I'm Still Bitter

I apologize; I'm going to discuss bodily functions.

A nurse looking over my post operative tests offered me a compliment. "Your kidneys are rock stars! I have never seen filtration numbers like this!"

"Well, thanks," I told her.

Talking to my husband later, I was more emphatic. "HA! Vindication!"

My family got to listen to me air my grievance, again, about the time I tried to donate a kidney - I was a healthy match, and they turned me down.

Years ago, a man from our church congregation - I'll refer to him by his initial, S - developed kidney problems. He and his wife had moved to another part of town, but we still saw them occasionally. They're great people. After not seeing them for a few months, I could not believe the change in him. His skin was gray, his teeth and hair were falling out. I wanted to help.

His wife, children and step-children had all been tested for compatibility, but none were a match.

I offered to be tested. What good are healthy organs if you can't share, right? I don't smoke, I've never subjected my kidneys to alcohol, and I only need 1 myself. Right? My husband and kids were on board.

So, I was tested, and the initial blood test showed me to be a match. Huzzah!

I then got a phone call from the university medical center in the next state; they'd be handling the transplant, if all went well. The woman thanked me for my interest in donating. Then, obviously starting to fill out a pre-written questionnaire, said, "We know you're over 18. What do you weigh?" I told her, accurately. It makes no sense to lie to anyone, much less medical personnel. There were more questions, and she took down my address. They sent out a packet that I had to take with me to the doctor's office when I went.

I was sent to a nephrologist, a kidney specialist. When she walked in the room and saw me, she got a look of annoyance on her face. She informed me that she didn't think I'd be a suitable donor. "Generally, patients of your size aren't healthy enough to donate."

"Isn't that why we're running the tests? Isn't that what they'll tell us?" Geez, lady. Work on your bedside manner.

She began speaking to me the way you would to someone not very bright - slowly, with small words and too much explaining. "Generally, patients of your size and age are pre-diabetic. That means that your blood sugar is high, but you're not yet actually diabetic."

"I'm not pre-diabetic or diabetic. My blood sugar actually runs low."

"Even if that's true" - yeah, 'cause I'm a compulsive liar - "once you have only one kidney, your chance of diabetic complications is higher."

"That's why we're running tests, right?"

"I'm going to insist on extra tests for you," she said, detailing four or five extra tests that she would order. I needed heart monitoring, a stress test on a treadmill, and more not normally ordered. She was sure that the tests would show me to be "unsuitable."

All in all, with scheduling, juggling doctors, getting tests, and waiting for results, it was six months before it was all completed. One day, I had 14 vials of blood taken at once. The monitoring electrodes (and accompanying tingles) were a very odd experience. But, guess what? Green lights all around. My primary doctor said, "Everything looks great." I passed all the tests - not just squeaked by, but was certified to be in good health AND a great match, by medical experts.

I was nervous about the surgery, but my biggest concern was whether to travel the 5 hours or so to the transplant center by myself, or whether to bring my husband and kids.

Then I got a letter from the medical center, informing me that I would NOT be able to donate. Why? My weight; using that single criteria, they informed me that persons of my weight were not accepted as donors.

They would consider me for transplant if I could lose over 50 pounds in the next 6 weeks.

WELL.

I wrote a letter back. I write really great letters. I write even better complaint letters.

I pointed out that my weight was quite literally the 1st thing they had asked me in that first phone call. If it was in the unacceptable range, THAT would have been the appropriate time to say something, I said. I would have thought that they were being arbitrary and nitpicky, but hey, rules are rules. That would have been that. But to inform me of this after SIX MONTHS of testing? Oh, no. Not OK.

"You state, repeatedly," I wrote, "that your primary concern is the health of S and myself. This is obviously not the case. S's health cannot be your primary concern, or you would not have spent six months of a terminally ill man's life, and thousands of dollars of his insurance money, paying for tests that you would then disregard. Why would you order tests if their results were not integral to your decision? It seems a waste of resources and time, and S's time is limited.

My health cannot be your primary concern either, because you have ignored all of the tests and medical opinions indicating that I am healthy, in no danger, and a tissue match. Losing weight at the rate you recommended is also going against every medical opinion on weight loss, which states that drastic weight loss should take place gradually, and such drastic weight loss in a short period of time would thus endanger my health and wellbeing.

If all you needed was a single number, my weight, you had that in the first phone call. There would be NO need for any further tests if that is all your decision would be based on, but, in fact, you not only tested me, but ordered extra tests."

I hinted rather broadly that taking six months to do very extensive and very expensive tests, only to ignore the results, amounted to medical malpractice.

Good gravy, people! Do you want a lawsuit? I can do that. So could S, or his family.

Which is probably why I received a phone call as soon as they received the letter. "Hi," said the woman, tentatively. "I understand that you're unhappy. Very unhappy."

I then verbally expressed my unhappiness, saying things like, "You do realize that S's illness is terminal, right? Did having a potential living donor knock him off of, or down on, the waiting list for a cadaver kidney? Because if it did, I will be even MORE unhappy."

"No! No! He's still on the list!"

This left us circling back to the central point. As she attempted to defend their decision by telling me all the risks of obesity, and I kept asking, "So, why did you order any other testing? If you knew the first time that you spoke to me that you wouldn't accept me, why did you spend six months running unnecessary tests?"

"The tests are very necessary! They determine your eligibility."

"And yet, you did not use ANY of their data in making this decision! All you wanted was ONE number, my weight, which I gave to you over half a year ago!"

We were at an impasse.

I'm pretty sure that the answer was, "We don't want to be accused of being weight bigots, so we don't tell you this upfront. We let you be tested because we assumed that the tests would show us that you're wildly unhealthy, and we'd be able to deny you without saying that we don't consider fat people." They won't say that, of course. That would open them up to lawsuits, you know.

Speaking with S on the phone, I growled. "They didn't even ask me about things that would have sounded scary, like the pituitary tumors I was diagnosed with at 24. That, I would have understood."

That gave him pause. "You have tumors, but they didn't ask about them?"

"Yeah. They asked if I'd ever had cancer, but they're totally benign."

"The problem is, anything you have, you might pass to me. I can't afford to take on any more health problems, on top of what I've already been through." Well, that makes sense. I was not offended at all when he said, "Would you mind withdrawing from consideration?"

Not if it's your own decision, based on your preferences and/or information received! In fact, I'd already been removed from consideration, so all I had to do was not contest it. And I see his point. I've had tumors, cysts, fibroids - I grow weird things. (But no cancer. Or diabetes.) If my kidney took that propensity to S, well, that could be a pain in the butt. I understand his reticence.

I learned, though, not to gripe to other people about the weight factor. Mentioning how badly I thought they'd handled everything to another woman at church, all she seemed to hear was, "You're too fat, and you're ignoring medical advice."

"You could lose the weight if you wanted to," she said rather pointedly.

Aside from the fact that I'd just been certified as healthy, at my current weight, the fact that a crash diet is always a bad plan, and the fact that it's none of her business, there's the fact that endocrine and thyroid issues, which I've had all my life, mean that my weight is only sketchily related to what I eat or how much I exercise. A friend with a similar endocrine issue is a professional dancer (obviously in great shape), and once restricted herself to only 1000 calories a day and still gained significant weight. (By "significant" I mean "at least double digit numbers." I can't stand it when people call two pounds "weight gain.") But let's just circle back to "none of her business." So, I don't usually discuss it.

Can I call myself "healthy" with endocrine and thyroid issues? Well, what I can say is that every test the doctors ordered said I was within the success parameters. That's not subjective. And if they aren't asking the right questions, well, maybe World Renowned University Medical Center ought to rethink their questions.

In a way, they did. A few more months passed, and I got a call again. "We've reconsidered your case," World Renowned University Medical Center said. "We've discovered that we can have success with donors your size." All of my tests were too old to use, though - would I mind getting all of the tests done again? Yes. I would mind.

"S has asked that I remove myself from consideration. Thank you."

The good news is that S agreed to a transplant from a cadaver kidney from a donor past the usual age, and the last time I saw him, he looked and felt fantastic. The kidney from the older donor was doing a great job.

So, why am I now going from "don't discuss it" to "put it out on the Internet"?

Because my kidneys are rock stars, with filtration numbers rarely seen. Boo yah.

And yeah, even many years later, my family occasionally has to listen to me whine about "the time I tried to give away one of my organs, and they wouldn't even take it."

Skin Deep

I'm musing here on size and appearance. I guess a little of that is inescapable.

It's been a few years since I wrote this. My once painfully thin daughter is now much rounder. Now I hear about how I should put her on a diet. That's just as annoying as hearing that she's too thin.

Why doesn't anyone ever think that someone is, in Goldilocks terms, "just right"?

*********************

I have, hanging over my dining room table, a replica of a newspaper ad from 1891. It's for a product called, "Fat-Ten-U-Food." "Respectfully tell the ladies," the headline blares, "Use Fat-Ten-U-Food to get Plump!" The copy is a scream. It trumpets your ability to become "plump and rosy, with HONEST fleshiness of form." It makes a point of saying that the pads, bustles and such in fashion at the time were dishonest and deceitful. Both the before and after images show women in their underwear, which, granted, cover more than most modern summer clothing, but was worn under all the additional pads. "Don't be like the poor unfortunate" in the "before" image, it warns. "Shorn of her artificially inflationary pads and devices, she must, in the confines of her bedroom, through shame, try to cover her poor, thin figure from the gaze of her beloved spouse." By today's standards, the "poor unfortunate" isn't even particularly thin. The look on her face, however, tells you that she's obviously mortified. She's holding her arms in a way that shields her bosom, indicating, of course, a flat chest. But wait, the ad promises, all is not lost! When you take Fat-Ten-U Food, you can walk "confidently through your bed chambers, conscious of YOUR PERFECTION of FORM!" The "after" image shows indeed, a plump, rounded woman. She's beaming and tossing her hair back. She has an ample bosom, dimpled knees, a well rounded stomach, and padded hips and bottom. Gone is the chiseled jawline of the "before" image. She looks like me with more hair.

 All this is followed by the requisite testimonial and photo. "In four weeks Professor William's famed FAT-TEN-U FOODS increased my weight 39 pounds, gave me new womanly vigor & developed me finely," the woman writes. She's sent in a photo of herself and her two sisters, who followed her lead and now, she writes, they all receive leading roles in the Grecian dance productions in Philadelphia. They too are wearing clothes best described as lingerie – fairly scandalous in that day and age, and certainly not designed to camoflage the body. They're very round and generously proportioned. My copy doesn't quite do justice to the original, which was displayed in the shop where I bought my print. In it, you can see far more detail. Believe me, you can pinch far more than an inch.

In my bedroom, I have a print of a Botticelli painting entitled, "The Three Graces." They're wearing diaphanous robes that again, are not designed to hide anything, including pounds. They're rounded and dimpled – no worries about cellulite there!

I display these things to remind myself, and everyone else, that the current obsession with being thin is very, very new. For most of history, thin people were pitied as being weak, sickly, and probably poor. Looking back through more ads of the nineteenth century, there are similar products sold to fatten up thin babies. The wording there plays heavily on parental guilt, and hints that people are saying unkind things about your poor, scrawny child behind your back. (Another benefit of these ads is to remind us that while we jeer at snake oil salesmen of the past, we're just as susceptible to miracle product claims as our ancestors were.)

It took me many, many years to be comfortable in my own body. That's true for almost everyone, I suppose; some people never do feel comfortable.

Marilyn Monroe was 5 foot 6 and weighed 145 pounds. MARILYN MONROE. In high school, I was 5 foot 8 and weighed 155. It was the early 80s, three decades too late to be considered Marilynesque. It was widely accepted by one and all that I was just too darned fat. I wore 12s and 14s while 7s were considered as large as you should ever be. The "guides" in magazines and such identified me as being "obese," more than 10 pounds above "ideal." My best friend since third grade wore size 3.

Even people who were trying hard to be supportive would say things like, "If you'd lose some weight, do something different with your hair, buy nicer clothes and learn to put on makeup, you could be pretty." I know they meant no harm, but it left me thinking: So, if nothing about me was the same as it is now, I MIGHT be considered acceptable? Gee, thanks. I feel warm and fuzzy all over. More usual were comments like this one, courtesy of my dad: "If you keep eating like that, you're going to get big as a house."

In my favor, even at my current, much higher than high school, weight, I've always had an hourglass shape. If I'd been able to carry myself back then with confidence, I would have been much better off. I'd still have been considered fat, but people wouldn't have constantly bugged me with their ideas for improving me. Judging by some of my photos, I could have passed for pretty as long as the viewer didn't have a waif fetish.

Just as annoying to me were my friends' efforts to change my hairstyle. I had long, naturally wavy, and, once upon a time, thick hair. I wore it straight down with nothing done to it for years, but by high school I was clipping back one or both sides with a barrette. That was it. Other girls, especially those with short hair, were itching to get at mine and make it over. Every now and then, at a slumber party or some such, I'd submit to having my hair done, usually to shut somebody up. I've never enjoyed that process. Anyway, most often they'd attempt to put my hair up in some fashion, because they could. I have a round face and a receding chin – if you put my hair up, I look like a senior citizen. I was a constant disappointment to girls who kept complaining, "Well, it should have worked." My favorite was the comment made after I'd had my hair French braided back: "You're right. You hair looks good by itself, but it doesn't look good on you."

Even my husband has never particularly considered me attractive. In his eyes, that's a good thing. He's always said that pretty women are conceited and high maintenance, which is why he doesn't want one. He'd also be unhappy with a wife people were hitting on behind his back. So, according to Dan, my not being pretty is good.

I finally came to the conclusion, well into adulthood and weighing much more than "ideal," that if people don't like the way I look, it's because I don't fit their taste, not because I'm flawed. Everybody's taste is different, and influenced much more by their culture than by any kind of objective standards. If I'd married a Polynesian man and moved to the islands, I'd still be considered scrawny, and they'd be trying to fatten me up. One size will never fit all.

I face the flip side of this coin with my children. You have no idea how much willpower it takes to be civil to people who say, "Don't you ever feed that kid?"

For whatever reason, I have children who have picked up the genes most apparent otherwise in my half sister and her second daughter. They're built like greyhounds. Much to my sister's, and sometimes their own, dismay, her other two daughters were built lush and curvy – more like me.

I am tired of relatives saying to my son, when he's wearing shorts, "Cover up those skinny legs!" I am tired of people telling my oldest that she doesn't eat enough. I am tired of hearing that my youngest has "a stick body." I am sick to death of body shape comments, from anyone or to anyone. I even hate it when they're positive comments. We are not cut out cookies, made by the same cookie cutter.

My youngest was fairly rounded at birth, but as she got older she thinned rather dramatically. I asked her doctor, when she was about eight or ten months old, whether I should be concerned. I wondered if, in the mess of her eating habits, she might not be getting enough to eat. His first comment was a flippant, "Oh, yeah, you've really got to watch that nursery peer pressure. It can be murder." He then told me that she was hitting all her developmental milestones and obviously happy, so not to worry. I still did, but I tried to keep it in perspective. All my children have had slight builds. If Hallie was smaller than her siblings, well, she's a different person. She's not going to be the same. Besides, I was aggravated to the point of screaming by the responses I got whenever I mentioned to someone that I was worried about her. "Oh, tall and thin – I wish I had her problems!" was typical. One friend said, "But you want little girls to be petite." We heard more variations on that theme. I was continually told how thrilled she'd be later in life. I wanted to slap people and say, "SHE'S ONE YEAR OLD!" I decided it was best to say nothing.

When she was thirteen months old, she was hospitalized with severe anemia. As soon as we arrived at the hospital, the nutritionist swooped down on us to talk about an iron rich diet. Hallie was still drinking formula at that point, because I was concerned about her, and formula has more nutrition, fat and calories than milk. Of course, one of the first things the nutritionist wanted to know was what kind of formula we'd used. I told her we were still using it, and handed her the container. She blinked and looked puzzled. "Well, this is exactly what I fed my kids," she said. After a few more questions, she was even more puzzled, so she ended up just dropping a bunch of literature on us and then leaving. We never saw her again.

After Hallie'd gotten well and been released, we were referred to a viral specialist, to see if she could confirm our doctor's hypothesis about the cause of the anemia, which he suspected to be human parvo virus. She seemed far more concerned with the baby's weight than with anything else. After the exam and review of her blood tests, she sent us on our way, telling us we wouldn't need to make a return visit. Then, she phoned our doctor and gave him an earful about how thin the baby was, and how it just wasn't right, and how she didn't think we were "concerned" enough about it. I'm sure the upshot of all this was that she thought we were unfit parents, and he had to get the baby out of our home immediately. The poor doctor spent the night awake, terrified that he'd missed something important, and called us into his office first thing the next day. His first comment when he came in to examine her was, "Well, that's just what Hallie looks like." She'd gained back a pound of the 1 ½ pounds she'd lost in the hospital, her color was back to a healthy pink, and she was cheerful and lively. Still, we put her on a new formula since she seemed to have a dairy sensitivity, and we went back and weighed her fairly frequently for the next few weeks. She gained slowly but steadily, the way she always had, and the doctor was satisfied that he hadn't missed anything. And lo and behold, she was still tiny. I don't think she ever got above the 5th percentile on the height/weight chart. He relaxed and wondered why the specialist had been so alarmed. We wondered how many other people we would run into who were sure we were lousy parents because our daughter was thin. They were as bad as the "thin is good" crowd, and quite possibly dangerous as well. A friend of mine had a miserable time sitting with a woman from Child Protective Services, trying to assure her that yes, her thin child ate as much as any other family member. The CPS woman was unconvinced, and my friend herself is built like a greyhound. I can just imagine the horror on a social worker's face when, gasp, fat parents have thin kids. You'd think with all the hysteria about childhood obesity people will be thrilled, but no.

I spend a great deal of my time telling my adolescents that they should no more expect people to have the same shape and size than they should expect them to have the same voice. My son plays sports, and we have never even hinted that he has to work harder than the burlier boys, or that the rounder kids are at a disadvantage. I won't allow anyone else to say such things to him, either. I'm fighting an uphill battle. WE SHOULD NOT ALL BE THE SAME SIZE OR SHAPE.