An ambulance technician in Scotland, in his post Fat Chance, has finally (and beautifully) put into words some of the frustration I’ve felt so many times when working with obese patients:

Morbid obesity is dangerous, hence the moniker, but in the emergency situation it’s not the ischaemic heart disease that causes the problems, nor the diabetes, cellulitis or dyspnoea. It’s just the weight. If we can’t lift you when you can’t walk, you’re not going anywhere.

Bravo. It’s not that we don’t like you because you’re fat. It’s just so incredibly frustrating not to be able to help you just because you didn’t try a little harder to help yourself when you still had the chance!

When I was a student nurse I once helped care for a 600-pound patient (he might have weighed a good bit more, actually, but that was as high as the scale would go). Amazingly, he had still been able to walk until a few days before, when one of his knees had finally snapped under his weight. It took the paramedics six hours to get him out of his apartment.

In the hospital, he kept wetting himself because he was so embarrassed at having to ask for help with the urinal that he nearly always waited too long to hit the call light. Of course, then he had to be changed and cleaned up, which was almost as humiliating and even more of an ordeal. Each of his thighs was, on its own, bigger than I was, and his bladder capacity was nothing short of amazing, which made those cleanup jobs pretty extensive.

A major part of the difficulty was that the part of him that needed to go *into* the urinal had been out of his reach for years, and had long since been buried in flesh, turning itself inside-out in a desperate attempt at self-preservation, and making the logistics of the situation just that much more problematic.

Picture a red-faced male patient, naked from the waist down, lying helplessly in a state of utter humiliation while two scrub-clad, purple-gloved, urinal-wielding nurses dig through the mounds of flesh over and between his legs, hunting for the pertinent piece of his anatomy…

There are two of us because, once we find it, one has to try to keep the rolls of fat at bay while the other attempts to compress the flesh surrounding the area enough to coax the part in question out far enough for the urinal to be of any use.

Meanwhile, the patient is clenching his teeth and moaning “hurry, hurry!” because in his state of mortification he has, of course, waited until the last possible moment to call for help, and his bladder is on the verge of bursting.

I can’t help thinking we could have ended childhood obesity forever — in boys, at least — if only we could have videotaped the ordeal and made it required viewing in all middle schools. Kids don’t identify with illness, disease, and death. Those are things that happen to other people. But the fear of lying helpless and exposed and being utterly humiliated — that’s something every prepubescent adolescent can intimately identify with.

I bet it would work.