Some of my earliest memories of doctors involve the pediatrician we saw when I was seven or so. He put me on a diet in which I couldn't eat corn (my mom only cooked three kinds of vegetables: green beans, carrots, and corn so that eliminated a third of my vegetable choices) and had to drink these Sego shakes that tasted like chocolate and vitamins mixed together. I also wasn't allowed to eat the candy hearts my Girl Scout leader gave me for Valentines Day while my skinny sister could.
At ten years old I was pushing 120 pounds and the new pediatrician I had was particularly peevish about obesity, as the nurse in a quiet, frightened voice warned me after weighing me before he came in. Dr. P scolded me in a voice that was about as scary as my browbeating stepfather. He demanded to know how much I was eating (not any more than my scrawny siblings) and how much exercise I was getting (two-mile-round trip walks to school as well as kickball at recess). "You're lying," he insisted. Turning to my mother he said, "she has to be secretly eating." I didn't know what to do with that. I knew I wasn't lying, but he was an adult -- and a doctor at that.
Unfortunately, after I started getting sick a lot when I was eleven or so with what may have been the early stage of Chronic Fatigue Immune Dysfunction Syndrome, I had to see doctors a lot. Most of the time weight wasn't really an issue. I mean, you can't blame pneumonia or dysmenorrhea on being overweight. But then again, I've had an ear, nose, and throat specialist advise me about my weight even though he was seeing me for benign positional vertigo. And it was that constant possibility that I might be harassed for being fat that has had me terrified every time I go to see a new doctor. Last spring as the appointment with a neurologist approached, I thought I was going to start having panic attacks.
I find myself preparing for a new appointment like I might for a date. What outfit should I wear? I want to look like I take care of myself, so something somewhat nice. But not too dressy that it would be hard to get in and out of. Or look like I'm not really sick (yeah, having an illness that is not taken seriously hasn't helped). Maybe something sporty...
Of course, if they make me undress into one of those paper tops, it doesn't really matter anyway.
Studies (yes, nameless ones that I can't be bothered to look up) show that people who are overweight have a harder time getting jobs and are often paid less. Yet I've never found that to be the case with me. Jobs usually love me. The academy has adored me (well, most of the time). I have this way of wooing people with a combination of intelligence and charm.
But get me in a doctor's office, it's a whole different story. I don't even think to woo. I'm bad, and I know it. I timidly review what the problem is and submit to whatever the doctor decides.
It occurred to me a few weeks back to ask myself why. What have I to be ashamed of? Why can't I woo the doctors the same way I woo professors and employers? I'm hardworking when it comes to taking care of myself. Indeed, last month when we checked my blood sugar for diabetes because, well, you know, my obesity puts me at risk, it was 96. Not even close to diabetic.
And I know my shit. Sure, I have only a rudimentary knowledge of human physiology (I mean, damnit, I'm an historian who studies Arabic and religion, not the autonomic system and leukocytes). But that rudimentary knowledge is a hell of a lot more than most of the patients who walk through their door. Plus, I live in my body. I know every little thing it does. I know it way better then they ever will.
And yes, I'm fat. I haven't been below 200 pounds since I was 15, and it's very unlikely (barring a major medical breakthrough) that will ever change. That diet the first pediatrician put me on, along with all the dieting I've done since, has made my metabolism run so efficiently I could live through a biblical famine (though probably not through the accompanying diseases). The damage is done, and I have to live with the body I have -- as do they.
I've been practicing my wooing at the free acupuncture clinic I go to. A year or so ago I admitted sheepishly to the acupuncturist that I'd been eating some Ben and Jerry's frozen yogurt. "Oh god, if that's the worse you do, I wouldn't worry about it. Seriously, you take care of yourself better than most of the patients I see." Since then I've amazed the other acupuncturists (mostly students) I've seen there with my tales of making congee and doing qi gong. Just last week as I left my appointment, I could see that look in the new acupuncturist's eyes that I'm used to seeing in new professors.
So as I approached my appointment with the new urogynecologist, I decided to be that Michelle who got accepted to grad school at Harvard, Chicago and Georgetown. I prepared the night before by putting together a list of meds, supplements, and hospitalizations, as well as a review of symptoms, treatments, and other pertinent information. And yeah, I did put some thought into what to wear, which in the end didn't matter because I met the new doctor with my feet in stirrups. After the catheterized clean catch (the antiseptic way to get urine) and pelvic exam, I returned to a slightly more dignified position to discuss my problems with her. Like two equals.
Sure, it helped that this was a clinic devoted exclusively to women. That the doctor supervising the resident treating me was named one of the 400 best doctors for women in America (and held my labia open with a kind hand during the pelvic exam). But for the first time I left a first appointment feeling like I had effectively advocated for myself. Left feeling empowered. Left knowing this fat girl can woo doctors just as well as I wooed cynical, judgmental, well-published academics.