‘She was my seventh patient. I’m certain, because right before going into theatre she asked me if I’d ever performed the operation before. Sure, I said, six times already. Oh, she said, that’s alright then. She was a young woman with morbid obesity, who had come to our hospital for a stomach reduction following many years of fruitless weight-loss attempts. I’d only been performing the procedure for a few months, at the request of some of my colleagues.
I was none too keen, to tell you the truth. When operating on patients with other conditions – like a hernia, for example, or cancer – I could always imagine that their fate might also befall me one day. But not obesity. I’ve always had a relatively healthy weight, and I found their situation almost impossible to relate to. Once the health benefits of a stomach reduction had become generally accepted – in patients with diabetes or high blood pressure, for example – the physicians at my hospital wanted to start offering the procedure and asked me whether I would consider doing the operations.
I agreed but did have lingering doubts. Was it something I really wanted in the long term? Should I really be operating on patients whose condition I didn’t properly understand? Rationally I knew I was contributing to their overall health, but I found it hard to empathise with their specific situation.
Then, eighteen months later, my seventh patient came back to see me. She’d lost sixty kilos and had taken part in the Dam-tot-Damloop, a sixteen-kilometre footrace from Amsterdam to Zaandam. I complimented her and asked her how she was doing, and she told me people hardly recognised her anymore. She even regularly got asked whether she was new at work and had to explain that she’d been working there for years.
It had never occurred to her before, but her sudden drop in weight made one thing painfully clear: that people had never noticed her when she was so overweight. They’d never approached her back then, and now they did. She’d been bullied in primary school, which was horrible of course. But far worse, she now realised, were all the classmates who had simply ignored her, as though she didn’t exist because she was so fat.
I thought back to my own primary-school days. There had been a girl in my grade four class who got bullied a lot. Although I was certainly never one of the perpetrators, I’d never spoken a word to her either. How lonely she must have felt. There were no anti-bullying programmes in those days, and the teachers did nothing to help. She eventually left the school.
I still remember that appointment like it was yesterday. She was in tears because she had suddenly realised what she’d been missing out on her whole life. And, sitting opposite her, I realised that we all have our prejudices: people who look different are clearly not worth the effort. I’d never truly thought about it until that point.
That conversation was my watershed moment. It’s been eleven years now, and since then I’ve performed over a thousand stomach reductions. That one patient helped me comprehend the kind of silent agony obesity can cause. Her words have since been echoed to me by countless other patients: if you’re overweight, people see straight through you. Well, not literally, of course.
I now gladly walk into my operating theatre. Of course all doctors have the urge to do good, but I want to derive my conviction from the patients themselves, not from an abstract theory or a textbook. It’s now clear to me just how great the consequences of my work can be. While my patients do become physically healthier, there’s more to it than that, something worth potentially even more: it’s the chance to make new connections, gain new friends, be noticed. It opens the doors to a more beautiful and fulfilling life.’