Thursday, 29 January 2015


Didn't in the end watch Shut-Ins. Can't say I'm sorry. I just didn't feel up to yet another possibly sterile exercise in salvation of fat people via calorie restriction. This feeling of spiritual fatigue came over me unexpectedly.

Ever see a fat person who seems kind of passive about being fat? I don't mean they've never dieted, don't see fatness any differently than a slim person would slimness, don't operate on the terms of the 'obese' construct and haven't been marked by that.

Because upon my honour, I've yet to encounter such a person. You know what we should resolve to do in 2015? Be that person! [Hey, is that a resolution?! Better late than never]

Do know what I see when I see a fat person who hasn't wasted themselves dieting? Ordinary. I see most of us actually are like in most things related to a health or medical context. We are as passive as that fat person seems, but isn't. I see other things too obviously, but I want to concentrate on that.

This false sense of passivity is played up in fat people strangely because; a) there is a fat standard and that's way higher than the ordinary one. Say in things like; pro-activeness, initiative, responsibility etc., anything related to or seen in the framework of health/self management. So an ordinary standard in a fat person looks really baaad, buuutttt, you are catching a glimpse of yourselves people.
What it looks like when the niceties, courtesies and acknowledgement accorded the ordinary standard are withdrawn.

This is a bit of a tangle.

The modern doctor patient relationship, has been formed around the infectious pathology/magic bullet golden era of medicine. Progress has seen the sun is setting on that. Now, modern healthcare is being dominated by; the nervous system, managing decline, chronic conditions etc.,

This is threatening to derail healthcare budgets-including Big Pharma's charging policies-and placing exhaustive demands on medical professionals. We need to change that relationship. The patient must emerge from a position of docility and obedience to more of a partnership with professionals. Something that's a tough change for them and lay people alike.

The latter have been taught that the compassionate practice of medicine =illness is misfortune, nothing to do with you-which is fairly apt for infectious disease. Whereas the management of a chronic condition can at times turn you into your own doctor and practice nurse. It's not unusual for patients with chronic conditions to know more about them than their own doctors.

Preventative medicine requires something akin to that level of awareness. A more active engaged patient who actually expects to and does demonstrate initiative with their own self management. It's a sense of responsibility way beyond the scope of the current patient posture.

For the professionals, its tough because a lot of their status and power seems to many of them to lay in this abjectness.

Alas, the higher ups seem to have decided not to face this squarely and instead to pass the same passivity off as something else, a lack of "personal responsibility". Blaming the patient for their health and the failing of any quackery that's supposed to bring resolution. For some reason, medical systems have difficulty with saying they don't know.

Strange though it seems to say it, it's almost as if this new era has turned medics towards the psychiatric model. People trying to claim their categorizations are biologically defined, asserting disease by committee and other dubious practise.

'Obesity' has become the vehicle to pioneer this horribleness.

A lot of trying to be slim, happened outside medical aegis. It meant fat people ended up surreptitiously advancing (part of) this new relationship with medics. Alas, the nature of the pathologized and dehumanized 'obese' construct has meant we weren't allowed to really go for it.

Many fat people don't even notice how much initiative and independence they've shown in pursuit of slimness.

At times people misunderstand me. Much decorated medics and specialists in eating disorders, addiction, 'obesity', mental health, speak their piece and others listen, absorbing it as holy writ.

When I can seem incredibly dismissive, to the point of perchance seeming positively arrogant. Not so. It's just the fat standard in action.

Of course the fat standard is hardly comparable to the disabled standard, where people have to negotiate a difference in function in a world not designed to acknowledge those needs.

This seeming ambivalence towards experts is closer to a patient response we are going to have to move to, whether anyone likes it or not. We're going to have to move to a place where we no longer take personally the possibility of culpability in conditions that aren't like a broken leg, sprained ankle etc.,

We're gong to have to learn to view all sorts of conditions with the same equilibrium as we do those. In other words, we're gong to have to accept that say, neuroses can be as much our dong as a broken arm and that bothers us no more than a having broken arm would.

We will all have the have the potential to seem arrogant, scanning the utterances of highly qualified experts with the alacrity we might show a priest or a politician.

Explains the reluctance of the white coat mafia.........

No comments:

Post a Comment