Every other day (Monday, Wednesday, Friday) the doctors, a nurse, and the therapists gather for what we call "Treatment Team" during which we review each patient and make various discharge planning, medical and treatment decisions. It's often an opportunity to let off steam, crack inappropriate jokes and receive feedback from our colleagues on difficult cases.
And then sometimes...its a chance to have an epiphany. Which is exactly what happened to me today. The doctor was updating me on a patient who is constantly becoming manic and psychotic, never really stabilizing once she leaves our unit. The doctor told me that the parent refuses to allow the patient's medications to be increased because the patient has gained weight and may gain more.
So in short, the patient will continue to be unstable, manic, suicidal and psychotic because, God forbid, she might get fat. The medication necessary to treat her psychosis does have the side-effect of weight gain and increased triglycerides. Yes, this does happen...and for the patient, it already has to some degree. The medication is not all to blame, she is less active and eats the starchy, calorie drenched food from the treatment program.
But it wrecks me that this mother is ignoring medical advice and refusing to allow the patient's medications to be increased so that her daughter who often self-harms, acts out bizarrely because it is likely her daughter will become fat.
I know this family, in fact, I've worked with this family for about a year. I know this patient, I know how sick she can get if she continues to be manic. I know this mother is a control freak and, in my clinical opinion, has not accepted that her daughter is sick. That her daughter will not go to college, will not get married and have babies (God willing) but that her daughter is likely going to be chronically mentally ill and will battle demons and voices haunting her for the rest of her life. But for heaven's sake, let's not focus on that...let's make sure her schizo-affective child is not a fatty.
Suddenly, from my mouth came the following words, "You know doctor, I'm overweight and I can tell you it is not the worse thing that could happen to a person. Being fat is not the worse problem in life. I'm loved, I'm married, I have a good job, and I'm good at my job. And I'm fat. They are not mutually exclusive." My coworker, Nurse Robin, leaned over and gave me a hug and said, "You are loved. We love you."
Saying those words out loud, I realized they were true. I'm fat. I've been steadily gaining weight. I'm also married to a wonderful, honorable, loving man who thinks my fat folds and dimpled ass are gorgeous and sexy (no kidding, he loves my fat). I also live in a great house. I have lovely friends. I am loved by my cat. I have many interests. I have a job that I enjoy (but not where I work) where I help troubled young women make changes in their lives. I am creative, I am useful and I am okay. I am also...fat.
And if I had to be dealt some horrible life tragedy, I guess being a fatty isn't so bad compared to the tragedies befallen my patients...I was never molested; I was never beaten; I never saw my mother get beaten; I never watched my parents shoot-up heroin; I was never in a gang; I never accidentally shot my sibling; I have never gone hungry, been cold, neglected or homeless.
So, if being fat meant I didn't have to deal with all those bad things...okay...I'll be fat. And dammit, I'm going to find a way to be happy about it.
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