The story I tell myself and everyone else most of the time is that hospital parking prices are obscene. Unless I’m actually sick or transporting a sick family member, I ride my bike. When I’m too ill or injured to do that, and it’s the nearby hospital, I walk. I walked to the hospital for my follow up appointment the week after I had my thyroid out. They were a little surprised at the clinic but really, it’s 2.5 km from my house. I was feeling fine.
I worry a lot about hospital parking prices and poor patients coming from outside the city. When my dad had cancer I was happy to see that for cancer patients at least there was some assistance available.
But truth be told that’s just part of the story.
The thing is when I’m coming to the hospital I’m often seeing health care professionals who don’t know me. They make judgments pretty quickly on the state of your health and well being. Often I think they do that on the basis of weight. And there’s not much I can do about that.
I want people to get things right and to not make silly mistakes. So I try to help. It’s like when I go to new workout or a new gym when traveling and wear my CrossFit hoodie. The fitness instructors worry less about me. (See Traveling, new gyms, and thin privilege.)
Riding my bike in, arriving at the appointment in bike shoes, sandals, helmet in hand, sends a signal. I’m signalling that I’m an active person.
What’s signalling? Economists talk about signalling as a way of sharing information. Often we use clothes and props to communicate messages about our self and our identity. Expensive watches send signals. But so too do deliberately thrifty choices. My reusable coffee mug both serves an environmental purpose and signals something about my values to the world. I may choose to carry a beautiful expensive briefcase (thanks Sarah!) as a sign that I’m committed to my career. We all signal, whether we are aware of it or not.
I get asked questions about the helmet and my cycling clothes that try to sort out just what kind of cyclist I am.
If it’s sunny they say, “Nice day for a ride.” They often ask if I bike in the winter. They ask, what’s the furthest you’ve ridden? Then they start to pay attention and see me as an active person.
They seem to switch gears mentally. I’m not just, Sam the fat middle aged patient. To some, I’m now also Sam the cyclist.
That matters to me, to my sense of identity but I also hope I’m helping them.
I’m here today for a bone density scan. It’s an issue for cyclists. I’ve written about it before here. I’ll report back!
This is an older woman issue, too. If I see a new orthopedist, I feel like I really have to be front and center with it to make sure they know I need to maximize my function. I may have to drive there, but I’m careful to describe what I can and can’t do as actively as possible (“I can bench and overhead press comfortably, but only about 80% of max” – or even better, with actual numbers. That usually gets a double-take 🙂 )
A standard intake question where I get care is number of minutes per week of exercise, and it would be great to see that become inseparable from routine weight and BP checks. It’s just as relevant!
Good idea, routinely asking about exercise. I find it’s so mixed. I go to a sports clinic for physio and they of course start off by asking what you currently do for physical activity and what You’d like to do but can’t do because of illness or injury. Wish other kinds of doctors had that approach.
Loved reading the post- it definitely resonated with me. Good luck with your scan.
Hi it’s always good to read your posts. I’m stuck on the sofa at the moment my backs gone out- again. Last time was December I have disc problems. I’ve been trying to walk more and have been swimming or going to the gym and carefully exercising so I feel fed up its gone again. I really want to strengthen my back and bones so any tips would be great. I loved seeing photos of Cheddar on previous posts such a great name! Tracy😊
Wow, I was surprised and pleased at the content of this. The title was so interesting and appears non-sequitur, but as I expected, the writing itself pieced the title together. Love the talk about cultural signaling, inherent “thin” people privilege, and our indoctrination of (wrongly) marrying thinness to health. Awesome post.
Thanks!
It’s the older woman image now. It is no longer about thin privilege.
I bike or take transit/walk not to send a message to any health care provider for my appointments: I just don’t drive and don’t have a car.
It just is and I have chosen to buy and live in homes close to necessary services. A lot of people can, if they start thinking about how mobile they will be 3-5 decades ahead in life.
Hope you have a positive bone scan.
I think there are many places I go yo where I choose my outward appearance carefully.
First impressions carry a lot of weight.
Thanks for the post, Sam. Making explicit what many of us experience and try to navigate is a huge help. I also do what you described. I took the bus to the hospital for my hernia operation a few years ago, as it was convenient and quick and I wasn’t ill– I just needed some internal fixing (which they did). They were very surprised. And I ride my bike to doctor’s appts whenever possible for the same reasons you mentioned. SIgnaling that I’m active staves off some (if not all) of the weight stigmatization and some of the ageist assumptions about my levels of activity and function.
Example: I got an small avulsion fracture of my ankle 3 summers ago while on a hiking trip. Long story short, I ended up at a podiatrist 4 weeks after the fracture. I rode my bike to the appt. The podiatrist told me that she would normally put my foot in an orthopedic boot, but since I was so active, she offered me a much lower profile supportive ankle sock and referred me to physio right away. So my treatment was hugely different because I rode the bike to the appt (and she saw my helmet sitting beside me).
It is troubling to me how contingent features like this dictate differences n treatment (for many meanings of this term) for older patients, especially older women.
Great article. There are many of misconceptions about fat, diet and fitness in the medical community.
I’m not super thin and no longer very young. I recently injured my knee throwing the discus. I can’t do my sport for awhile (and may have to give it up *cry*). But the doc immediately suggested sports I could do NOW and how to get back to throwing the discus. Not the usual “wait and see”.
Thanks for this. I’ve been fortunate not to have spent much time having to meet new health care professionals, but also not needing to dispel first impressions. I don’t appear athletic but I’m average sized and that’s usually enough for them. So yes, these aren’t things I’ve had to worry about but as some commenters have mentioned, the age factor might kick in a whole new set of assumptions at some point. My own doctor is excellent and always says stuff like “you’re so active I never have to worry about you in that way!” I love her for that.
Update: My bone density was just fine.