First Day With Real Patients

Today was my first day of my preceptorship. Essentially each first year gets assigned to a community physician, who they will spend several days mentoring over the next year. I was assigned to a general surgeon who specializes in bariatric surgery (weight loss surgery). I guess I wasn't expecting much... but I was pleasantly surprised. Not because I have a newfound interest in bariatrics... but because I really liked my preceptor. He's in his 60's, Irish (complete with accent) and totally cool. We chatted, we saw patients, and he called me "Doctor". I'm telling you, graduating from med school is highly overrated. Just slap those letters on the end of my name and lets get rolling!

Anyway...

He explained to me that he started working in bariatrics because he felt that obese people were shunned by the world... including by other physicians. He spoke to me about the stigma attached to being obese, and the fact that people (even physicians) have no tolerance for "fat" people. It's like a plague. Many physicians don't want a waiting room full of obese people, stigmatized as having a lack of control, smelling bad, having poor hygiene, sweating, etc. He also talked about the reasons why people get so obese, generally different reasons for men and women... for example obese women often have a history of physical and or sexual abuse. I thought everything he said was rather insightful and very humanistic.

He made me realize the prejudices associated with looking at obese people. Just like there is with a drug user, a smoker, or someone who has green hair... there is a perceived lack of credibility associated with obesity. If someone morbidly obese tells you something, your common sense says "ok, thanks for the input... but you are so clearly severely out of control in this one area of your life... how can I trust your judgement on anything?" The difference between obesity and smoking or drug use? You can't hide obesity, even temporarily. It is really a sad state of affairs.

Then we went and saw patients. Today he actually had to explain to one patient that her llama was not a significant enough support system to see her through the surgery (?!).... Identifying your support system is part of the requirements for the surgery... I guess she doesn't have anyone and loves her llama. Well, that's only one of her problems because she is also bipolar.

Any way, it was a good day and overall a great time. But don't misunderstand... I like him and all but I surely wont be signing up for a career in surgery anytime soon. I would like to have a paycheck before I'm 50....