Dear Aunt Fattie,
I have a friend who is heavier than I am, and insists that there’s no point for HER to go to a doctor, because a doctor won’t help her, and she’ll just be wasting the copays to consult with them. She says that it makes sense for ME to go to doctors and take care of myself, because I’m less than 100 pounds overweight, and didn’t damage myself horribly while a child or adolescent.
However she was a horseback-rider as a teen, and has broken more bones than I can count. She seems to think this means she needs a doctor less than I do, because her case is already hopeless. At this point, she can’t sleep, because her arms fall asleep when she lays down, and she is having crippling back pain, and still says there’s no such thing as a doctor who can help her.
Screaming in Worried Frustration
Aunt Fattie does not envy your position, Screaming. Your friend has dug in her heels, and short of a dead-of-night kidnapping scheme there is no guaranteed way to get her to a doctor’s office. Nothing Aunt Fattie can suggest will be foolproof.
It sounds as though your friend is suffering from a touch of what some people, often talking about their mothers, refer to as a “martyr complex.” She is convinced that her suffering is somehow important, that it is necessary, and that it must not be endangered. In fact, her physical pain may have become an important aspect of her identity. Aunt Fattie mentions this in order to help you understand what you are asking her to give up, and why she is resisting. If her self-concept and security are wrapped up in her suffering, seeking treatment is a radical act.
So, your friend will not, or cannot, do this kind thing for herself, and you can’t do it for her. Or can you? If your friend were convinced she couldn’t have a desperately-needed new washing machine, you might take up collection to get one for her birthday, and the same approach could work in this case. Offering to cover her copays has no guarantee of working, because it’s likely that money is just a red herring here. But it does take away one of her excuses, and framed correctly — “I can’t stand to see you in so much pain, and if money is an obstacle, I want to make that go away; I know you think this is futile, but please consider taking care of yourself as a gift to me” — it is also disarming. Seeing that her pain is causing you distress and that you’re actively looking for solutions — even if the solutions are relatively symbolic, like fronting her the $25 for the copay — might melt her a little, maybe even enough to make an appointment. Putting in some research (RateMDs.com, Fat-Friendly Health Professionals, asking around, and maybe even doing some legwork to interview doctors) will help remove another excuse and make her feel more secure in taking that first step.
There is, of course, always a point at which one must step back and allow our friends to make decisions we think are harmful — our only choice is whether they make them with or without our support. But Aunt Fattie understands why you are not yet ready to give up on your friend, and wishes you luck.
If you’ve got your own questions on fat, fatshion, fatiquette, self-esteem, or body image, send them to firstname.lastname@example.org.
Update from Kate: It’s clear from the comments that Aunt Fattie should have broadened this response to include the possibility that our letter writer’s friend is hesitant to see doctors because of a history of being treated badly by them with regard to weight and/or chronic pain issues.
The thing is, Fillyjonk and I co-edit an entire blog about doctors’ mistreatment of fat people, and we’ve all talked both there and here about the dismissal of chronic pain as “all in your head” and/or something that will go away if you “just lose weight.” Our positions on those things–to wit, that they’re egregious failures of the medical profession to help people in need–have not changed. But this letter suggested something else, something we haven’t covered before: the fact that some people do indeed put off medical treatment because the suffering has become part of their identity. So that’s the angle Aunt Fattie took, in response to the particular letter in hand, rather than the general concept of fat people avoiding medical treatment; the omission of other possible angles was not meant to downplay the very real suffering of people with chronic pain or the very understandable fear many fat people have of going to the doctor.
We’re really sorry it came off that way. Please see the comments for some excellent exploration of those other possibilities, and what a friend can do to help.