I was exhausted. My therapist had enough. I could see it in her face. She knew. We had been spinning in circles for months.
“There’s only so much we can dig here,” she told me. “Your baby hasn’t slept in two years. Your mom is dying. There is a global pandemic. Give yourself a break?”
I needed an antidepressant. I had avoided them for 15 of my 35-year life. But my resolve had finally shifted. I was tired of caring only for my two small children and my husband. I wanted to care for me.
So I called Dr. J. He wasn’t just a random doctor. He was my family doctor. He had treated my parents. My grandparents. My aunts and uncles. He had treated me since I was in grade school. I walked into his office looking like a mess. Greasy hair. Dark bags under my eyes. I felt relief. He knew me. He would help.
I have always been a fat person. I weighed over 10 pounds at birth. Two weeks late. My mom used to tell women about it with a knowing, exaggerated eye-roll. A giant episiotomy. She never let the story fade. I never grew out of it. I tried Weight Watchers at 12. At 22. I climbed up and down 60, sometimes 70 pounds at a time. I pressured myself to squeeze into a wedding dress because I didn’t want to “regret” the photos.
But here I was. And now, my size was the least of my problems.
“What’s going on, Sara?” Dr. J asked.
“I’m in therapy,” I said. My second child was up every night. For hours. For two years straight.
“The second one comes in like a bat out of hell,” he nodded.
“I have no help.”
He nodded again. He knew about my mom’s dire diagnosis.
“She’s dying.”
I couldn’t lie. Not about this. Others danced around her cancer. They acted like she was some warrior defeating an enemy. Even the most advanced scientists can’t beat this. I saw her suffering. If she could have, she would have been there every night to help me with the baby.
“My therapist wants me on an SSRI,” I said. “I haven’t slept in two years. I’m parenting two small kids during a pandemic. And I am watching my mom suffer through treatment when we all know she is terminal. I’ve avoided antidepressants for a long time. But I’m ready now.”
“We can do that,” Dr. said. “No problem.”
Relief washed over me. I grabbed my coat. I breathed.
“But we gotta get you on the scale.”
“What?”
Sweat prickled at my hairline. “The nurse didn’t record it?”
“She didn’t. I need to write it down. Step on up.”
I laughed. A little nervous laugh. I had told the nurse earlier I didn’t need to be weighed. I had enough troubles in my head. But I had made a point to say no to things bad for my mental health. Why break that rule now?
“No,” Dr. J said. His voice dropped. “You do.”
I stared at him. Disbelief hit hard. “I don’t want to.”
“I don’t care.” He used his folder to gesture. “Get up there.”
You ever think that we are all just angry 15-year-olds who never grew up? Because that was me. Hands on hips. “Yeah, who says?”
“Me. I do,” he said.
“What is my last recorded weight?”
He checked the folder. 275.
“It hasn’t changed much,” I said. “I know I’m fat. So do you. But if you need it for dosing, I’m about the same.”
“Go.”
I stepped on. The number was exactly what I said it would be. When I stepped off, I made a silent vow. I would never set foot in Dr. J’s office again.
I didn’t seek medical care for years after that visit.
I wish this was the worst fatphobia story I have ever endured. I wish it was. Sitting with a trusted doctor while you confess you don’t know how you’ll make it through the day without wanting to die… and having them go on a power trip about your weight? That was painful. Ridiculous, even. But it wasn’t the worst. It was just the most absurd.
I am stable now. Thanks to the antidepressant.
A couple of years later, my mom passed. My child finally slept. The pandemic panic subsided. I felt a strange relief. The battles were resolved. I wanted joy.
During my second pregnancy, I picked up my toddler. Bent down. Slung him onto my hip. Something cracked in my back.
It didn’t feel good. But moms keep going. I ignored it. Parenting a toddler. Caring for a dying mother. I didn’t have the wherewithals. Besides, I knew Dr. J would just blame my weight for any pain I mentioned. He had done it plenty of times.
But a couple of years later, the crack had turned into a lump. A lump that ached every single day.
My life had finally roomed out. I wanted answers. I made an appointment with a spine specialist.
I was terrified. Would she dismiss me when she saw my fat body? Would she tell me to lose weight first? Would the lump disappear if I shrank? Was a protruding lump in my lower spine enough to prove I deserved medical attention?
I agonized over the appointment. I canceled twice. I rescheduled twice. I wondered if I should just live with the pain. Avoid the shame of the scale.
I came prepared. I had facts about fatphobia. I sat on the exam table. I waited for Dr. White.
I had rehearsed a speech. A defense. I was ready to advocate. I puffed out my chest. Nothing to lose.
Dr. White entered. She sat down. “So you’re having back pain?”
“Yes.” I took a deep breath. The words spilled out. “I’ve had pain for a long time. Something cracked a few years ago. I know I’m a fat person. Past doctors have told me to lose weight before addressing medical issues. But this giant lump has absolutely nothing to do with my size. It’s not normal. I’m not even 40. I know fat people get ignored. I will not be ignored today. Please treat this as if I were thin.”
Dr. White froze. She blinked.
Did she think I was crazy? A combative feminist?
She opened the folder. Pulled out my MRI.
“Of course you’re in pain,” she said. “You have three herniated discsin your lower spine. You also have scoliosis.”
She paused. “Has anyone ever told you that?”
My mind flashed to my middle school nurse. A note sent home for suspected scoliosis. I remembered Dr. J looking at my 12-year-old back. Telling my mom I’d just “grow out of it” if I lost weight. Buh-bye.
My 37-year-old spine told a different story. An 11% curve. Still crooked.
“I’m so sorry,” Dr. White said. Her voice was soft. “You haven’t been taken seriously. But your weight has nothing to do with an actual medical issue.”
My head floated. I was smiling. Not the good-girl-smile. This was real.
I had been seen. Truly seen.
Dr. White laid out a plan. It is ongoing. We try things. We assess. When I go in, I know I will be viewed as a legitimate patient. My concerns will be valid. I will be heard.
Dr. J’s dismissal cost me years. I avoided care I needed because the shame was too heavy. I let fatphobia in healthcare dictate my health decisions. I ignored pain because doctors focused on my body instead of my symptoms.
But once I got stable… once the events of life evened out… I could see it for what it was. My doctor’s fault. Not mine.
Now, when I meet a new doctor, I prepare. I give myself a pep talk. I arm myself with my speech. I am ready to advocate.
But I also know the line.
If I have to do more than just speak my truth to be seen beyond my fatness?
I walk away. I pick a new doctor.
The healthcare system still has a long way to go. But I am no longer waiting for permission to take up space. Or to seek help.
