Friday, December 5, 2014
Fat Shaming And Scare-Mongering
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?