Courtesy of Ashanti Coleman
- Ashanti Coleman, a nurse and stroke survivor, was discharged with what doctors called a migraine.
- She really had a torn and blocked artery, and could have died if she didn’t go to another facility.
- The way doctors dismissed her pain, she said, is common among Black female patients.
- Visit Insider’s homepage for more stories.
Ashanti Coleman wished she could rip off her head. Over the past week, what had started as an ache on the right side had become increasingly persistent and intense. As a stroke survivor and nurse practitioner who works in a pain clinic, Coleman knew she wasn’t experiencing a run-of-the-mill headache.
But in the emergency room that May of 2019, Coleman said she waited several hours before being seen. Eventually, she was admitted with a “mini stroke” diagnosis, but spent days awaiting attention from a neurologist to determine the source of her now severe headaches.
When the doctor did see her, he didn’t ask about her pain or conduct a neurological exam, Coleman said. Rather, he dismissed it as a migraine and discharged her – despite the fact he had treated her first stroke and so knew her health history and profession. “That did nothing for me,” said Coleman, who lives in Memphis with her husband and two kids.
That night, Coleman woke up with excruciating pain in her neck. “It felt like something was tearing,” she said. So she went to a different hospital, where learned her right carotid artery – one of the two major sources of blood to the brain – was ruptured and 50% blocked, and she needed emergency surgery right away.
It turned out that, when doctors attempted to remove a clot after her first stroke in 2017, they damaged that artery. It didn’t fully repair itself, creating the tear, blockage, and Coleman’s symptoms.
"The whole right side of my brain was not getting in any oxygen or blood, which was causing those headaches," Coleman, now 41, told Insider. "Eventually, that tear could have gotten worse, and I could have died."
Through a partnership with the American Heart Association, Coleman spoke to Insider about her experience as a two-time stroke survivor and Black woman navigating the healthcare system. Even as a PhD-level nurse, she said, she's subject to systemic racism that negatively affects care.
Coleman was 38 years old and healthy when she suffered her first stroke
When Coleman woke up one morning in 2017 with an ache on the right side of her head and body, she brushed it off and went to Starbucks. Back home, though, "the headache just kept pounding, just kept persisting," she said. Then, her husband noticed her speech was garbled.
In retrospect, Coleman says the symptoms were "textbook" stroke. But she was 38 years old, maintained a healthy weight and good blood pressure, exercised regularly, and didn't drink, smoke, or eat red meat. "I was just a little bit in denial when the symptoms started because I'm like, 'I don't have anything wrong with me,'" Coleman said.
But then a sharp pain went down her left side, the left side of her arm felt numb and tingly, and she lost coordination. "That's when I knew I was having a stroke," she said. Her race and birth control medications were her only risk factors.
At the hospital, she was promptly diagnosed with a stroke caused by a blood clot in the right side of her brain. Doctors first gave her a "clot-buster" medication and then attempted to remove it, but it was small enough at that point to leave in place.
She then began physical therapy, occupational therapy, and speech therapy to recover her lost functioning. Early on, for example, Coleman couldn't open and close her left hand by herself. "My mind was telling my hand to do it, but it would not do it, so that was so frustrating," she said. "I couldn't do my daughter's hair, my hair, or my clothes."
As some stroke survivors do, she also developed an accent that lasted about six months. Hers sounded Jamaican. "My speech therapist actually asked me where I was from," Coleman said. "I was like, 'I from Chicago.'"
But after more than two months of rehab, Coleman was back to work as a nursing professor at the University of Memphis. "I was determined to get back functioning as quickly as possible," she said.
Courtesy of Ashanti Coleman
Coleman felt dismissed during her second stroke
Coleman doesn't know why her second experience at the same hospital and with the same provider went so differently. But she does know it feeling ignored and having pain overlooked by healthcare professionals is all too common among Black women.
"I hear it a lot," she said, "that African Americans, and specifically women, are just dismissed with their pain."
One 2016 study, for instance, found that about half of white medical students and residents endorsed false beliefs about biological differences between Black and white people, like that Black people's nerve endings are less sensitive and their skin is thicker. In turn, they rated Black patients' pain as lower and made less accurate treatment recommendations.
Coleman said her pain wasn't treated at first because, as the neurologist told Coleman's primary care physician, "she doesn't look like she's in pain."
"They presume that individuals are not in pain because we're not presenting the way they think we should," Coleman said. "I wasn't writhing on the ground. I wasn't using profanity. But everyone's pain is different."
Coleman, who's currently administering COVID-19 vaccines and working to publish research on women and cardiovascular disease, wants to teach her nursing students just that. "I hope to train them where they are not looking at a person as this skin color," she said. "I hope that they are looking at a person as a whole."
She hopes patients don't box themselves into a category either, like thinking that because they're young and healthy, they can't experience a stroke. "I use my strength to keep going and pushing forward and advocating for other people," Coleman said, "so that another young lady does not have to go through what I've been through."