My therapist had enough of me. I knew it; she knew it. Our sessions had been going 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 mom is dying, and there’s a global pandemic. Give yourself a break.”
It was time for the antidepressant I’d been avoiding for at least 15 of my 35 years.
Armed with a newfound resolve to take care of myself instead of only taking care of two small children and a husband, I made an appointment with my primary care doctor. Dr. J had served as my family doctor from when I was in grade school. He had cared for my parents, my grandparents, my aunts and uncles, my siblings. And so when he came into the office where I was sitting with greasy hair and bags under my eyes, I felt relief. Dr. J knew me. Dr. J would help me.
I’m a lifelong fat person. I was over 10 pounds when my mother pushed me out of her body, two weeks late — accompanied by a “giant episiotomy,” she’d always tell other women with a knowing, exaggerated eye roll. I never grew out of being the fat girl. I went to Weight Watchers meetings at 12 and 22; I climbed up and down 60 or 70 pounds at a time on many occasions; I pressured 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 kid is up every night, all night, for hours and hours. And it’s been two years of that.”
“The second one comes in like a bat outta hell,” he said, nodding.
“And I have no help,” I said.
Dr. J nodded again. “Your mom…” he said, knowing of her dire diagnosis.
“She’s dying,” I said. I could never not tell the truth. Others danced around her cancer diagnosis and acted like she was a warrior who was supposed to defeat the same enemy that even the most advanced scientists in the world couldn’t beat. But I saw my mom’s agony and suffering. She would have been there night and day to help me with the second kid, if she could have.
“My therapist wants me on an SSRI. I haven’t slept in two years, I’m parenting two small kids in a global pandemic, and I am watching my mom needlessly suffer through treatment after treatment when we all know she’s terminal. I’ve been avoiding going on an antidepressant for a long time but I feel ready to accept it now.”
“We can do that,” Dr. J said. “No problem.”
“Thank you,” I breathed. I reached down to gather my coat and bag. I felt so much relief.
“But we gotta get you on the scale,” Dr. J said.
“What?” I asked. Sweat pricked along my hairline.
“The nurse didn’t record your weight earlier,” he said. “I need 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. I have enough troubling my head right now.” I laughed a little, good-girl syndrome even as I defied authority. But I was proud of my earlier resolve to say no to things that are bad for my mental health, which was the explicit reason for my visit.
“No, you do,” Dr. J said. “Get on up there.”
I couldn’t believe what I was hearing.
“No,” I said. “I don’t want to.”
“I don’t care,” he said. “Get up there. I need to write it down.”
You ever think that we’re all still angry 15-year-olds and we never really grow out of that? Because that’s what was happening when I literally put my hands on my hips and said to him, “Yeah, who says?”
“What do you have for my last recorded weight?” I asked.
He checked my folder: 275.
“It’s not much different now,” I said. “I’ve always known I’m fat, doc. And so have you. But if you need my weight for dosing or something, I’m just about the same as I was before.”
“Go,” he said, using the folder to create a herding gesture toward the tall medical scale.
When I finally stepped on the scale, it balanced out just as I said it would. And when I stepped off the scale, I told myself I’d never set foot back in Dr. J’s office. In fact, I didn’t seek any sort of medical care for a long time after that visit.
I wish I could say this was the worst I’ve ever been treated by a medical professional due to my fatness. I wish I could say that sitting with a trusted doctor who just listened to you say 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 worst experience I’ve ever had as a visibly fat person in a medical setting, but it’s not. It’s just the most ridiculous.
Photo Courtesy Of Sara Knight Bidlack
I’m stable enough now to recount this, though, thanks to the antidepressant.
A couple of years later, my mom had died, my child was finally sleeping, and the pandemic panic had subsided. I felt relief that these battles were resolved, regardless of the outcomes. After such an intense and long period of suffering, I so badly wanted to grasp for joy.
During my second pregnancy, I bent down to pick up my toddler, slung him onto my hip, and heard something internally crack in my back. It didn’t feel good but I kept going with my daily activities, as moms so often do. And with pregnancy, parenting a toddler, and my mom’s illness, I didn’t have the wherewithal to get it checked out at the time. I also knew Dr. J would likely explain my pain away with my weight, as he’d done plenty of times in the past. But a couple of years later, that crack in my back had turned into a lump that ached all day every day. And now that my life had a little bit of room in it for me, I wanted to seek medical help to figure out the source of my back pain.
I was fearful when I made the appointment with the spine specialist. Would she dismiss my pain when she saw how fat I was? Would she tell me to go home and lose weight first before she considered any sort of treatment for me? Would the pain go away if I actually did lose weight? Is the lump protruding from my lower spine enough to convince a doctor that I am worth medical attention beyond weight loss?
I agonized over the appointment, and I even canceled and rescheduled a couple of 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 examining table and waited for the spinal specialist to enter the room. I had rehearsed my spiel, was ready to advocate for myself, and I would not be dismissed. Battle mode. Chest puffed out. Nothing to lose.
Dr. White walked in and greeted me as she sat down. “So you’re having lower back pain?” she asked.
“Yes,” I said as I took a deep breath. “I’ve had lower back pain for a long time but something cracked down there a few years ago and it’s been worse since then. I know I’m a fat person and many doctors in the past have told me to lose weight before they would address my very separate medical issue, 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. Fat people do not receive adequate medical care because they are usually fat-shamed instead of being seen as individual patients but I will not let that happen to me today. Please treat my lower back pain as if I were a thin person.”
Dr. White was motionless in her chair and just blinked at me for a second. Did she think I was a crazy person? A combative feminist? A problem patient? Then she opened the folder in her hands and produced the image of the MRI of my spine from a few weeks ago.
“Of course you’ve been experiencing pain,” Dr. White said. “You have three herniated discs in your lower spine and you also have scoliosis. Has anyone ever told you that?”
I was instantly transported to my middle school nurse sending home a note to get my back checked out by my family doctor for suspected scoliosis. But good old Dr. J looked at my 12-year-old spine and told my mom that I’d grow out of it if I just lost weight; the end, buh-bye. My 37-year-old spine was still crooked, with an 11% curve, as I’d learn from Dr. White.
“I’m so sorry you haven’t been taken seriously,” Dr. White said back in the spinal examining room. “But your weight has nothing to do with the fact that you have an actual medical issue.”
My head felt floaty. I was smiling and it wasn’t even good-girl syndrome. I had been seen, truly seen. And I didn’t even have to advocate to be treated like a human and fight the stigma of fatness.
Dr. White laid out a treatment plan for my spine. It’s ongoing. We try something and then assess its efficacy, and when I go into her office, I know I’ll be viewed as a legitimate patient. I know my concerns will be treated as valid. I know I’ll be heard.
Dr. J’s dismissal of my mental health needs caused me to avoid the medical care I needed. For several years, I just ignored my pain because the shame of doctors’ focus on my weight was too much. But once I got stable from antidepressants and the events in my life evening out, I could see my mistreatment as my doctor’s fault, not mine.
Now, whenever I meet a new doctor, I give myself a pep talk and equip myself with the speech I gave Dr. White. But I also know that if I have to do much more than give a few sentences of advocating for myself for them to see me beyond my fatness, I need to pick a new doctor.
This piece was previously published on HuffPost and is being shared again as part of HuffPost Personal’s “Best Of” series.
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