A doctor has written a piece called “A morbidly obese patient tests the limits of a doctor’s compassion.” No power on this Earth will make me link to it. It seems like the doctor wants an opportunity to revel in his prejudice while getting credit for being brave and talking about it. What it ends up being is a guide to how healthcare goes wrong for fat people. This post may be very triggering – you can skip the indented portions and that may help.

Considering the piece is named “A Morbidly Obese Patient Tests the Limits of a Doctor’s Compassion” you might have some ideas about the patient’s behavior so I’m going to go ahead and give a spoiler – he tested the limits of the doctor’s compassion simply by existing. Charming. It does not get better.

The piece centers around a patient who went to the emergency room for treatment with stomach pain, and is fat. In addition to being accompanied by a headless fatty picture. Throughout the article, the doctor describes the patient in shockingly prejudiced language

a mountain of flesh a prisoner in an enormous, fleshy castle an oversize mirror, reminding us of our own excesses

This is not examining prejudice, it’s reveling in it. This patient is not a metaphor, a mountain, a mirror, or a castle of fat. He is a human being – a patient who has to suffer not just through pain, but through dealing with a series of health professionals who feel comfortable reveling in their bigotry often at the expense of his medical care.

The patient knows what’s up, he’s used to this:

He recites a litany of consultants he’s seen for his back pain, his headaches, a chronic rash on his ankles, his shortness of breath, his weakness, his insomnia and his fatigue. “All of them have failed me,” he says, adding that the paramedics didn’t have the proper ultra-wide, ultra-sturdy gurney to accommodate his body. “The Americans with Disabilities Act says that they should have the proper equipment to handle me, the same as they do for anyone else,” he says indignantly. “I’m entitled to that. I’ll probably have to sue to get the care I really need.” I don’t quite know how to respond, so I say nothing.

How about responding by saying something like “That’s terrible. I’m so sorry that you haven’t been able to get good medical care.” How about “I’m sorry that happened, I’m going to help you find [an advocate, a doctor who will help, something, anything.]” How about saying “I’m sorry that we don’t have the proper equipment to treat you.” How about responding with empathy, with compassion, by helping the patient get treatment for his health problems, instead of splashing around in a pool of your own prejudice?

“Don’t put him in a room right over the ER,” whispers the unit secretary to the admission clerk. “The floor won’t support him. He’ll come crashing through and kill us all.” Glancing across the hall at the patient, I see by his eyes that he’s heard her comment, and I’m suddenly sure that he’s heard all of the side remarks aimed his way.

Does he apologize to the victim of this abuse? Does he apologize for his role in the abuse? Does he address the completely unprofessional behavior of the unit secretary? Of course not! He doubles down with more “poor everyone but the fat guy” language:

Finally, a slew of huffing, puffing, grunting attendants wheel him down the hall, leaving me to reflect on his plight. He lies at the very large center of his own world — a world in which all the surgery mankind has to offer cannot heal the real pain he suffers.

We get it, the patient is heavy – if it was so hard for the attendants to push the guy down the hall than get more attendants, or find stronger attendants, or get equipment that helps people move people more easily, or act like it’s no problem for the sake of the patient, just like you should do for other patients who have issues that might be embarrassing or make the staff uncomfortable.

The belief – that [medicine] can’t heal the “real pain” of being fat – is often at the core of why doctors don’t provide competent care to fat people. Here’s a novel idea – do your fucking job and try. See what happens when you treat fat patients without stigmatizing them, when you treat their actual health problems instead of diagnosing them as fat and prescribing weight loss (especially considering you don’t have anything to offer them in terms of changing their body size.) See what happens when you encourage people to appreciate the bodies they have and give them options to help them reach their goals. While you’re at it, see what happens if you actually examine your prejudice rather than selling fat people up river for catchy turns of phrase.

Perhaps this patient did share with the doctor that he has issues with what he considers to be compulsive eating , I don’t imagine that he did it so that the doctor could write a piece suggesting that this person’s experience is every fat person’s experience. Disordered eating is something that affects people of all sizes and when healthcare professionals intimate that you can tell someone’s eating habits from looking at them, they do everyone a tremendous disservice.

The thing about the entire piece is that it is a self-absorbed exercise, written to make the doctor feel good about himself for “examining his prejudice” when really what he is doing is just heaping more stereotypes and stigma onto fat populations with the force of an MD behind it.

Having been called out on by commenters the doctor published an apology laced with the exact same issues as the piece:

We all have a burden in life; his was just larger and more apparent than most. The surgeon and the secretary were guilty of being judgmental and critical (much like some of the comments about my character here) because they were forgetting the man inside the patient.

Fat bodies are not burdens (though the stigma, shame and marginalization that is steeped upon us by people like this doctor can be.) “Forgetting the man inside the patient” may be the absolutely more horrific thing he says in the article (and that is saying something.) There is not a thin person inside fat people who deserves to be treated well. The fat person in front of you deserves to be treated well as they are. And neither the surgeon nor the secretary called him a “mountain” or “Fleshy castle” so maybe this doctor shouldn’t have exempted himself from the list of people who were guilty of being judgmental and critical.

This story was an attempt to relate a difficult encounter honestly and factually so that people (including me) could examine their own prejudices. It looks like it worked.

It’s a poor attempt and it didn’t work. Had the doctor said “This story was an attempt to make myself look good while profiting from the stigmatizing of a fat person without his consent” then I suspect we’d be more in the ballpark.

Dear doctors – many of your are doing much better than this, thank you. For those who aren’t, please start now. Thanks.

If you are looking for a doctor who will treat you appropriately, consider the Cat Dragon List (if you know of such a doctor, consider posting them to the list.)

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