Living My Life

“Living my life.” That was the answer from a 45-year-old, 300 lb man in the ER for a simple injury related to a slip on ice while intoxicated. I was examining him while simultaneously asking about his medical problems. I was determining what needed X-rays, and our conversation went something like this:

“What medical problems do you have?”

“Hypertension and being overweight.”

“What are you doing about that?”

“I’m on meds for the hypertension.”

“What about the weight?”

“Living my life.”

That tells me he is aware it’s a problem, as he brought it up—not me. It sounded like indifference and/or defeat. He’s resigned himself to the fact that he is stuck that way and nothing is going to change it.

Based on interactions and observations of many patients just like him, I suspect a few things are going on in his head.

He’s tried and failed. He doesn’t like being overweight. He’s aware it’s not great. He recognizes that carrying extra weight makes everything harder. He perhaps has not connected the dots that even falling on ice and breaking an ankle is possibly related.

Sure, plenty of people of normal weight fall and break an ankle. However, I’ve also seen fractures that are much more severe than you would expect for the degree of trauma. I’ve seen an ankle fracture-dislocation in a 14-year-old girl playing volleyball. She was about 250 lbs—which is way too much for any 14-year-old—and her ankle was destroyed just from landing awkwardly from a jump. That should usually just be a sprain.

As his visit wasn’t directly related to his hypertension or weight, and wait times were very long that day, we didn’t have further conversation about it. He was mostly interested in getting the ankle figured out and going home. I address those things when I have time AND patients have an interest. We had neither the time, and he did not have the interest—at least not that night.

It sticks in my head because I wish he had a better answer. For his sake.