My therapist had had enough of me. I knew it; she knew. Our sessions had gone nowhere for months.
“There’s only so much we can do here,” she said. “Your baby hasn’t let you sleep in two years, your mother is dying and there is a global pandemic. Give yourself a break.”
It was time for the antidepressant I had avoided for at least 15 of my 35 years.
Armed with a new resolve to take care of myself instead of just caring for two small children and a husband, I made an appointment with my doctor. Dr. J had been my doctor since I was in grade school. He had taken care of my parents, my grandparents, my aunts and uncles, my brothers and sisters. And so when he entered the office where I sat with greasy hair and bags under my eyes, I felt relief. Dr. J knew me. Dr. J would help me.
I am a lifelong fat person. I weighed more than 10 pounds when my mother pushed me out of her body two weeks late—accompanied by a “giant episiotomy,” she used to tell other women with a knowing, exaggerated eye roll. I never outgrew the fat girl. I went to Weight Watchers meetings at ages 12 and 22; I climbed up and down 60 or 70 pounds at a time on many occasions; I put pressure on myself to fit into that wedding dress so I wouldn’t “regret” my wedding photos.
But here I was, in Dr. J’s office, and now my fatness was the least of my problems.
“What’s going on, Sara?” he asked.
“I’m in therapy,” I said. “My second child is awake every night, all night, for hours. And that was two years ago.”
“The second one comes in like a bat,” he said, nodding.
“And I have no help,” I said.
Dr. J nodded again. “Your mother…” he said, aware of her serious diagnosis.
“She’s dying,” I said. I could never tell the truth. Others danced around her cancer diagnosis and acted as if she were a warrior who had to defeat the same enemy that even the most advanced scientists in the world could not defeat. But I saw my mother’s pain and suffering. She would have been there day and night to help me with the second child, if she could have done so.
“My therapist wants me to get an SSRI. I haven’t slept in two years, I’m caring for two small children during a global pandemic, and I watch my mother suffer needlessly from treatment after treatment when we all know she’s terminal. I have avoided taking an antidepressant for a long time, but I now feel ready to accept it.”
“We can do that,” said Dr. J. “No problem.”
“Thank you,” I breathed. I bent down to grab my coat and bag. I felt so much relief.
“But we need to get you on the scale,” Dr. J said.
“What?” I asked. Sweat prickled along my hairline.
“The nurse didn’t record your weight before,” he said. ‘I have to write it down. Can you step on the scale?”
“Oh,” I said. “I told her I really didn’t need to be weighed today. My head is bothering me enough as it is.’ I laughed a little, good girl syndrome, even though I was defying authority. But I was proud of my earlier decision to say no to things that were bad for my mental health, which was the explicit reason for my visit.
“No, that’s right,” said Dr. J. “Go upstairs.”
I couldn’t believe what I heard.
“No,” I said. “I don’t want to.”
“I don’t care,” he said. ‘Go upstairs. I have to write it down.”
Have you ever thought that we’re all still angry fifteen year olds and we never really grow out of it? Because that’s what happened when I literally put my hands on my hips and said to him, “Yeah, who says that?”
“Me. I do.” he said.
“What did you get for my last recorded weight?” I asked.
He checked my folder: 275.
“It’s not much different now,” I said. ‘I always knew I was fat, Doctor. And you too. But if you need my weight for dosing or something, I’m about the same as before.
“Go,” he said, using the folder to make a herd gesture at the tall medical scale.
When I finally stepped on the scale, it balanced exactly as I said it would. And as I stepped off the scale, I told myself I would never step foot in Dr. J’s office again. In fact, I didn’t seek any form of medical care for a long time after that visit.
I wish I could say this was the worst I have ever been treated by a medical professional for my fatness. I wish I could say that sitting with a trusted doctor who just listened to you and told you that you don’t know how to get through the day without wanting to die, and then responds to your confession by going on a power trip about your weight, was the best solution. worst experience I’ve ever had as a visibly fat person in a medical setting, but that’s not it. It’s just the most ridiculous thing.
The author as a 10-pound baby in 1986.
Photo courtesy of Sara Knight Bidlack
Thanks to the antidepressant, I am now stable enough to tell you this.
A few years later, my mother had died, my child was finally asleep, and the pandemic panic had subsided. I felt relief that these fights were resolved, regardless of the outcome. After such an intense and long period of suffering, I desperately wanted to reach for joy.
During my second pregnancy, I bent down to pick up my toddler, slung him on my hip, and heard something crack in my back. It didn’t feel good, but I continued with my daily activities, as mothers so often do. And because of the pregnancy, parenting a toddler and my mother’s illness, I didn’t have the resources to get it checked out at the time. I also knew that Dr. J would likely take away my pain with my weight, as he had done many times in the past. But a few years later, that crack in my back had turned into a lump that hurt all day every day. And now that there was a little room for me in my life, I wanted to seek medical help to determine the cause of my back pain.
I was scared when I made the appointment with the spine specialist. Would she ignore my pain if she saw how fat I was? Would she tell me to go home and lose weight first before she would consider treatment for me? Would the pain go away if I actually lost weight? Does the lump protruding from my lower back protrude enough to convince a doctor that I’m worthy of medical attention, aside from weight loss?
I was worried about the appointment, and I even canceled and rescheduled a few times. I wondered if I could just live with the back pain instead of going to a doctor and risking being turned away because of the number on the scale.
Armed with facts about fatphobia and discrimination against fat people by medical providers, I sat on the exam table and waited for the spine specialist to enter the room. I had practiced my story, was ready to stand up for myself, and I didn’t want to be fired. Battle mode. Chest inflated. Nothing to lose.
Dr. White came in and greeted me as she sat down. “So you have lower back pain?” she asked.
“Yes,” I said, taking a deep breath. “I have had lower back pain for a long time, but something broke a few years ago and it has gotten worse since then. I know I’m a fat person and many doctors in the past have told me I needed to lose weight before they would address my very strange medical problem, but this giant lump protruding from my lower back has absolutely nothing to do with my weight. It’s not normal to have a lump here and I’m not even 40 yet. Fat people don’t get adequate medical care because they usually feel fat ashamed instead of being seen as individual patients, but I’m not going to let that happen to me today. Please treat my lower back pain as if I were a skinny person.”
Dr. White sat motionless in her chair and blinked for a moment. Did she think I was crazy? A combative feminist? A problem patient? Then she opened the folder in her hands and pulled out the image of my spinal MRI from a few weeks ago.
“Of course you experienced pain,” said Dr. White. “You have three hernias in your lower back and you also have scoliosis. Has anyone ever told you that?”
I was immediately transported to the high school nurse and sent a note home to have my back examined by my primary care physician for suspected scoliosis. But good old Dr. J looked at my 12-year-old spine and told my mother that if I just lost weight, I would grow out of it; the end, bye. My 37 year old spine was still crooked, with an 11% curve, as I learned from Dr. White had heard.
“I’m so sorry you weren’t taken seriously,” Dr. White said in the spinal exam room. “But your weight has nothing to do with the fact that you have an actual medical problem.”
My head felt floaty. I smiled and it wasn’t even good girl syndrome. I was seen, really seen. And I didn’t even have to advocate to be treated like a human being and fight the stigma of fatness.
Dr. White created a treatment plan for my spine. It’s happening. We try something and then assess its effectiveness, and when I go into her office I know I will be considered a legitimate patient. I know my concerns will be treated as justified. I know I will be heard.
The rejection by Dr. J of my mental health needs caused me to avoid the medical care I needed. For years I simply ignored my pain because the shame of the doctors’ focus on my weight was too much. But once I became stable on antidepressants and the events of my life came to light for a night, I was able to see my abuse as my doctor’s fault, not mine.
Now when I meet a new doctor, I give myself a pep talk and equip myself with the speech I give Dr. White loved. But I also know that I will have to choose a new doctor if I need to do much more than say a few sentences to advocate for myself to see past my fatness.
This article originally appeared on HuffPost.