Tuesday, 4 March 2014

Testing the Limits of Hubris

The author of this article has responded to the comments both for and against. I can't figure how to link specifically so I'll copy it's main points;
This piece was originally published elsewhere under a different title. The WP changed the title, did away with the pseudonym ("the patient" is, to me, much less personal), and thereby changed the perspective of the story. If you..... re-read the story, you will find that I made an effort NOT to actually voice my own thoughts during the the description of the work-up; I don't consider being "momentarily put off', "trying to get a sense of him as a person,' and 'leaving me to reflect on his plight' as being synonymous with having the limits of my compassion tested, nor being a bigot. I knew that this story would provoke comments, because the patient himself provoked comments -- he is us. We all have a burden in life; his was just larger and more apparent than most. The surgeon and the secretary were guilty of being judgmental and critical (much like some of the comments about my character here) because they were forgetting the man inside the patient. I cannot share the details of the other things I learned about "the patient" -- particularly events that occurred in his past that might explain his eating addiction -- anymore than I had space to share the facts that he told me himself about eating 8,000 calories daily to numb the pain and that he asked for me by name on subsequent visits because he sensed I was much more interested in helping him than in judging him and finding him flawed. To address a few other concerns mentioned, he had a team approach to his inpatient care after going upstairs. .......This story was an attempt to relate a difficult encounter honestly and factually so that people (including me) could examine their own prejudices. It looks like it worked.
Fat phobia is the default. Its more disconcerting when not or hardly there. Like the prank where you land on your behind because your chair was swiped as you went to sit on it. 

Despite this ubiquity, it's still an affront and obvious. Perhaps the dismissal of fat people means people don't trust us to be able to hear such clanging chimes of judgement, if they've affected not to.

In this case, the author "Edward Thompson" may have imagined his even tone hid more than it did. That the guy asked for him is not much of a recommendation. Its in comparison with a surround of others who have maintained less of a hold on themselves. It may be appreciated, but its still not good enough.

In a way, I can stretch to his perspective. I know the medical profession as the prime movers in this campaign of fat hatred-short of some of those dabbling in the dubious field of 'obesity'.

I'm unsure what to make of some fat activist's reactions. If they feel that badly for those at the top end of the weight spectrum, why aren't they; a) advocating openly for proper scientific research into metabolic function, rather than behaving as if being fat is like being gay? [Not even being gay is like being gay in that sense] and b) why won't they accept the medical profession's role in legitimizing the 'obesity' tirade? Why keep making excuses for them and trying to make this all about the slimming industry?

I hold no truck with them,  never have, but, Poison Ivy is not The Joker. 

The article is valuable because it tells us exactly why the medical profession feels so much resentment towards fatness. And no its not "societal attitudes" or "what they're taught in medical school" we're deemed inconvenient, extra work;
Facing him.......I’m not sure just where to start the examination, and when I begin, my hands look small and insignificant against the panorama of skin....It’s hard to tell, exactly....[where] pain is coming from.....We try a chest X-ray, turning up the power to the maximum setting. All we see is white: The patient’s body is just too thick to allow standard X-rays to penetrate to the bones....Morphine at doses high enough to make me dance on tables merely makes him a bit drowsy.

Finally, we move an ultrasound machine into his room — it barely fits between the bed and the wall — and the technician goes in to take some diagnostic images. Minutes later, he emerges.
“I need to get the radiologist to help me,” he says. “This is impossible.” A half-hour later, the chief of radiology comes out of the room, rings of sweat under his arms. “I think we have something,” he says. “A gallstone.” “Don’t put him in a room right over the ER,” whispers the unit secretary to the admission clerk. “The floor won’t support him. He’ll come crashing through and kill us all.” Finally, a slew of huffing, puffing, grunting attendants wheel him down the hall....
Where's room here to cut a dash? Nothing fits, there's extra work, hard work and sweat. Its labour intensive, maybe most importantly of all, nerve wracking, draining. How to negotiate bodies that look and feel different. Stuff's not where its supposed to be, stuff is there that's not supposed to be. How to find out what's wrong and perform your wonders and look aptly omnipotent?

You could overdose the person trying to anesthetize them, it goes on and on and on and on.

It feels to them like fat people change the nature of medicine. It becomes more manual labour. It's as if fat people reduce the value of medicine, it's sense of its own dignity, it's haughtiness takes a knock, becoming more earth bound. Who knows, that may affects the image of the profession, the overall esteem in which its held.

All because people want to eat too much and sit on their fat arses!!! Our bodies feel like an act of aggression to them. They feel sorry for themselves. Why is this/are we spoiling it for them?

Really though, they've had a long time to gear up for this. Weight watchers started in the early 1960's in the US and came to the UK in 1969. When it was clear western [model] societies were gearing up for a weight spike, in the 1970's the medical profession needed to get real and insist 'obesity' or preferably metabolic science became a priority, if they felt so badly about fat bodies. Making sure to follow that up with pointed comments about why was no progress being made etc.,

Instead, they chose the route we are on, convincing themselves they had the power to make success out of failure. They thought their support of chivvying and health hype could do better than fat people's strenuous often self willed efforts. They've continued the weight loss dieting fantasy much in that vain, even to the extent of ushering in fast food giants onto hospital premises (including children's) in the 80's and 90's. They had it in hand right?

Between them and the fat hating public, they'd soon break our will to eat. We were under their thumb.

The medical profession know calorie restriction has failed, they've known for decades.They simply refused to accept it, because, well.....they don't have to. Who's going to make them? Either they have to  sweat or fat people do, why shouldn't it be fat people?

Weight loss dieting held in place by stigma that could repress societal weight gain, rather like homophobia held the expression of homosexuality in check. Disappointment just seems to make them and everyone else all the more determined to cling on to delusion of eventual victory.

It's somewhat amusing, the new desperate thrust to brand fat people 'addicts' when it is those who adhere to calorie restriction delusion that fit the premise of faux addiction that's so au courant. Except, instead of damaging themselves to pursue this dependence, it's someone else. Which means they have more stamina for it obviously. Like the man featured in this report. People like him pay most of all for the lack of rigourous objective study. Or should I say the need to insist fatness is a direct elective choice.

The profession bleat when they feel inconvenienced when reality impinges. So perhaps their resolve to throw fat people to the wind will crumble. 

People who's metabolism is affected by their experiences, like this man are suffering whilst being accused of deliberately choosing to be a problem. It's not that people like him reach for food to soothe their pain as they're told, it's that their body awakens its own pathways to this, instinctively.

What it needs to bring about the changes it needs to absorb that; extra calories and/or lowered activity, biochemical changes in everything from their yes glandular activity to their cardiovascular function,  follows in the wake of that.

It's not "food addiction", that's just trying to rejig gluttony in order to preserve dieting as lifestyle change/weight management or whatever. This kind of response comes from the whole body. It doesn't lend itself to crude partial attacks on part of the process. The reversal needs to get the body working as one. We have no precedent for this kind of thing. Weight is unique and must be understood and defined on its own terms.

Given the make up of the profession and the way it has successfully helped to manipulate public opinion, taking advantage of the bully and shit in all of us, there's not much prospect of change unless enough people in the profession rebel and fat people stand their ground.

The latter will probably be what brings about the former. The professionals only have unbidden 'compassion' for those with social value.

Fat have behaved superbly in many respects and when we wake up to that we will be unstoppable. But we could still listen better to those who are in thrall to this loopy cultism.

Even as a youth, the extent of medical anger and disgust just didn't make sense. These are people who collect and examine samples of your piss and shit. They deal with all sorts of necrotic pus filled matter. Things you and I could barely imagine. Did you notice that? No, you wouldn't, because they don't go on about it.

So when they kick off on like a bunch of permanently tantrum throwing toddlers over your fat arse, you have to know something unusual is up. Do them the honour of hearing that and stop making excuses for them. They honestly are better than that. Have a bit of respect for them!

I honestly do not think they can make the change without fat people's help. I'm being serious about that. They need us to make a sort of intervention. No one else is going to drive this.

Reporting on some of the staff below him as judgey; "they were forgetting the man inside the patient." Well, who was intimately part of defining the (wo)man out of the patient in the first place? 

Medical outliers frame any state or condition. They help define its parameters, the range of difference in human function. Therefore, they help us all to know our amazing anatomy and ourselves.  Focus on them, inadvertently humanizes, bringing them firmly into our focus, getting us used to them. Framing them in the cooler gaze of objectivity.  

Which calms everyone down.

Often they are over-fixated on, the most glaring exception I've ever known is 'obesity'. Where they are most excluded of all. Hidden away. Turned into spectres haunting lesser fatz in case they do not continue to "motivate" themselves, to avoid their fate.  

Signing up for "food addiction" with its complement of pseudo science is just prolonging the inevitable at other people's expense.

The whole thing is a stupid mess and there's only one way out. The most obscene thing of all. The truth.

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