Do No Harm: Part 1

April 2020, 9am.

I sat in the waiting room, in the midst of my second panic attack of the morning.

My legs bouncing, heart racing, throat constricted. I had been in the room for only 5 minutes, but I’d already rubbed a blister on the back of my hand with the opposite thumb. I had fingernail marks on my legs. I sat in the silent waiting room, wishing, hoping, praying with all my might that I could somehow disappear.

The feeling of dread was overwhelming and all-consuming.

This was the first time I’d seen a doctor in 5 years. Not because I hadn’t been sick for 5 years, but because I was scared.

No, not scared…

Terrified. Petrified. Frozen.

The door opened. “Miss Howard, you can come on back now.” The nurse sounded like she was talking to me from the end of a long tunnel.

She led me around the corner to a scale that stood in the middle of the hallway, and asked me to step up.

My throat suddenly felt full of sand, and my tongue had been tied in a double knot.

“I don’t want to be weighed.” (I think) I said, barely audible.

“I’m sorry, we have to.”

The advocate inside of me said, “No, actually, you don’t. The number on this scale does not make a bit of difference when it comes to the care I receive today. It will not change the outcome. It is completely irrelevant.”

But the fearful, anxious, terrified me said, “Okay,” as tears flooded my eyes and streamed down my flushed cheeks.

A few minutes later, I sat in the office, still attempting to regain my composure, waiting for the doctor to come in.

As it was the first time I’d seen a doctor in 5 years, I had quite a list of issues to discuss. Thank God I had the sense to write them down, or else I’d have forgotten them all.

The real reason I was there, however, was because my dietitian made me.

Ok, so she didn’t hold a gun to my head and say, “Go to the doctor, or else…”

But she and my therapist had been trying to convince me for several months to seek a higher level of care. (Meaning, residential treatment, partial hospitalization, or intensive outpatient.) And at that time, I was 1000% unwilling to even consider it. (Ha…more on that later.)

So, part of the agreement we made was that I could continue seeing my therapist and dietitian on an outpatient basis IF I agreed to go to the doctor for regular labs, to make sure I was physically healthy enough for the outpatient level of care.

That was it. That was the only reason I’d agreed to go to the doctor. But I figured, since I’m going, I’d might as well address the loooooong list of complaints/questions/concerns I’d been making for the last 5 years. Ya know, 47 birds with one stone.

There was just one problem: I’d never told a doctor I had an eating disorder before, and I wasn’t sure how to.

It sounds simple, right? No big deal?

I’ve talked about this a little before, but when you struggle with an eating disorder and you live in a larger body, it’s not uncommon to not be taken seriously. In fact, it’s (unfortunately) extremely rare to be understood, validated, or even believed.

The sad reality is, I never even knew what to call my eating disorder until a few months ago. I always just said, “I’m just a little weird with food, that’s all.” When I was in residential treatment, my therapist asked if I knew what my diagnosis was. I said no, because I was sure it was going to be some obscure, almost-but-not-quite-diagnosis that didn’t really count.

She looked me in the eyes and said, “Mary, you have anorexia.” That was the first day, after nearly 20 years of struggle, that my eating disorder had a name.

It may not sound like a big deal, but it was a life-changing moment.

But enough of the unfairness (and even harmful, stigmatizing and fatphobic) treatment of eating disorders based on body size. (But trust me, there’s more to come, because I have a lot to say on the topic…)

In preparation for this dreaded appointment, my dietitian sent a note, along with her lab orders, to my doctor. She told me I wouldn’t have to say a word, and that they doctor would see the orders, send me for labs, and that would be that.

But that wasn’t that.

I went through my long list of issues with my doctor, and was feeling ok. I had calmed down a bit and was feeling better about it all.

And then, we got to the end of my list. She said, “Well, if that’s it, I guess I’ll see you next time.”

My heart dropped. What about the labs??? I did not go through all of this to NOT get the damn labs I came for.

“Um, I think I”m supposed to get some bloodwork done today?” I said, quietly.
“Ok, why? Who ordered it?”
“My dietitian.”
“Hmm. Why are you seeing a dietitian?”
“Because I have an eating disorder.”

I said it. Oh my gosh, I said it. I just told a doctor that I have an eating disorder. I used those words…eating disorder. SHIT.

Doctors have heard everything, I told myself. Nothing shocks them. Nothing surprises them. I can say anything…right?

She looked up from her computer, and I watched her eyes trace my body up and down.

The look on her face…what was it? Confusion? Disgust? Maybe she thought she didn’t hear me right.

“What do you mean, you have an eating disorder?”

“I have an eating disorder, and I see a dietitian for it. She wanted labs.

Again, she looked me up and down. She pursed her lips and rolled her eyes.

I squeezed my eyes shut, blinking hard a couple of times. Maybe I’m seeing things.

But no. SHE…ROLLED…HER…EYES.

I stood in a doctor’s office, terrified, admitting to her that I have an eating disorder…and I was met with indifference at best, but probably more like disbelief or even disgust.

I had never felt more humiliated, more rejected, more unseen.

This.

This is why I’d not been to the doctor in 5 years.

This is why I’d suffered through flus and sinus infections and bronchitis and near-constant migraines and strange, unexplained symptoms for 5 years.

Because that day, my doctor did more harm than good.

And because that, unfortunately, is what I was used to: Harm.