I went to see the nurse to get my blood pressure checked and to book a cholesterol test and I ended up with one of the worst clinical encounters I've had for a very long time. A doctorate in queer fat activism, a publishing track record and nearly thirty years of experience in collectively critiquing fat hatred is a pretty good foundation for getting your blood pressure checked whilst fat, one of the most basic medical interventions around, but it does not protect you entirely from feeling as though the rug has been pulled out from under you when a nurse pulls some fatphobic moves. I ended up with old memories of self-loathing, feeling destabilised and confused, and this from a clinic that says it is passionate about supporting people's health and wellbeing in its mission statement. I worry about the people who don't have my experience and credentials.
I have no intention of ever booking an appointment with that nurse again, but I have some pointers from this experience that may be of use to other medical practitioners.
How nurses and other health practitioners can support people of all sizes to have optimum health
Keep a set of weighing scales in the middle of the room like a monument to BMI. It makes it look as though this is the most important tool of measurement for you and reveals how little you know about body weight and health.
Smirk when a fat person declines to be weighed. Declining is a brave act of self-advocacy in the face of monumental pressure to capitulate to a system that does not have fat people's best health interests at heart.
Judge. Fat people can tell you are doing it, we have had a lot of experience of this.
Be surprised when you ask a fat patient about their life and they reveal themselves not to be the saddest sack of the universe, especially if you find out that they have more going for themselves than you do.
Gloat about your own thin privilege.
Get stressed or blame the patient when you struggle to find a pulse or do a basic check because you are not comfortable touching a fat person.
Treat patients as repositories of data for your poorly designed computerised records systems of questionable security.
Use any fat-sized medical equipment that has the name of a weight loss drug plastered all over it, especially if that drug has been implicated in the sudden deaths of fat people. Buy a large-sized blood pressure cuff, don't use one that is basically a giant advert for Reductil. How can your patients ever trust that you are not in the service of those brands?
"Take control," patronise patients with empty promises that "it will come together" to excuse your inability to listen to a person and support them with their needs that they have plainly stated.
Sneakily schedule blood tests for all the so-called fat diseases, which the patient has had before and for which there is no evidence that these diseases are a problem for them. Don't think your patient won't notice what you have done and know that you have been judging them the whole time. Don't be surprised when this patient does not go along with your great fatphobic plan. You may be tempted to stereotype fat patients like this as wilfully non-compliant and self-sabotaging. Don't do that.
Treat people as automatic fodder for the medical industrial complex. Maybe a medical solution is not appropriate.
Touch someone weirdly. Don't rest your hand on mine as you tell me about your ex-wife who was also a psychotherapist.
Remember that bodies come in all shapes and sizes and that this is human.
Listen to the patient. If they say their problem is stress, or anything else, do not assume that their problem is that they are morbidly obese(sic).
Listen extra hard if you have only just met that patient. Get to know them as a person.
If time is tight or the computer system determines what happens in the clinic, acknowledge that you are working within limitations.
Understand that being weighed is not a neutral act. Don't proffer it. Try and have some compassion and understanding for what scales might mean for a fat patient, even if your own experiences of being weighed are nothing to write home about.
Collaborate. Treat fat patients as people who are invested in their own healthcare, especially if they make an appointment out of the blue to get their blood pressure checked. This is proof that they care about their bodies.
Get consent. Share data with your patients without them having to drag it out of you.
Try and laugh when your patient makes a joke about being a zombie when you are unable to find their pulse because you are uncomfortable with handling a fat body. They are being generous and are trying to help you.
How to recover from a bad interaction with a medic
Remember it's more likely to be them and their system that is the problem than your fat body.
Talk to someone you can trust with your feelings, don't be alone with it. Perhaps resist posting on social media even if you feel alienated and upset, you may find that people's responses there are far from soothing.
Write down what happened, get it out of your head.
Make another plan for looking after your health.
Send the clinic some feedback if you feel up to it.
Make some tea.