bad medicine

the other day, a friend needed a recommendation for an orthopedist in the city and fast. i told him that i had one, but that he was a jerk on a personal level. he said he didn't care about that, and then he asked for the story and here it is:

about a year ago, i was having problems with my right hip which was just constantly hurting. as i often did, i assumed it was weight-related and figured it would get better when i lost weight so why seek medical attention? don't worry, this doesn't end badly, it really was weight related and nothing horrifying, but eventually the pain got bad enough that i figured i needed some relief and scheduled an appointment with an orthopedist i'd seen before. he took x-rays and determined that it was a little arthritis and prescribed an anti-inflammatory. because i was so used to doctors telling me i needed to lose weight, and because i was already scheduled for my surgery and armed with a plan, i felt the need to tell him right away that i knew it was probably weight-related and that i was going to be having the surgery, etc. i was so used to being on the defense in medical situations that i was happy to, for once, have a confident plan to lead the conversation with rather than “well i rejoined weight watchers and…” but in spite of my confident plan, this doctor managed to stun and shame me anyway. he was unmoved by my announcement of the surgery and my looking forward to it and instead pursued his own line of questioning.

doctor: so how long have you been this size?

me: well i've been in this general area for many years...since college i guess, but heavy in high school too.

doctor: wow.

me: yeah, so the surgery really feels like the right choice for me.

doctor: so what do you, just eat a lot?

me: um, yeah i guess. but its a little more complicated than that…
 

doctor: i mean, i can understand sometimes you just want to keep eating and (makes piggish noises and a shoveling motion with his hands to his mouth) but i mean, you have to just stop yourself.

me: (almost speechless) yeah i mean, like i said it's not as simple as what you're saying. i mean, i've done lots of reading and i'm in therapy and it’s a disorder even though many people don’t understand that, and --

doctor: okay well good seeing you. good luck, i'll see you again after you've finished the anti-inflammatory. take care.

when i told mitchell this story, he was infuriated and shocked, but i sadly wasn’t. i was used to this kind of treatment from doctors and other people alike, though admittedly, this time did seem particularly brutal. the truth is that many studies show that obese people receive the absolute worst medical care for two reasons – first, because doctors often blanketly assume that ailments are weight related (as do obese patients). though they often are, or certainly are exacerbated by weight, it sometimes causes patients and doctors alike to ignore symptoms that should be further explored because they’ve assumed the obvious, visible answer. and secondly, because some doctors, like some laypeople, are repulsed by obesity and see obese patients as lazy, lacking self-control and piggish. how can you care for someone in a respectful, responsible way when that’s what you think of them?

and the obvious other factor is that when people are treated this way and shamed by their doctors, it takes an awful lot to push through those feelings and drag yourself there when something hurts, especially when it’s something you know your weight affects. i didn't go back to the doctor after i finished my prescription. and my friend who didn't care that he was a jerk went and saw him and thought he was a jerk. shocker.