The appointment started, as usual, with a weigh-in, followed later by the requisite fat-shaming from my GP, who scolded me she wants to see me "losing a pound and a half a week!" because I'd been exactly the same weight when I'd been in the office a week before for acute costochondritis.
So, I was supposed to lose weight, apparently, exclusively by starving myself, since I was meant to be on almost complete rest to heal from the chondritis which made exercise out of the question. Um. Was my doctor really recommending something so absurd? Well. It was no more absurd than the contention that weighing in at the same weight two weeks in a row meant I hadn't lost a pound and a half, or gained it, or a little more or less, and then arrived back at the same place again on that particular day, since weight can naturally fluctuate a couple of pounds every day, anyway.
I was aggravated more than anything about being talked to like I am a stupid person. I thought: I need a new doctor. But this doctor is the only one in town who's in my insurance network. So.
But back to the pap smear.
The nurse gave me two sheets of material that was something between the butcher block paper they put on the tables and a giant paper towel. "One for your top and one for your bottom," she said. "Just kind of cover yourself up with them." She avoided my eyes. The offices that use those disposable paper "gowns" never have them in a size big enough for me. I know this. But instead of her saying to me, honestly and forthrightly, "I'm sorry—we cannot accommodate your body with the covers we have," she awkwardly avoided the subject altogether. As if I couldn't figure it out. As if her embarrassment for me was not evident.
When the doctor came in and looked at me, she asked the nurse, "Where's the top gown?" The nurse quietly stammered, "Those ones are too, um, flimsy—I just gave her two of the bottom ones." They both looked at me, lying on the table, naked, but the two giant paper towels laying over me. I would have preferred to just be naked, instead of lying there, feeling obliged to cover my fat body for the comfort of my nurse and doctor. The proverbial lightbulb went on. "Ah," said the doctor. They exchanged a look.
Later, I would consider with bitter amusement that the USian medical community constantly howls about the Obesity Crisis!!!eleventy! and all their OMGFAT!!!eleventy! patients, and yet despite servicing a fat clientele they can't shut up about, they can't find a fucking paper gown to fit me.
As my doctor began the procedure, she gave me the same line I always get from doctors doing my pap smear, the "sometimes smears are hard to get on obese patients" disclaimer, to which I responded, as I always do, "You won't have any problem. No one ever does." Which naturally elicited a dubious rejoinder, just to make sure I felt good and shamed, before the sample was retrieved instantaneously and with no problem whatsoever.
Afterward, my doctor began to give me a breast exam. She sighed and told me my breasts are too big. She wrote me a prescription for a mammogram. She told me to lose weight.
"Okay," I said miserably. As she swept out of the room, one of the giant paper towels slid off and fell to the floor.
On the way home, I felt like shit. I thought about all the fat women who have experiences like that and decide that preventative care just isn't worth it. I thought about the fat women (and men) who have died, because of the emotional toll going to the doctor can take. I considered that I hadn't had a pap smear in several years, because I dreaded having the day I'd just had. I'm still waiting anxiously for the results.
I made a mental note to bring my own robe from home next year.
Yesterday, I had my mammogram. I went to the same place I'd been five years ago, when I'd discovered a lump in my breast that had turned out to be benign—the Breast Care Center at St. Anthony's in Crown Point, Indiana.
It is a space designed for care. Medical care, yes—but not just. When you walk in, you are greeted by a nurse who signs you in and then directs you to a table with coffee and tea and water, and into the waiting area, which looks like a living room. There are upholstered couches and overstuffed chairs, an area rug, and a cherry-finished armoire and shelving, holding a television tuned not to Fox News, but the Food Network. In the corner is a game table with a glass chess set. It is bright and warm and cozy.
It is the opposite of clinical.
I wait and watch a female chef whose name I don't know make a strawberry torte. After only a few minutes, a nurse-technician calls my name and introduces herself to me as Jennifer. She leads me back to a changing room, which is appointed like a small guest bathroom in someone's home might be, where she hands me a cloth gown. "Just for your top," she tells me. "You can leave your jeans and shoes on. Just walk through the door at the back when you're ready."
I close the door and put on the gown. It is loose. I am swimming in it. It could accommodate a woman much larger than I am, women who are not used to being accommodated.
There is no weigh-in.
When I open the door at the back of the small room, it opens into the mammography room, where Jennifer is waiting for me. She smiles and reminds me to make sure the front door in the changing room is locked.
And then we begin.
I slide half out of the gown, and I position myself beside the machine as instructed by Jennifer. She lifts my breast into position. She helps me get my arm just right, my torso turned just so. She is gentle, and she is comforting, chatting to me about the beautiful weather and this and that, manipulating my body, my fat body, with care and ease.
She explains what she's doing, what each different angle will capture. "This one will be from your nipples backward." She talks to me like I'm an intelligent adult woman who is engaged in her own care. She touches my body, my fat body, with the casual confidence of someone who is familiar and comfortable with fat bodies, even though she is thin—I am not an alien, but just another woman with breasts that need imaging.
She guides me through four images on one side, and five on the other—because one turned out a bit fuzzy and she is a perfectionist, she tells me, laughing.
I am so grateful to her for allowing me to just be another human in her care and not a grotesque monster whose body makes her uncomfortable, for letting me feel safe and respected in this very vulnerable moment.
I want to tell her all of this. But instead I just say, "Thank you for making this so easy. I really appreciate it."
Which is all I can muster, because I am overwhelmed with brimming gratitude—and a slowly boiling anger at the world outside the Breast Care Center that I should be so grateful to have been treated with basic dignity.