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Well, apparently not. From the Just-Can’t-Win Department:

I just came back from the orthopod, where I was told that the sometimes excruciating pain in my right knee means I most likely have a degenerative tear of my meniscus, which isn’t worth scoping. He also told me that it didn’t matter what the studies said about fat people having a decent outcome for knee replacement, Hospital Protocol said BMI of 40, which for me means losing 45 pounds. End of discussion.

I wasn’t at my best for it even if I did have a shot in Sheepdom, because the PA had put me on the exam table with my head near the door, and thus I had just heard his entire little precis for the attending, which included the words:

“She’s not a good candidate for it no matter what she does–she has a history of bipolar disorder.”

I mean, sheep me. He said WHAT???

Apparently stigma is alive and well in the People’s Republic of Cambridge.  So I came home and wrote the following letter in their MyVoice(tm) email system:

Please make sure Dr. Ortho sees this; I expect a response from him. [These emails are read by the entire team, or can be. Attendings are too important for this sheep.]

Dear Dr. Ortho,

I’m not sure whether or not you realize it, but (having my head right near the door while on the table) I heard every word of what Jerkface said to you before you came in the room: “I don’t think she’d be a good candidate no matter what she did–she has a history of bipolar disorder.” I unfortunately am one of those women who cry when they’re really upset, so I didn’t say anything while I was there. But–I’m REALLY upset.

I’m not sure why my *past* history of BP automatically makes me a bad candidate. I do know, however, that although I’m not a big success at controlling my weight, I kick serious butt in recovering from a major mental illness. Check and see–I haven’t been hospitalized in over seven years, and in fact my job requires me to be in strong recovery.

Jerkface’s remark was ignorant and insensitive. It doesn’t matter that I wasn’t meant to overhear it, it shows that he needs to learn a lot about mental illness. He gives a good shot, but I’d rather he not be involved with my care in the future. I very seriously suggest that your staff have an in-service on mental illness and stigma: NAMI is a great source for such things if you can’t arrange it in-house.

As for my being a poor candidate “no matter what:” I’m fat, not crazy. I’m fat, not incompetent. I’m fat, not lazy. I’m just fat, not some creature without feelings. Just fat.

Please respond.

Most sincerely,

(Ok, I didn’t call him Jerkface.) What surprised me about this was how upset I got. Why should I care what some escapee from an overzealous tanning bed thinks about my mental status, based on a five minute interview and a cursory scan of my chart? It’s not like Dr. Ortho responded with, “Yah, I don’t cut them crazy bitches. We cool.”

Maybe it was the sum of the whole visit, with stigma piled on top of the obligatory medical fat-bash. (Dr. O did say something like, “WELL. It all depends on how important your knees are to you.”) I dunno.

I think I’m going to take the rest of the evening off and have some ice cream. With a potato-chip garnish.