I Always Say

...I miss fat people. Well, I have the perfect example to illustrate why that is:

Last wednesday evening, I was studying for the 2nd med surg exam with my student mentor, who also happens to be the TA for the course. Her friend and roomate is the only big girl in their class of 60+. (I am the only big girl in my class of 80+) And let me just say, by "big" I mean "not skinny, and a little past thick," or for those of you who don't mind the term, FAT. Anyway, this big girl came over to us and was distraught. For real. Why? Because someone had the audacity to come up to her and her physical assessment partner and tell her partner that he shouldn't do his physical assessment (which included a breast exam) on her because the bigger the person is, the more time it takes to do the assessment, and if you don't finish the assessment in the allotted amount of time, you get docked points. And he was risking points by choosing her as a lab partner because she was big, and her breasts were big. (This all happened a few feet away from me)

Now. Ok. This is true, it takes a little more time to do an assessment on a fat person because (duh) there's fat covering their entire body. So, when you're feeling around the stomach for example, you gotta press harder, and sometimes you still don't feel what you're looking for. It is especially hard to palpate (feel) for the liver and bladder when someone has a lot of adipose tissue (fat) or sometimes hearing the heartbeat is a little harder because (duh) the stethoscope can be much farther away from the heart depending on the amount of fat or skin. But even with that, we're talking a significant amount of fat, which no one in this program is big enough for this to be the issue. It's the difference between doing a breast exam on a small breast and a large breast - there's more breast to assess, if that makes sense.

Regardless:

1. This is the most skewed cross-section of a population I've ever seen. There are more pre-pubescent body types in our class than in an issue of 17 magazine. So here we are doing all these practice exams on people with no body fat at all, when the US population more often has a little fat than not. People had better get used to touching/feeling fat people. The day when you simply pretend they didn't exist is long gone for you, future NP. Everyday you will be confronted with us, and I dare you to act like you don't want to touch my skin.

2. Who the hell are you to walk up to two people who aren't even talking to you and voice your idiotic opinion to make some one feel inferior? Yes, I know we have the cute little saying that no one can make you feel inferior with out your consent, but I'm here to tell you, words hurt even the strong and the brave, sometimes. Hell, my feelings were hurt, and she wasn't even talking to me. Just from one fat girl to another.

3. Why the hell are we being so competitive? It's a freaking POINT. Isn't the measly point worth getting hands-on experience with someone whose body type actually mimics the actual patient population?

4. It's a d-e-m-o-n-s-t-r-a-t-i-o-n, meaning, you aren't actually trying to find something wrong, you are simply trying to demonstrate that you know *how* to look for something, you aren't actually assessing whether the person has a S3 heart sound, just that you know *where* and *how* you would put the stethoscope to hear it. So, really, you aren't spending that many more seconds than anyone else.

Maybe people are wondering why this matters so much to me. It matters because the lack of diverse body types is sometimes isolating in itself. But to have someone actually think they can actually walk up and comment on your weight/size/shape is especially troubling. I know we spend a lot of time assessing health, so it's only natural to observe those right in front of you, but there has to be respect. Being fat (or black, or jewish or anything else) does not mean that you have the right to inspect, evaluate or *touch* yes, I said touch! me. And, if you do decide to interrupt my private conversation and make a a comment *about* me, please have the decency of saying it *to* me, instead of talking about me, right in front of me, as though I am invisible.

I wanted to say something to the girl who made this comment, but I can't fight other people's battles for them.

I wanted to post something else today. I am reading Alice Walker right now, and realize that something is about to change in me. But now, I don't have the time.