The mortal danger of being sick while fat.

A mourning rant, addressed to my doctor.

[Content notes: weight, fat-phobia, cancer, death]

Why are weight discussions off-limits today? It’s a long story.

To sum up: I am in mourning, and I am very angry at medical professionals who saw the friend for whom I am now mourning as a case of the fats, rather than a whole person with complex needs. You probably don’t need to know more than that, but if you’re curious, here it is.

A dear friend of mine died in July. The cause of death was metastatic cancer — as yet we don’t know what type of cancer or where it originated, because the cancer wasn’t found until a few days before she died.

She was fat. She also had lipedema, which is a fatty tissue disorder that causes abnormal and intractable fat deposits in the legs and hips, and eventually leads to lymphedema. The effects were visible on her body for at least 20 years before she was diagnosed, and that diagnosis didn’t come until she had lymphedema so bad that she was losing liters of fluid a day through wounds that would not heal in her legs. In between, she was constantly told to diet and exercise, and disbelieved about what her actual food intake and activity levels were.

She was in and out of the hospital, but mostly in, for two years, with a cascade of problems and complications, some of them clearly related to the lipedema, some of them more mysterious. When her kidneys were doing confusing things, they considered doing an MRI, but the hospital where she was didn’t have an open MRI machine, and she wouldn’t fit into a closed one.

Eventually, after many false starts and detours, the lymphedema was properly treated. She lost about 100 pounds in a very short time, mostly in fluid. Just as she was starting to regain the ability to walk with support (which she had lost being bedridden so long), she was transferred to a nursing home which was supposed to provide rehabilitation but was in fact not equipped to handle physical therapy for a patient of her size, and not willing to provide her with physical therapy at all past the first week.

While she was at the facility known among my friends as Corey Hell, she gradually and without professional assistance rebuilt the strength first in her back and then in her legs to the point where she could transfer between bed and wheelchair or commode without assistance, and to walk unassisted for short distances. She was supposed to go to her best friend’s housewarming. But she suddenly became much more ill, with digestive problems and loss of mental clarity. She was transferred back to the hospital, where they did a full body MRI. Which they *could* do now that she was small enough to fit into their machine. They found a huge number of tumors all over the place. One of the tumors had broken through her skin, and been taped over by the staff at the nursing home.

I found out she was going back to the hospital on a Thursday; I decided not to cancel my long weekend trip to visit my father. I found out that she was dead the following Tuesday morning as I was starting out to visit her.

I don’t know for a fact that fat-phobia killed her. But if her doctors when she was younger had thought of her as a person rather than a case of the fats, her lipedema might have been diagnosed and treated earlier, she might have had more time to do the things she loved and was excited about, rather than those two years in the hospital just as her cake-decorating business was starting to take off. If her lipedema had been diagnosed and treated earlier, she might have been small enough to get into the MRI earlier in the course of her illness. Without the cascade of complications from the lymphedema, the cancer might have had symptoms that could be identified early enough that it was treatable. If the medical community gave a fuck about fat people, she might have had access to imaging even at her largest.

None of those ifs happened. My strong, smart, bold, creative friend is gone. She can’t tell me off for being so slow to recognize what has happened to my marriage, what being around that is doing to my daughter, because she is gone. She can’t teach my kid how to paint narwhal cookies, because she is gone.

I am fat. I am fucking death-fat, if that’s what you need to put on your forms. And I WILL NOT talk with you about my fat today.