On Doctors

Still feeling quite icky.

I slept in very late this morning, and I think it threw me off, because I'm also very sleepy.

So yesterday, when I mentioned going to the doctor, I also mentioned, in parentheses, that I am leery of other doctors. And I figured, since I can’t remember if I made a “real” post about that before, I would make one today. My feelings on doctors and medicine in general, especially as a fat woman in modern culture.

Firstly, many (if not most) of you are aware that my father is a doctor. A very good doctor, in fact. He’s got the fancy job name of “pediatric intensivist”, which translates to “very important guy who works in the hospital with very sick children”. This means he is not a “family doctor” with a practice and a waiting room. He’s one of the doctors you hope you’ll never have to talk to, but are very grateful for when you have a really sick kid. He’s very good with kids, and exceedingly gentle. He can intubate a newborn (which is really, REALLY hard). I am quite proud of his profession and general speak glowingly about it, if you hadn’t noticed.

However, like most doctors, my dad has a few flaws. He has often had trouble keeping emotional distance from his patients, which means he gets very frustrated when a child gets sicker or dies under his care (even though 99% of the time he couldn’t have possibly done anything to prevent it). He also has a bit of the intellectual superiority thing going on, which is understandable because he is a very smart guy, but can be frustrating when you attempt to engage him in conversation about something he is absolutely certain of (like, oh, perhaps, Fat Acceptance).

Still, my dad is a good man and a good doctor, and he’s helped a lot of kids in his time, and intends to help many more before he retires. That is something I’m proud of, and I tend to hold him up as a standard against which I measure any other doctors I meet. Sadly, most of them fail.

The sad truth about doctors is that while there are some good ones out there, there are also a lot of bad ones. Like any other profession, there are those who excel, and those who barely made the cut. And trust me, you don’t really want the guy who made Cs in every subject in medical school to be your doctor. Sadly, because of the dearth of qualified people who want to go into that profession (mostly because malpractice insurance is freaking ridiculous now that everyone has become litigation-happy), they’ve pretty much got to take anyone who isn’t utterly hopeless with a stethescope. Of course, any doctor who wants to have any sort of specialization (surgery, gynocology, ENT, etc) has to have additional schooling, and often even more schooling after that (my dad spent, I believe, 4 extra years after medical school doing his residency). That means that the majority of the GOOD doctors end up being the ones you turn to when you’re really sick. It also means that the majority of the bad ones end up as “general practitioners”, colloquially “family doctors”.

Now, it’s fair to say that I have a much better knowledge of how the medical world works than the average able-bodied person (people with terminal illnesses or handicaps are exposed to it enough that many of them know more than me). This, unfortunately, means that I am more leery of doctors in general than the average person. Add into that the factor of my weight, and my anxiety, and you have a recipe for disaster.

You don’t really need to look very far to find stories of mistreatment of fat people (especially fat women) by the medical community as a whole. First, Do No Harm is a blog that exists specifically to gather these stories via submission, and share them with the internet. There are some absolutely horrible things on that site, including diseases that went un-treated for so long that they created chronic problems or even led to death, simply because doctors were unable and unwilling to look beyond the patient’s weight to find the real problem. There are horrendous stories of doctors bullying fat patients, verbally abusing them, and even sometimes physically abusing them (the second story on the page is a good example of this, where a pregnant woman actually had a doctor push so hard on her during an ultrasound that he split her skin). Most fat people have their own stories of medical neglect or bullying, and many of us thusly have very little interest in going to doctors, or hospitals, unless we feel in real danger for our health (being unable to breathe, perhaps, or having a stabbing pain that makes it nearly impossible to function). Many of us (and I won’t pretend I haven’t done this) will ignore minor issues, hoping they go away, in favor of avoiding the doctor rather than being forced to listen to another lecture about how “everything will go away if you just lose weight, including your broken ankle, sudden mysterious back pain, and any other symptom that suddenly cropped up yesterday and has never been an issue in all your life as a fat person before”.

When we find a doctor who doesn’t treat us this way, who acts like we’re a real human being with thoughts and feelings and viable opinions on what is causing our pain/discomfort, we cling to them for dear life. We fear the day they retire, or move, or we move, because the odds of finding another one are so incredibly low. I adore my doctor, as she’s only made vague reference to my weight once or twice (she has tested me for diabetes more often than necessary, but otherwise she never tries to talk to me about exercise or weight loss, as so many doctors have over the course of my life), and is generally willing and eager to listen to what I feel and think about whatever issues I may be seeing her for. And she always greets me with a smile, which some doctors don’t deem necessary at all. Hello, if I am already scared and anxious that you won’t treat me like a real human being, it wouldn’t kill you to smile and say “hey how are you?” when you walk in the door! I understand that being a doctor is stressful, but there are lots of other stressful jobs that pay a LOT less where people manage it (waitress immediately springs to mind), so I think you can fucking muster some human sympathy too, jackass.

My doctor’s office does not have a digital scale. It has one of the old fashioned “weight balance” scales, and it only goes up to 350 lbs. Since I am over that, if the nurse attempts to weigh me, I simply tell them it’s not possible because I weigh more than the scale goes up to, and they shrug and move on. NEVER has it been an issue. Not once has anyone said “well we really need your weight, can you please try?” They either mark me down as 350 for the sake of writing something down, or they move on to taking my blood pressure.

Yeah, I am afraid of what will happen when I move away from here, as I intend to do in a few years. I will hate to lose her as my doctor, and I will likely go a few months without one rather than attempt to find one who treats me like a person. And yet no one seems to think there could be a correlation between “fat people have poor health” and “doctors treat fat people like shit”. If you had to fight to be treated like a fucking human being, how often would you go to the doctor? It’s all well and good to talk about “preventative maintenance” and an entirely different thing to have to face up to what is, for some people, absolutely crushing fear and anxiety of being belittled based on a number on the scale/how they look.

The truth is, I’m really fucking lucky that my dad is a doctor. Both he and my mother are extremely vocal about medical advocacy as a result of it, and neither of them will take any shit concerning their health from asshole doctors because of it. I learned that from them, and I’m not afraid to stand up for myself if I think a doctor is being an asshole to me for no good reason. That doesn’t negate the fact that it’s normal for me to want to avoid putting myself in a situation where I might encounter that, as it would make me very angry and stressed, which aren’t going to help my health either. Being able to stand up for oneself and wanting it to be necessary are two completely different things. Sure, if I go to someone and they’re a dick, I’m going to defend myself. But it shouldn’t be necessary for me to. It shouldn’t be necessary for any person, regardless of why the doctor is being a dick to them. It should never be necessary to tell the person who you are going to for the purpose of being healed, that they should treat you like a goddamn human being.

And that’s all I have to say about doctors. Thank you.

P.S. Completely unrelated, but a very good link so I am putting it here because I’ll probably forget it tomorrow: How to Care for Introverts.

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