Cardiology: 'Neurotic Angina' Legacy

Dr. Elizabeth Comen is a board certified oncologist at NYU Langone Health, co-director of the Mignoni Women's Health Collaborative, and author of the groundbreaking book “All In Her Head: The Truth and Lies Early Medicine Taught Us About Women’s Bodies and Why It Matters Today”. In this powerful conversation about medical gaslighting and women's healthcare, she and Dr. Mary Claire Haver trace the deep roots of medical misogyny and reveal why the healthcare system still dismisses women's symptoms today.

Dr. Comen shares the story of a breast cancer patient on her deathbed who, hours from death, apologized for sweating during a hug. It's a moment that captures what nearly every woman experiences in a doctor's office, the reflexive apology for being in a normal human body. Whether it's apologizing for leg hair in stirrups or hiding underwear during an exam, women have internalized tremendous shame about their bodies. Dr. Comen explains this isn't random. It's the legacy of a medical system built by men who dismissed women's pain and symptoms as hysteria, neurosis, or anxiety.

Through meticulous research into medical history, Dr. Comen reveals how this medical gaslighting became embedded in healthcare. She discusses William Osler, one of cardiology's founding fathers, who described women's chest pain as "neurotic angina" and wrote that "these women do not die." Yet heart disease is the number one killer of women. She explains how women are twice as likely to call an ambulance for their husband's heart attack than for themselves, and when they do seek help for chest pain, they're far more likely to be misdiagnosed with a panic attack instead of receiving proper cardiac care.

Dr. Haver and Dr. Comen discuss the systemic healthcare gaps across medical specialties: why 80% of autoimmune diseases affect women yet it's not considered a women's health field, why female specific surgeries are reimbursed at significantly lower rates than comparable male procedures, why Alzheimer's disease is twice as common in women but received almost no research funding, and how the legacy of dismissing women's sexual health continues in breast cancer and oncology care today. They explore bizarre historical medical fears like "bicycle face," the myth that women would become ugly and infertile from exercise, and how plastic surgery evolved to make women "marriage material" rather than serve their actual health needs.

Despite the sobering history of medical misogyny, this conversation ends with hope. Dr. Comen shares why she's optimistic about the cultural shift happening in women's healthcare now, the importance of women advocating for themselves in medical settings, and how the next generation doesn't have to wait for menopause to stop apologizing and start demanding better healthcare.

Guest links:

Dr. Elizabeth Comen

Dr. Elizabeth Comen (Instagram)

Dr. Elizabeth Comen (LinkedIn)

Dr. Elizabeth Comen, MD (NYU)

Books

“All in Her Head: The Truth and Lies Early Medicine Taught Us About Women’s Bodies and Why It Matters Today,” by Dr. Elizabeth Comen

“The New Menopause,” by Dr. Mary Claire Haver
“The New Perimenopause: An Evidence-Based Guide to Surviving the Zone of Chaos and Feeling Like Yourself Again,” by Dr. Mary Claire Haver

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