Tuesday, February 26, 2019

Bias is heavy.

There is this thing I had to fight off the moment I laid eyes on you. This feeling, this bias that I wish I didn't have toward you but that I know I do. As soon as I stepped over the threshold into your room, I could feel my heart shadowboxing to try to press it down, hold it back.


They make whole television shows about you. And people tune in as appalled voyeurs, wondering how someone could reach the kind of weight that renders them immobile. Or totally isolated. Or maybe not isolated but still unable to fully participate in the kinds of things that most people can do. Admittedly, I don't watch. But I'd be lying if I said it was because of my tremendous empathy and disapproval of people making your reality into a spectacle. Instead, it just reminds me of those who come before me as my patients who are like you. And how helpless I always feel.

Yes. That.

See, that's my bias. I like feeling like I can do something. And a body mass index that matches my age always makes me feel like my hands are tied. And like there is nothing I can really, truly do. Especially when resources are low on top of it.


So after I saw you, I told my team what I am saying now. That I am struggling with my bias and I want to do better, be better. And that I would try. Like, really try.

"How?" my student asked me.
"I don't know," I said. "But I think first? I'm just gonna be still and think about it."

Which I did.

And so. I came back. And this time, I didn't just go through the motions. I sat down and spent some time talking to you. I told you flat out about how sometimes I struggle with seeing my patients who carry as much weight as you. And then I said sorry in case it sounded mean. You said it was cool.
But then we started talking. About music. About family. About parents saying crazy stuff and what we put them through as kids. We laughed about land lines and how kids now will never know how it feels to have somebody pick up the phone and start dialing while you're trying to ask somebody to go with you. Or pretend you ain't eavesdropping on a three-way call. We cracked up laughing.
Then, after that, you took out your phone and showed me a picture of yourself. Not in the hospital. Standing outside at a cookout. And yes, you were still as heavy as you are now, but your eyes were dancing and you looked alive. You did.

"You still struggling?" you asked me.
I thought for a minute. "You know what? No."
"People don't see me," you said.
"I didn't before. I do now," I replied.
"It's crazy because when you real, real big, people treat you bad and the world seem like they cool with it." You shook your head. "I'm not talking about being husky. I'm talking about when you get like me. Like people let they kids stare or they look at you and frown right to your face. Like 'Uggh.' And don't nobody say nothing."

"Dang." That's what I said.

Because that was all I could think to say. And because I felt my toes squishing under the weight of that truth.

I'm learning that confronting our biases head-on is one of the only ways to overcome them. I'm also constantly reminded that the longer you stay with someone, the more you'll find where you intersect. And the more you'll see them.

Because I saw you, I took better care of you. The plan became more meaningful and, as the leader of the team, allowed me to help my whole team see you, too. Like, for real see you. I also told them what you said and we all promised to do better. Or at least try, man.

Thanks for helping me to be a better doctor. I'm a work in progress for sure. But today--thanks to you--I think I progressed.




  1. I'm really glad you addressed this because most doctors (and I say this without any statistics but I bet you) have a very strong bias against people who are large. And you know what? Those people don't want to be that big any more than you want to see them that way. And first off, fat-shaming is the worst thing you can do. As you know, I am sure. You and I have no idea the struggles that people who are vastly obese go through. It's as much an illness as anything else. Just because science hasn't figured it out, doesn't mean it isn't. I think that the best thing a doctor can do with a patient like that is to simply do what you'd do with any other patient- try to treat the illnesses presented with all of your skill and knowledge. Do you go into a spiel about how them losing weight would make some of these problems much less serious? Maybe briefly. But assume that they already know that. Fat don't mean stupid. Ever.
    I'm sorry. I don't mean to be giving you advice because that would be ridiculous. I am very proud of you for admitting your bias. It's not easy. But admitting it is not enough. You have to work through it in order to give your patient the best care available. That's what I think.
    And as always, Sister Doctor, I love you for your honesty and I am glad to see you back here.

    1. Love you, Sister Moon. And love when I see a comment from you. It's actually one of the things I miss the most about regularly posting. You. Angella. Elizabeth. My faves.

      You are so right about needing to do the work when it comes to bias. It isn't easy. But, I swear, I am trying. I want to make my implicit biases explicit to me so that I can do the work. And you are also right that there is no person who said in kindergarten that they hope to be 600+ pounds someday. Just like no one wants to be an addict or sick or anything.

      Ms. Maya Angelou said: When you know better you do better. And what I say is: When you know better, you need to make up your mind to try to do better until it becomes habit.

      Love you, friend.

  2. As always, Ms. Maya Angelou was right.
    We're all trying to be better, aren't we? If it were easy, we would be, simple as that.
    Love you too.


"Tell me something good. . . tell me that you like it, yeah." ~ Chaka Khan

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