Last week I wrote about two stories where "Obesity experts" just don’t get it. This week I'm writing about a doctor who tries but fails to get it. Dr. Edward Thompson writes about treating a 600 pound man and seems to not realize how much he marginalizes his patient.
The patient lies trapped in his own body, like a prisoner in an enormous, fleshy castle. And though he must feel wounded by the ER personnel’s remarks, he seems to find succor in knowing that there’s no comment so cutting that it can’t be soothed by the balm of 8,000 calories per day.
I've mentioned before that fat people fear going to the doctor. I know that I hate going to a new specialist because I hate to have yet another fat talk.
In this man’s case, the ER doctors couldn’t handle his size and looked at him as if it’s his fault rather than the hospital’s lack of equipment. I don’t believe the doctor went out of his way to marginalize him but fat equaling bad, lazy, a slob, and stupid is so ingrained, he might not have realized he was making his patient less than a person.
Even though dieting does not work in the long run, because weight is fluid and can be artificially changed, doctors assume that it's either the patients fault for being lazy or society's fault for making food so accessibility to people too stupid to know better.
I know why my colleagues and I are so glad to have this patient out of the ER and stowed away upstairs: he’s an oversize mirror, reminding us of our own excesses. It’s easier to look away and joke at his expense than it is to peer into his eyes and see our own appetites staring back.
A few months later the doctor's patient died.
Though I have no way of knowing it, within a few months a crane will hoist the patient’s body through a hole cut in the side of his house, a hole that allowed EMS personnel to lower the body onto their new ultra-wide, ultra-sturdy gurney.
I have to wonder if the patient thought about seeking medical care, remembered being made fun of and marginalized, and decided against seeking treatment.
Not only were they a study in the power of negative metaphors, but as a fellow physician, they felt all-too familiar. They were the way I had, on many an occasion, heard patients’ bodies talked about; ways that I, during my training, had perhaps referred to patients’ bodies. The simple words felt so easy, so unexamined, and in that very ease was embedded their violence.