For the record, and before the medical folks who read the blog feel it necessary to chime in, I am not saying that obesity does not pose any risks to either general, or pregnant health. But so do a zillion other things that have nothing to do with body mass (like, do you live on land that used to be farmed? Do you live in a high-pollution area such as, say, Beijing? Do you not take prenatal vitamins because you don’t like pills? Did you get pregnant while on any number of prescription drugs? Are you underage? Overage? Have a chronic disease that hasn’t yet manifested? One that has? Was your mother a nutjob who refused to have you vaccinated for no good reason?). As long as you’re not fat, you can be pretty certain that you won’t have some jackass with a medical degree (a D.O. in this case, which makes it worse, since supposedly they’re trained to see the whole person in context–my GP is a D.O., so I do not suffer from that particular prejudice–in fact I kind of expect more from them than from MDs) treat you like you’re undeserving of basic decency. Which is not to say that there aren’t plenty of jerks out there practicing obstetrics and treating “normal” women horridly, there are, but being not-fat increases your chances of being treated civilly considerably.
34 years ago, when I was pregnant with my first child, my Ob/Gyn, who’d been a family friend (my father being a dentist, we had lots of medical folks in our circle) whose sense of humor I’d always admired (he hung IUDs on his Christmas tree…) informed me solemnly that my pregnancy was high-risk because I was fat. I asked why. He muttered a bit and then blurted out that 9 out of the last 10 fetal mortalities at the Hospital I was worried would intervene excessively had happened to obese mothers. I shot back that he hadn’t told me anything about those mothers’ pre-natal health, their pre-natal care, their socio-economic status, or their ages, and that the absence of any of that information rendered his single statistic invalid. He replied with an eye-roll and the concession that I could crouch in the corner and howl for all he cared as long as I had the baby in the hospital. This all happened after he’d (as I later found out) lied to me and told me the local Birth Center wouldn’t/couldn’t take me because of my weight. There are now state laws that might have prevented them from taking me, and they’re bullshit, but back then, he was just plain lying. Happily, he was not the OB from his practice who was on call for either of my labors. Unhappily, because I was in the damn hospital, no one made me get up off my exhausted ass and walk my way through the ineffective contractions that were an exact match of my mother’s first labor (both of us almost died, for a variety of dumbass reasons) and her mother’s (my would-have-been-uncle did die). In my case, 24 hours in, they gave me some Pitocin and my stupifyingly beautiful and healthy daughter popped out 45 minutes later. So it turned out fine, but the midwives at the Birth Center would have had me walking, and it also would have turned out fine and taken much less time.
That daughter has now had two gloriously healthy babies while fat. My younger daughter (a rather easier 7-hour natural delivery) is now 26 weeks into her first pregnancy. About 6 weeks ago, she and her husband, for a long list of smart reasons, moved in with us from out of state, and she had to switch OB practices. She didn’t get into her first-choice practice because it was full, so she ended up in a practice that has superb docs and midwives and NPs, but the worst office management in history (I left it because of that, though I really liked my doc), and that practice sends all its patients to Maternal Fetal Medicine at Christiana Care for their sonograms. MFM used to just be for high-risk pregnancies (real ones), but Christiana Care, the local corporate-creepy hospital near-monopoly has recently undergone something of a conversion and radically lowered its c-section rate, radically upped its lactation support, and managed to turn around what was a pretty dismal rep. as maternity unit. So, good. Great, actually. But part of that whole transition has been to extend the reach of MFM. So off our daughter goes to her sonogram, which went fine (nice wiggly baby girl in the precise middle of the size chart), but then The Doctor (Anthony Sciscione, and yes, I am calling him out), who had never met or seen our daughter before that moment walked in, plunked his arrogant, fat-shaming, sadistic, misogynistic ass down and announced to her that, in spite of her blood pressure being 110/60 and her blood sugars being (as far as anyone knew–which has turned out to be true) absolutely normal, and in spite of the fact that she has a very physical job, so is moving and lifting stuff all day, she was at serious risk of STILLBIRTH simply because she’s fat. He managed to reduce a tough cookie to tears (not hormonally induced–rage-, humiliation-, and terror-induced). What the fuck sort of physician says that shit to a woman who is 24 weeks pregnant????!!! With a healthy baby and no family history of bad outcomes???? What the fuck sort of human is that cruel to any other human, let alone a pregnant woman? Well, I grew up hearing that there were, generally speaking, specific personalities that tended to be attracted to specific medical fields and that the two specialties that tended to attract sadists were orthopedics and Ob/Gyn. Way to inhabit an ugly stereotype, Dr. Sciscione…
I know doctors are trained to despise fat men and women. I’ve been talking myself blue in the face about it for ages, so I’ll spare you that specific rant. But this is up there with kicking puppies and tripping the aged. There is no medical justification for threatening a pregnant woman whose medical condition is lucidly healthy with the worst thing a pregnant woman can think about. Stress is not medically useful. Humiliation is not medically useful. And his demeanor was in no sense either medically useful, or humanly acceptable.
This is Delaware. There is a mathematically significant chance that I know someone who’s a friend of his. Maybe even someone who would testify to his sterling character or medical brilliance or even his deep feminism. There is even a chance that I may run into him one of these days. I hope so. Because he was a sadistic shithead to my daughter BECAUSE she’s fat. And that is medically inexcusable.
Yes, she will be sending a letter to his immediate superior, along with several articles about the real damage done by fat-shaming, the invalidity of much of medicine’s approach to obesity, and some suggestions for alternate careers for Dr. Sciscione. Preferably somewhere his mysogynistic carcass will never be near another woman.
For the record, the nurse he then handed her off to so she could be trained in how to treat herself like a diabetic disaster-in-the-making started out by handing her a tissue and speaking softly and respectfully to the pregnant woman in front of her about how to manage any remote-but-potential risks without using terrifying language or treating her like a moral/mental deficient because of her size. And the front desk staff explained to her, without comment, how to avoid ever having to speak to Dr. Sciscione again. Almost as if they know how much of a toad he is. Nurses always know.
A couple of infuriating/frustration-inducing things have come my way in the last week (aside from the terror/anguish/guilt/fury cycle that is the larger-world news) about fatness and fatitude. The first was an article from a research study in Britain (with a whole 38 subjects!!!) that concluded that fat people have fewer grey cells in their brains. If you’ve read more that 2 of these blogs, I don’t need to tell you my opinion on that.
The second was this: https://www.buzzfeed.com/louispeitzman/it-gets-better-unless-youre-fat?utm_term=.wiwpYMgJD#.hnOMZ3PVL which was re-posted on Weighty Matters. I’ve re-re-posted it here because it’s probably important for people to remember that just because some progress, even large progress, has been made in one area of human rights doesn’t mean that the issue is over and done with. And I suspect that there are some readers out there for whom that piece is a sort of balm, in that it names a piece of their reality that has been mostly silenced.
But then this popped up on FB today: http://www.theestablishment.co/2016/05/05/depression-busting-exercise-tips-for-people-too-depressed-to-exercise/
The blog is the sanest thing I’ve seen about exercise in a long time. It swings a bat at the exercise industry’s obsession with perfection and better-better-better-ism (which is a weird mirror of quarterly capitalism, come to think of it…). It also treats the relationship between depression and exercise with humanity and calmness. It is the opposite of the dumbass article I ran into recently that “suggested” (as in Drill Sergeant) that in dealing with either type of diabetes, you should do at least an hour of cardio a day as well as weight-training 3 times a week and some form of stretching three times a week. I was so stressed by the time I finished it that I wanted a nap. Sarah Kurchak, on the other hand, says things like “…if you’re still here, you’re already doing the hardest workout imaginable.” I wanted to kiss her, except she’s (according to her bio) on the Autism Spectrum, so that would just be mean, me being a complete stranger and all…
Meanwhile, I want to take a minute to bitch. There’s a woman at my church I actively avoid talking to, even though she’s super actively engaged, so we cross paths often. She’s maybe 10 years older than I am and loves to talk about how she’s still wearing the same size she wore in Junior High. But she also loves to talk about my body, and the bodies of every other fat woman in our congregation. I’ve been wimping out for years on just saying to her “Please stop talking to me about my body. It’s MY body, and mine to deal with, and you are not expressing concern or support, you’re stroking your own ego.” I should probably leave out the last part. It weirds people out when you explain their own language to them, and makes them defensive–a thing I have learned in discussing my Least Favorite Hymn with people over the years–the theology of “I Am the Bread of Life” is ickily triumphalist and the words don’t scan–and they look hurt because I’m suggesting that their theology is triumphalist and exclusionary. It’s kind of like trying to explain to someone from the “Heritage, not hatred.” crowd why their Confederate flag sticker really does mean they’re a racist. Doesn’t tend to go well. Anyway, I keep wimping out. It’s partially the culture of niceness that pervades church communities (more often a good thing than not, but sometimes…), and partially because I don’t trust myself not to be self-righteous and aggressive. It’s funny that something like this should be so complex–I need to avoid her long enough to calm down about her enough to be able to call her out on invasive and passive aggressive behavior.
And, God, if it’s that complicated to ask someone to stop talking about my body (which means that my body size is a very large component of her ideas about who and what I am), then imagine how complicated it is (big leap coming) to talk about race. But we need to find ways to stop being wimps without becoming screaming jerks (or worse), and that’s getting harder day by day. Which is depressing and paralyzing. Continue reading
Just because it’s angonizingly frustrating to those of us who are round that some people are just plain skinny by nature/genetics/disposition doesn’t make it okay or useful to hate them any more than it’s okay for minority folks to hate majority folks, or non-normative folks to hate normative folks. Sheesh, it’s tough enough being a round peg in a narrow-normative world without wasting energy on hating those who happen to fit. Not that I haven’t been guilty of it–envy is a cancerous beast, and I have to fight with it all the time. That’s human. But loathing begets nothing but loathing. Which begets more loathing…
If I despised all the friends who have things I don’t, it’d eat my entire brain. Cripes, making the list alone would take an afternoon. And I’d be a despairing, self-loathing tangle of bitchery at the end of the afternoon.
Skinny people who work at it have bodies.
Skinny people who don’t work at it have bodies.
Fat people who are somewhere in the “engages in healthy behaviors” range have bodies.
Fat people who are fat for complicated reasons, or genetics, or whatever set of reasons have bodies.
Bodies deserve kindness. Or, at the very least, courtesy. Right? Ditto the planet that holds all those bodies.
That’s kind of an important thing if humans are going to make any progress. Which is looking increasingly critical. We are screwed up around here (by which I mean Earth), and spending way too much time figuring out who to hate.
Here endeth today’s sermon.
On the off chance that you missed this:
I’ve spent much of the day working with a friend’s poetry manuscript, grateful for her humanity, and her love of the messy natural world as I process, distractedly, what happened in Orlando last night.
I am cynical and bitchy enough to suspect that the members of the Orlando Chamber of Commerce are more worried about what will happen to their city’s image (Disney! Universal Studios! Disney! Florida Sunshine!) than they are about what happened. Sometimes I remember my manners and my religion and try to forget what I’ve seen come out of the mouths of other members of other Chambers. And sometimes I remember to be human (in the sense of Menschlich) to imagine that most of them will be grieving with the rest of us and maybe standing quietly in long lines, trying to stay hydrated enough in the Florida summer sunshine to be able to give blood. That some of them may have quietly given some of the hundreds of thousands of dollars to the GoFundMe site for the victims and their families.
But Trump and Pat Robertson and dozens of other heartless drones of conservative fundamentalist (religious or not) patriarchal pseudo ideology will break into my attempts to remember to be human and make me wish, against ALL my own moral/ethical/religious beliefs that they would die painful deaths, or at least that the testosterone-generating parts of their bodies would just fall off.
I don’t much like who I am in the face of stuff like this.
So I am going to keep reminding myself that Donald Trump’s chubby body is sacred. Pat Robertson’s scarecrow body is sacred. The bodies of the Orlando shooter and the guy they stopped from blowing up the Gay Pride parade in L.A. are/were sacred. And if their bodies aren’t then neither is mine.
I don’t mean that all lives matter, although it would be good if we could collectively get that through out thick damn heads. “Matter” is different from sacred.
Sacred means that black lives get to matter more noisily until there is no difference between having a black body and having a white body.
Sacred means that fat bodies matter until the hive-mind stops thinking they are ugly/gross/indicators-of-immorality-or-failed-character.
Sacred means that LGBT bodies matter because ALL bodies get to chose who to be and who to love and too many people want to chose for them.
Sacred means childrens’ bodies matter terribly because they’re fragile and we continue, too often, to believe that hurting them is ever an act of love.
Sacred means women’s bodies are theirs, and do not owe anyone pretty-ness or smiles or any kind of access.
Sacred means that General Westmoreland looking into a camera and explaining that it was okay to kill Vietnamese people was okay because they didn’t value life as much as Americans did scarred the minds of a generation, as it should have.
Sacred includes Muslim bodies. Even the bodies of members of ISIS. Which was hard to type. It includes the bodies of all 57 religions (and atheism) whose symbols Arlington places on gravestones. It includes the bodies of humans who do unspeakable things to other humans and to other species.
Sacred includes the bodies of cis-hetero white men.Even the assholes in the booth next to my daughter this morning who were being so vilely sexist to the waitress (I gendered it on purpose) that they drove her out of the restaurant before she’d finished her meal. Scumbags. But sacred.
Sacred includes the bodies of every human I wish I didn’t have to share planet-space with. This kind of sucks. Not least because it involves staying conscious that it includes my body, which I have not always respected or treated kindly, even though others have loved it and it bore my children, who are my heart.
I suspect that’s the thing about sacredness. It demands that we, whether religious or not, understand that we must all exist together in something more powerful than “tolerance,” though that would be a start. It doesn’t mean that Omar Mateen wasn’t a horribly damaged and horribly vile human. But he was a human. If we make him into a monster of any sort (If I make Donald Trump into a monster of any sort…) we deny that part of ourselves that we, to varying degrees, have to work on keeping at bay. Recognizing the sacredness of other human bodies means we have to recognize them as family. No matter what.
This doesn’t mean that I wouldn’t have shot Hitler or Mateen, given the chance and if that had been the only way to stop them. Hopefully, I can stop Trump by voting (though Delaware is not exactly a swing state). I might not even feel I’d violated my own codes for long. I have no way of knowing, and hope fervently that I never find out.
I’m talking to myself as much as I am to you-who-read-this. Maybe more.
Maybe Flannery O’Connor was right and “Beauty will save the world.” In which case I’m going back to working with my gorgeous friend’s gorgeous poems.
Predictably, there is some pushback to the NYT article about the wretched long-term results for The Biggest Loser. The Washington Post shot back with
I was, frankly, a bit surprised by the moderate tone of the WaPo article. Sure, it (as did the NYT piece, though even more briefly) argue for bariatric surgery, citing a study that showed the the metabolic kickback that follows bariatric surgery disappears after a year. Which is interesting, though it only tracks one aspect of post-surgical affects.
The TBL folks are, indeed,”outliers” as the WaPo article says, which is why they are both deeply relevant to the larger discussion and irrelevant at the same time. Relevant because they have been driven into what amounts to functional eating/exercise disorders during their tenure on the show, which is not at all unlike what many “medically supervised weight loss programs” do.
There are several new bariatric procedures–all considerably less invasive than the standard ones (and mostly not covered by insurance, of course). There’s the Gastric Balloon, in which a saline-filled silicone balloon that’s inserted in stomach for 6 months. There’s AspireAssist, which is kind of gross, in which a sort of tube-and-valve system is implanted that allows the patient to physically dump about a third of what she/he consumes directly from the stomach–this one sounds like a medically supervised form of bulemia to me, but I suppose it’s considerably easier on the esophagus and teeth. There’s one called vBloc which involves a pacemaker-ish thingy that’s plugged into a part of the lower stomach where nerves control appetite. It’s kind of a TENS unit for your appetite, a neuro-regulator. It claims a truly tiny complication rate. And there’s Bariatric Emobolization, in which an interventional radiologist implants teeny beads at the end of veins leading to that same appetite controlling area of the stomach. Also interesting–esp since cardiologists have been using a similar procedure for enough years to have some idea of how it works.
All these procedures are out-patient and only involve Versed or similarly lightweight anasthesia, which is a good thing. I got pretty excited, in truth, about the vBloc, until I read that having a hiatal hernia takes you out of the running for it. But, supposedly, I could get my occasionally very painful hiatal hernia repaired (which I gather, might also cut down on heartburn, so maybe…). Oh yeah, it also requires, at least according to the web page, that I have undergone a “medically supervised weight loss program” before trying it, which is just bullshit.
Maybe these procedures will pan out. They’re all new enough not to have serious longitudinal studies done. That being said, I am kind of tired of my own heft and the whackadoo cycle of depression that leads to not exercising that leads to eating really badly that leads to feeling shitty about myself. Decades of therapy have not dislocated that cycle, and no amount of body-positive discourse is going to dislodge it. Watching my skinny mother slide into dementia has added an absolute terror of Alzheimer’s to my psycho-cognitive atmosphere (I also have rosacea, which apparently indicates an increased likelihood for Alzheimer’s–like having zits at 60+ isn’t enough of a bummer), so the weather is getting kind of stormy up there, which feeds the depression, and so forth, and so on. Fuck it.
Lots to think about (well, definitely not the one with the valve-thingy). So here I am wallowing in what feels a bit like hypocrisy because I have spent so much time on the blog railing against bariatric surgeries (I still find the violence involved a difficulty on many levels). But these are “procedures,” not “surgeries,” and that’s a big difference.
And I will admit that I have been profoundly disturbed by the discovery that organ donor programs don’t want mine because of my weight and the “black fat” that surrounds them. Until they get the growing-livers-in-petrie-dishes thing worked out, I’m kind of attracted to the idea of my bits helping someone else hang in there. I know it’s a funny thing to be focusing on, but there you go.
No conclusions here. TBL is still evil. Weight loss/management is still mysterious and overwhelmingly mistreated by the medical community. The body-positivity and health-at-any-size movements are still good things, especially for younger humans who can still be taught not to regard themselves as monsters. And I am still here and trying to figure out how to have a body.