“Why do you have to weigh me to look at a bumpy place on my skin?”
My doctor, really a very nice lady, must have thought I was particularly annoying today.
I went in to see her because I have a bumpy-up place on my skin – right in the “bad sunburn” triangle that developed on my chest during a childhood spent grumpily reading books at the beach. (I am a vampire in a family of sun-worshippers, and until I was old enough to stay at the rented beach house alone, I used to be dragged unwillingly to various beaches, where I would inevitably lobster up but never, ever tan.)
My mother is constantly sporting bandages from the dermatologist where they’ve once again carved out a hunk of her skin that at last, after many, many decades of exposure to solar radiation, had finally begun to protest this abuse; mild forms of skin cancer are her daily bread.
So when I got the bumpy-up place (and it was mildly itchy), I hove myself over to the doctor for a look-see, just in case. And I noted the reason for my visit in the “comments” portion of the electronic appointment system.
Today, when the (entirely pleasant) nurse called me from the waiting room, she took me immediately to the Station of Shame. You know the one – stand on the scale, get your blood pressure taken, hold a thermometer in your mouth.
“Why do you need to weigh me so the doctor can look at my skin?” I asked her. “You don’t need to, do you?”
“Yes – it’s a vital sign. I have to get your vital signs.”
She weighed me.
“You know,” I said huffily, “I saw a study once that said many women were put on blood pressure medicine unnecessarily because they get anxious when weighed in a doctor’s office.”
“Really?” she said, not at all impressed with the scientific authority of “I saw a study one time.” “I maybe should take the blood pressure before I weigh people?”
It was nice of her to imply that she might change her time-honed routine. I grimaced and shook my head. “Won’t matter. I’ll know the scale is coming up.”
As it happens, my blood pressure is quite low – a genetic gift from my maternal grandfather – and she looked at me as if vindicated. Clearly MY blood pressure hadn’t been affected by being weighed. See? I just shook my head; she wasn’t going to be able to re-configure the entire massive Kaiser Permanente system just on my bitching anyway.
But while I was waiting for Dr. Long, I got to stewing about it. I didn’t need any prescriptions; there was no need to calculate pharmaceuticals. I had no chronic conditions like diabetes or anorexia that might make weight maintenance critical to a care plan. I had a bump on my skin.
Why did I have to be weighed?
The longer I sat there, the more I fussed. So when that kind, long-suffering woman walked into the room, I practically leapt like a wrestler who’d scaled the ropes to really get a good drop on her.
I explained to her that I’d been spending the last three years coming to grips with the fact that the scale is a liar when it comes to being a good measure of health – and that having to be weighed just to enter the inner sanctum was an immediate reversal of all that good work. It was like she was saying my weight was the only measure of my health that she was interested in.
She explained that there are several easy constants that she – and all doctors – can use to map a body’s condition over time, and that weight is one of them.
Then – because she’s a very good doctor and likes a thoughtful question – she posited a few what if’s for me. What if I was a diabetic? Would it be wrong to do regular weight checks?
(But I’m not a diabetic, I replied with a pout, and this wasn’t a check-up; it was for a specific issue. And the nurse had stopped to check my file to make sure she’d gotten all the vitals she needed before putting me in the exam room; there could have just as easily been a note to her that said my weight was of annual – and not more frequent – interest.)
If you had an anorexic daughter, she asked me, wouldn’t you want her weight to be part of every doctor’s visit?
(I have very little experience with anorexia, but I offered the opinion that telling an anorexic that her weight was the key indicator of her health was a terrible idea.)
She told me that it happens that people don’t realize that they’ve lost or gained weight, and she can forestall larger issues (she said the word “malignancy,” which is like a trump card in any exam room discussion) if she can see what’s going on with their weight.
“Everyone knows what they weigh. You can feel it in your jeans.” I dismissed her comment.
“Not if they don’t want to know,” she shot back – and damned if she wasn’t right. We all see what we want to see, and if you fear that your sudden unexplained weight loss is a symbol of a returning cancer, you might very well choose to ignore the potential horrors.
She explained that weight can even be a factor in arthritis, which was a pretty good stopper to my arguments – and she clarified that for her, weight is not about shame or societal expectations or emotions; it’s a scientific measure of the body and that’s it.
“But my weight is ALL about shame and expectations and emotions to ME. You’re not weighing me to upset me, but that’s the result.” I was terribly pugnacious today.
If I was empress, I told her, I would change the policy in every doctor’s office. I’d have a scale in every exam room instead of one scale in the nurse’s area. And once the doctor came in and found out why the patient was there, the doctor could choose to say “Let’s see if weight is a factor in what you’re telling me; step up on the scale.”
“You’ve given me something to think about,” she said – which proves she’s a kind as well as a skilled doctor. And then she used nitrogen to freeze the bumpy place off my chest because it wasn’t even a remotely interesting case to the dermatologist she consulted.
It’s hard enough to give up the idea that my weight determines my health – it’s even harder to go up against the medical community. But I’m telling you: Weighing every patient, every time, is unnecessary and sends a bad signal to anyone who already feels badly about their body. It might even cause someone to avoid the doctor entirely.
I guess it’s easy for a basically-healthy person to say that. What’s your take?
I’m really getting good at the ugly selfie. That’s my bumpy place, after being insulted by a nitrogen freeze treatment. There goes my career as a bikini model, at least for a while.
PS: I’ll be sending a link to this post to my doctor; maybe she’ll correct my errors in a comment! Hi, Dr. Long. Want to continue the discussion?