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I Trust in Second Opinions

by Jeanette DePatie, MA, ACE

I hate going to the doctor.  I mean, a lot of people dislike seeing their doctor, but I truly loathe it.  This is especially true when I’m seeing a new doctor for the first time.  For days ahead of time I feel anxious.  By the time I’m driving to my appointment I have sweaty palms and feel sick to my stomach.  Usually by time I get to my appointment, my pulse is racing and my blood pressure has risen many points above my daily average.  It’s a big deal.

I think this stems from my childhood.  I was sick a lot.  And by a lot, I mean a lot.  It was not unusual to miss four or five days of school per month being painfully, desperately ill.  The doctors didn’t have an easy answer for what was wrong with me.  So they convinced my parents that I was “making it up” in order to “get attention.”  I lived like this for nearly a decade.  They sent me home year after year, sick and in pain and telling me it was all in my head.

As it turns out the problem was not in my head.  The problem was in my neck.  I had several severe tumors that left untreated could have ultimately led to brain damage or even death.  At one point, my parents finally put their foot down.  They said they would not rest until we figured out what was wrong with me.  If that meant a lot of tests, it simply meant a lot of tests.  And there were many.  Once we finally got a diagnosis, we were able to schedule surgery and remove the tumors.  I have not suffered with that particular illness since.

What I have suffered since is some serious trust issues around doctors.  When I was younger, my doctors accused me of making up an illness in order to get more attention from Mom and Dad.  As I grew older, and we knew that I had suffered from a real and dangerous medical issue, I’ve simply had to deal with doctors diagnosing me as fat.

Going in for knee pain?  Told to lose weight.  Got a sore throat?  Told to lose weight.  Feeling fatigue?  Yup, you guessed it: it was time to lose some weight.  Once again, I was discounted and disbelieved about the state of my health and told that if I undertook this one simple fix (to lose weight) everything would be just fine.  Of course, outside of the usual mimeographed diet (one egg, one piece of dry toast, 1 cup of coffee for breakfast, one salad and scoop of cottage cheese for lunch, broiled chicken breast and steamed vegetables—no carrots or peas—for dinner) the doctor didn’t really have any reliable method for me to lose weight and keep it off.  That was apparently up to me.

A few years back, on the advice of a friend I saw a new doctor.  This guy was supposed to be really good and not fat phobic at all.  I saw him a couple of times and things seemed to be going pretty well.  I explained to him that I believed in a Health At Every Size® approach to wellness and preferred not to focus on fat as a diagnosis.  I agreed to work carefully on healthy behaviors and follow his directions for such.  The last time I went in to see him we sat and went over the results of my recent health screenings.  He agreed that all my numbers looked very good and were well within normal ranges.  He complimented me on my healthy diet and regular exercise.  He agreed with me that eating well and exercising don’t necessarily lead to significant weight loss.  And then, he proceeded to ask me when I was planning on having weight loss surgery.

I stared at him in disbelief.  Did he not just say all my numbers looked good?  Why aren’t we celebrating the fact that by all reasonable measures, I’m quite healthy?  He responded by saying, “We should consider weight loss surgery as a preventive measure.  Although you’re well now, you’re bound to get sick and die unless you lose weight.”

I responded, “Well, I’m not a doctor or anything.  But I’m pretty sure I will get sick and die regardless of whether or not I lose any weight.  I’m pretty sure that happens to humans of all shapes and sizes.  And what are you 65 years old or so?   Don’t men your age often have prostate problems and problems with testicular cancer?  Maybe we should start cutting some stuff off, you know, just for ‘prevention’.”

I couldn’t believe that the doctor was recommending risky, sometimes irreversible, surgery based on some vague idea that I might get sick someday.  As a kid, I couldn’t get anybody to run tests to see what was wrong with me.  As a fat adult, I had a doctor ready to significantly alter a perfectly normal human organ because I might get sick someday.  I became very, very angry.

And of course as I’m standing there, red faced and trembling, the doctor felt this was a good time to check my blood pressure.  And lo and behold it was a little high.  The doctor pointed to this as proof that it was time to get in for surgery and get cutting.  I didn’t feel I had the sanity points left to explain that those points of elevated blood pressure was the direct result of me trying not to strangle him.  I left the appointment and didn’t see that doctor again.  In fact I didn’t see any doctor again for another two years.  Somehow I don’t think this is the kind of preventive medicine that doctor had in mind.

But all too often that is the result when we are shamed and belittled and stigmatized and not believed about our own experiences and symptoms in the doctor’s office.  We are angry and hurt and frustrated, and we just stop going.  There are a number of studies being conducted which look at this very issue.  Are fat people no longer going to the doctor because the experience is so traumatic and deeply troubling?  And what are the long-term effects of delaying medical treatments and routine care?

Eventually, I shopped around until I found a good doctor.  I have a great deal of respect for my current doctor and I believe he respects me as well.  But honestly, I always wonder if this is the visit where it all changes—if this is the visit where he turns on me and shames me and stops respecting me and my experience.  And as a person of size, this is something that I will always wonder.  Because the experience of being shamed in the doctor’s office is not unique to me.  In fact, fat people experiencing shame at the doctor’s office is probably more common than not.  For now, I have a good doctor and am seeing him regularly.  For now.

But I fear deeply for those who don’t have the energy or the resources to keep trying to find a doctor who will respect them.  What about those who are too sick to wait?  What about those who simply assume they deserve to be shamed and believe every shameful thing a doctor says to them?  What about those who have wives or husbands or parents or children or siblings that are only too happy to reinforce those messages of shame?

That is why I speak out about this emotional, frightening and sometimes embarrassing subject.  That is why I speak out about fitness and wellness as Jeanette DePatie (AKA The Fat Chick).  That is why I teach fitness classes to people of all ages, shapes, sizes and abilities.  Because I want people to know that they don’t have to be shamed at the doctor’s office.  And that it’s always a good idea to get a second opinion—whether it be about a particular treatment or medication or an exercise plan or the general attractiveness of your thighs.  Never let a single voice other than yours be the final voice in terms of your rights, your wellness, your experience or your life.

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