Discrimination in Healthcare
Sizeism is highly prevalent in postmodern society. (Puhl et al. ,2008)Sizeism is discrimination based on size, and although there are essentially two measures of the size that is height and weight, the latter is the most focused on. Discrimination based on weight, especially when one is overweight, is pervasive in healthcare. The following story seeks to describe the situation in the real world though it is a fictitious story. The story is a narration by Victor, a fictional character for the sake of the analysis to be made afterward.
I pick up the phone and make an appointment with a doctor that had been recommended to me by a friend. I used to go to a certain doctor for many years, but this time it would be different. Why would I be requesting an appointment with a new doctor? I recently visited my usual doctor for a recent anomaly in my weight. I had gained about 55 pounds suddenly: I had not changed my diet, and I was was not lazing around. Something then must be wrong, but when I went to see my doctor, she without much thought pointed to Body Mass Index chart hanging in her office. She then provided me with a pie chart that showed food categorized in macronutrients they contain.
I was about to explain myself when the doctor interjected and said, “you are what you eat.” If she was offensive, she did little to show, but either way, I was offended. I was very confident that I had not recently had an increased appetite and taken more than my usual servings of meals. However, I was not about to argue with the doctor because, in the years she has treated me, she has not been wrong, so a benefit of the doubt, in this case, would suffice. The issue of sudden weight gain had been there for a long time, but then I had not been considerate in my meals, and the weight gain would be somewhat explainable and expected. The recent case, however, I could not explain.
After I went home and had a serious thought about the events at the hospital, I had the realization that I had been size discriminated against. The idea of weight discrimination had been introduced to me through a story I read in the New York Times. Still, the possibility of similar discrimination to happen to me by my primary doctor, I had not considered. The idea, however, lingered in my head. The recent events thus served to remind me of the story, and the events that happened between my doctor and I were a mirror image of those in the story. Suddenly I found myself burdened with the reality of having to deal with bias derived from size discrimination.
As I waited for the day of the appointment to come for three consecutive days, I had sleepless nights. I was considering the possibility of similar events with my primary doctor, who would repeat themselves with the new doctor. I did not go out of the house, did not necessarily eat though I did some cardio. I think I might have taken a long walk, but my memory was impaired from watching YouTube binge-watching. I was anxious and tense at times; I thought of picking up the phone and canceling the appointment. I, however, wanted to confirm my fears of receiving biased health care based on size discrimination.
On the night preceding the appointment day, I also stayed awake, but this time somehow, I was not worried. Somehow the thought that whatever will happen will happen even if I worried myself sick about it had lifted my spirits. The above thought was a consequence of my knowledge of Murphy’s law, which suggests that anything that can go wrong will go wrong. I even played out the scenario of the appointment in my head. I pictured myself telling the doctor I eat my vegetables, rarely eat out or have snacks, and the familiar look of skepticism that might accompany what I had said. I chuckled at the thought and considered the possible doctor’s response, “Victor, right? I will not be able to make correct conclusions if you don’t tell me the truth.”
Finally, the day came. I don’t remember much of the events of the morning before the appointment at 9 am. As I entered the doctor’s office, I realized what I was going through might be a reality of many people, and I panicked. I could hear my heart racing away in my chest, and sweat running down my back and forehead. I was suddenly panting. As I was told to take a seat, I also realized my panting and sweating might confirm any existing bias on obesity if there was any. The doctor, however, did not seem to make a note of that. He took my medical history, then excused himself and went into an adjacent room. I thought to myself, “that wasn’t that bad, I think he even believed me.” The doctor walked in, sat down, and paused for a moment before he spoke. He said I had an endocrine disorder, and that was the cause of my current change in weight and even the previous ones. Half of my troubles were solved. The only problems left were the implication of my diagnosis and the realization that indeed my primary doctor had biased with regards to my condition.
For the above story, had Victor not sought a second opinion, he might have continued his life considering himself an abnormality. Apart from the physiological consequences of bias informed by size discrimination, the underlying cause of the sudden weight would have gone unmediated, which might result in further complications.
References
Puhl, R. M., Andreyeva, T., & Brownell, K. D. (2008). Perceptions of weight discrimination: prevalence and comparison to race and gender discrimination in America. International journal of obesity, 32(6), 992-1000.