Rants from the Crib

An Ob/Gyn gone mad

Another Rollercoaster

I have been in two worlds. Like Tiresius in Greek mythology, who was both male and female in his lifetime and could finally reveal (but never did) which gender is happiest and enjoys sex more, I have straddled two places, fat and thin. I know that some people who will read this may have been overweight all their lives and my “awful” top weight might seem irksomely low. But for me, as shallow and as concerned about my appearance as I have always been, that top weight was disastrous.

I am 5’3″, and I have been as light as 115 pounds (I am 120 pounds right now). I was 190 pounds just before I gave birth to my daughter, and I hit my all-time “I may as well look like hell because I am dying an endless death in my soul-killing job” high at 175 pounds, definitively NOT pregnant.

When you are fat you disappear. This is largely due to humiliation – in those 3 years I carried so much weight, I passed up so many opportunities to connect with old or new friends because I was so humiliated to be seen like that. No one tells you look nice anymore, especially your husband, because you don’t. And people just look at you differently, or more accurately, not at all. When you leave the societal expectation of reasonable weight, you attain “nonperson” status, especially in the shallow and competitive world of the physician and Junior League spouses, which is where I now was. My neighbors didn’t wave at me any more. I will never know if it is because they found me grotesque, or because I found me grotesque. I suspect both.

In high school I was never fat but I was awkward, curveless, had braces, and acne, and didn’t know what to do with my hair, which was stringy and awkwardly layered. I had had all my hair cut off, and instead of looking like a pixie, or, as my mother had hoped, Dorothy Hamill, I looked like an adolescent boy. I was absent all sensuality. I was a pariah.

When I hit college, I got beautiful. I was a late bloomer, very late, so I consider the beauty I had to be fair. It gave me the humility of the ugly duckling and the pride of the swan. I was a stunner. And I weighed 115 pounds. It was effortless, because I was always broke, and my quick meals were a Coke and a candy bar out of a machine, because that was all I could afford. I learned that my “skinny hair” could be made amazing by being grown out into a long straight curtain, with straight bangs that brought my sharp chin out of focus. I had huge blue eyes, and high cheekbones, and the acne went away. At 115 pounds, I still had the curves, and a size 36C bra. Men I didn’t know literally followed me down the street. I learned I could get a man to do ANYTHING, and I misused that and hurt both myself and them.

I have been a “yo-yo dieter” my entire life and I can tell you exactly what that feels like. My closet now and at any time contains a range of sizes from 2 to 12, because eventually, those sizes will come again. The time I hit rock bottom, or I should say, boulder top, there were size 18 clothes in my closet and I wanted to commit suicide. I destroyed those as soon as that weight finally came off; to paraphrase Scarlett O’Hara, I would never be that fat again.

My weight went up in college when I dated a guy who was 6’4″; I thought I could eat like he did and we drank beer and grilled steaks all the time. I gained a LOT. He was a great guy, but we finally broke up when I realized I was becoming obese. My mom made me try on and buy a size 14 dress; I slammed on the brakes and he stopped the relationship because he didn’t like and couldn’t afford the healthy foods I was trying to eat. We are still friends at a distance, and he too has struggled with weight his whole life.

I lost the weight. I went off to med school. I dated an athlete who pushed me to do crunches and windsprints with him – I was in great shape (although the muscles made me bigger). When we broke up, I had just moved to New Orleans to start my residency, and I was depressed over the failure of the relationship and drank and partied myself to an unattractive and unhealthy weight. In New Orleans, partying among professionals is not tolerated, it is expected. The mantra there: “We work to live, not live to work”. I dieted, and my weight swung between about 120 and 150 pounds, which remained my all top worst weight for years. 150 pounds at 5’3″ puts you at about a size 12. I never weighed because I couldn’t afford a scale, but the sizes of my clothes told the story. At that point I had dieted so many times that I could pinpoint my weight almost exactly by the size that I wore.

I moved to Atlanta for my first real doctor job. The shallowness of that town depressed me horribly. There was a homogeneity to the girls who went out at night in Buckhead; they all wore black and their clothes hung off them as if they were clothes hangers. I literally overheard, one night at a club, a guy say that he “couldn’t find beauty in anything larger than a size 5 dress.” I was miserable.

I met my husband in Atlanta and was a reasonable weight. I quit drinking and smoking, and was about a size 8, give or take, for several years. I looked beautiful in my wedding dress.

A year or so later I got pregnant. I was ecstatic; we both wanted a child, and for the first time since I was 12, I didn’t have to watch what I ate. The first 15 pounds of my pregnancy were my “Oh, thank God I don’t have to be on a diet any more” weight, which I joke with my patients about all the time. Most of them know exactly what I am talking about.

When I was pregnant, I ballooned to 190 pounds right before my daughter was born. I didn’t feel that bad about it; she turned out to be a huge baby and I figured I’d get the weight off after she was born. At that point I outweighed my husband by about 50 pounds – he is a small and fit man and he used to joke that I had gotten so big that “smaller OB/Gyns were orbiting around me.” I had heard him say the same things to his sister when she was pregnant, and it irked me, but didn’t really bother me that much. I threatened to sit on him if he pissed me off. He flung back that I’d have to catch him first.

I did have one eye-opening new experience while I was pregnant – for the first time a man looked at me with utter crawling disgust on his face. I remember the night well; I was in a Chinese restaurant picking up dinner and I saw a redneck bearded man looking at me, and the look on his face suggested that were he in a deer stand, he would do me a favor and put me down. I know that some men just don’t like pregnant women, but the look on his face really shocked me.

I was right about one thing though: I did lose the baby weight. I breast fed for an entire year, and when my daughter was 2 or 3, I got down to about a size 6. I hadn’t been that size since I was in college. I was thrilled, and dressed to the nines all the time. There are pictures of me with my family at the time, looking thin and relaxed and happy.

Then life happened. An OB/Gyn works hard, but my partner and I hit a really bad patch. There were 3 of us in the practice, and our older partner quit doing OB, as older folks will do because it takes so much out of you, so we hired a new partner. The new partner fooled us, and she turned out to be a bonafide sociopath. After tortuous debate, we fired her, even realizing that it would be just two of us covering call for an indeterminate amount of time. We didn’t want to hire just anyone, especially in light of our recent disaster, and that indeterminate amount of time turned out to be two and a half years. Being on call every other night, in a practice that delivers about 45 babies a month, is a life changer. You are either on call, getting slammed from every direction by extra phone calls, add-on patients, unexpected surgeries and deliveries, planned surgeries and deliveries, and just the kinds of crises that come up when you work with women for a living, or you are off call, which means you still have a full work day ahead of you, and which finds you bleary, fuzzy-eyed, staggering, unable to make up that sleep deficit because you need to at least say hello to your family when you get home, and filled with the knowledge that when the alarm goes off at 5:30, you have to hit the ground running and are on call for another 24 hours.

Damage was done. The job was destroying me. I worked 80 hour weeks, barely saw my family, and earned the enmity of my husband for providing no sex, no housework, and little or no attention for my daughter. I slid into a black depression, from which there was no escape, because no amount of pharmaceuticals were going to fix the underlying problem: I was working at a pace that was killing me. OB/Gyns are trained to be ultra-tough; it is a matter of pride never to call in sick. I only took 4 weeks off after my c-section, largely because I knew that at that point my partner had been on call for 4 weeks straight, and I couldn’t hit her with another 2. I went back to work and put my new daughter in day care. I literally fell to my knees and cried in the day care room the first day we dropped her off.

I gained weight. An unbelievable lot of weight. My life was so overwhelmingly out of control, and I had so little time off, that literally my only spark of pleasure during the day would be to stuff down a cinnamon sugar Pop Tart on labor and delivery or an extra dessert in the physician’s lounge. I tried to diet and get the weight off, but at this point I loathed my life and everything in it so much that I fell off any diet near daily, whenever I encountered any setback. I tried Atkins Diet, which had worked for me in the past. I even tried a diet where I ate nothing but dessert in the doctor’s lounge 24/7, because I thought maybe just carbs and fat would shut my body down and make it start losing weight, or I might get so sick of sweets I’d stop eating them. Such was my blurry logic.

My fat clothes stopped fitting. I had never gotten to the point where those 12’s didn’t fit. I shuddered as I bought my first pair of 14’s – God bless J. Jill for her stretch jeans. I started wearing size large scrubs, and it must be noted that they don’t make surgery scrubs in women’s sizes – just men’s. Even worse, scrubs can really let you lie to yourself for a long time; they are so loose and they come in so many sizes that you can just convince yourself that the scrubs you are wearing are still loose; things are OK. I think for me, rock bottom was when I bought a pair of elastic-waist jeans on sale at Coldwater Creek – they were a size 18, and my fat still rolled the waist down. I was too tired to even cry.

Then something amazing happened. Our hospital was bought by a large outside entity, and due to incredible skullduggery, my only chance for a job in that town was to agree to work in the new “elite” practice which was run by unethical hateful men whom I had known and avoided in town for 10 years. Oh, the stories I’d heard, and the things I’d seen them do. I could not work with them. They just wanted me because I was female, and had 10 years worth of patients accumulated in that town. They owned the practice and I would have been their employee. I was well acquainted with two women who had been employed by them previously; their experience had been so bad that they had both quit the practice and moved to another town. The men were stunned when I turned them down.

My only other choice was to start a difference practice, an act which I was made to understand would not be sanctioned by the hospital and would have been seen by the hospital as an act of war. With sheer glee, I turned in my resignation and decided I would do what I had wanted to do since residency and become a locum tenens, which is Latin for “traveling temp doctor”. I could work as much or as little as I wanted, depending on what my family needed.

I got myself the hell out of that job and began traveling for work, part time. The weight just fell off. I made 2 rules: I never ate out, and there were only certain foods I was allowed to eat; fruits and vegetables that were minimally doctored with fats and sugars, fish, chicken, and yogurt. Lots and lots of yogurt. In other words, a healthy diet.

When the weight started coming off I felt so happy. I felt happier every day. I didn’t know how much I weighed, or how much I’d lost, because traveling I did not have a scale. On one of the greatest days of my life, I went to a mall in a small town I was working in and saw a pair of jeans on the sale rack that were beautiful. I picked them up and thought to try them on, but they were a size 6. I didn’t think there was any way in hell that that would be possible, but they didn’t look that small and I thought, “What the hell.”

I went to that dressing room and they fit. THEY FIT!! I was beyond astonished. I hadn’t been a size 6 in at least half a decade. I hadn’t thought it would ever be possible again. I was delirious. I was ecstatic! I went back to the hotel and posted a selfie that night on Facebook, with the caption “Size 6 Jeans!”. My nurse friends, who had last seen me topped out at 175 pounds, were AMAZED. The well-wishings and the compliments and the “how did you do its” poured in. I felt beautiful.

When you are thin you are an object of mock horror and annoyance. I had forgotten about that; it had been so long. I must say, this is much less onerous than the personal and societal disgust that come with fat. I’ll take “skinny shaming” any day. The nurses in North Dakota where I traveled watched me drop sizes until small scrubs were loose. “You need new scrubs,” they told me. “You look like a stick,” they told me. “You’re probably cold all the time because you don’t have any body fat,” said one of them.

I love it! You can skinny-shame me til the damn cows come home! “You’re so little,” said one of the nurses in Ohio. “I’m used to hunting for 2X scrubs for our regular doc.” Don’t throw me in that briar patch, Br’er Fox!!

I let myself slip and put on 9 pounds. I went off the deep end. I was alone in a hotel room, and I cried. I screamed. I hit myself in the head. I threw things. I sobbed for 2 hours straight. I was a madwoman. I did a lot of soul-searching. Why would I overeat and sabotage my hard work, this acheivement that brought me so much pleasure? Overeating is such a fleeting rush, leaving only an uncomfortable feeling of fullness and shame. Thinness is a rush that lasts all day. Why would I sabotage myself? I took a deep look at my life, at the things that had brought me to this point.

I was raised by a mother who was a beauty queen. She was actually homecoming queen of a huge state college in 1962, among other things. When I was a kid, I was walked around the house with books on my head. I was a small child, never an overweight one, but Mom told me I couldn’t have a pair of jeans because they wouldn’t look good on my “lazy little tummy”. By this she meant that I wasn’t self conscious enough to walk around sucking it in all the time. Yet. Weirdly though, when things went wrong, she’d soothe me by taking me out for ice cream or a gingerbread man. But I could only eat when SHE sanctioned it. She could hear me peeling a banana across the house and would swoop upon me, objecting that I would “ruin my dinner”. She once told me that if I didn’t stop eating, she’d have to buy my clothes in the “Husky” section at Sears. I weighed maybe 65 pounds.

I went on my first diet when I was 12. I was not a bit overweight, but I saw all the diet tips in my copy of ‘Teen Magazine, and I guess I thought I’d become miraculously beautiful, or popular, if I did what the beauty magazines said. My mom wholeheartedly applauded my attempts at betterment, even though in the 7th grade I was still wearing girl’s sizes. When I fell off the diet a week later, when confronted by a plate of doughnuts at a school function, Mom expressed disappointment in my lack of willpower.

My mom treated my father’s eating with equal scorn, even though he wasn’t fat either. In fact, he was a jogger, did military pushups, and was in fabulous shape. My father and I became partners in an eating conspiracy. We would happily meet each other in the kitchen after bedtime, and would share cartons of ice cream or bags of chocolate chips. When I was home alone, I would scour the kitchen, eating marshmallows, brown sugar, cereal, chocolate chips, and raw oatmeal.

So I internalized a couple of things in childhood. First, appearances and beauty were tantamount. Second, when you were sad or blue, you got a sweet treat. Third, sneaking around and eating was a way to spite and defy my mother. I used sneaking and eating later to defy boyfriends, my husband, and more importantly, myself. Somehow I was punishing myself by taking in those calories.

Then, in high school, I was such an ugly duckling that the message of the importance of beauty was really slammed home. I couldn’t be less awkward, or have fewer pimples, or make my hair do anything, but by God I could control what I put in my mouth. It was the only thing I felt I could control.

In college, when I was pretty, that brought home the kind of power that a beautiful woman could wield. I was heady with that power, and hurt a lot of people. I also established unhealthy relationship patterns that would persist well into adulthood. And at the top of that list was the constant need to be reassured that I was beautiful, prettier than everyone else in fact. And I raged when I met a man who denied me that reassurance. I dated him for 5 years to make him change his mind and grovel. He never changed, and he never groveled. Many years later, he admitted to one of my friends that we had had one of the better relationships that he had ever had, and that I was probably one of the prettiest girls I had ever dated, but he denied me that to the end. The pain of the failure of that relationship dogged me for more years than we were actually together. He was an emotional terrorist.

I have a terrific marriage now, but my husband is a certified fat-phobic. He is ex-Navy, wiry and muscled with big lats and the proud carriage of an ex-military man who has stayed in shape. He and my daughter have the metabolisms of shrews, or hummingbirds, and it seems that they must consume at least twice their weight daily in food and remain in constant motion to surive. My husband does not like overweight people, and does not censor the things he says about them. When we first moved back to Alabama, he was horrified by the obesity he saw there. One day in Walmart, we encountered a family: the two parents were each in one of those motorized carts, with their fat rolls hanging down. They were each probably 400 pounds easy. Their teenaged son was with them – and he was well on his way to 300 pounds. I kid you not, they were in the candy aisle, heaving bags into the baskets on their carts and arguing about which multipack to pick up next. My husband backed away from them, eyes wide, as if he had encountered an intruder with a gun. He pulled me swiftly into the next aisle and whispered hoarsely, “Oh, my God, can we please move back to Atlanta?”

I know that my massive weight gain hurt him, but he was actually very kind. I think he understood, at some level, how much stress I was under and how really broken I was. And he knows me well enough to know about the “spite” game – he knows I was passive aggressive enough to fight him with sneak eating if he forced the issue too much. He just stopped complimenting me. Which was OK, it wasn’t hurtful as far as I was concerned because I knew how he felt about fat, I’d let myself go, I looked like hell and didn’t deserve complimenting. It’s nice to be married to someone who knows you well enough to provide you with the best strategy to keep yourself from shooting yourself in the foot.

He’s delighted that I’ve lost the weight. Now he compliments me. And when he sees a heavy woman pass by, he does what he did when we were first married, and leans over and whispers, “Thank you”. I’ve worked my way down to somewhere between a size 2 and a size 4 now, and I am holding. I reined back in, tightened up, and got those 9 pounds back off by giving myself a positive peptalk, rather than belittling myself. I lost a total of 55 pounds in 9 months, and I hope with my new attitude, with an understanding of where I have come from, and my new enjoyment of my appearance, that I will keep it this way.

I did mention to my husband that I thought it was odd that fewer of my long-term acquaintances had mentioned my new appearance than I thought would. He thought about it and said that in today’s world, sometimes extreme weight loss means that something bad has happened. I thought about “divorce diets” and HIV and cancer and decided that was right. He also suggested that they might be jealous. I was OK with that too.

So I’ve been on both sides now. Many times. And as the Tiresius of weight gain, I have lived with fat and fat predjudice, and thin and thin predjudice. And I will say, having worked both sides, I’d rather be sassed by somebody who is jealous than by somebody who is feeling superior and disgusted. And, shallow as it may be, looking great is the best revenge!


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One thought on “Another Rollercoaster

  1. Boy did you ever – I really enjoyed this. I know I’ve been lucky to not have the zig zag and can only relate regarding age and how that has changed my self-image more than I thought it would

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