doctors and d-bags: a ranty blog post

(cross-posted, slightly edited, from my LiveJournal)

So I’ve been dealing with chronic pain issues for, oh, maybe a little over a year now. Before that I had back pain for roughly 8 years, and now it’s pretty much everywhere. I have good days and bad days, and today was not a good day.

I was 30 minutes late to work because getting out of bed took longer than I thought it would, and I figured I would feel better as the day progressed (it’s often bad in the morning and then gets better as I start moving around and doing stuff). I was supposed to teach today–I had to cancel last week to process some family shit that’s going down (everything will be fine in that department, a lot of stuff just happened a couple of weeks ago), and I was in tears when I had to call the treatment center to cancel today’s classes.

Then I felt stupid for crying, which led to a mini-breakdown in the bathroom.

I feel like people don’t believe me when I tell them I’m in too much pain to do something, which sucks. It’s also why I tend to overexert myself and “suck it up” rather than stop when my body tells me I need to stop. When the President was in Minneapolis on Saturday I was too distracted by pain to pay attention to what he was even saying–I caught snippets here and there, and a lot of his speech seemed like stuff I’d heard before, but shit. I was hoping I would be totes inspired once he started speaking and my pain would go away because of his magical Presidenty powers, but that didn’t work.

I went to the tribal clinic at home (~1.5 hours away from where I go to school) about six months ago and the nurse practitioner told me to lose weight. Then I tried to go to Health Services on campus and when I called to make an appointment they said I needed to get records of my visit from the tribal clinic faxed before I could be seen, probably so they could make sure I wasn’t just looking for pain pills or something. That took forever and I never made another appointment.

Now, it’s getting bad enough that I know I need to see a doctor but I fucking hate doctors. I need to find a PCP that will listen to and believe me instead of being a douchebag, but I don’t have time to go looking for one.  SOMETHING’s going on here. I just don’t have any fucking clue what. I’m lost.

Maybe, JUST MAYBE (I know I’m not the first person to say this), people perceive fat people as unhealthy because we (and I can only speak for myself here) put off going to the doctor until something’s massively fucked up and preventative care isn’t taken into consideration, and when we DO go to the doctor they don’t listen to us because they see fat and think “oh, this person just needs to lose weight and all of their health problems will go away.” Yeah, not a super effective approach.

When I’m stigmatized by the people who are supposed to help me, I have a rough time trusting that the next person won’t treat me like crap.  This leads to a difficult relationship with everyone who might judge me based on how I look, and doesn’t make me want to find another doctor.  I’m constantly reminded of the uphill battle we fight in order to show our faces in public.  Yes, sometimes I have difficulty walking because I’m in pain.  No, it’s not because I’m fat.  No, you do not have the right to judge me for taking the elevator because walking down the stairs aggravates my knee.

And when doctors are seen as authority figures in our society, we pick up signals from them about the acceptable treatment of fatties.  Oh, just lose some weight and you’ll be healthy.  Just go on a diet and all of your problems will go away.  Just get some exercise and you won’t have depression or anxiety anymore.  Hey, if you took the stairs, maybe your knee wouldn’t crumble under the sheer mass of your fatz!

These judgments seem to give people the right to be openly disgusted by my body.  Eww, fatties making out?  Gross!  Who wants to see that, amirite??

And it’s totes reasonable to be offended by fat bodies on television.  No, really, how dare I exist so that people have to (gasp!) look at me when I am in their line of vision! Anything I do in front of other people (walking!  standing!  sitting!  talking!)  is definitely offensive to innocent bystanders, and I would be silly to think that someone who looks like me has the right to make out on television.  What was I thinking, assuming that people wouldn’t automatically barf at the sight of my flabby arms or my double chin? </sarcasm>

WTF.

P.S. Neglected blog is neglected; hopefully I’ll have more time to post regularly sometime soon.

October 27, 2010. Tags: , , , . real-life wtfery. 4 comments.

indigenous HAES

Whenever I have conversations about health disparities affecting Native people, the subject of diabetes has a good chance of coming up.  Not always, since it’s often about reproductive health (I don’t think I’ve mentioned it here but I’m a sex educator) , but fairly often.

I went to an amazing and inspiring presentation about language revitalization and the keynote speaker talked about what it “really means” to be Native.  It’s true that many of us* (not all, of course) grow up hearing “be proud to be Native!” but are never told what that means, but seeing our cousins, friends, etc. engaging in destructive behaviors–alcoholism, gang violence, etc.  This can contribute to the belief that being Native really means drinking, living in poverty, and being a stereotypical “lazy Indian.”

It’s also true that we have the highest rate of diabetes among all races, and that 95% (according to the American Diabetes Association) of Native people with diabetes have Type 2.  I’m not an expert on diabetes by any means, but I hear about it left and right from elders, medical professionals, etc.

I posted maybe a year ago about historical trauma and its effects on health disparities, and it comes up a lot in my college classes and fairly often in my job.  I can’t help but wonder, though, whether someone looks at me and makes judgments based on my body about the food I eat and whether it has given/will give/is giving me diabetes because omg deathfat.  Of course, it’s none of their business anyway, but being judged is annoying even when you know it’s unwarranted, shallow and inaccurate judginess.

So how do you overcome the assumptions of predominantly white medical professionals (who may or may not be totally excited about working in Indian Health Services clinics)?  How do you get your voice heard when it’s already being muffled by your race, gender, and size?  How do you explain that the reason why your blood sugars are normal and good “despite” your fat is that hey, fat cells do not automatically raise one’s blood sugar? Or that you are not actually in immediate danger of dying because you’re fat?  Wait, it’s almost like fat in and of itself doesn’t kill people!  Wait, thin people get heart disease too?  WTF??!?

Clearly my fat is leeching sugar and cholesterol into my blood ALL OF THE TIME and that is totes causing health problems because that’s how the obesity works.  How sad.

Ahem.

Whatever it “really means” to be Indian is subjective.  I would hope it doesn’t involve the stereotypes, the alcohol/substance abuse, etc. but everyone’s reality is different and while eating fast food every week may not be part of what it means to be Native, people who do so aren’t less Native.  People like to think that disease is caused by fat and that fat is a choice people make because they’re afraid that they will someday get fat and if they do, they gonna die.  My mom used to (and she hasn’t done this in a long time, knock on wood) “casually mention” how much weight her friends were losing just by cutting out soda, even diet soda! or by eating a handful of whole flaxseeds every day! or by using the Wii Fit! (this one was more recently), or whatever.  As I got older, I interpreted this as “you have my genes and you are fat and if these people lost weight then you can lose weight and I will be reassured that my genes won’t make ME fat omg-please-don’t-let-me-get-fat.”

It seems kinda similar to the way some thin Native people see fat Native people (and I am not comparing fat and alcoholism here, but also the way some sober Natives view alcoholic Natives) as “ruining our image for everyone,” like non-Indians are going to look at us and be like “OMG, a fat lazy Injun!  THEY ARE ALL FAT AND LAZY AND NOT TO BE TRUSTED, AHHHH!!!!” which is all kinds of fucked-up.  We are not obligated to be the sole representative of our race/tribe.  It sucks that a lot of people are forced into that role, but that’s another blog post.

Maybe that’s just my experience.  It’s more of an unspoken (or less spoken, not completely unspoken) thing, and I have no idea whether other fat Native women have experienced this or if just read too much into things/make shit up.  Whatev.

I will write something more coherent about this soon.

*disclaimer:  there are over 560 federally recognized tribes in the U.S. alone, and obvs. every tribe, band, family and individual is different so it’s a) difficult and b) inappropriate to make sweeping generalizations about Native experiences.

June 4, 2010. Tags: , , . FA, intersectionality. 8 comments.

seeking input for a size acceptance/HAES workshop

I know it’s been forever since I posted here, but I have some really exciting news!

As a project for a class, I’m facilitating a workshop/presentation/discussion called “Body Love, Size Acceptance and Health at Every Size” at my university on November 18. I’m super excited, and I hope that everyone who comes will benefit from it–so I’m coming to you all for advice!

If you were completely new to FA/SA/HAES, what kind of information would you want? I plan on showing the Fat Rant YouTube video by Joy Nash, talking about the basic principles of Health at Every Size and probably providing a list of resources like blogs and books–so any “absolutely must-read” resources would be great. I might follow the general outline of Lessons from the Fatosphere, but I haven’t put together a format yet.

I’ll focus on fatness in particular because I’m fat, but I know there will be people there who aren’t. I’ll try to talk about thin allies in the fat acceptance movement; anything else I should mention regarding non-fats? I definitely want to include the fact that thin people also face body image issues, but I’m not sure how to approach the subject.

There’s a lot of information I could include, but it will only be an hour long so it’ll be somewhat of a crash course. Hopefully I’ll be able to make the whole thing as effective as possible in the time we have. I’m thinking about having a follow-up meeting/get-together for people who are interested, too, to see if/how they’ve used this information, and maybe more discussion on the topic can come out of that.

Thanks in advance!

October 15, 2009. Tags: , , . FA. 11 comments.

on intersectionality and HAES

I’m a little late, but there was some talk recently over at Fatshionista about diversity within the fatosphere, and after reading this post last month I shamelessly plugged this here blog and decided to start posting more… which hasn’t been working too well because I’ve been really busy, but I’m working on it.

As a Native deathfat, I’m especially “at risk” for type 2 diabetes based on the fact that I’m Native and Morbidly Obese Omg.  Medical professionals say that losing 10-15% of my body weight would reduce my risk.  For me, that’s 31-45 pounds, depending on the day.

Since I started reading about Health at Every Size (HAES), I’ve been thinking about this; if I practice HAES, which I do, it’s contradictory to want/try to lose weight to reduce my risk of getting diabetes, right?  But, says the thought at the back of my head, they aren’t saying I should be thin–just a little less fat.  After all, if I lost 31 pounds I’d still weigh around 280.  I’m aware that these concepts are inconsistent, but damn there’s a lot of pressure–especially when so many Native people are now trying to improve their health, which is a good thing but unfortunately equated with losing weight for a lot of them.

The race factor plays into this in different ways.  Some people think that so many ndns have diabetes because after frybread was invented we all ate too much of it (deep-fried dough isn’t great for you, I’m guessing).  Maybe a little simplistic, but it makes sense.  (For the record, I eat frybread maybe 3 times a year… om nom nom.)  Others, perhaps in the same vein in a sort of roundabout way, see diabetes–along with alarmingly elevated rates of alcoholism, suicide, depression, domestic violence, etc. among Native populations–as a symptom of historical trauma*, which is interesting.

“Compared to the U.S. average, American Indians are 770% more likely to die from alcoholism, 650% more likely to die from tuberculosis, 420% more likely to die from diabetes, 280% more likely to die from accidents, 190% more likely to commit suicide and 52% more likely to die from pneumonia or influenza.”  -Michelle Sotero, A Conceptual Model of Historical Trauma: Implications for Public Health Practice and Research

Alcoholism, suicide and domestic violence make sense.  Native women being 2.5 times more likely to be sexually assaulted than any other population in the United States can also be attributed to historical trauma.

Unfortunately, in the public health sphere, type 2 diabetes is tied to fatness even though there are plenty of fat people without diabetes and thin people who have it.  I haven’t been “diagnosed” with prediabetes, but in the eyes of a lot of people I’m at risk because I weigh over 175 lbs. and I’m Native and… oh wait, that’s it.  I have no significant family history of diabetes, and I’m young and fairly active.

Late last year, I was at a funeral and someone made a joke (heh, it’s what we do) about how in Native communities, something’s wrong if you’re too skinny. Which is kinda true; if someone who’s not fat but not naturally really thin suddenly becomes really thin, there’s probably a health problem going on there.  I found myself laughing nervously and avoiding the eyes of everyone around me, though, because that wouldn’t be true for me; if I were to lose a lot of weight people would probably congratulate me and encourage me to lose more.  Indigenous people have been assimilated to the point where we subscribe to society’s notion of beauty and health, at least the thin aspect.

I’m about to start my second week at a job with a 6-week summer program for Native high school students interested in careers in medicine.  It’s a great job and I think it’s really important to get more Native doctors working in tribal communities and urban communities with large Native populations.  It’s through the medical school at my university and has a focus on developing healthy lifestyles, which is great!  But once in a while someone will say something about how the OBESITY EPIDEMIC BOOGA BOOGA BOOGA is a huge problem for us as Native people.  When this happens, I generally bite my tongue and feel uncomfortable because calling the person out and trying to educate them about HAES is a little bit out of my comfort zone.  I’m an undergrad and not pre-med, and everyone else working there is pre-med or already a med student and the person talking about how fat Indians are pretty much in mortal peril (okay, slight exaggeration) was an authority figure.

I think it would be great to educate medical professionals serving reservations and POC communities in general–and, hell, everyone else!–about Health at Every Size.  I have issues with a lot of tribal health programs, including the lack of sex education, which IMO could prevent some of the gratuitous amounts of teen pregnancy (sex ed probably isn’t the cure because my 15-year-old cousin is pregnant on purpose–don’t even get me started–but it could definitely help) in our communities.  The local tribal clinic, not the one where I grew up but close to where I go to college/live now, is and pretty awesome.  They have a nutritionist and walking clubs and stuff, which is great and important, but from what I can tell a lot of it is geared toward weight loss if you’re fat and staying thin if you aren’t.

I don’t know, maybe someday my frustrations will be quelled when indigenous feminism turns into an actual movement and HAES is supported by doctors at tribal clinics, but for now I will plot and have conversations with people when I can/feel comfortable doing so.

*Historical trauma is the concept that Native people still have a lot of historically unresolved grief, which spans across generations and manifests in six stages:

1. 1st Contact: life shock, genocide, no time for grief. Colonization Period: introduction of disease and alcohol, traumatic events such as Wounded Knee Massacre.
2. Economic competition: sustenance loss (physical/spiritual).
3. Invasion/War Period: extermination, refugee symptoms.
4. Subjugation/Reservation Period: confined/translocated, forced dependency on oppressor, lack of security.
5. Boarding School Period: destroyed family system, beatings, rape, prohibition of Native language and religion; Lasting Effect: ill-prepared for parenting, identity confusion.
6. Forced Relocation and Termination Period: transfer to urban areas, prohibition of religious freedom, racism and being viewed as second class; loss of governmental system and community.

There has also been research done WRT Jewish people and the historical trauma resulting from the Holocaust.

June 15, 2009. Tags: , . FA, intersectionality. 5 comments.