Sunday, December 24, 2006

An episode of House and a few blogs that I have read..........

I thought I should try to get back to a normal blog life... something other than this med-school induced pity party that I have succumb to so here goes.
I was watching an episode of "House" and in the episode a 10 year old girl was referred to House because she had a heart attack which is very unusual for someone her age. I was very fascinated with the show until the "chase" character began a rant on the fact that the girls weight was the problem and that no other explanation could suffice in her case and condition. This is not the first episode of House that I have seen that has dealt with the issue of an obese patient. The other episode I watched featured an obese man, and in this episode House himself was the one to immediately attribute the man's symptoms to his weight.

So the other half of this rant comes from the fact that I have been reading a lot of blogs and forum post on the topic of overweight medical students. I know for a fact that I am overweight, but I do not feel that this fact in any way dictates the quality of service that I can provide for my patients. One poster went so far as to say He couldn't understand how his fellow classmates could sit in classes and listen to lectures where they are told repeatedly that being overweight is unhealthy and not do something about it.
Well I would like to say to him " How do you know what they are doing?"
The only interaction that you have with them is the interaction in the classroom, you do not know or can understand what their home situation is like. I have watched people cut back and try to lose weight only to gain 10-20 pounds due to stress and anxiety. It had nothing to do with their overall intake but everything to do with their anxiety levels.
What really angers me about the topic from the doctor and the patient standpoint is that there seems to be nothing that a skinny patient or doctor can do wrong, until you look at the facts. Just because you are underweight does not mean that your cholesterol levels are low, it does not mean that you can't get diabetes, it does not mean that you aren't going to have high blood pressure, and it definitely does not mean that you are healthy. The reverse is also true. Just because you are overweight doesn't mean that your are going to experience any of those things either. I am over weight but I don't have high blood pressure, I don't have high cholesterol, and I don't have diabetes. The consequences right now are stretch marks that I really could do without.
It is only in the last year and semester that I have become very sedentary in pursuit of higher grades and things like graduation. Yes I worry about the things that can occur if you are overweight but I do not believe that my weight is the answer for every medical abnormality that I encounter and I hate to think that physicians think that way. Not only is it narrow minded but it hampers the care process. Can you honestly say that you are giving your patient the best possible care if all you can think about is the fact that they have more weight on them than the average person. Wouldn't that be considered negligence? Think about it.

Oh.... In both of these cases the obesity had nothing to do with their conditions and focusing on weight hindered the diagnosis.
Think on that for a minute.

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