There's this strange place I inhabit, a fine line I walk between being a virtual hypochondriac who obsessively searches herself for signs of catastrophic disease and being a woman who dreads going to the doctor's office. Here, the intriguing intersection that shapes my identity--that fact of being a fat, black, once poor woman--has influenced, probably dictated, the treatment I receive behind medical offices' closed doors.
It began when I was 18 or 19. Home from school, I went to the parish health unit to receive a prescription for birth control pills. Newly sexually active--but not all that naive--I tried to answer all the nurse's questions truthfully. She asked these two back-to-back: Do you use a condom each time you have intercourse? Have you ever had an STD? My answer to both of those was no--a contrite "no" to the first, of course. But my contrition was not enough. She stopped in her survey and told me, "You're lucky. Next time he might shoot you up a load of AIDS." Now, that may have just been her way of talking or her attempts to scare me into safer sex, but I was humiliated. I left that day and have never been back.
5 years later, and 5 days overdue, I went to my hospital's maternity ward complaining of back pain, and a trickle of fluid from "down there." I had a "new" nurse who told me that as long as the bottom line on the monitor didn't move, I wasn't having contractions. Well, the bottom line kept moving and she kept saying, "You're not in labor. Your waters haven't broken." She kept trying to check my cervix, was unable to do it, and had to call in another nurse repeatedly. I lay on my back from 9:30 to 3:30, in pain, until my impatient, angry sister said, "We're taking her home." A few hours later, I was back, straight into delivery, amnitoic fluid long gone. Afterwards, in an obvious face-saving move, the doctor told me, "First babies come fast like that some time." He couldn't explain why the nurse didn't know my water had broken.
Fast forward another 5 years (and several horrible experiences later). My PCP in my late 20s was a brusque woman who was absolutely appalled by my "choice" to be fat. I went to her for over a year, feeling that I deserved her insults, hoping they would spur me to do something. Some of the most memorable:
(When having me stand and stretch) "Stand with your feet together. Well, as close as you can get them."
(When I went to her crying with back pain) "You should really consider getting your breast size reduced. If you lose weight. As far as the pain, I'm not going to treat the symptoms if you won't remedy the underlying cause."
(During a routine check-up) "Your knees and back are going to be gone in a decade.
(During a painful Pap smear) "I'm sorry, but I have to press harder and really search for (whatever the hell she was looking for) in a woman your size.
Only after talking to some friends, who looked at me as if I was crazy when I talked about my experiences, did I realize I didn't have to take that treatment, that maybe every complaint I had was not an outgrowth of my being big. I mean, I went to the ER after the back fiasco and found out I had pulled a muscle and I'd never had a painful Pap before. I could be hurt or sick in a way unrelated to my size. That was amazing.
The latest incident involved an ER visit with a seemingly nice doctor who apparently decided I was a moron:
"What's bothering you?"
"Abdomen and lower back hurt badly. Really bad nausea. My doctor can't see me til Wednesday."
"Does it hurt when press here? Here? Can you jump? Does that hurt? Can you bend? Does that hurt? Has it gotten any better? Are you sure it's your abdomen and back? Do you think you could be pregnant?"
I answered each question patiently. Then he asks:
"Have you eaten?"
"Because of the nausea."
"What about it?"
"If I eat, I'll throw up. If I throw up, I can't stop."
"Oh. Well, are you hungry?"
"Okay. Would you like someone to bring you something to eat?"
"Fine. Are you sure you're not just hungry? Have you eaten anything?"
Five minutes of this until he decides that, despite the fact that I'm fat, maybe, just maybe, I'm not currently interested in food. Eventual diagnosis: bladder infection.
I'm really curious as to whether this is commonplace. Do other people experiece it? Am I just especially sensitive? And no, I don't mind my doctor saying, for your health, you should consider weight loss. My current PCP said just that, but she talked to me about methods, alternatives, etc. without being condescending or cruel. She works in a clinic that sees mostly underserved clients which is why, despite the long wait for appointments, I chose her. So finally, I'm happy. I get to be treated like a whole person and not some conglomeration of unappealing parts.