Merigian Studios


One Fat Angry Email

One Fat Angry Email

Several years ago, I embraced email as a great way of connecting to patients. Over the years, we have had great success with it and we will continue to look forward to using it. I suspect the next step would be texting, however I am not sure I am ready to take the leap.

The ideal email delivered to our office is one that is short, to the point and perhaps bulleted to show the major ups and downs of a patient's progress, questions or complaints. We usually tape the emails in the author's chart because they serve as medical updates, they help us stay on top of each patient's problems. Phone calls are usually hit or miss, take a long time and patients tend to get off track easily while talking. In addition, we only have four incoming phone lines, so we like to keep the chatter to a minimum. Emails usually can be answered within a very short period of time. And I am supposed to see each and every email. Tammy screens them, highlights the pertinent information and questions. She rarely takes any action without my approval. I usually write the responses and she communicates through her email account what I write on the printed email.

Recently we received an email from a patient that was a bit over-the-top. The author of the email is a middle aged professional woman who is also writer by hobby. She works full time in a vice president position of a good size company. Her reason for coming to the Stone Institute was to get her hormones in alignment so that she could lose a sizable amount of weight. She travels a great deal and seems to be in a vocational position that is what I refer to as unrelentingly stressful. She has a personal trainer and a number of pharmacists and paramedical support persons that advise her about her health. There are many worldviews being expressed to her about her obsession with her inflated weight and what best road to travel to get it off.

She is an epicurean and indulges herself in the finer things in life. She is a sophisticated woman who tries very hard to get things right. The problem is, she has too many consultants, too many world views advising her and too many frustrations to be successful. I have found that many successful professional corporate stars are closed to novelty and continue to hold onto old, antiquated ideas. Partly because they are frozen in time, partly because they are concerned with their image amongst other corporate stars. They see themselves as celebrities in the corporate world.

The email that I am speaking about was well written. It was filled with emotion and frustration about her lack of response to my prescribed therapeutic adventure for weight loss. What is clear from her email is that her linear approach to life is simple: she should lose weight if she burns more calories than she takes in on a daily basis. The more she exercises and starves herself, the more weight should come off. However she does not actually starve herself. She eats. And depending on the person she pays attention to, she eats different things. Although this axiom, eat less, workout more, lose weight is a very popular one with personal trainers, allopathic physicians, osteopathic physicians, chiropractors, pharmacists, massage therapists, paramedics, nurse practitioners, physician assistants, registered nurses, licensed practical nurses, certified medical assistants, nutritionists, dieticians and a whole host of other misinformed medically trained persons, it is absolutely balderdash. Weight loss is without question the most misunderstood process existing in medicine today. Cancer and heart attacks are also in that misunderstood category.

There is an abundance of medical assertions related to weight loss. There are well accepted surgical and non-surgical approaches to weight reduction in the healthcare marketplace. But what is missing are two important facts: one is that our metabolism is imprinted in us when we are developing in utero; the other is that people do not wish to take responsibility for their ancient or outdated worldviews.

There is no question, research has shown that maternal stress will result in lifelong changes in her offspring. This data stretches back decades. The human vessel is built to survive in the environment in which it matured as a fetus. Even in 1919, Aldus Huxley wrote about this idea in his book The Brave New World. In his scientific fiction novel, in-vitro test tube fetal development was conditioned so that the babies would be adapted to the environment to which they were earmarked to populate. Bottom line, in order to lose weight, one must get in accord with their personal metabolic imprint and stay with it. Patients who deny their authentic reality will live in frustration and fear, which increases cortisol levels and contributes to the accumulation of white fat in their body. White fat does not burn like brown fat under the influence of exercise. There are ways to convert white to brown fat, but the methods are harsh and people tend to gravitate to easy, simple and comfortable solutions to their difficult, complex and uncomfortable problems. People who want to be slim who have the metabolic imprint of survival in a harsh environments cannot live in abundance and be slim or thin at the same time. They will be large and overweight regardless of how much they run or work out at the gym.

The frustrating part of being a change agent, a physician who utilizes life-style change to get the results that a patient desires, is that people do not want to change, ever. They see themselves and deny who they are, then expect a simple solution to an ever present, complex and mysterious problem. I am one of those human that was born with a Dutch Winter Baby metabolism, I am metabolically imprinted for a harsh environment and accepting it makes it much easier to control my hormones, weight, how much I need to exercise and what to eat. For me, weight reduction can take a long time to achieve unless I subject myself to harsh environments to speed up the process. It is a difficult reality to embrace, but it does not make the reality less true. I had to transcend and accept my metabolism and fashion a life that is best suited for me. And living an epicurean life style is not in my wheelhouse. The sad reality, it is also not in our email author's wheelhouse either. As long as she lives in the past, she will continue to grow in size. There is a point where none of her weight will come off. And that will ultimately destroy her in one way or another. Her email was so vitriolic, so emotionally disturbing, no one wants to help her in the office. The office staff sees her as spiraling out of control and no one wants to be around her when she crashes because a few innocent bystanders might get injured in her collision with the ground. A strong willed, overweight, compassionless, corporate celebrity on the loose is a very dangerous animal to be around, especially when she bites the very hand that is trying to give her grace in her desperate attempt to drop sixty pounds. Patience is not one of her virtues. We have yet to respond to her email, so that calmness will prevail in the aftermath of her fat angry email.

Please continue to email me and my office whenever you feel the need. We enjoy them immensely and it helps us to stay in touch with everyone's medical adventures. On the other hand, please refrain from using the email as a way to vent your frustrations without regard to those who will be reading them. If your emotions are out of control, take a deep breath, take your estrogen, if you must, light up a cigarette, and count from one to one hundred before putting your fingers on the keypad. And after all that, you decide to take someone's head off in an email to my office, be aware of the fury of a patient man. Words can never be taken back once they are spoken or written and apologies never heal the emotional scars.

Human are feeling animals that think, not thinking animals that feel. Keep that in mind when drafting your next email. I always do.

Posted by Amanda Sanders at 8:38 AM
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