Ms Crankypants. April 15, 2008Posted by phledge in black bile, fat, health, medical school, osteopathy, yellow bile.
If I seem a little less than graceful or generous it’s because my campus in deep in the throes of what is being called “Fit For Life Week.” The motivation behind this is misguided at best and fat-phobic regardless. The current president of the American Osteopathic Association, a Dr Peter Ajluni, has taken it upon himself to overcome Teh Obeeeeeesity Crisis!!!!1!eleven! during his tenure which, thankfully, ends in July (the tenure, not the so-called crisis—forsooth, something can’t end if it hasn’t yet begun). His presidential theme is “DOs: Fit For Life” because he thinks that it’s absolutely shameful for osteopathic physicians to not look good. Oh, hell, let him tell the story:
I could freaking go on. My favorite?
Many resolutions as well as my inaugural address focused on fitness and obesity. I believe it’s important for us as DOs and future DOs to set an example for patients by living a healthy lifestyle that includes exercise and eating heart healthy foods. After all, would you go to a dentist who had bad teeth or a barber/hairdresser who had a bad haircut? Probably not. So my theme this year focuses on us getting in shape.
Yeah, except, raise your hand if you know what’s different about fat as a marker of your health? That’s right, it’s a fucking RUSE. (And a funny commenter on that page mentioned that getting a bad haircut is the responsibility of the barber’s barber, not his own doing.) As a physician am I supposed to be posting my blood pressure, cholesterol count, and 5K times on my front door? Or should I just let my patients decide that I’m unhealthy because I’m not the size they and the dominant culture think I should be? OR, Maude forbid, they can come to me because I’m compassionate and competent and because I treat them like humans instead of approaching them as the godhead to which they should all aspire? What? How is that, what you say, revolutionary?
Oh, and also? Make our profession a place such that it is FUCKING POSSIBLE to lead this life you purport is so crucial for good doctors. Not “hee hee the ACGME put work limits on residents but we don’t have to.” Not “we support insurance companies so our members have to see forty patients a day to meet overhead plus loans hee hee.” And sure as hell not “what do you mean you have to spend most of your waking hours explaining what a DO is hee hee?”
My problem (besides the brain damage) is that someone is asking me and my colleagues to be “perfect.” That just in case it’s not already difficult enough to be a good doctor in this sue-happy, managed care nightmare that is modern medicine, we are expected to be models of health, wealth, knowledge, saintly behavior, and probably good taste in luxury goods. That in order for me to be an excellent physician I have to be an outstanding role model in all of my representations. The unfortunate fact is that my weakness (if that’s what you want to call being fat) is visible, like a bad haircut or dental caries, while others’ weaknesses—beating their spouses/children, abusing both legal and illegal substances, engaging in high risk behavior such as speeding, gambling, and unprotected sex, or just generally being a tool—are easily overlooked. Oh, and that my “weakness” doesn’t hurt ANYONE ELSE while, well, there’s some shit that just won’t fly when it comes to keeping your license (although if Dr Marathon had his way it’d probably be grounds for revocation of licensure to be faaaaaat). If El Jefe Osteopatico deigned to meet me he would discover that I swear and I am fat, but that I’m one of the top students in our class and, damnit, people like me. (Disregard the fact that I am blogging during a pathology lecture.) There’s just so much wrong about it that I feel like Prometheus.
Which brings me to this week.
Thus far we have had two presentations in concert with our FFL Week: first, a lecture about how to eat healthy on a small budget, by a registered dietitian. Hey, I’m okay with that, actually! Someone finally addressing the fact that socioeconomic factors can impact your food choices! Wow! Someone has a neuron! But wait. The student group endorsing this event put a flyer together that had a picture of a headless fatty (eating, no less—the horror!) with the caption, “Look like this?” next to a picture of a male and female model in bathing suits with musculature consistent with a body fat percentage in the single digits, with the caption, “Learn how to look like this!” followed by the information for the talk. No no no no no NO. I couldn’t go to the talk due to a previous engagement, but the flyer haunted me for days.
Second presentation was “Lose Weight In Medical School?” Okay, I have to point out how ridiculously close that comes to one of those cheaply printed signs one sees on interstates and nailed on telephone poles, short of saying, “Ask me HOW!” And even then, the flyers they put out specifically said, “Hear personal success stories of weight loss in med school, how they did it and what they recommend.” I had every reason to believe that I might have spontaneously combusted if I went to that presentation, and in all honesty I like the people whose “success stories” were being showcased so had I become a feverish drooling case of pseudorabies on their asses I would have ultimately felt really bad.
Now, remember, this is about being “Fit For Life.” I must absolutely, unequivocally state that I am ALL ABOUT people being able to eat pesticide-free fruits and vegetables, naturally-raised animal products if they so desire, whole grains as their GI systems can stand them, and a wide variety of foods they like for whatever reason they have. I am ALL ABOUT shifting our concept of physical fitness to disclude painful, joyless exercise regimens in which one partakes because otherwise they’ll die die die, and to include movement of all kinds that gives the physical and emotional body the numerous benefits associated with stretching, strengthening, challenging, expressing, and loving the activity.
I just think it’s incredibly fucked up to say I have to or else I’m a Bad doctor/you’re a Bad patient/we’re Bad people. I think it’s incredibly fucked up to say that these things don’t matter if we don’t look like we do those Good things. I think it’s incredibly fucked up to tell physicians-in-training that anything less than these judgments are malpractice, not standard of care, not in the patients’ best interest, and why don’t you just go stomp on kittens while you’re at it?
That’s why I’m cranky. Mr Phledge wisely noted that, “if you’re not pissed off, you’re not paying attention.”