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Students are not getting the care they need from Student Health

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I had been experiencing extreme left flank pain for three days. The nurse practitioner at Student Health was pressing down on different parts of my belly, intensifying the pain when touching my left side. 

“Yeah, it looks like it’s gas,” she said. 

“Are you sure?” I responded, certain that it was something more serious. 

“Yep, just eat more fruits and vegetables to help you go to the bathroom and I’m going to give you some Gas-X,” she said. 

“I eat a lot of fruits and vegetables and I feel like I’ve had gas pains before. This feels different. And why would I only have gas pains on my left side?” I said, as my voice rose in frustration and urgency.  

“Happens,” she responded, dismissively. 

I felt uncomfortable further challenging a medical professional, so I walked to the pharmacy to pick up the Gas-X, bending over in excruciating pain. 

The next morning, I woke up paralyzed in pain. The Gas-X did not work. I called Student Health and explained that my pain was now 10 times worse, asking what I should do. The nurse nonchalantly suggested that I go to the ER, “if you feel like you need to.” 

My roommate drove me to the ER, where a scan showed that the pain was caused by a massive hemorrhage around my left kidney. I later learned that the bleeding resulted from an 18 x 14 cm cancerous tumor. 

I look back at Student Health’s grave misdiagnosis with little complaint that they got it wrong. I found out soon after and that’s what matters. 

What troubles me is how casually the nurse practitioner wrote off my concerns. How she was so certain that it was “just gas pains,” despite my repeated attempts to push back and emphasize that I was experiencing a 10 out of 10 on the pain scale. Her extreme carelessness led to something as laughable as cancer diagnosed as gas pains. 

I would feel less perturbed if this were a one-off event. But since stepping foot on campus, I have heard stories of Student Health misdiagnosing students or somehow making their lives harder. I know individuals who completely swore off Student Health, choosing to go directly to a local urgent care when sick. 

Take senior Sam Elliott, for example. At the end of his first year, he was sicker than ever—fatigued, winded while walking up the stairs, crackling in his chest while breathing, and coughing up thick green and yellow mucus.

At Student Health, the nurse practitioner listened to his breathing through a stethoscope and conducted a lung function test. She then diagnosed Elliott with asthma and sent him on his way with an inhaler.

Elliott, a former Division I athlete who had never experienced issues with breathing, did not feel that he was given adequate care, but wasn’t sure how to communicate that to his provider.

“When they said [the diagnosis], I was like ‘I don't think so,’ but at the same time I felt that they were the professionals,” Elliott said. “I was a freshman in college with zero medical background and just trusted doctors and nurses. But now I realize you should always question what's going on.”

Elliott continued to feel very ill, until returning to his home in Kansas a week and a half later. His mom took him to a Minute Clinic, where the physician assistant quickly suggested the possibility of pneumonia and the need for an x-ray.

The scan showed that the physician assistant was correct. Elliott ultimately needed two rounds of antibiotics before his symptoms began to subside. Elliott said that the improper care he received at Student Health led him to finding light permanent scarring on his lungs and feeling ill for much longer than he would’ve felt if given an accurate initial diagnosis.

“I've gone back to student health to get blood work done or a referral, but other than that, I don’t really go back. I try not to go to student health. I don't trust them,” Elliott said. 

Sophomore Cate Schick felt similarly dismissed by Student Health. Schick was sitting in the front row of the class when her professor noticed that her face had “completely swelled up” and immediately excused her for a student health visit. She recalled that one of her eyes was almost swollen shut.

In the five to ten-minute meeting with Schick, a doctor asked whether she was stressed and if she had any midterms coming up, which she answered yes. After noting that Schick had previously visited Counseling and Psychological Services, the doctor decided that the swelling was a physical reaction to stress, and suggested that she returns to CAPS.

The swelling subsided by the next morning, but Schick later learned that contrary to what the doctor said, she was experiencing an allergic reaction to a cosmetic product.

Schick said that the doctor not only gave a misleading diagnosis, but also was condescending in his dismissal of her concerns.

“I just felt like they were trying to dismiss me because they were busy that day. I felt very not wanted in the office,” Schick said.

John Vaughn, director of Student Health Services, told me that he cannot comment on any specific case, but he would be reluctant to use the term ‘misdiagnosis’ because symptoms can evolve over time.

“Students can come in one day and it can look like an allergy or a cold, and then within three days it can be full-blown pneumonia,” Vaughn said.

Richard Chung, Duke Health adolescent and young adult medicine specialist, agreed that initial diagnoses are not infallible.

“A key concern is a matter of making an initial judgement and then following up and communicating afterwards to confirm that diagnosis, or to change the diagnosis and do something differently,” Chung said. “Part of the issue may be there isn't that clear infrastructure for that follow-up to happen.”

While patients should follow up with their provider if their symptoms are not improving, clinicians can also reach out to check on their patients, said Chung.

Both Schick and Elliott said that their provider did not suggest for them to follow up after the appointment, so they did not think to either.

Vaughn thinks that Student Health is doing “an outstanding job,” and that over 90% of students who visit student health have a good experience. He added that he’s also heard positive feedback from a student advisory committee that analyzes student feedback and liaises between Student Health and the broader campus population. 

But Vaughn’s confidence in Student Health, as well as the feedback that he receives, struck me as inconsistent with reality. 

The above experiences are only a few of the countless anecdotes that I had learned through interviews and other conversations. 

A culture of dismissing and neglecting student need exists in Student Health. To start, Student Health employees require training in how to foster trusting and communicative relationships with students, who should learn to take greater control of their interactions with clinicians. 

The University should seek to continue this conversation, because a Student Health that completely lacks the faith of its students surely fails to adequately care for their health. 

Rose Wong is a Trinity senior and a Local/National Editor.

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