I began having pains in my breasts in the summer of 2011. At first they were mild and transitory, but by Halloween they were much worse. The pain was constant and I could feel hard masses when I examined my breast tissue. I had put off going to the doctor because I didn't have insurance, but by then it was necessary.
The trouble started the day I called the office. I had been a patient with this gynecologist since I had graduated from high school. I told the nurse in reception what was going on and she pulled up my patient data, then proceeded to tell me that they didn't have an opening until January. When I reiterated that I was feeling painful LUMPS in my breasts, and could I speak to her supervisor, she magically found me an appointment with a different doctor in the practice. I was desperate, so I took it.
The visit was a disaster from start to finish. I was beyond nervous, and when the nurse asked what was wrong, I told her. Her response was a raised eyebrow and an “Uh huh.” Then, when she took my blood pressure, she pumped the cuff up high enough to leave a bruise ring all the way around my arm -- and I don't bruise easily. So it really wasn't surprising my pressure read as high. Not super dangerously high, but definitely not my normal.
Did that stop the lecture? No. Nor did she ask questions about my eating and exercise habits. She just assumed I ate sugar and fat all the time and never exercised. Vocally.
“You really should eat less and move more, regular exercise is good for you,” the nurse said. “And definitely cut down on all the ice cream and cookies. Have you ever tried fresh fruit?”
Those words and her tone of voice, her whole attitude, are burned into my memory.
Let me reiterate. Out of all the questions she asked me, not one was about my food intake or exercise habits. Nope, no questions on that subject at all. Instead she made assumptions about me based on nothing but my body size and blood pressure, which was high because of those not-so-little anxiety and panic disorders I have. They had kicked into overdrive once I realized I might be facing breast cancer.
I won't even discuss what happened when they put me on the scales against my wishes. Some things are better left repressed.
It was humiliating and frustrating and I felt like all I could do was sit there and take it. I should have been on fire with anger, but I realize now I was going into a form of shock.
And I hadn't even seen the doctor yet.
When I finally did see the doctor, she was distant and hardly touched me. As in, she kept a foot of space between us at all times (not office policy or typical for her; I asked about that later). Her fingers barely made contact with my skin. It was maddening. How was she supposed to diagnose anything if she barely laid a finger on me? Did she have X-ray vision?
After a few minutes of this, I asked her if she wanted me to guide her to where I was feeling a lump. She agreed, and when I put her hand right on one of the “lumps” and she finally — finally! — actually touched me, I thought we were going to get somewhere. So it was a shock when she pulled her hand back after barely 20 seconds and said my breast tissue was too dense for her to feel anything. She couldn't make a preliminary diagnosis from the physical exam.
What physical exam, I wondered?
She ordered blood work and recommended I have a mammogram and ultrasound. Then, as she was finishing the chart, she looked up and said, "With your blood pressure and weight, have you ever considered bariatric surgery? You should. It would help a lot."
I was floored. That is not a subject you broach with someone who is worried she might have breast cancer. It's just not. Period.
Why would anyone do that? How is weight-loss surgery going to “help a lot” if it's cancer??
I got out of there as fast as I could.
Sitting in the car afterward, all I could do was shake and cry. I knew, on some level, that I had been treated horribly, but I never said anything to anyone about it. These people were medical professionals, they had my best interests at heart. Right?
This is what I told myself as I waited for my next appointment, this time at the imaging center.
Thankfully, the imaging specialists and the radiologist were far kinder. I was also relieved to learn it was not cancer. My problem was a massive hormonal imbalance that was causing all the glands in my breasts to swell to ridiculous proportions and harden. It was causing other problems, too. I was referred to an understanding endocrinologist who didn't automatically assume anything. Instead, he actually took the time to listen to what I had to say, to look at test results, then explain the drug interventions I would need to start treating the problem.
Not once did he bring up my weight. Nor did he act like I was a freak of nature. I was treated, surprise surprise, like a patient deserving of care.
To paraphrase Marilyn Wann, the only things you can tell by looking at a fat person are 1) the person is fat and 2) the degree of your own bias and prejudice against fat people.
Being fat is not an excuse or reason for bad healthcare. There are no "fat people" diseases; skinny people get diabetes, high cholesterol, high blood pressure, etc., too, only they get proven health interventions from the outset. Doctors and nurses should not be fat-shaming patients who are there because they're scared they might have cancer, or Parkinson's, or any other disease. They should not be fat-shaming their patients at all, ever.
Fat-shaming doesn't work anyway. For the most part, all it leads to are more humiliated, scared, frustrated people who avoid doctors for fear all of them are assholes.
People like to accuse fatties of “doctor shopping” because we don't like what we're told. I say it's more likely we don't like the way we're treated. There's nothing wrong with demanding unprejudiced treatment and evidence-based healthcare -- and leaving if you don't get them.
I learned this lesson the hard way. It's my hope others won't have to.