by Lisa Ireland
Mezz was taken aback for a moment. She’d expected a tale about an unwanted pregnancy or perhaps an STD. Now she knew why Melissa had travelled so far to see her and why she expected her to understand. She was fat after all. Fatter than Melissa, it had to be said, who was apparently so displeased by the state of her body she’d decided surgery was the only answer.
She realised Melissa was looking at her, waiting for her response. ‘Okay,’ she said. ‘Let’s take this one step at a time. Before we talk about this any further let me first work out your BMI for you.’
‘My BMI is 37, so I qualify on BMI alone but I have a comorbidity as well, with the high blood pressure, so I’m sure there will be no issue getting a surgeon to take me on.’
Obviously she knew her stuff. Using terms like comorbidity marked her as someone with a medical background. A nurse maybe? Or a fellow doctor? And she clearly knew what she wanted. Talking her out of this drastic measure wasn’t going to be easy. ‘Okay, great that you have a handle on all this. But would you just humour me and let me take your measurements, just so the documentation is accurate? It’s not that I don’t trust you but if I’m going to record a BMI I want to double-check that it’s been calculated correctly.’
‘Not a problem.’
Mezz had her patient step on the scales first and then she did a height measurement. It didn’t escape her notice that Melissa was taller and weighed less than she did. How could this woman be considering surgery? Surely she wasn’t that desperate. Perhaps Mezz should mention the WON program. No, that would be unethical. She couldn’t recommend a specific commercial program, but she could make some lifestyle suggestions, give Melissa a referral to a dietitian and talk about the many options available online, both free and commercial.
She punched the numbers into the BMI calculator and sure enough the result was 37. ‘You were spot on with your calculations. So now we’ve ascertained that you qualify for a referral as far as the numbers go, but before I make any decision I’d like to talk about this idea some more. Find out a little bit more about you and what’s brought you to this decision. Is that okay?’
Melissa nodded. ‘Fire away.’
‘So I know from your history that you’re married. No children. Do you work outside the home?’
‘I’m a teacher.’
‘Oh. Primary or secondary?’
‘Primary. You seem surprised.’
Mezz smiled sheepishly. ‘Sorry, I didn’t realise I was being that obvious. It’s just I had you pegged as a medical professional, that’s all. Silly assumption. You seem to know more medical terminology than my average patient.’
‘I’ve done my research.’
Mezz nodded. ‘Fair enough. So I’m wondering why you think surgery is the best option for you?’
‘I’m thirty-one years old and I’ve been dieting now for over half my life. I know how to lose weight, I’ve done that successfully many, many times. But it always comes back and each time I regain the weight I end up weighing a bit more than the last time. Like I said before, I’ve done my research. I know that dieting doesn’t work. My research tells me only five per cent of dieters, or as they like to call themselves these days, ‘lifestyle changers’, ever succeed in keeping their weight off. That’s a ninety-five per cent failure rate, and I know from my history that I’m not ever going to be one of the five per cent.’
Mezz’s chest tightened. Surely that wasn’t the case? Of course the statistics weren’t great, but ninety-five per cent failure seemed excessively high. None of the literature she’d read had been that blunt. All the government literature focused on helping patients to achieve small lifestyle changes. There was no focus on what happened if those changes didn’t work, or couldn’t be maintained. God, what if Melissa was right? What if it truly was impossible to lose weight? ‘Look, Melissa, I don’t usually do this but I can see you are really struggling with this. If you like, I could trial you on an appetite suppressant. I can write you a prescription today and we can make an appointment for you in two weeks’ time to see how you’re doing with it.’
Melissa’s mouth formed a hard line and she shook her head. ‘No. I’ve tried the drugs before. They made me anxious and gave me heart palpitations. I did lose weight, but I put it all back on and then some once I stopped taking the drug. I know surgery is the only option for me.’ Her voice had begun to waver and her eyes became glassy with tears. ‘Look, I really thought you’d be sympathetic, but if you can’t help me, I’ll just have to find a doctor who can.’
The assumption hit her like a slap in the face. She was the fatso doctor, of course her patient had expected understanding. Melissa was probably wondering why she wasn’t lining up for surgery too. ‘I really want to help you, Melissa, but I can’t just write a referral without giving it proper consideration. I want to know that you understand what you’ll be in for, so we need to talk some more. I promise you I am listening and I haven’t dismissed the idea out of hand, okay?’
Mollified for the moment, Melissa nodded.
‘There are several different types of weight loss surgery. Are you thinking about a lap band or one of the other surgeries?’
‘I think the gastric sleeve would be the best option for me. I’m a fairly healthy eater. I don’t pig-out on chocolate or biscuits, that type of thing, but I do eat too much. I never ever feel fully satisfied. I can always eat more. That’s why I think the sleeve is the best option for me. It will help me control my hunger and the rest will be up to me. I think with that sort of restriction, I will easily be able to maintain my weight.’
‘The lap band is a safer option and it’s reversible.’
‘It’s marginally safer, but it has a much lower success rate than the sleeve. And I don’t want something that is reversible. This will be a lifelong problem for me and I need a lifelong solution. I’ve researched the risks, obviously. But they really aren’t any higher than for a laparoscopic gallbladder operation and I’m sure that’s not something you’d warn patients against having.’
She had a point there. ‘I’ll be honest with you, Melissa. I don’t know much about the gastric sleeve. I’ve never had a patient who has had one and it’s not something I’ve investigated myself. I’ll make a deal with you. Give me a week to investigate the procedure properly. If I’m satisfied with what I find out I will write you a referral to the surgeon of your choice. Does that sound fair enough?’
‘Yeah, okay. I guess I can’t ask for more than that. Once you start looking at the evidence you’ll see for yourself.’
Mezz laughed. ‘I love your confidence. Okay, let’s have a look at that blood pressure before you go.’
★
It was after dinner before Mezz could check to see if there were any messages from Ellie or the others. After her weight loss patient she’d been inundated with others – late flu season sufferers mainly, plus the odd diabetes check-up and a suspected fractured collarbone. Still, she’d made it home in time for dinner and was rewarded with happy children and an impressed husband. If only every night could go so smoothly.
Now Sean had taken Max with him to the gym at the footy club. They’d both agreed that it would do Max good to get some physical exercise. Of course outdoor exercise would have been preferable but there was little hope of that. Max detested any form of team sport and it appeared he was averse to sunlight. Sean had bribed him with the promise of some expensive new gaming apparatus and he’d reluctantly committed to joining his dad two nights a week at the club. Both she and Sean were hoping the physical stuff would lead to an improvement in Max’s concentration and behaviour, but Mezz wasn’t holding her breath. After almost a decade of paediatricians, parent–teacher meetings, psychologists and behaviour modification programs without significant improvements, she didn’t hold out much hope. Sean, always the optimist, thought otherwise. If nothing else, it was nice for the two of them to have some one on one father and son t
ime.
She’d supervised the younger two completing their homework and rewarded them by allowing them half an hour’s extra screen time, so all was quiet in the house. If she was lucky she might get a whole thirty minutes to herself.
Mezz took a black coffee (unfortunately the WON program didn’t accommodate her nightly wine habit) and headed into her office, closing the door behind her. Once the desktop started up she went straight to the forum and noticed with glee there were several messages in her inbox.
User Ellie Phant: Private Message to Users Mezz, Kitty Kat and Princess Jewels
Tuesday September 8 2015
Wow! I’m so excited that you are all on board. I’ve been walking around the gallery with a huge smile on my face all day, so much so that my colleagues keep asking me what I’m so happy about. (Which just goes to show I must be an awful grump to work with most of the time!)
Anyway, I’ll work on our new page/blog/whatever when I get home tonight. I was thinking I could make a simple WordPress blog and if I make us all admins we can simply add our own posts each time we want to update. I promise it won’t be any more difficult than posting to Facebook, but it will be a lot more secure. How does that sound?
We’ll need a name for our blog too. Any ideas? Let me know your thoughts and I’ll have it up and running ASAP.
You’ll all need to PM me your email addresses so I can invite you to the blog. It’s fine to use a gmail address if you don’t want to leave your usual details here. I will delete your messages containing any personal information as soon as you accept the invitation to join the blog.
Cheers,
Ellie
User Princess Jewels: Private Message to Users Ellie Phant, Mezz and Kitty Kat
Tuesday September 8 2015
Thanks so much Ellie. I’m loving the idea of the blog and I have an idea for its title. Now, I hope none of you are offended by this, but whenever I get online at night to check the forum, my husband Matt (who could stand to lose a few kilos himself) always asks me what’s going on in ‘Fat Chat’. Please don’t think he means anything horrible by it. Matt is a sweetheart and totally supportive of me, it’s really just a little joke between us. Anyway, I thought it might make a good title, but will totally understand if people don’t want to use it.
Jewels xox
User Kitty Kat: Private Message to Users Princess Jewels, Mezz and Ellie Phant
Tuesday September 8 2015
LOL, Jewels, I LOVE the name Fat Chat. Let’s go with it! Really looking forward to having our own completely safe place to chat. I have lots I want to talk to you all about. Things are not going so great here at the moment.
Kat x
Mezz smiled at the messages and didn’t hesitate for even a second before typing in her response.
User Mezz: Private Message to Users Ellie Phant, Princess Jewels and Kitty Kat
Tuesday September 8 2015
Fat Chat is fine by me! Like Kat I can’t wait to have our very own place to chat freely. An issue came up at work today that has really got under my skin. It involves weight loss and it’s something I’d really like to get your opinions on. I don’t want to risk discussing it here, so will wait until we’re all set up.
Thanks so much for thinking of the blog, Ellie, and thanks for setting it up.
Looking forward to having some deep and meaningful conversations soon.
Mezz ☺
Mezz was still smiling long after she’d hit ‘send’ on her message and shut down her computer. She’d made the right decision by agreeing to join the private blog. These were her people. She’d finally found her tribe.
Chapter Six
FAT CHAT
The Life and Times of Four Fabulous Friends
FAT CHAT | Wednesday Sept. 9 2015 | Ellie
Good morning everyone.
I’m so excited to be posting here in our very own private space. I thought I might start by doing a proper introduction, so I can tell you all the things I couldn’t say before.
As you know I moved here from London two years ago to be with my partner.
What I didn’t mention earlier is my partner, Jenn, is a woman. She’s a senior adviser to one of the federal ministers here in Canberra. She travels a lot and I’m often left here alone. Well, except for our cat, Leonard.
Before I moved here I had my own flat in London and I lived alone, but I was never lonely. I had a large network of friends and work colleagues and of course my family are in England too (such as they are but that’s a story for another day!).
To be honest I’m finding it a tad lonely here. I don’t love my job. I don’t hate it either, but it’s not challenging enough and I can’t see any chance for promotion in the immediate future. There’s no one at the gallery that I would call a friend. My immediate boss, Bridget, is around the same age as me and has the same qualifications as me, so I think she sees me as a threat. Honestly, I’d be happy in my job if she gave me a bit more responsibility, or at least let me take credit for the work I do. It seems I do all the behind-the-scenes work and then when it’s time for an exhibition to open, or to do a media spot, Bridget sweeps in and takes all the credit. (Not that I want to do any of the media nonsense with the way I look at the moment. Perish the thought!)
I’m afraid my interests outside the gallery are not terribly thrilling. They’re certainly not hobbies that help me meet people. I like to read and I like to sew. I’ve recently taken up quilt making and that helps to fill my time when Jenn’s away.
When Jenn’s home we’re often quite busy, although we don’t get a lot of alone time. She’s a woman in demand and we seem to be constantly out at parties, gatherings, openings and the like when she’s in town. Sometimes these events are fun, but more often than not I feel awkward and uncomfortable, especially at the formal events. I never can seem to find anything to wear that I feel good in. I love clothes, but it’s so difficult to find decent things to wear at my size. I’m short and most plus-sized clothes seem to be made for women of Amazonian proportions, don’t you think? (You’re probably all tall!) Sometimes I can alter the clothes to suit, but lately I’ve resorted to designing and making my own clothes.
I’m sorry. I’ve probably bored you all witless by now. It’s just so nice having somewhere I can talk openly. Jenn is skinny and gorgeous. Her parents are Chinese, but moved here decades ago, so Jenn was born here. Anyway she’s naturally tiny and doesn’t get the fat thing at all. Last week, just before she headed off to Indonesia, she got tired of me complaining about the state of my body and said, ‘If you are so worried about it, do some exercise and cut back a bit. It’s not rocket science.’ Of course I immediately dissolved into floods of tears, which I think annoyed her even more. It’s not like me to be so sensitive, but I was a bit low about her leaving and I was a bit hormonal too. I got my period the next day. (Sorry if that’s TMI!) Plus, I’d already told her I was doing the WON program days earlier and apparently she’d forgotten that. Sometimes I think her head is somewhere else, even when she’s at home.
Well, that’s probably enough from me for one day.
Looking forward to finding out more about all of you.
Cheers,
E x
Jewels had read Ellie’s post three times now and she was still no closer to forming a response. In fact she wasn’t sure if she could reply at all. She’d accepted Ellie’s invitation to the new blog eagerly and was looking forward to chatting with her newfound weight loss buddies, but after reading Ellie’s post she suddenly realised that she was dangerously close to forming actual friendships with these women. If she joined in the blog and started exchanging intimate stories with the other women it was inevitable that they would become close. Reliant on each other perhaps. How had she not seen this coming? Already she’d found herself looking forward to the other women’s posts. She should have realised that moving away from the
forum to a private blog was bound to strengthen the bonds between them all. And Jewels wasn’t sure if she was up for that.
She’d spent a long time holding herself at a distance from intimate female friendship. To the casual observer it probably looked as if her life was filled with friends and it was true she had plenty of acquaintances, women she could meet for a coffee or see a movie with, but there was no one she would open herself up to. Not since high school.
Not since Josie.
It was so long ago now, but just the thought of her best friend’s name could still bring tears to her eyes. They’d been everything to each other once, and then Josie was taken from her in the most terrible of circumstances. Her seventeen-year-old self had vowed no one would ever take Josie’s place, and for a long time she’d backed away from anyone who threatened to get too close. Somehow – long after she’d realised that denying herself the friendship of others wouldn’t bring Josie back – keeping part of herself closed off became a habit.
The sound of her mobile ringing diverted her attention. It was Sofia calling. She was tempted to decline the call but her sister was persistent. If she didn’t pick up Sof would try the landline and if Jewels failed to answer that then she’d call around in person. It was easier just to pick up. ‘Hi, Sof.’
‘Where are you? I’ve just been to the shop and you’re not there.’ Sofia sounded unreasonably annoyed.
‘I’m at home. Didn’t I tell you last week that I’m going to start having Wednesdays off? Now I’ve got Kylie in the shop I can relax a bit. She knows what she’s doing and she’ll ring me if there are any dramas.’
‘Do you really think you can afford to be away from the shop for another whole day?’
None of your effing business. Jewels mentally bit her tongue. ‘You do the accounts so you know the answer to that already. And it’s only one day off not another day off. On Mondays I work from home. Look, with wedding season upon us, not to mention Christmas coming up we’re going to be flat out. Last year I worked six or seven days a week and I was exhausted. I can’t let myself get run-down like that again.’ She’d read somewhere that stress was not conducive to making a baby, and even if that turned out not to be true, the fact was that you had to be awake long enough to actually have sex with your husband to make a baby. She’d been so busy and so tired at the end of last year that sex had become just another chore on her to-do list. And that wasn’t good for anyone.