Monday, 27 August 2007

Sizing you up

I like walking round the hospital with the Giant. He's so tall, it's like having your own bodyguard. Almost a one-man entourage. When I gave up rapping to concentrate on the medicine, I thought I'd left my "bling" lifestyle behind, so this is quite a treat.

Not everyone takes so well to his enormous height. A small Filipino nurse started screaming at him to "BACK AWAY, BACK AWAY NOW", startling everyone in the vicinity. Turned out she just had a bad neck and staring up at his face from a close distance was giving her serious pain.

In hospital, I think everyone's judged on their physical appearance. Patients judge doctors, doctors judge doctors, and doctors definitely judge patients. "You look better"; "this guy looks dehydrated", "that doctor's nervous". It's part of the clinical assessment.

Sizing someone up isn't always so straightforward. Take obese people. Aside from the negative social stereotype, it's more difficult to treat a patient who's overweight. It's harder to take blood, harder to get their wounds to heal, and much harder to interpret test results. We had a patient who had to be referred to a different hospital just because he was too big for our scanner. He literally couldn't have a CT scan because he'd break the machine. There was talk of sending him to the Imaging department at London Zoo: a serious suggestion, because it's been successful before.

It goes both ways: there's evidence that patients trust obese physicians less than thin ones. So while I'm wondering why you didn't stop eating Big Macs after your second heart attack, you might be wishing you had a junior doctor without a pot belly.

Maybe this isn't any different to a normal social encounter. People respond to the way you look and dress, and you expect that. But when it comes to health, size really does matter, and doctors need to be able to take a dispassionate look at an expanding waistline without the interference of a social stigma. I just hope that there's enough appetite there to take on the obesity epidemic.


Anonymous said...

Have you met Chris Oliver? He's our friendly local orthopod who's recently lost 6 stone after having his stomach banded:

Anonymous said...

i remember reading somewhere that patients are also less likely to trust a doctor with a moustache, not sure how muhc truth there is in that (and not an issue for female docs either).

Re: your comment - do you expect to be sued at some point in your career, no matter how good a doc you might be?

it is worrying...

Elaine said...

(Not sure if "the moustache thing is not an issue for female docs either" is entirely true - have you seen some of them? :-)

HospitalPhoenix said...

As a patient, I was always wary of doctors who didn't look me in the eye.

On that level, nurses (in general) made a far better impression, and seemed far more trustworthy.

steph said...

As regards what Hospital Phoenix has just said, I think I've every reason to be very wary indeed!!!

Anonymous said...

Please let us all know when you found a safe and functional diet for people who cannot move easily due to chronic pain ;)

What gets my trust from a doctor is their willingness to make a plan to cure me. Not what they wear or how fat they are... although someone normal (fat, wrinkled, without much fashion sense, but a good smile) appeals the most to me, if we go purely by beauty parade judgment.