Tuesday, April 25, 2006

Return to Sender

During my college years my best friend was a brilliant and artistic person, outspoken and strong-willed, but who constantly struggled with weight concerns. One summer they lost over 100 pounds, only to gain a fair portion of it back over ensuing months.

Later I came to understand just how typical this is, and I worked for a time in a hospital setting with bariatric surgeons and their patients. Now I am convinced that at this time the best treatment for many morbidly obese people is surgery; indeed, when I see a very large person, what I say to myself is not "that person needs to eat more sensibly," but instead I think that person needs surgery.

Many people do not understand this, and continue to think that diet will work for the morbidly obese. To such people I recommend this: go on a 1200-kilocalorie-per-day diet for the rest of your life, then get back to me. Good luck, and have fun.

Having said all that, some people are just fat obnoxious hate-filled pigs.

Like the patient in the corner room, whose call light was always on, whose family had continual little hissy fits over the most mundane things, whose nurse (thankfully not me) made every effort to please them and meet their needs only to get no appreciation for any of their efforts.

This patient was an unhappy sloth who saw it as their remaining life's goal to make as many other people also as miserable as possible, and after many decades of practice they had become quite proficient at this. And their younger family members, whose upbringing had convinced them that such ugliness was normal, played right along with it.

A sucking vortex of meanness and abject misery, plain and simple.

The day before yesterday was the patient's day to be discharged to whatever bright shining hell-hole they lived at, and the nurse was so happy in thinking that the patient would not be there in that corner room the following day. They rejoiced openly.

But on the way out to the stretcher van that was to transport the patient to their residence, the patient fell off the gurney and fractured a shoulder. They also probably broke a thumb, but the fear of a broken hip was ruled out on X-ray. The patient was re-admitted to the hospital and ended up in the very same room, much to the dismay of the nurse so assigned.

Paydirt. The mother load. Ka-ching.

Now the ugliness of their family misery was compounded by revengeful greed, and of course they've got a case.

Later that day I saw a couple strange-looking creatures, like the space lizards in Zathura only a little smaller, poking around until they finally found the patient and entered the room.

While they were visiting the patient did not put on their call light.; not even once, for about a half-hour. Then they wordlessly walked out and down the hall, eyes straight ahead.


The surgeons decided that the patient was not a candidate for repair, so the plan was to discharge them the next day with a sling for their arm and shoulder. Naturally "I'm so glad I have tomorrow off" was the nurse's constant refrain.


may said...

i don't want to "see" a lawyer. ever.

Nurse Mia said...

Difficult patients come in all shapes and sizes and ages. I've seen my fair share, as well. Hang in there.

gail said...

The lead to this tale makes it sound like it wouldn't have been so bad if this person wasn't fat.

And how is a fractured shoulder not "candidate for repair."

A hospital emergency room sent my mother [she was not fat, quite thin and petit] home with a broken arm (in two sharp pieces) with no more than bandages and a sling. It took over a week to get an appointment with a real doctor in his office. As soon as he saw the xrays he had her in surgery as quickly as possible.

Sorry fat people annoy you and you think they should be surgically altered. Perhaps the crew in the emergency room that took 'care' of my mother did not like petit elderly women.

Anonymous said...

As a "fat person" who has been surgically altered, I agree with you for the most part. Having lost over 200 pounds, I now find myself in the struggle to maintain my new eating habits after the surgery will no longer do that (old eating habits die hard, and can return)

I must admit, even at 500 pounds, those people who felt entititled just because they were obese grated on me then, too. I have some empathy, I know what its like when breathing can be an all-day workout.

But no medical condition entitles you to be an ass...

shrimplate said...


The patient had an INR of 5 or 6.

That is why the surgeons initially balked. Also, it was a fracture of apparently a "hairline" variety, for which surgical repair was less than appropriate.

Simple maintainence of bone position was all that was clinically required, and indicated by proper slinging.

Aside from that, she was a complete fucking asshole, which was not clinically of orthopedic interest.

The point of my post was quite the oppositie of that which you may have mistakenly assumed. "Fat people" do not annoy me. I have more than great sympathy for them. Heaven knows I am not one to cast stones.

I sincerely apologize for having been misunderstood. As I tried to make plain in my post, though I am thin, I have some great sympathy for those who are morbidly obese.

It is a condition for which I do not hold people behaviorly accountable.

That is one point you will see me make over and over in my posts. I belive morbid obesity is a surgical, not a behaviourable, problem.

Anonymous said...

I. Love. This. Description. Of. Lawyers.

Gail, I don't know why you're accusing the blogger of being annoyed with fat people. Did you skip over this part?

when I see a very large person, what I say to myself is not "that person needs to eat more sensibly," but instead I think that person needs surgery.

Many people do not understand this, and continue to think that diet will work for the morbidly obese. To such people I recommend this: go on a 1200-kilocalorie-per-day diet for the rest of your life, then get back to me. Good luck, and have fun.

Are you unable to recognize compassion?

gail said...

Dear shrimplate,

Yes it was me, or I, that felt there was an anti-fat prejudice pervading your post. I enjoy your blog and have a sense that you are good at your job and a caring person.

And I appreciate your clarifying the issue of the shoulder.

That said writing that you don't blame the fat or have the utmost sympathy for them, in itself, doesn't negate my impression about what you think about fat people.

There are many fat people who certainly do not need surgery. Perhaps you were refering only to those who cannot carry out daily tasks or take a hike, etc. I don't know.

There is a blog that may be of interest if you are interested in getting a view of how 'fat' people view, and take on, a world of prejudice: www.bigfatblog.com

Where does 'fat' end and 'morbidly obese' begin?

shrimplate said...


Again I apologize and I am very sorry if I offended you personally.

Generally speaking, having a body-mass-index of 40 or higher would qualify a person for being described as "morbidly obese." and I firmly believe that, at this time, the only real treatment for this is bariatric surgery.

I have seen too many friends go on the roller-coaster of unsuccessful diets to think that there's any behavioural remedy for this condition.

Perhaps someday a medical treatment will be discovered that will precede the need for a surgical approach to morbid obesity.

Please accept that I am not "anti-fat," for indeed I am actually quite thankful that people come in a wonderful variety of shapes and sizes, and I have been known to enjoy many of these, pardon me, sensuously speaking.

There is nothing in the world more beautiful than a Renoir bather.

I am, however, enormously fearful and prejudiced against psychopathic fucking assholes, irregaredless of their physique.

Thanks for the link, and keep up your good work.