Friday, September 7, 2012

Memoirs of an Obese Physician

To my fellow medical students who are on the heavy side: ignore the haters.



Three years ago I took an online sexuality course with the American Medical Student Association. We broached the topic of body image. In our small group, one of my classmates, who attended a nearby medical school, vented about how other classmates looked down upon her because of her weight--- especially during lectures on diabetes or obesity. She would receive dirty or arrogant looks from her slimmer classmates.

As someone who has always struggled with weight and body image, it struck a chord. Medical students are trained to not tolerate those who happen to have a BMI greater than 25--- a sign that one is considered 'overweight' by medical standards.

I get it. We live in America. People here are fat--- or rather, huge. There are also countless studies that show how obesity can increase your risks deadly diseases like diabetes, hypertension, heart disease, cancer--- you name it.

However, does this give us the excuse to be such assholes? (Pardon my French)

Joseph F. Majdan, MD, a cardiologist at Jefferson Medical College, doesn't think so. In his Memoirs of an Obese Physician, he recounts the negative experiences that has continuously shattered his self-esteem throughout his career:


"I vividly recall that during medical school, a physician approached me as I stood with my tray in the cafeteria line. He said loudly for all to hear, 'You know you should watch what you eat. Don’t you see yourself?'"
"While putting on my scrubs during my surgery clerkship, an attending surgeon looked at me with disgust and sarcastically bellowed, “Hey, hey, hey, it’s Fat Albert!”
"During my internal medicine residency, staff physicians would often— unilaterally and in the presence of colleagues and nurses— offer me their unsolicited opinions on how and why I should lose weight. I wondered why physicians would be so insensitive and callous."
"A surgeon stopped me on the floors and told me I needed gastric bypass surgery; another internist sat down next to me at a nurses’ station and openly guessed my weight, then pontificated on what my approach to weight loss should be."
"A fellow cardiologist stopped me on the street to tell me I looked “disgusting” and asked whether I 'had no shame.'"

His memoirs, which was published in the Annals of Internal Medicine, revealed many doctors' perceptions of the obese: "ugly, weak-willed, sloppy, and lazy." However, this may not be the case.

A recent study published in the European Heart Journal discovered that obese persons who have an adequate level of physical fitness were "metabolically healthy" and had "no greater risk of developing or dying from cardiovascular disease or cancer than normal weight people."

In their study researchers measured height, weight, waist circumference, and body fat percentage on 43,265 obese participants. They also assessed physical fitness with a treadmill test. They initially found that nearly half, 43%, of individuals were already metabolically healthy according to the cardio exercise tests. After following them for several years, they found that these metabolically healthy obese people didn't develop the deadly diseases that the metabolically unhealthy participants developed.

Based on the study, Dr Francisco Ortega, PhD from the University of Grenada made these comments to Science Daily, "Physician[s] should take into consideration that not all obese people have the same prognosis. Physician could assess fitness, fatness and metabolic markers to do a better estimation of the risk of cardiovascular disease and cancer of obese patients. Our data support the idea that interventions might be more urgently needed in metabolically unhealthy and unfit obese people, since they are at a higher risk. This research highlights once again the important role of physical fitness as a health marker."

...so not only may some physicians' callous remarks and opinions about the overweight/obese be just plain rude, it may also be unfounded as well--- nearly half may be as healthy or healthier as you.


Hence, to my fellow medical students on the slim side: Don't be a hater.

Dire Apologies

It's been 759 days since my last post--- I can't believe it's been that long since my African road trip.


Since then: I've read many books (skimmed some of them), saw many patients, gained more friends (and lost some), shed many tears, had at least two breakdowns, and took a 18 month trial of antidepressants. 

But who said medical school was easy anyway? ... aside from the satirists and the compulsive liars, of course.

Now, I'm a different person--- wiser, braver, fatter, and more realistic than before. I look back on my eager first days of medical school with nostalgia and a twinge of embarrassment. I have finished my third year of medical school, and I'm closer to being a doctor than ever. However, I'm taking an "academic" leave of absence to take a job as a medical journalist--- to get away from the perils of school and develop my interest in writing.

I couldn't be happier with my decision; with no academic commitments and a full salary, it's nice to be a real person again.

Now, it's time to start where I've left off. I still want to build this blog into a good resource for medical students and pre-med students.

Sorry for the delay.

Click here for my brand new post--- I dare you.

Wednesday, August 11, 2010

Kisumu

Back to day 4 of my backpacking trip: Kisumu (point C, here), smaller than Nairobi, resides in the region where Barack Obama, Sr. grew up. Our bus left an hour late from Nairobi, but I was still able to arrive to Kisumu around 5pm – before dark. After I checked into the Sooper Hotel, I knew what I had to do: see the infamous great lake – the purpose of my entire trip. Fortunately, the hotel had a terrace at its roof. 38 steps later I was there – at least at one of its many bays.

I made it.

The lake and I needed to get more closely acquainted, so I immediately left the hotel and walked down Oginga Odinga road toward its end, where I found a shore-side car wash, a few fish restaurants, and the water of a lake fit for a queen – Queen Victoria. As I stood between the truck and the sedan and rinsed off my shoes with the murky water, this Great Lakes man had finally encountered the “other” great lake before the sun went down.

Tomorrow, during my less than 20-hour stay in Kisumu, I hope to take a boat tour of the lake before boarding a 12:30 bus to Kampala, Uganda. I also will be north of the Equator for the first time since June!

That initial view of the lake – one of many, hopefully – made my trip worthwhile. I can go home happy.

My flashlight saved my life.

The god of irony strikes again. I’ve been able to safely traverse Lake Victoria alone; however, the day I find my way back to familiar Moshi "home," a stranger almost attacks me on my first day back.

I went to my favorite internet café down the road to get more waffles and ice cream and skype a friend. As I waited for him to go online, it got dark, so I forfeited the skype and started my 20-minute solo journey back home down the rural, poorly lit Lima Road. I took one of those maglites to help guide my way.

Others were walking – a slight comfort. I noticed a white-shirted man walking behind me and allowed him to pass. As I kept watch, he turned down a side street and stopped. Pretending not to notice, I kept walking and soon found him jogging behind me. My light skin tone must've labeled me as a “rich” Mzungu (foreigner). I froze to let him run past, but he stopped beside me and asked something in Swahili.

“Si fahamu.” – I don’t understand – I replied as I increased my distance from this strange gentleman. He wouldn’t let up. I knew what was happening. It was dark. The road was empty. When he poked my left pocket, I had had enough.

“GET BACK!” I screamed multiple times as I charged him – maglite in hand. I took a few retaliation swings. They got harder. The man backed away. The screams got louder. He lifted his arms for self-protection. I could feel the adrenaline surging through my veins. Primal impulses returned after 2 million years of evolutionary dormancy. He realized my anger. I managed to strike his forearm before he ran in the opposite direction.

After checking the perimeter, I continued my journey– sweating and more freaked out than before. Though I was happy to be alone, I slightly regretted not pursuing this man and striking his head. At the moment, I was a Mzungu not to be reckoned with.

It was my fault, I shouldn’t have walked alone at night. I had learned my lesson.

As I write this, after four hours of cool down time, my nerves are still a tad shaky. Being a 6 foot tall half-black man from Detroit helped -- though I realize my luck. I tried to call someone to talk about it, but the connection was shaky, so now I write this to help process what happened.

Please don’t be freaked out by this post – I only have 3 days left here. I will post more updates on the backpack trip later.

Tuesday, August 10, 2010

Ten Medical Aid Workers Slain in the Line of Duty

Before commencing my African trip updates, I must halt to share an article that shared saddening events that took place in Afganistan:

http://www.nytimes.com/2010/08/10/world/asia/10aidworkers.html?_r=1&hp

I know there is a war taking place there, where soldiers and civilians are injured and killed almost daily. However, harming and killing someone who has come to help -- no matter the killer's initial assumptions of spying or Christian proselytizing -- astounds me.

Please take the time to read through each of the workers' altruistic accomplishments. Hopefully, it will aid in their memory.

Monday, August 9, 2010

More American Priviledge

Last night, I just arrived in Bukoba, Tanzania (Point E, here); however, I must update you on what happened last week in Nairobi:

As a privileged American who hadn't previously left the country, I forget about visa-related issues. As I travel more and more, the thought of having to pay money to any government to travel in any country (and spend money in that country) is next to egregious.

Those thoughts ripped through my head after being forced to visit the Nairobi immigration office when I realized I had made a drastic mistake.

I had entered Kenya on July 31st under the impression that my stay would last only three days, which qualified me for a three-day term transit visa ($10 US). After I decided to expand my desperately-needed urban stay in Nairobi, I was forced to ask the infamous $25-dollar question: Do I really need to purchase another visa to stay in Kenya for two more days? Will they give me that much more trouble at the border?

The blank stare of the officer compelled me to regretfully comply. $25 dollars and one whole passport page later, I left the office annoyed.

However, while walking down Kenyatta Avenue I realized that if I were a foreigner entering the US, the entry process would my much more complicated and expensive. A friend of mine in Russia wanted to visit her brother in the States. She had to travel several hours by train to Moscow for an interview at the American Embassy and pay $200 US to visit the USA. She had no choice. Before the interview, her entry visa was not guaranteed.

After putting things into perspective, I cooled down and continued to a swanky Nairobi cafe to enjoy a cup of joe and my novel.

Sunday, August 1, 2010

I left my heart in Nairobi

After a 7-hour bus ride, I have finally arrived at Nairobi, the first stop of my crazy lonesome journey. What a beautiful city! After being in small-town Moshi for 5 weeks, Nairobi with it's concrete, traffic lights, gridlock, and skyscrapers reminded me of New York -- there is even a Central Park here!

I took the impala shuttle, which left Moshi at 6:30am dropped me off in the city centre at 3pm, where I found the Terminal Hotel. I got an adequate single room for 1700 Ksh (Kenyan Shillings), which is around $27 US. Clean room, sink, hot shower -- I was in heaven!

One benefit (and curse) of this large city are the abundant restaurants. On the first day, I had lahmacun, a Turkish pizza. This morning, I found a shnazzy coffee house that makes banana walnut pancakes to die for!

Later this afternoon, I visited the 30-floor Kenyatta Conference Center, the second highest building in Nairobi. At the top (105 meters), I was able to see all of Nairobi -- including the former site of the US Embassy (bombed by Al-Qaeda members in 1998), which is now a parking lot.

I wish I could show you pictures, but my computer is still in Tanzania. I promise to post pictures at the end of my trip.

I still want to visit the National Museum, Village Market, and a few contemporary art centres. Soon, I will leave for Kisumu, on the coast of Lake Victoria!