Maggie's Farm

To a Fat Lady Seen From the Train

O why do you walk through the fields in gloves,
     Missing so much and so much?
O fat white woman whom nobody loves,
Why do you walk through the fields in gloves,
When the grass is soft as the breast of doves
    And shivering sweet to the touch?
O why do you walk through the fields in gloves,
    Missing so much and so much?

Frances Cornford wrote that - the charming form is called a triolet.

Our editor asked me to comment on Dr. Helen's piece on fat people. As a doctor, I tend to be a "Do as I say, not as I do" sort of guy. I smoke cigars and I am pleasantly, or some might say prosperously, or some might say, grandfatherly, well-fed.

When patients of mine are seriously overweight, I tell them straight out. The word fat does not bother me. I have a model in the waiting room of five pounds of adipose tissue designed to get a reaction. It is disgusting.

As someone who did my share of general surgery earlier in my career, I can tell you that fishing through gallons of yellow adiposity, getting your gloves so greasy you cannot hold the scalpel, is no damn fun. If you are fat, and saw what you look like under the skin, you would be horrified.

Another complication recently published is that obesity makes it more difficult to make a diagnosis. It's called "study or exam limited by body habitus."

However, I also understand that the flesh is weak, and that staying in youthful shape after 45 is no mean feat. It takes work and discipline, and the evidence that it leads to longevity or health is minimal. However, being in good shape adds a lot to quality of life. On the other hand, being obsessed with health is for the crazies.

Plus there is the vanity factor: few guys will look at a fat girl, and no gals will look at a fat guy - unless he is rich or powerful. But, at some point, unless we are narcissists, we accept reality and don't care all that much.

Final word: If you are too fat, I will say that. And, if you care, I will tell you how to deal with it. But your life choices are not my problem, beyond that: your doctor is not your Momma, nor is he/she responsible for your health. Your health is in your hands, and God's, and nature's. My only responsibility is to give you advice as your friend, and to try to help you when you get sick.