Letter to a doctor

by Hanne Blank, author of Big, Big Love (web site at www.hanneblank.com)

Today I went to a new GP -- an occasion that makes me good and nervous and worried that I'm going to get the same old round of "if there's anything wrong with you it's because you're fat" blaming, medical harrassment, and so on.

Before I went in, I was thinking "Okay, how can I manage this situation and make my position really clear to this new doctor in the shortest amount of time, so that she will at least know where I stand on fat issues?" I decided to sit down and write a one-page letter describing my history of being fat and dieting, my health management approach to my own weight, and what I expect from my doctor in regard to my weight and my health.

I then took three copies of the letter in with me. I had the nurse put one of them in my chart. I handed the second one to the doctor when she came in -- "Hi, I'm Hanne. I have something I'd like you to read before we get started, it's about my health care."

It took her maybe three minutes to read the letter, and you know, it really saved me a lot of time explaining things. Now, this doctor may well have been reasonable about fat issues BEFORE I gave her the letter, I don't know -- she sure was reasonable, even going out of her way to be reasonable, about them after she read it. I think that having a well-written, reasonable, thought-out document in front of her, and being asked to read it in front of me, the patient, made it very clear to her what was cool and what wasn't.

At the end of the visit she thanked me for the letter, and asked me if I would mind writing up a short list of fat and health resources for her. She also asked me if I would be interested in perhaps coming into the clinic where she works and giving a short seminar or talk to the rest of the doctors she works with about fat patients and treating them compassionately. Not bad, eh?

I think this strategy is really worth a try. I'm going to do the same thing when I see my new gynecologist tomorrow (switched health plans, so I end up having to switch doctors across the board). It worked out so well with the GP that I have high hopes. I'll let you know how it works with Doc #2.

Here's the letter that I wrote:

Dear Dr. R.....,

I'm Hanne Blank, a new patient of yours. I am fat. You will have noticed this by now. I am here because it is important to me to be a healthy person regardless of my size, and I trust that this is also important to you.

I am aware that being fat is a contributing factor to some diseases, but my weight is not why I am in your office today. I'm here for an annual physical, and to address a few health issues that I have: [ I identified the health issues by name here, date of onset/diagnosis, and a little added info about them ].

Here is some information that will help you work with me:

-- I prefer not to be weighed. I spent most of my childhood and teenaged years on doctor-administered diets, being weighed weekly. I find, as do many fat people, that being weighed tends to be a traumatic, usually very depressing experience that makes me feel powerless and hopeless. If there is a pressing medical reason that I should be weighed, please talk to me about it. I am not an unreasonable person. However, I see no reason to subject myself to psychological trauma for the sake of gathering statistics.

-- I am well aware of the existence of weight loss diets and weight loss surgery. I have dieted for much of my life, as many lifelong fat people have. You may rest assured that if I ever wish to avail myself of medical assistance for weight loss, I know that you and other experts are available. In the meantime, since weight loss is an elective and largely cosmetic procedure, I would prefer to be permitted to make my own decisions in this regard, just as I would be with any other elective cosmetic therapy.

If you have any questions for me about fat, fat-acceptance, or anything that comes up during my visit, please feel free to ask. I am not open to harrassment, but I am very open to dialogue.

I do exercise, eat a balanced diet, take my vitamins, brush my teeth, wear my seat belt, vote, call my mother regularly, and seek medical care when appropriate. I am looking forward to enjoying the benefit of your professional expertise in protecting my health and well-being, and trust that you, as a professional, support me in doing so regardless of my size or weight.

Hanne Blank

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