Doctor negates woman’s experience, doesn’t diagnose problem

Mary D writes:

I am fat, I know I am fat, and what it is to be stigmatized as the morbidly obese cretin unworthy of the health dollar. I live in Australia where the obesity witch hunt is in full flight. It is an area of discrimination sanctioned by government and encouraged by the media. Fat aussie kids are brutally bullied and their parents cruelly accused in the urgency to curb Childhood Obesity. Having worked in television most of my life I am deeply offended by networks grabbing ratings and advertising. I am upset when thin and attractive people of limited qualifications become stars and go unchallenged as they carelessly forecast imminent death to the obese. It is grotesque as they display and torture desperately unhappy fat people, on treadmills and cross country runs, in some televised freak show. It is hardly surprising that despite negligible success or quantified results the multi-million weight loss industry continues to make huge profits or that some surgeons have jumped on the Bariatric bandwagon and are offering high priced loans to desperate podgy patients of limited means as such treatment is not covered by our health service. Despite negligible results the multi-million weight loss industry makes huge profits.

Up until now because of my embarrassment at being fat I have not had the courage to point out that the human rights of the obese must be addressed. After a particularly humiliating appointment with my doctor I felt betrayed and realised I had to act. This is a matter of Human Rights and I have started with this letter:

Dear Dr ****,

I don’t want to offend you but I need you to understand how I feel. If I seemed confused on Tuesday and had trouble expressing myself it was because I was trying to avoid tears. I am very sensitive to the subject of obesity as experience has taught me that the moment a doctor mentions my weight and goes straight to diet he/she no longer sees past my size meaning serious illness might go unnoticed or untreated. The fight or flight reaction kicked in and I became more stressed as the feelings of rejection increased. Ironically, having come to trust and respect you I had made the appointment specifically to discuss my weight and the unusual structure of the fat, on my abdomen and between my shoulders, which is possibly not entirely attributable to Lymphodema but I didn’t have that opportunity.

It seemed to me that you did not believe me when I tried to outline my regular diet. To clear up any confusion: my diet mainly consists of lean meat, grilled fish, smoked salmon or six oysters, eggs (yolk removed after first egg) and various salad leaves (the dressing of which are sugar free and no fat, or plain lemon juice, or Balsamic vinegar) and seasonal vegetables steamed or stir fried in olive oil (mainly English spinach, fresh asparagus, capsicum, aubergine, microwaved mushrooms, spring onions, broccoli, celery etc).

When you pulled up < I felt it as an act of infantalization, as you had formerly treated me as an intelligent and cultured woman. No part of the picture blog, with its demonstration pile of white sugar cubes, applied to me. I do not consume fizzy drinks, fast food or processed foods nor do I eat pizza and would never darken the door of McDonalds or Kentucky fried because surprise, surprise, I am a very good cook and when I was slim and wealthy mostly dined at the finest restaurants in many parts of the world. I was staggered when you said I should replace fruit with a carrot. I eat one small serving of fresh fruit maybe once a day (raspberries, strawberries, red grapefruit, passionfruit etc and tomato) all of which are not much above the carrot in sugar content. I do not have bread, milk, sweets, cake or biscuits in the house. Items like the repellant tins of John West tuna, sardines or baked beans you suggested are quite foreign to my eating experience.

Had you believed me, you would have immediately realised that punitive micromanagement of my diet was not only unnecessary but would be detrimental to our goal. Had you thought about which person you were talking to, you would not have attempted to impose such a grossly culturally inappropriate diet. The approach denied my person, and nullified my own achievements. I don’t understand why you would want to do that.

During our conversation I attempted to say that I thought humiliation was fattening and as a fat woman I feel every cut delivered daily by the media about obesity. The Rudd Center for Food Policy and Obesity at Yale confirms this and the New York Times weighed in, “Dr. Peter A. Muennig, an assistant professor of health policy at Columbia, says stigma can do more than keep fat people from the doctor: it can actually make them sick. “Stigma and prejudice are intensely stressful,” he explained. “Stress puts the body on full alert, which gets the blood pressure up, the sugar up, everything you need to fight or flee the predator.” Over time, such chronic stress can lead to high blood pressure, diabetes and other medical ills, many of them (surprise!) associated with obesity.”

I really felt that stress on the way home when I recalled you saying to me “If you keep going this way you might be one of those people who have eventually to be removed from their house by a forklift truck (sic)” and tears started to roll down my face. Overcome by embarrassment, I fled to the shopping centre in a blur wanting to be comforted, I bought things I have not bought for years. For dinner on Tuesday night I fought against sorrow with two dozen oysters, an entire bottle of decent wine and a whole bar of chocolate. Bring on the forklift truck!

Having no advocate, my normal response would be to creep away, seeking medical help from the hospital solely when catastrophe strikes. I only have to look to my left or my right, to find someone who has never experienced a weight problem, keen to act as a judgmental dietitian. I don’t need them. I know more about weight and diet than most health workers because I live it. What I need is a doctor – I need you, Dr ****, I need the cultured man who reads books and I had come to respect. The doctor who treated me as an intelligent woman who was once a top flight journalist and award winning screenwriter, not merely a cretinous fat blob. Dr ****, I need you as a diagnostician, and it is there that you excel.

I will make another appointment. Do you think we could start again?

Mary D

Posted by vesta44 on November 10, 2010

https://fathealth.wordpress.com/2010/11/10/doctor-negates-womans-experience-doesnt-diagnose-problem/