When I was in nursing school (a real bastion of fat-phobic thinking) and the program director/instructor asked students what kinds of patients they didn’t want to work with, several of my classmates said “obese people.” The instructor nodded her head knowingly. I was disgusted and horrified. I had not yet discovered Size Acceptance, but I finally spoke up and said “I think the reason that so many of you are prejudiced against fat people is that we’re very visible.” I don’t know if I got through to anybody, but I couldn’t sit by and endure that kind of hatred unchecked.
When I was doing my clinicals, I took care of several extremely heavy patients. One of them weighed about 425 pounds. She was bed-bound , which was a fairly recent thing for her. Her kidneys were no longer removing toxins from her system. She said “never in my life have I felt so weak and helpless.” One day when I came in to assist her, a doctor was there lecturing her and her husband on their need to lose weight. How about addressing the freaking kidney problem, and whatever other underlying medical problems she’s in the hospital for first? Gaaaah!
I noticed that this woman was on an extremely high dose of statin drugs, way out of safe ranges in fact. I’m not a pharmacist, nor am I a doctor, but I could not see anything in her presenting medical history that would indicate such a high dose of statins being called for. Statins can cause muscle pain and weakness, and I wondered if in such a high dose, they might also cause kidney damage.
The other very large woman we assisted was depressed almost to the point of catatonia. She was fairly well unable to assist us in any way. It took four of us to turn her. Fortunately, nobody expressed any hateful attitudes towards her. The hospital nurse explained to her what we would be doing and we did our best to make sure the experience was as comfortable as possible for her.
Another of the larger patients I assisted also had kidney issues. She was a thirty year old woman who had three kidneys. One of these kidneys was atrophied, and it seemed to be causing problems. It was a real head scratcher that the attending physician was recommending lap band surgery rather than removal of the atrophied third kidney.
The fourth woman was an older lady who had broken her shin. She was able to help the staff with turning and positioning, and was an “easy” patient.
Weight can be important, as in cases of kidney dysfunction, where one needs to check weight to see if the patient is retaining excess fluid or if treatment is helping them. It should never be used as a weapon for making people feel badly.
I’ve said it before and I’ll say it again. Using “lose weight” as the order that will cure all ills is lazy medicine, and it gets people killed. It actually harms people with thin body types too, as they are assumed automatically to be healthy, so no-one checks for underlying problems.
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…
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