Students Dissatisfied with Health Center Experiences

Tywen Kelly

Photo by Tywen Kelly

Georgia Lyon

If your life’s in danger, should you go to the Welty Health Center? Whitman’s Health Center is ranked tenth in the nation by the Princeton Review and touts a wide array of services, yet some students have been placed in danger due to poor diagnoses and advice received there.

The Health Center prides itself on providing a wide array of services–nurses on call, regular doctor hours, 24/7 services, and 12 beds open for students. The Center will arrange transport for students to off-campus appointments, conduct simple lab tests, and give allergy shots, nutritional guidance, and physical and massage therapy.

However, the availability and quality of these services has been variable for Whitman students. In some cases, students with serious conditions have been told to wait to see if they improved or worsened over time. Others have been misdiagnosed. In these cases, the Health Center endangers their health more than if they had chosen not to receive the service in the first place.

Appendicitis emergency

A sharp pain in her lower-right quadrant led senior Brooke Bessen to the Welty Healthy Center three years ago.

“I have a high pain tolerance…[the physician] examined me and pushed on my belly, and he said, ‘you don’t seem like you are in enough pain, so I don’t think it’s anything, but come back another time if it’s still really hurting you,’” said Bessen.

Bessen’s pain worsened. She returned on Friday, and the staff member on duty suggested that the pain may have been due to menstrual cramps. Although female-bodied first years have a tendency to have irregular periods due to the stress of the college transition, this did not happen to Bessen, who knew the pain she felt was different.

“I just went home because they weren’t helping, and then on Sunday morning I woke up just in tears because my stomach was hurting so much,” said Bessen.

According to the Health Center Director Claudia Ness, the source of abdominal pain can be hard to identify.

“Abdominal pain is a very vague, sometimes confusing thing to diagnose what is causing the abdominal pain because it might be multiple different things…That is a tricky one because abdominal pain in females is much more problematic to diagnose than our male counterparts,” said Ness.

Nearly unable to walk, on Sunday Bessen returned to the Center for a third time. The nurse on duty did not know how to respond to her pain and arranged for Bessen to be transported to the emergency room. After four days of the Health Center failing to diagnose Bessen, the emergency room doctor diagnosed Bessen with appendicitis in minutes, and she was rushed into surgery.

Appendicitis occurs when the appendix, a small pouch attached to the large intestine, becomes inflamed and swells in size. This produces extreme pain and, if untreated, may end with the appendix rupturing. Without surgeries or antibiotics, this has a mortality rate of over 50 percent.

Patients suspected of having appendicitis are often rushed to the emergency room, even if symptoms are uncertain. Appendectomies, the removal of appendixes, are the most common procedures done in emergency room surgeries, with over a quarter of a million performed in the United States each year.

At the Health Center, nurses have a cluster of symptoms they look for when attempting to diagnose appendicitis, but often this requires individual patients to feel high levels of pain for a long period of time.

“There are a lot of things that need to be narrowed down before you diagnose appendicitis…Depends on where the pain is, where does it radiate, how high up, but those are all specific to individuals too,” said Ness.

Bessen was lucky enough to have her appendix removed with some time before it would have burst, and fully recovered. Other people have appendicitis that progresses much more rapidly, such that a four-day delay is less than ideal. In some cases, a fatal rupture can occur within 36 hours.

“I know quite a few people who have mistaken appendicitis here…I guess it’s important for a student health center to be aware of their limitations. It’s a lot better to be ignorant and aware of it than ignorant and think that you’re doing the right thing,” said Bessen.

Tywen Kelly
Photo by Tywen Kelly

Cold or crisis

First-year Julia Mason contracted an upper respiratory infection last November, and in

a week-and-a-half-period went to the Health Center five times. Originally, her symptoms included fatigue, which made it hard for her to walk, congestion, and a bad cough. As the sickness progressed, Mason lost the ability to get out of bed. She had a fever that made her delirious and lost eight pounds over the course of two weeks, but even as she worsened, the Health Center recommended she let the infection work its natural course.

“The Health Center told me…I just had the flu, and that I should just go to bed and get some rest, and that I’d be better in a couple days. So I did. I got some rest. And I was not better in a couple of days, so I went back to the Health Center…when I was getting worse. And they just kept telling me I had the flu, and that I should take some aspirin, drink some water, and go to sleep, and I’d be fine,” said Mason.

According to Ness, the Health Center usually recommends that patients attempt to sleep, drink water and take aspirin for one-to-two weeks if they have a viral infection. If that does not clear the sickness up, then the Health Center may start looking into the possibility of more severe infections or bacterial infections being the cause of illness.

“An average virus is a seven-to-fourteen day progressive illness, and any time during that progression it could get a bacterial component to it. And any time during that, an antibiotic would be helpful…I advise my students…that if it is staying on for greater than another five, ten days for sure, come back, by then it might have bacterial aspect…That’s the thing about the viruses are an evolving condition,” said Ness.

A week-and-a-half into the sickness, Mason began to suspect that she might have more than the flu when a Health Center nurse found puss in her ear. After that, she called her mother, and her mother insisted that she go to urgent care.

“My mom’s not the most overprotective mom in the world, so if she was worried, there was definitely a problem. Just from hearing me she was ready to call an ambulance, so that’s why I went to urgent care,” said Mason.

When Mason arrived, the urgent care doctor diagnosed her with acute sinusitis and severe bronchitis, which was on the verge of becoming pneumonia.

“Urgent care told me exactly what was going on, and then gave me the medication that I needed,” said Mason.

After several weeks and two rounds of antibiotics, Mason recovered, but she wishes that the Health Center had admitted defeat and recommended that she go to urgent care much earlier in the course of her sickness.

“Because I was really sick, so I wasn’t thinking for myself really well…It would have been nice if they had said, ‘we don’t know what is going with you…You should probably go somewhere else that is better equipped to care for you,’” said Mason.

Reacting to allergy shots

For 12 months, first-year Lizzi Wong took two shots a week to stave off allergic reactions. When she came to Whitman, these happened at the Health Center.

The Health Center has requirements that allergists, nurses and students must work to meet so that it can administer the shots safely. The allergist provides the medication, the nurses keep it at the health center along with a chart of information with the student’s allergy history and the student guarantees that the nurses have time to review their history. Students must also stay after their appointment for 30 minutes in case they have an adverse reaction.

Despite these policies, Wong has been unimpressed by the Center’s handling of her biweekly shots. According to Wong, wait times are long and clinic staff have often appeared unprepared.

“I had people coming in who obviously didn’t know what was going on, saying, ‘what are your doses?’”, and I said, ‘I don’t know…You’re supposed to know this it’s on my chart’”, said Wong.

In one instance, Wong was almost administered the incorrect shots, which would have had serious consequences.

“Apparently there is another [person with my name] who gets shots too, and I only figured this out right as they were about to give me them because they were like, ‘so you have three shots. Which ones do you take in which arm?’ I don’t have three shots actually…Thankfully, they hadn’t given me the shots yet, but there was a distinct possibility that I was getting someone else’s allergy medication.”

Receiving another person’s shots can trigger a serious reaction. Each allergy shot has different medications and dosages based on how long the patient has been having treatment and the allergens involved.

The danger of even slight changes in dose and type of medicine became very clear to Wong when she went into anaphylactic shock on December 1st, 2015 during her regular shot routine. Wong had never had this sort of reaction before, and it is possible it occurred due to how the shots were administered, though there is a small chance for regular shots to trigger this sort of reaction even when everything goes according to plan.

“The doctor did know what to do, so they are pretty good on the response front, they just weren’t really good on the prevention front. I was at the hospital for the rest of the day and part of the night, which was unfortunate because I had a big test coming up in two days, and I also had to be on a bunch of Benadryl and other meds” said Wong.

Fulfilling The Mission?

Students entering the health center are greeted by the words of Herophilus of Chalcedon, Physician to Alexander the Great:

“When health is absent, wisdom cannot reveal itself, art cannot become manifest, strength cannot fight, wealth becomes useless, and intelligence cannot be applied.”

According to Ness, this quote guides the mission of the Welty Health Center. The Center’s high rank among other college health centers would suggest that, at least in some ways, this mission is being met.

Bessen, Mason and Wong all agree the Health Center tries to meet students needs as best it can. However, an apparent lack of training on preventive measures and on deciding when to refer students to other health services can sometimes undermine this goal.

“I feel kind of bad saying this because they are really nice people but it’s just…scary to go to because I didn’t feel like people knew what they are doing,” said Wong.