[Content Note: Medical Issues, Surgery, Fat Hatred, Dieting]
Ana's Note: This is a Fat Acceptance 202 post, not a 101 post. If you need a 101 course on Fat Acceptance, please refer to Kate Harding's excellent archive; there are about 10 linked posts in that archive and they are all awesome and admirably cover most FA 101.
Please also note that this post is going up the week I'm in hospital. That means moderation will be done on a smartphone whilst I am under heavy medication. Comments which are not FA-friendly will be removed without notice, warning, or apology.
I went to a new dermatologist today to have a mole removed.
I have lots of moles removed. Little brown ones that lie flat against my skin sometimes puff up and I get worried. Or they rub against my clothing and bleed, and that worries me too. For the longest time, I went to my general practitioner doctor to have them removed, even though I can't stand him because he has a habit of poking at painful places and saying with a grin, "This hurts? Right here? This is the hurting place? It hurts? Are you sure?" *poke* *poke* *poke* I keep meaning to get a new GP -- I've had "get new doctor (HAES)" on my to-do list for two years now, but mostly I just don't go to the doctor. I spend a lot of time with specialist.
I decided to go to this new dermatologist because my GP started charging me twice for mole removal: once to come in so he could look at the mole, and then a second time to come in for removal. I couldn't afford that on our insurance plan, so I found this dermatologist who would do everything in one sitting. And I picked a woman doctor because I'm at the point in my life where I just don't want to be naked-in-a-paper-gown with any more strange men than necessary, and maybe I'd hit jackpot and get someone a little more compassionate than my GP.
And this dermatologist was nice. Got me in and out real fast, cut the mole off like nobody's business.
But she was thin and I am fat, and one of the first things she said to me -- without any discussion whatsoever about my health or my family history -- was "I can tell by looking at you that you have a genetic risk for diabetes. So you might want to think about lifestyle changes."
I could hear the clock on the wall.
Really? You know, that's very interesting, given that no one even remotely related to me has diabetes.
It's interesting that you can tell that just by looking at me. Did they teach you that in dermatology school? I ask because my parents -- both of them quite thin -- have not been told of this genetic risk that apparently runs through our bodies, and I'm distressed that they're not receiving adequate treatment from their current doctors.
Lady, my "lifestyle" is complicated. Do you really want to hear all about it, or do you just want to cut this mole off and be done with me?
She was trying to help, I'm sure. Hippocratic oath! Serve and protect! Heal all the harms! I'm sure she genuinely believes in the DEATHFATS, and wants to save and educate as many people as she can. I'm sure she optimistically believes that everyone can Do Better! and that if they're not already, it's just a question of educating them to Do Better!
I'm sure she'd be shocked to find out that I already know quite a lot about diabetes because she's not the first person to diagnose my genetics from a quick once-over. I'm sure she'd be sorry to hear that I have a non-obvious physical disability, that I'm under the strictest orders from my specialist to walk as little as possible, and to never run or jump under any circumstances.
I'm sure she'd be surprised to learn that I have an expensive recumbent bike -- expensive because a mesh-chair that conforms to my painfully hunched back is considered a luxury in the exercise bike world -- and that I do in fact use it regularly in order to keep my muscles active, yet with no effect on my weight. I'm sure she'd be disbelieving to hear that the last time I went on a calorie restricted diet, my basic body functions essentially starting shutting down over the course of a very long year: I was cold no matter how many heaters were pointed at me or sweaters were wrapped around me; I was sleepy to the point of almost narcolepsy, regularly falling asleep at my desk despite my best efforts to stay awake.
I'm sure that if I really wanted to tell her all this, she'd probably sit down and politely listen. Maybe she'd even learn something, but if my experience is any indication, she'd be more likely to file me under "Strange Special Snowflake Butterfly Patient". And then she'd forget it, and I'd have to explain it all, all over again, the next time. My entire life with doctors is repeating myself, over and over, as I explain my physical disabilities, my infertility, my medical history that I'd really rather not have to relive once or twice or thrice a month to complete strangers who won't even do me the courtesy of remembering what I tell them.
And this is why I still have my GP as my GP and haven't crossed that "get new doctor (HAES)" line off the to-do list. Because I can't just call up a doctor's office and say "Is she accepting new patients, and also is she going to bring up my weight because I don't want that." I can't say that because I'm pretty sure that the nice person on the other hand is going to say "no" because the nice person on the other end is going to believe that the doctor won't.
The dermatologist didn't walk in today and say, "Hello, I notice you are fat." She tried to bring to my attention a concern she had about me.
But she based this concern 100% entirely on the fact that I am visibly fat.
My mother -- who has been slender all her life -- has never once been cautioned about diabetes. My father was Fat Like Me a year ago; in one year's time he's lost over 40 pounds, and has been praised by doctors and family members alike for his deep devotion to Health. And now he's also the first in our family to be diagnosed with cancer, the first symptom all the cancer doctors ask him is "have you lost a lot of weight?", and he's under doctor's orders to gain as much weight as he can in the few weeks between now and chemotherapy because his life may literally depend on him not starving to death in the process. However, if my thin father walked into this dermatologist's office today, I'm sure she'd proclaim him the picture of good health. Why not? He certainly looks like it.
Except that you can't tell health by looking. No one has ever correctly deduced on meeting me that I have constant debilitating pain, that I carry a hunched back and a full-body scar underneath my clothes, or that most physical movement is both painful and incredibly dangerous to my health. And yet a dozen or more doctors in my life have felt the need to tell me that I'm "genetically" at risk for a disease that doesn't run in my family, based largely on the indicator that I look pretty darn fat. Not that there's anything wrong with that! But you should know that you're an unhealthy fatty who needs to make "lifestyle changes"! Do they bother to ask what my lifestyle currently is? Of course not! We all know that fatties don't exercise or eat anything other than baby donuts! Otherwise, they wouldn't be fat. Q.E.D.
By the time this post goes up, I'll be in the hospital recovering from yet another surgery to correct a spinal problem that manifested when I was a skinny child and the spitting image of my slender mother. At the same time, my father will be in the middle of a seven-week long, daily radiation and chemotherapy treatment to cure a cancer that doctors told him for a year he couldn't possibly have because he looks so very healthy. Tragically, terrifyingly, ironically, distressingly, I have a better chance of surviving my hospitalization than he, simply because I started out fatter.
Frustratingly, we have both experienced extensive misdiagnosis that has added risk to our lives: him, because he just looked so dang healthy and because extensive and unprecedented weight loss in a single year is Healthy! and totally not an indicator of something Very Wrong until suddenly it is; me, because I just looked so dang unhealthy and because Laziness! and DEATHFATS cause all things, including back pain, until suddenly they don't and there actually is something Very Wrong and the fat was just another symptom.
And the worst part, of course, is that I can't say all this when I'm in the paper gown and the nice dermatologist lady is smiling sweetly at me and the clock on the wall is ticking. I have a life, I have a job, I have deadlines I need to go out into the big wide world and meet. I have a limited number of spoons each day, and I can't bear to spend the last few combating the person who just unknowingly took a whole handful of spoons from me with her callously "helpful" remark.
It's a battle I'd spend the rest of my life trying to fight and never able to win.
And yet it's a battle that keeps being lobbed at me, over and over and over again.