Dr. M
TW: fatphobia, ableism from a healthcare professional, discussions of weight
After the marathon of infections had begun, the nurse practitioner PCP I had wanted me to switch to an internal medicine doctor. She did it in a strange way - seeming to be upset that I went around my urologist for a genetic test to find what was actually wrong - which was unusual for her. But, I thought it could be helpful and started the search.
The internal medicine clinic's doctors didn't have any openings other than residents, but I went ahead and switched to a resident, Dr. M.
Dr. M was very good at first. When she finished the appointment, one of the attendings would come in and do everything that she did to ensure she did well. It was sort of like having two doctors and not at all a bad experience! Dr. R was often the one I saw after Dr. M; everything was going smoothly.
After the swelling, inflammation, and infections intensified, I was going to the doctor more often. I still wasn't able to see a nephrologist to treat the genetic kidney condition I knew I had, despite many doctors trying to refer me to one. The computer system meant to streamline the referral process was actively preventing a referral from being sent - it didn't have a section to put “autosomal dominant hypercalciuria” and would automatically delete the request. It recommended a urologist instead, but urologists wouldn't take me because of the kidney condition and told me to go to a nephrologist.
It was a never-ending loop that resulted in me getting sicker and more swollen.
At one point, the inflammation and everything got so bad that I had a leukemia scare. Dr. M ordered a bunch of tests and I had to see an oncologist for more. It was tense. Thankfully, it was also negative.
Then, I was hospitalized. I ran into another awful doctor, but thankfully a great team other than him. I got to see a nephrologist, finally.
Once I was released, I improved a lot. However, I was still swollen and didn't feel good. My liver enzymes were coming back abnormal, I had more pain, and it was obvious I was sick.
To Dr. M though? I needed to diet.
Dr. R had left the clinic and I had a revolving door of attendings checking on us. Dr. M seemed to absorb the personality of her current attending. When it was a good doctor, it was fine. When it was a bad doctor? I was told that I was just fat.
However, I had enough. I felt awful and I didn't have much to lose. I chewed her out - telling her that if she really believed it, I'd just eat nothing for a few days and return to her, still sick. I said some other things and the rest of the staff caught wind and they rallied around me.
I fired her.
Then, I switched to Dr. R for my PCP. He's a good listener, thorough, and isn't threatened by a patient being well informed about their health. I went to a rheumatologist, and an entire other fiasco to discover primary immunoglobulin deficiency. I went back to the oncologist/hematologist and began IVIG.
But, I thought about the patients who might not have the strength (and stubbornness) to leave Dr. M and sent her a message in the portal:
I kept complaining of swelling and recurring infections, but you told me to diet and exercise. You didn't seem to believe me when I said I was barely eating. I thought it was related to my immune system, maybe something autoimmune. I went to St Louis for a rheumatologist and they put me in the hospital for a bad infection. I had fluid in my abdomen from it and they found an immune deficiency. I've started getting IVIG infusions and I dropped to 128lbs.
I only send this because it could help your future patients because it illustrates the need to listen when someone says something is wrong, even if you just think they're obese and bitter.
