7 a.m. I’m walking to the subway. Tap, tap, tap. I hope that my quick brisk steps make me look professional. But inside my heart is surprised by my nervous thoughts. Today is Day 1 of my dietetic internship at Tufts Medical Center/Frances Stern Nutrition Center.
My first rotation is at the Tufts Weight and Wellness Center (WWC). The WWC is an outpatient clinic devoted to the treatment of obesity. Patients lose weight through medical weight loss programs or bariatric surgery (gastric bypass or gastric-band).
I enter the WWC. I meet the dietitians. I watch a few counseling appointments and soak in the terminology. Gastric bypass, gastric band, restriction, fill, B12 sublingual. At midmorning the dietitian leads me to a conference room. For the rest of the day I will observe Immersion Day, an information session for patients who are preparing for bariatric surgery.
Immersion Day goes all afternoon. I meet seven new patients and learn with them the requirements of the surgery, the struggles to be expected, and the keys to success. We meet the administrator, the doctor, the dietitian, and the surgeon. I feel my brain switching to maximum absorption capacity. But this time I am not hearing new vocabulary. Rather, I hear about Mr. T. Mr. T looks forward to playing tennis with his kids after the surgery and weight loss. I gasp with Mrs. F, who met a drunk driver last night in her yard. Everyone looks around the room and chuckles, and suddenly a cohort has formed. I listen to Mrs. X, who complains about the three parking tickets she received in the last two months. She re-tells the success story of her daughter’s gastric bypass, and the room is filled with hope.
It’s 4 o’clock and the last doctor arrives. I am tempted to dismiss her when I see her shaggy bangs and wrinkled coat. But then she starts talking about the challenges of exercise for the obese. She demonstrates chair running and asks the patients to write down personal fitness goals. I like her. This doctor is not embarrassed to mention the self-esteem issues, the bathing suit issues, the flabby skin,or the inability to walk. Even though she is thin, she doesn’t try to build rapport by pretending to be fat. She is frank and experienced; the patients love her.
6 p.m. I am eating dinner and organizing my notes. I put down my rice bowl and recognize the faint sensation that has been brewing in my mind all day. Respect. Today I have gained a new respect for individuals of size. Gastric bypass surgeryis a big decision. Imagine having a stomach the size of an egg! In pursuing this surgery, these patients have a motivation that I don't own. I admire their humility, as clinician after clinician tells them what to do and how to change.
Their conversations linger with me. Even now I remember Mrs. B. One day the doctor told Mrs. B that she needed to lose 100 pounds before she could get a knee replacement. Mrs. B, I am rooting for you. Although I will not see these patients again, I hope their surgeries are successful, their weight loss prolonged and consistent, and their lives improved in health and happiness. Tonight my thoughts are for them.
Read more about Rachel's experiences in her dietetic internship on her blog: coconutcrumbs.blogspot.com
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