think about the systemic issues, I think, one, we don't put dollars and effort into researching wound conditions that are not pregnancy related. Number two, in medical education and training, we literally silo reproductive health, anatomy, physiology, knowledge to like single blocks, maybe three weeks, maybe, maybe two weeks, maybe one week of information to students. Meanwhile, it affects everybody's system. Meanwhile, it's just as important as the heart, the lungs, the brain, everything. But even in medical training, we act like it's a

Starting point is 00:06:38 niche issue, which means that physicians, when they get out and they start training, they don't have to have basic knowledge, basic knowledge of our wounds and how what happens affects them and how the symptoms can show up and what they can look like. So that's another layer of issue. A third layer is our insurance companies and what we consider to be optional or not. Most cardiac care that you need for your heart covered, lungs covered, kidneys, covered. Like, you're not fighting for that. When it gets to the womb, it's ridiculous. It's ridiculous what is considered optional, what is considered appropriate, et cetera. Why is gynecologic care one of the things that we get to, that gets to be kind of adjusted or played around with the numbers? It's another

Starting point is 00:07:24 level of devaluing. And I think lastly, I would just say on a very individual, like a really personal level, I think that we teach young children. I think that we teach young girls. The first thing that they learn about their period is how to cover it up. The first thing they learn is success is that nobody knows this is happening. And so when you do that, when that's the message that the young girls get, and then you get older and older and that message doesn't really change, then we all also devalue our own wombhouse. We also think of it as something that's below the belt, something that we're just managing, until it becomes a crisis. And unfortunately, that's what I see in my world, which is that people are coming in way too late.

Starting point is 00:08:05 They're coming in with severe symptoms. They're coming in when there are very few options. And my whole goal is to change that for all women in this country. Okay. My brain is pinging all over the place. So, okay, I think it's important that we really hone in on. on what we're talking about here. First of all, we are half the population as women.

Starting point is 00:08:30 The idea that there isn't money for this is ridiculous. The amount of money that's been spent on Viagra research could cover. I mean, and I think what I'm hearing that you're saying is all of our focus is on our reproductive, like our ability to get pregnant and deliver a child when it comes to our womb. but there's so much more to it. You mentioned fibroids. I had a guest on who talked about endometriosis. Yes.

Starting point is 00:08:59 PMS, just in general, PCOS, hormones, menopause. I mean, there is the idea that this is so under-research, under-taught, under-informed. It's crazy to me because you'd think there'd be a ton of money there. Even if it wasn't the right thing to do, you would think some people would come along and be like, there's a ton of money to be made here if we could, fix this problem for women. So, okay, I'm going to go down a rabbit hole, but I guess my question is,

Starting point is 00:09:29 what would you say to the person who is like, well, you know, there isn't the money or we can't expect our doctors to know everything? Or I don't know, there's like some things that we say to kind of dismiss this issue that I can't wrap my head around. Yeah. I think it comes from just, I understand that when we talk about those statistics, it does feel, the scope feels too big. And I do that we naturally as humans, right, we go to like, well, I can't do anything about this. Like, I can't. And so I appreciate that. I do. But also, we've only ever moved the needle on anything important because we just decide this is absolutely unacceptable and we're not doing this anymore. And so it's why I start with us as individuals, despite the fact that this is a systemic issue.

Starting point is 00:10:12 Because like when women demanded better care, we got the patient's bill of rights. Like we, there are ways that we have changed how we interact with the medical system. I want women to say, listen, I am done with this idea that my womb health is secondary. I'm done with this idea that because you're not an OBGYN, you literally cannot comment at all in any way, shape, or form about an organ in the body, despite the fact that you are a board certified whatever doctor. Number three is that I am going to divest from the idea that suffering is just part of my womb health. Like that is just, that's just what I have to accept. There's a lot of messages we get around that. So when somebody says there's not just money. I think that's what you were saying, right? Like, what do you say when it's like,

Starting point is 00:10:55 oh, this is, we can't expect this from doctors. I say, if I live my life this way, I would not be sitting and talking to Nicole right now. If I live my life in a way that just accepted the messages given to me, medicine is not for you. You're a black woman. Are you sure that you want to shoot that high? Are you sure you can be a researcher? Can you really do all of these things? You want to be a mom. Can you really do this? If I accepted all of the messages that constantly, that constantly were we're told, then, you know, we would make nothing real in the world. I wouldn't be able to talk to you. So all I want people to acknowledge and maybe to recognize is that that is just part of the myth. Those ideas that we can't expect more from our doctors, that we can't expect more from the NIH, that we can't expect more,

Starting point is 00:11:34 is just part of the oppression, honestly, that keeps us thinking that it's reasonable to be anemic, that keeps us thinking that it's reasonable to not care about womb health other than getting pregnant, contraception, and sexually transmitted infections until we reach 51 and we have menopausal symptoms. That is not the reality, but it's the narrative. And I want to change that because womb health lasts a lifetime. Okay, your book is called a terrible strength. And I know you didn't pick that by accident. I want to talk about this thing where we focus on the, and I'm just going to put in air quotes, the strength of women. And I do believe we are emotionally, mentally, the strongest gender.

Starting point is 00:12:23 But listen. No argument. We may not be able to lift heavier, but I mean, we do push humans out of our body. So even the physical thing. Anyway, but you're honing in especially on black women. And I do think there is a narrative of how strong black women are. And I will be honest, I subscribe to that narrative. Sometimes I'm like, how do you even live in this world, in this country, in this time, and not want to just go around punching people in the face?

Starting point is 00:12:56 Mm-hmm. So my question is, how does this perceived strength work against women, black women specifically as it relates to our womb health? Yeah, I understand that it like is a little bit odd of a phrase, the idea of a terrible strength, but it is very intentional because. I think it's really important to honor that black women are incredibly strong. That is not a myth. We are strong. We have to be in order to navigate the society and certainly to achieve, you know, to make meaning of our lives and all of those things.

Starting point is 00:13:33 And so the reason why it's called a terrible strength, though, is that when you are so strong, when you are perceived to be so strong, you are not perceived to be vulnerable or to be in need of care, support, or help. And when it comes to the womb, that translates to black women being able to endure the unimaginable in terms of symptoms and suffering and pain and bleeding. And in my world, cancer and progression with nobody stepping back to say, whoa, whoa, whoa, whoa, this is not normal. This is not okay. So it's a terrible strength because the very ability to endure is killing us. And what I want so much for black women and for any woman who feels like her go-to tool for dealing with her womb health, whatever it is, is endurance.

Starting point is 00:14:26 I want to transfer all of that energy of endurance into advocacy, personal self-advocacy, agency, and demanding better of your life. What part do all women play in that? Because while it is individual, And as a black woman going to a doctor, not settling for less, demanding, requiring to be taken seriously, I would imagine is the assignment. And if they're the only ones doing it, isn't there the potential that they get even more dismissed or even more denied? And so where do we all need to play the part? Yeah. I think, thank you for asking this. Because I think actually, you know, I think we understand that there is an inherent risk in walking

Starting point is 00:15:18 to a room that's not built for you or walking into an environment where you're supposed to be a certain way and you choose to show up in your fullness or whatever. I think we all have that feeling of like, yeah, there's a risk there. So I don't say lightly when I say, I want black women and all women. I want us to walk in and demand better care, et cetera. Part of the reason why I wrote my book is because I want to give you the tools to do that well. And one of those tools, is knowledge, Nicole. One of those tools, if you actually understand the underlying physiology of these conditions, when you actually understand why we do certain tests and what those tests mean, what the labs are, you are now, you're now having a conversation on a different level. It's not

Starting point is 00:15:59 just, help me, help me. It's I can be in conversation with you about what the steps are, and now I can ask you more pointed questions that create accountability. So one thing that always, men need to do is have this knowledge so that you can also be an ally and supporter when a woman is asking for an ultrasound or asking for a test. That's like, no, this makes sense. It doesn't, we need to look into this. We need to look into this further. The second thing is that black women have a history of galvanizing everybody. You know what I'm saying? When you look at the fight for democracy, when you look at the fight for the vote, when you think, I mean, so I would say that we can pull on our own history to say, listen, when we all demand better, if black women are the intersection

Starting point is 00:16:44 where we are vulnerable to all of the overlapping vulnerabilities as I think of it, right? The racism, the sexism, the xenophobia to some extent, like all those things. If we're behind and saying this is unacceptable for black women, everybody improves, right? Because you are closing all of the gaps in which people can fall through the cracks. So I would say all of us having the knowledge will elevate all of our. abilities to advocate and especially black women's abilities to advocate. I would say the bottom line is when you think about the numbers, they're just a lot more non-black women than there are black women in this country, right? So like the bottom line is I'm a numbers girl too. I'm like,

Starting point is 00:17:22 if all of y'all are going into the office being like, listen, we're not doing this anymore. I need to understand what the steps are. I need to understand what the treatments are. I want better for myself. Then we're now creating a new environmental norm. And that is helpful too. Because me as a black woman, there's not as big of a gap for me to close. Sorry to break in, but this part matters. Rate the show, share it, and support the sponsor so I can keep making episodes worth interrupting you for. What are your thoughts?

Starting point is 00:17:53 Because I do think this desire to increase our knowledge to grab hold of things that seem like they can't be explained or being dismissed. Like I, you know, struggled with paramedopause for many, many years. Mm-hmm. where it was just sort of chopped up to like, that's part of aging. And I'm like, no, no. Absolutely not.

Starting point is 00:18:14 But I could not find the medical professional or the doctor or the resource that helped me get the answers for many, many years. And so my question is, any advice or any thoughts about sort of the health and wellness trends that are taking over, I on one hand admire the like discover and become knowledge. And on the other hand, it starts feeling really grifty and... Nicole. Disgusting. And how do we navigate this sort of like, we want to be responsible?

Starting point is 00:18:49 Yes. We're not settling for less. And there is an abundant amount of misinformation and bullshit out there. And it gets really confusing. Yes. So, first of all, I appreciate this because I actually wrote, like, my book starts with a letter. and like my whole point of that letter is saying like we're not going to do the us versus them. Yes, I'm a double board certified gynecological oncologist.

Starting point is 00:19:13 Yes, I'm a scientist, all this. I have no interest in the demonization of the us versus wellness versus them because it's not helpful because of what you just said. People are just looking for ways to make their life better. Individuals. So it's not helpful to start to demonize like where they might have found information that they thought was helpful, et cetera. What we actually need to do is I think create a. another level of common knowledge that is like unassailable. Let's all agree on how these organs work, what things impact what, and then we can move forward. So I'm going to answer your question

Starting point is 00:19:46 in a little bit of a roundabout way. One of the one, the four conditions that my book focuses on is heavy bleeding, endometriosis, fibroids, and uterine cancer. And when you say those, when I say those, people are like, I don't like, what is the connection? And I'm like, exactly. When you understand how all of those are connected, you are operating with a different level of understanding of the reproductive system that will help you avoid the grifters. Because you have a different level of understanding the cause and effect and how these things work. And some of the phrases no longer hold the same power. So one thing is I think when we're just a little bit more informed, which is possible. It's doable than we can be better consumers. Number two is, I think they're honestly,

Starting point is 00:20:30 they're kind of two different camps in the wellness world. There are people who are genuinely trying to fill the gap that Western medicine has left, all of the terrible experiences like you had, trying to get help, being dismissed, told that it's just aging, right? And they might not have the right information, frankly. And so my book is for them. Like, please read this so that you are better informed. And then there's the actual grifters who know better and they're just out to make money. Okay. The things that I look out for that I tell people to look out for is things that sound like click bait. Like we're all on the same protocol doing the same thing. Like we're the cool girls. Wom health is not about clicks. Everybody is not supposed to be on the same protocol.

Starting point is 00:21:09 Everybody's not supposed to be on the same hormone therapy regimen. Like that is not how this works. So one, when you start to get that kind of energy of like, oh, you're not on this supplement. What's wrong with you? I back off because I'm like, that's not ever how medicine has worked. It is always personalized. Number two is if you can control replace what you're hearing with diet culture language, pause. I get really concerned about that. I'm like, if it's easy for you to, if we used to say low fat and now we're just saying protein, if we used to say skinny and thin, and now we're just saying, I don't know,

Starting point is 00:21:42 toned and strong, like just take a pause because it sounds, a lot of it sounds to me like the same body optimization diet culture stuff wrapped up in something different. And I don't like that either because that, I mean, because of all the reasons, right? because underlying that is about shame. It's about, you know, the male gaze, frankly. So those are the two kind of vibey things that I look out for. The idea that we all have to be on the same protocol doing the same things and whether I can basically just replace these words with diet language and it sounds the same.

Starting point is 00:22:16 It's amazing to me how often anything reproductive or like HRT, the things you hear is it reduces belly fat and growing skin and, you know, full hair. I'm like, shut the fuck up. I just want to feel like a normal functioning, healthy human who can live a good life for as long as humanly possible. Correct. If it comes with some great skin, fine. Fine.

Starting point is 00:22:43 You know, but like, why do we always have to package that as the priority for anything that? I can tell you why, Nicole. You know what? Okay, I'm so glad you. You know why? Because our health is not enough. Because it's not enough to say, you know what, during the perimenopause years is the, by far, right, the time in your life where your risk of uterine cancer increases, like fivefold. Uterine cancer is the number one rising cancer in the United States. It's going to be second only, only to breast cancer by 2030. It's more common than colon cancer already. So I'm sitting here thinking, we're talking about perimenopause and menopause, but somehow people's like literally your life, like the fact that you're about to enter into this world and we have a problem with uter and cancer and all of my colleagues know it. We know that this thing is rising every year and women are dying and the mortality rate is going up.

Starting point is 00:23:42 But that's not the message. The message is your glowing skin and your hair. Why? Because your health is not enough, Nicole. It's not about. And so that's, I hope I'm not like getting too deep or political, but I do think about that a lot. And that's why uterine cancer is in my book. And I'm like, listen, I'm not trying to scare people, but don't you, wouldn't you, Nicole, want to know that part of what is happening in your body is this transition.

Starting point is 00:24:07 And part of what's happening in our society is rising rates of womb cancer. And wouldn't that be something important that you'd want to think about as you enter your pari menopause and menopausal years? Why does that not lead the conversation? Yeah, I literally teared up when you said that because I know, like, I heard something true. Our health is not enough. And I think the part that gets me is our health is not enough in society. Our health is not enough on social media. Our health is not enough to garner the male gaze.

Starting point is 00:24:42 The list goes on. But the part that really makes me sad is we've gotten to the point because of our conditioning in our experience that our health is not enough to us. Yes, exactly. And that breaks my heart because what could be more important? Like who cares about how your skin looks or your belly if you're living your day to day feeling unhealthy, physically, mentally, emotionally, somewhere along the way. I think so many of us, I know I did, bought into the lie that our health is

Starting point is 00:25:19 enough. Yeah. I think that, you know, we are products of our culture and our society. And so, like, you know, I think we certainly aren't born thinking this way, but we are probably, you know, we, we live in this, in this society, too. And it's not like I don't care how my skin looks. It's not like I don't care, you know, like I understand also the privileges that come with, with fitting in to some extent, right, to what is ideal. And I do think it goes back to what I want to share with people is that your gynecological health lasts a lifetime, but if you're taught from the beginning that it's only one thing or one or two things, it does make sense to me that we wouldn't lead a conversation about reproductive health with actual reproductive health, which is basically what we're talking about.

Starting point is 00:26:06 Like, right, in perimenopause, menopause, like the transition of like, this is a conversation about your ovaries, your uterus, your tubes, like, right, your reproductive organs and reproductive of health. That conversation is led by skin, body size, muscle, appearance, hairfulness, in the depths of my heart and what I am all about is reclaiming a full humanity for women to say that, no, no, no, no, no. It's not like those things don't matter at all. I'm all, I'm all like, you can have both. But like, they don't matter at all. But like, can we think about what participation in this dialogue is doing to us when it's not focused on our actual health from top to bottom.

Starting point is 00:26:50 I don't know if this is going to resonate. I feel like I'm purposely consciously, trying to shift to an inside out model versus an outside in because you're right. I like having good skin or great hair. And I mean, if I'm healthy and that reduces my belly fat, amazing. We'll take it. Yeah, not upset about it. But it's this focus on that first and then hopefully fingers crossed, I'll be healthy on the other side of it, versus if I hone in on the things that make me healthy, if I care about my womb health, if I care about my heart health, if I care about feeling good inside of this body, those things can and potentially will have.

Starting point is 00:27:40 happen and that'll be great. Like you said, we can have both. I think it's the order in which I prioritize that I'm really trying to shift. Yes. And I offer that we know how to do this in other arenas because we do this when we are trying to be successful in the workplace and we realize, you know what, I have to care more about how I feel about my work. I have to create my own standards of quality. I have to do that before I give so much power to the external validation of this person or this CEO or this, right? We do know how to do that as women. That's why I try to remind people, you have probably done that in other areas. You have figured out how to go inside out. And it was scary at the beginning, but then you were like, see, it's fine. Actually, my inner confidence

Starting point is 00:28:23 mattered more than what this person thought of me and I still got the promotion. So we know how to do it. So what I say is that I actually think this arena of womb conditions that don't have anything to do with pregnancy. I think that this is an arena where we still allow for suffering and silencing and all of that because we're taught to do that, right? And we succeed despite. And I'm sitting here thinking, for example, I saw a woman in clinic once who came in for a pap smear and she had, her blood level was so low, it would have resulted in like an emergency, like, if she was in the hospital, she would have been like rushed for a blood transfusion because it was like dangerously low. And she was just living her life, Nicole. And I'm like, oh my God, like, you have to come in.

Starting point is 00:29:09 She laughed at me. She was like, this is, we have strong periods in my family. It's fine, et cetera. And my thought was, what could you do with a full tank of blood? Do you know what you're capable of? Because we already, I already know what this means. This means that you're cognitively slow. This means that you have brain fog. This means, like, I know physiologically what this is doing to you. So what I think about and what I want to offer is that the inside out here, work, the same way, is that what if your norm that you have just decided as like, this is how it's got to be, you just, you don't recognize how much better it could be. What would be possible? What opportunities would we create? What potential would we, if we didn't accept, fill in the blank, pain, heavy bleeding,

Starting point is 00:29:55 endometriosis as just something we're supposed to deal with. To deal with. Silently, by the way. Exactly. Quietly. Yeah. Nobody wants to hear all that. Quietly. I remember taking physics exams while like literally hemorrhaging, you know? And it never occurred to me, right, that this is, it could be bad. I just like, well, this is what I have to deal with, right? Like, I'm sitting here thinking like, that's crazy, but that is norm.

Starting point is 00:30:21 How many women have you heard? Like, oh, I am doubled over in pain. Almost cannot stand up straight, but I'm going to this board meeting. Or I am like having hot flash after hot flash. I'm literally sweating through my clothes. and I'm still going to show up to the board meeting and deliver, you know, A plus quality work. Oh, of course. That's never in question. Like that's the thing is that we're, that's never in question. I just, I want to elevate our womb health to the same level. I want to say, that's great.

Starting point is 00:30:47 Have your work quality never be in question. And let's also have the quality of our own understanding of what's going on with our womb and our womb health and our treatment and our demand for good conditions be the same. So that's on the same level of we will not accept. And there are, the thing. is there are amazing doctors out there. There are amazing people who want to help you. A lot of them are not on social media, which is why I talk in the book, like, if you want to find out how doctor, how like we find who to go to, we don't scroll. We're not Googling. Like, it is about network, like, it's about these other things. So it's like, I think there, it kind of goes back to that question you had about, like, what do we do with the wellness of it all and like the menopause gold rush of it all? And it's like maybe reminding us that like good quality care is, is, is

Starting point is 00:31:33 is not necessarily something that's online. And like the best doctor you can imagine does not necessarily have an Instagram page of 2 million followers. And so there are ways to find these heroes, as I call them, because they're my colleagues. So I know that they're out there. Okay, my last question is around,

Starting point is 00:31:52 and thank you for saying that. It confirms my underlying belief that social media is just a cesspool, but... Okay. And I'm actively on it to make sure that we're clear about my... my own hypocrisy here. Yes, continue. And I do scroll and I do get caught up. And there are a few amazing people that I follow that do absolutely make a difference. So yes, I say that as a general

Starting point is 00:32:17 statement, even though I am on there. Okay. So my last question is around something you say, which is that when medicine learns to overlook suffering in one group, it builds the habit of dismissing literally everybody. So I want to make sure I frame this in a way that works in that this impacts all of us as women. And we as women cannot move forward without focusing on and addressing the black womb crisis. Yeah. Thank you for bringing us back here. So this is true.

Starting point is 00:32:55 Anytime we try to move forward and make progress and just leave a whole group behind, it never works. It never works. Never can. Never should. It never can, never should. What's happening with the black womb crisis is that one in three black women with heavy periods is walking around clinically anemic right now, right now walking around without enough oxygen carrying capacity in their blood. One in three. What's happening right now is that black women with fibroids are getting fibroids earlier.

Starting point is 00:33:25 They're growing larger. They're more symptomatic. they pull them from the workforce, they also cause anemia, and incredible amounts of also body dysmorphia and suffering and things that just are not spoken about. What's also happening is womb cancers, which are on the rise, but most so in black women. And black women actually have double the mortality rate.

Starting point is 00:33:53 So they're twice as likely to die after this cancer, which when detected early is cured. And so when I look at that, what I see is a group of women who have been told directly and indirectly that your life does not matter. Your womb health does not matter. From the time you get your first period to the time you draw your last breath, we don't care. And if you've heard about the maternal mortality crisis, if you've heard about, if you've seen the horrible videos of people being treated terribly online, I told people that is the tip of the iceberg of what black women deal with. And I'm when they are trying to access basic gynecologic care.

Starting point is 00:34:34 And so my mission is to shine such a light on that and use what is happening to black women as a way to teach all of us what actual high-quality, great gynaecologic care looks like, to teach all of us how to understand these conditions so that we can assess and be aware of them in ourselves and then teach all of us how to go to board certified trained clinicians and have quality interactions so that we get what we need out of it.

Starting point is 00:35:07 I could ask you one million more questions, but thank you for being here. Thank you for doing this work. Thank you for sharing it with us. Thank you for writing this book. I mean, so many thank you. So I'm going to invite you, our listener, to order the book. It's called A Terrible Strength by a By

Starting point is 00:35:25 on Amazon or wherever it is you buy books or let's just keep our local bookstores in business. So go there. And I'm going to encourage you to buy three copies, one for you, one for a woman you love, and one for whoever it is that you're paying attention to when it comes to women's health. Hopefully you're a doctor, but if not that, an influencer, I don't care. Whoever you're paying attention to, get it for them. And if you're looking for more of Dr. Kemi's work, you can find her on Instagram or on her website at Kemi Dahl. We're going to put all the links, all the ways to find and follow her in show notes. I would absolutely encourage you to do that.

Starting point is 00:36:01 Dr. Kemi, thank you. Thank you so much, Nicole. It's been a pleasure. The pleasure was all mine. All right, friend, we don't get to claim progress for women while some of us are still being dismissed, denied, and dying from things that we know how to treat. And we don't get to call it woman's work until it works for all of us, which means that we are not done.

Starting point is 00:36:22 Pay attention, speak up, demand better, yes, for you, in doing. but also for women collectively, because that is woman's work.

This Is Woman's Work with Nicole Kalil - A Terrible Strength: How Medical Bias Is Costing Women Their Lives with Dr. Kemi Doll | 408

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