I was 22, lying on a table in a hospital with monitors beeping.
The cardiologist turned to look at the screens when my heart started to feel like it was about to jump out of my chest. I had only met this woman a day ago and I was hoping she had a handle on the situation, but I wasn’t sure. I tried to hide the quiver in my voice when I told her that my heart was feeling very strange.
Without taking her eyes off the monitor she responded, “That’s the feeling of exercise; it’s just your heart rate increasing. It’s not something you’d have any experience with.”
At 383 pounds, I was gathering the necessary clearances to undergo weight loss surgery. And if I hadn’t just been injected with medication meant to artificially raise my heart rate, I’m pretty sure it would have skipped a beat by itself.
When something appears extreme, doctors stop listening. They stop searching for answers because it’s easier to assume all the evidence needed is on display, which leaves patients liable to fall through the cracks.
As a fat kid, I spent an inordinate amount of time in spandex. My twin brother, Ted, and I learned how to swim at age two. I took to the water immediately with a graceful stroke in the manner of Ester Williams, while he thrashed his way to the wall. We were opposites.
By age seven, I was already close to 100 pounds and outweighed my brother by 30 pounds. My parents signed us up for swim team (which was really a brilliant parenting move); we came home every night exhausted, disinfected and hungry enough to eat any vegetable. Ted easily ate twice the amount I did, yet he stayed skinny as a rail.
Twins: same meals, same environment, same exercise routine. One fat, one thin. This equation did not compute, so it was time to go to the experts for answers and help.
I didn’t mind going to the doctors. In fact, as soon as I got past the whole scale portion of the visit, I loved the entire experience. By second grade I had decided (as illustrated by my journal and my Halloween costume), that I was going to be a doctor when I grew up, because I wanted to help people.
Now, I’m not sure exactly how I came to believe that doctors are helpful. In my case, I didn’t receive help, wasn’t given any answers and just kept gaining weight. We coined a name for this game: “Stump the Doctor.”
First on the list was the pediatrician. She looked at me, then told my mother her parenting was equivalent to child abuse. She refused to believe that I didn’t spend my afternoons eating twinkies while watching cartoons. My mother refused to believe she owed payment for that assessment. We stormed out of the office, and I realized I was different—a bad different. I also realized that wasn’t a good doctor, and I was off to the next one.
The endocrinologist ran lots of blood work and declared me perfectly healthy—but fat—so he referred me to a dietitian, where I played with plastic food and identified broccoli. No one had answers, or could explain why I was gaining weight. The hope became that I would just grow out of it once I hit puberty.
I didn’t grow out of it.
Despite being 300 pounds in high school, I was an excellent water polo player. The opposing team didn’t know what to make of me. They either underestimated my ability to knock off a quick backhand or they were terrified of me. I loved the sport, but hated walking in my swimsuit from the lockers to the pool deck. I figured out the quickest route that allowed for minimal exposure before throwing my towel on the bench and slipping into the water.
But it was worth it, because underwater I felt free, movements came easy and I could trust that my body would do what I asked.
When convention fails, alternative treatments become viable options, so I started acupuncture treatments. I was muscle tested to see how my body responded to different foods. Turns out I was allergic to everything: wheat, corn, soy, dairy, eggs, beef, chicken, fish and the list goes on. During this year-long treatment my diet consisted of mainly rice. I didn’t lose any weight, but I only gained 10 pounds. It was a banner year.
Following high school graduation, my parents approached me with the idea of weight loss surgery. I was vehemently opposed and didn’t want to play the sick kid any longer. I wanted to experience college—which was the first time I felt seen and accepted despite my weight.
I graduated pre-med with a major in biology and moved home planning to finish a physics class, study for the MCAT exam and apply to medical school. All of these activities seemed reasonable, but inside it felt like I was heading straight towards a brick wall.
How could these dreams could be accomplished? Who would take health advice from a morbidly obese doctor?
My world was closing in on me. It was difficult walking more than two blocks before searing back pain would stop me in my tracks. I began blocking out the world in order to be in it. I wore a baggy sweatshirt with a front pocket to hold my iPod, which was constantly blasting show tunes in order to drown out unsolicited comments. I wore dark glasses, even indoors, so when the looks of disgust came my way, people couldn’t see how hurt I felt. My body, no longer giving subtle signals, started to scream. My structure could not bear this load any longer.
Now, I never hated myself—I didn’t like that I was fat, but I never identified with it. My body image and identity never solidified as super morbidly obese. As a kid, photos always came as a shock; I hardly recognized myself. I lived somewhere between delusion and a refusal to believe that my body was a true representation of who I was. I just didn’t buy into it. I always had a sneaking suspicion that this whole situation was not permanent, and I felt I just needed to keep going until a solution presented itself. Clearly, I had some expert-level coping mechanisms.
Surgery came as an answer at exactly the time I was ready to hear it. I knew that if I continued doing what I was doing, it was a certain path towards chronic disease. When the topic was first broached at 18, surgery appeared extreme and I immediately dismissed it. Now at 22 and 383 pounds, surgery felt like a means for survival. The decision didn’t feel forced or uncertain, and I think it saved me from plunging into a mindset that would have caused me to turn towards self-loathing and hate.
I made an appointment with a surgeon who listened, He said, “You know I’d say about 50 pounds is your own doing, but the rest—we don’t know why your body decides to hang onto every last calorie as if it were your last. We don’t have those answers yet, but this surgery will help you loose weight.”
For the first time in my life I felt heard. And while it’s disconcerting not to be able to answer why I had gotten so heavy, sometimes you have to allow the unknown and take a leap of faith in order to heal.
Surgery was successful. I lost 10 pounds in the first week, 30 pounds by the first month, 100 pounds after six months and 200 pounds after 18 months. It was a bit of a head-trip to discover that I had ribs, collarbones and hip bones. It’s funny how quietly pain leaves the body. Once a constant companion, I didn’t realize it had left until I tried searching for it after a two-mile walk and realized that not only was it not there, but two more miles were entirely possible.
I now practice as a Chiropractor, in the same medical building where that awful cardiologist had her office. One day I saw her in our office suite visiting a colleague. I immediately recognized her, hairs prickled on the back of my neck and I was thrust back into the memory of feeling judged and silenced. I was torn between my desire both to flee and to chew her out. Instead I paused, and in between my own fear and anger, I was able to listen as a sad woman explained that she was going to have to close her practice.
Here’s the thing: after losing 200 pounds, nobody recognizes you. But with her I really didn’t worry, because while I saw her, she had never bothered to see me. So I shook her hand, introduced myself and silently thanked her for showing me exactly what not to do as a doctor.
When I see my patients, I listen. I believe them. I try to explain why, while also allowing the unknown. And I recommend all children spend an inordinate amount of time in spandex.
Author: Meg Zepfel
Editor: Nicole Cameron
Image: Author’s Own