Fat Shaming And Scare-Mongering
So the other day I was on a visit
to a friend working at a large (lets leave it unnamed) famous corporate
hospital where I was waiting in the reception while my friend was busy with a
patient in one of the consultation rooms – professional courtesy requiring that
you did not disturb a man who is busy earning his living and just by
happenstance I managed to overhear what seemed to be a doctor couple counseling
a patient in one of the adjacent consult rooms – telling him candid stuff like “you
are too over weight, don’t you know that obesity kills?” and such stuff. While I
waited for the hither though unseen patient to exit out of the consult room
curious as I was to see such a morbidly obese patient on the verge of getting a
coronary, I was shocked to see a pretty normal looking guy in his mid thirties
with a mild paunch walk out of that room with a dazed expression clutching a
bunch of sheets full of tests to be taken. I was shocked to say the least and I
couldn’t wait to discuss this with my friend in the privacy of his consult room.
But he was largely dismissive of my concerns with “it’s just the practice
around here to get people to sign up for regular screening programs”. By then I
was seriously wondering whether I too should sign up for one of their screening
programs since I was way too over weight compared to the guy who had just come
out of the adjacent cubicle. In fact if I had even accidentally popped my head
into the other consult room- the doc’s there would have taken one look at me
and immediately admitted me into the ICU for a heart surgery. I guess I am just
exaggerating here or maybe not.
The thing is, ever since- for the
last six months or so- I moved out of doing cosmetic surgery and into working
with a surgical oncology group doing facial reconstruction for cancer patients
I have achieved a far better perspective of life and my profession than what I
used to believe in my younger days. Treating real patients with real diseases-
life threatening diseases made me realize the kind of stress I was dealing with
in my past practice- suppressing it with sweet words directed at clients who
were never satisfied and always wanted more –even if they (or their
husbands/parents) were paying for it through their noses. I feel such mental relief
that I don’t have to think anymore naughty thoughts about paying clients like “madamji,
all that botoxing and firming of your
upper back and arms to fit you into that sleevless, backless, strapless dress
is still not going to change the bitch you are basically”. I wish I had never thought
of such things but once the thoughts came in I wish I could have detoxed them
earlier from my consciousness. Pardon if I sound like an asshole but I am,
again, detoxing here.
Anyway to get back to the topic in
question- dealing with death, real death row patients just living out their
lives raises uncomfortable questions in my mind about the practice of the
medical profession to use scare mongering and even death mongering to make a
living. Haven’t we all – basically all doctors including me, been guilty of
saying at some point or the other of “oh, you are over weight? You are obese? You
have diabetes? You have hypertension (high BP)? You are going to die- you are
going to have an heart attack you are going to have a stroke or you are going
to have a so-and-so” just to get a patient to agree to some test or treatment
which we feel that they may hesitate to commit to? Even though we may justify
it as being in the patients best interests surely we alone know the truth if it
really was for the benefit of the patient or if it was a tight month with a lot
of unpaid bills piling up for us. I am not pointing fingers but just throwing
up some hard truths here.
Besides, the worst culprits in such scenarios
are not even the doctors themselves who know when not to talk too much but the
support staff - especially in the corporate hospitals who prime the patients
with fear before unleashing the doctor on the frightened patients. Naturally
people who cannot make the distinction between causal and casual take
association studies seriously enough to believe that they are going to die soon
and hence sign up for whatever unwanted treatment fads the corporate hospital
is pushing currently. At least when I was practicing cosmetic treatments the
most I could do was appeal to people’s vanity “I can make you look as young as
your daughter, madam, so that on her wedding night people will wonder who the
actual bride is” and such marketing spiels. But people who throw words like heart
attacks, strokes and deaths so casually frighten even me into believing that a
little bit of weight around the waist and you are a walking corpse who doesn’t
know it yet. Seriously dudes (fellow docs?) do we have to resort to this level
to make a living? Why don’t we tell those corporate receptionist/front office
types where they get off and stop scaring our patients? After all the real
judge of people’s lives are they themselves and if they do feel they don’t mind,
who are we to predict death for them? After
all we live in India- a place where death is a constant companion- your building
may collapse on your head any day you sit relaxed at home, a rich young brat
may plough his jaguar into you any minute on the road and even the police may
do an encounter death on you if they don’t find anyone else to fill their
caseloads by the end of the month- shit happens in India naturally so why add to
it by scaring people?
All I am saying is lets advice and
counsel our patients to our hearts content but lets do it in a postive way stressing
on the benefits of healthy living and being fit. Lets not use the threat of impending
death to make patients take notice/care oftheir own health. After all if it for
their benefit shouldn’t they invest in it? As someone once said, the truth
shall let you free- so lets all tell the truth and hope our patients take care
of themselves because they want to and not because they are afraid. Lets trust
our patients to make the right decision for themselves, ok?