Fat (3 page)

     “How much milk does he drink, Kate?

      “We finish a gallon every one or two days.”

      I know Albert and Kate don’t like the taste of milk so that “we” is really just a “he”.

     “That is way too much milk for him.”

     “He loves it, and would drink it all day if he could.  So we let him because milk is healthy, right?”

     Milk is a great food, but like everything, in moderation.  Carrots are great, but if that’s all you eat, you’ll wither away as your skin turns starkly orange.  Literally die looking like a carrot.  Xander’s problem with milk is simple science.  Red blood cells need iron to function.  Milk is not that great a source of usable iron.  It’s tough to get iron otherwise when milk is being abused as the major part of an unbalanced diet, so dark vegetables and lean red meats become an afterthought.  This kid just drank himself to iron-deficiency anemia.  Here’s a two year old kid already causing health problems by overconsumption of food – a milk monster.  And he has a sippy-cup in his hands right now, sucking back on that white as if he were a man with a breast shaped mug filled with beer.

     “In moderation, Kate, you have to only let him drink milk in moderation.  You have to cut his entire diet into one of moderation or he’s going to get unhealthy, er, unhealthier.” 

     I think back on the history of his office visits, when I initially gave just gentle suggestions that Xander was a bit chubby, and then started stating the kid was fat, and then  just telling Albert and Kate to stop feeding their roly-poly so damn much.  Now here we are at two years of age and my words have dented them as much as a bullet into Superman.  Maybe today I should show Kate a picture of what I see is up the road for Xander: his head pasted on a nude Rosie O’Donnell. 

     During many of Kate’s office ramblings, I often day-dreamt about calling DCFS, reporting abuse via over-feeding, or in the least claim neglect of health, but ultimately, has any kid ever been taken away from his parents due to the kid being too fat?  Neglect is not feeding your kid; it is not feeding your kid too much, right?  Maybe if I had gotten the process started early, Xander vs. the State of Illinois could have become a landmark case, maybe the next Scopes monkey trial, the next Roe vs. Wade.  But the only open case going on right now was Xander vs. Milk, and Xander was absolutely winning.

     Albert and Kate always had the same response: “Oh, he’ll grow out of it.”  Deluded ridiculousness.  Fat is not a pair of OshKosh B’Gosh overalls.  Body rolls and extra breasts are not like pubertal acne.  The only thing Xander is growing out of is being able to externally verify his sex as his penis is fast disappearing into his pubic fat pad.  Instead of just being a fat little kid, he’s going to become a fat grade-schooler, a fat teen, a fat adult and a fat-ass corpse.  Let’s say best case scenario he becomes tall like his dad – he’ll just be a tall fat guy that may be able to create an optical illusion with his height that he’s only obese and not morbidly obese.

     I had the nurse do a fingerstick hemoglobin.  Xander didn’t make a peep as she got a drop of blood from his fingertip.  I half expected the blood to be milkshake thick with chunks of fat globules, but it was a normal runny red.  Xander seemed oddly interested in the whole procedure, and was ecstatic about the SpongeBob Band-Aid.  His hemoglobin was 9.4.  This aspect of being a doctor must be like being a homicide detective: in pursuit of solving a case, the only true consistent discovery is the disappointment in humanity. 

     “You really let Xander drink that much milk?”

     “Sure, why not?”

     Maybe I’ll try a series of simple sentences this time.

     “Xander is anemic from drinking too much milk.  He can get really sick if you let him drink that much.  All that juice is not helping, either.  He’s drinking way too many calories.  He’s ridiculously overweight.”             

     “Oh, Dr. Grant, you’re such a worrier.  I’ll try to cut down on his milk.  As for his weight, I am sure he’ll just grow out of it.  He’s just going to be our little football player!”

     Fuck.

THE WHITE WHALE

     Albert and Kate have been inviting me out to dinner for months, and I have been skillfully dodging them with excuses of being a too busy doctor.  The last time I saw Xander was when Kate rushed him into the office for a cold last winter.  “He’s just got a cold, Kate.”  “But he has a cough, runny nose and fever.”  “That’s a cold, Kate.”  You can tell a lot about a parent as to when during the normal 7-10 day course of a cold, they bring their kid in to see the doctor.  Some rush their kid in after mere hours of symptoms, as if the standard cold symptoms were the tip of some life-threatening illness – telling of overprotective and over-bearing helicopter parents, or people with bags of rocks for brains.  Some parents wait until about day 3, when a cold’s symptoms typically are at their worst, again attributing the normal worsening and persistent symptoms of a typical cold as some harbinger of death – jumpy and paranoid parents, but better than the overprotective and over-bearing, though very much still that their brains are bags of rocks as well.  Both types of parents are bringing in their kids with the expectation of some antibiotic, not understanding the uselessness of antibiotics in treating viral illnesses, and carrying senses of entitlement that every boogery nose needs instant meds on meds, regardless of efficacy, because they as parents somehow knows more medicine than everyone else.  Why did I waste my years on college, med school, internship, residency and years of private practice when all I needed to learn medicine was to have a kid and be able to Google a list of symptoms?  Then there are the parents that don’t bring their kids into the doctor’s office for simple colds, parents that know what a cold looks like, remembers what a cold feels like (as everyone has had a cold before), and just takes care of their kids with home care until they improve in 7-10 days.  As a result, smart and sensible parents like that are unfortunately the ones that I don’t get to see too much.  Kate brought Xander in that day after 2 hours of runny nose and fever.  Thankfully I’ve been able to avoid them since.  But because of the seemingly never ending requirement of Continuing Medical Education to keep my licensure up to date, I go to Wisconsin Dells for a conference and decide to eat at the hotel’s restaurant for dinner instead of ordering room service and catching Bulls vs. Bucks on TV.

      I was just waiting for my table.  Damn fifteen minute wait for this dinosaur themed restaurant.  The triceratops robot nodding at the front door was taunting me.  It appeared to start shouting my name.  

     “Dr. Grant!  Dr. Grant!”  The voice was ricocheting off the robot and not coming out of its jaws. “Dr. Grant!  It’s me Xander!”

     The kid came running at a full sprint up to me, every foot strike sounding like it was breaking tile.  He had a King-sized Hershey bar in paw and his face was smeared in chocolate.  He was in swimming trunks and a slightly wet white T-shirt clinging to his rolls.  At least he ran the few dozen feet to me and burned off about a dozen calories.

     Kate came up just behind him.

     “Hi, Dr. Grant, crazy seeing you here!”

     “Hi, Kate, what are you guys doing here?”

     “Just a quick weekend at the water parks up here, Xander loves the water, he’s like a fish.”

     He obviously looked more like a whale.  A small one, but still a whale.  No way was he resembled any type of fish.  Maybe she meant fish in the colloquial use as referring to any sea creature as a fish.  

     “Where’s Albert?”

     “He’s meeting us here tomorrow, after he gets off work.  What are you doing here?”

     “Just here at this cardiology conference until tomorrow.”

     “Are you here by yourself?”

     “Yeah, sure am.  These conferences are a great opportunity for me to get away for some alone time.” 

     Except when I run into patients.  It feels like when as a kid I would run into teachers running errands.  Breaking away from set roles in routine settings gets weird.  It’s always a bit awkward going to the neighborhood Portillo’s Hot Dogs and running into the parents and the seven year old kid who was just at the office with such bad constipation and withholding that he crapped his pants during the peristalsis release of the rectal exam, and then watching him eat nothing but cheese fries when I just gave the parents a lecture on how they needed to up his fiber intake and try to cut down on cheese and starch.  Or the mom that is now stuffing her giggling one year old with handfuls of McDonald’s who had just rushed her daughter into my office without an appointment spouting off loudly in the waiting room about some mystery life-threatening illness that had symptoms of poor eating and a “fever” of 99.2 lasting an hour, and then spending the entire visit demanding antibiotics to cure her baby lest her baby become more lethargic without some emergent treatment.   Or running into the fattest patient in my practice a few hundred miles away at a Midwest version of a Vegas hotel, and then getting a live show of him erasing chocolate.

     “Why don’t you join us for dinner here then?  I know Xander will love it.”

     Then right on cure, Xander popped the rest of his candy bar into his mouth and piped up, “Yeah!  Please, Dr. Grant?  I’ll teach you how to draw a stegosaurus.”

     Even an overly chubby kid’s cocoa-smeared, moon-faced smile was impossible for me to shoot down.  So here I am being seated in a booth in the shape of a brontosaurus, across from Xander and Kate, about to spend the next few hours eating dinner with them and learning about all things Xander.  Time needed to bleed out quickly, and awkward silences would only prolong the pain.  I started by asking a question I knew would kill at least half-an-hour without much of my participation: “So, how’s Xander been?”

       So Kate went on about how much he could read now and all the activities she had signed him up for and how he was going to kindergarten in the fall and how great a kid he was.  I could tune out her voice easily, just as I could tune out dozens of wailing babies in a nursery as I focused on examining just one, but now my focus was being steered to using my peripherals to examine two other types of babies.  I must have always had my nose buried in Xander’s chart during Kate’s ramblings at his office visits, and Kate must have dressed conservatively at those visits, and the sourness that descended onto my disposition in anticipation of Xander’s office visits must have also put pause to my manhood, because now I couldn’t stop looking at her somethings.  To me, Kate was not classically beautiful, a little too much forehead for that, but she did have two assets that must have contributed to Xander downing breast milk in such quantities when he was a baby.  And she had them in full on display in her bikini with her cover-up only partially covering them up.  And it was sharply cold in the restaurant.  I was surprised at my maleness for continuing to glance at them, knowing on whom they were attached.  They were softened from time, but still supple and ample with just barely a noticeable sag.  And the cleavage was wonderfully tight in its spacing, not artificially mashed together as with a push up bra or bizarrely frog-eyed like the implant variety.

     “Look, Dr. Grant, I drew a Stegasaurus!”   

     Xander was furiously scribbling onto his placemat with a green crayola.  His shirt was still wet.  He actually had a large pair showing as well.  They were floppy buds, as if he were an obese preadolescent girl, but they were ample enough to fit the definition of breasts.  A five year old boy with a chest like a fudge-loving, never exercising preteen.

     The waitress came and we placed our orders.  Me and Xander ordered the same meatloaf dinner – called the Stegasaurus Loaf here.  Kate ordered the T-Rex burger platter which was just a standard bacon cheeseburger with waffle fries.  She must work out quite a bit to stay in the shape she’s currently in whilst eating bacon, grilled ground beef and deep fried crisscrosses of potato.  Or maybe she’s just eating her one bad meal allotment for this week.  Or maybe she’s just splurging on these calories because she’s on vacation. 

     Now I sound like one of them, where the current obesity generating lifestyle is rationalized as just a temporary hiatus to the healthier lifestyle which will start after coming back from vacation, or after the holidays, or in the New Year, or after this birthday, or in the summer – always about to start at some never-arriving, ever-delayed future.  Where massive volumes of food go in, massive volumes of excuses burp out.  All that needs to be said to complete the classic rhetoric is to go on about the exploits of the skinnier, fitter person of the long ago past that could’ve beat anyone in physical feats of strength and stamina, and then complain about the various current joint aches and resultant immobility that is preventing proper exercise in between bites of a fast disappearing Philly cheesesteak with whiz.  The common path of mental self-preservation seems to be to gloss over the current state of deconditioning by shifting focus to a future change, and then try to impose an image of potential fitness with tales of the unverifiable past.   

     Oh good, the food is here.  I was starving.  Look at this Stegosaurus loaf.  The waitress needed two arms to unload it from the standing tray.  Restaurants seem to pack a garbage can with food, then flip it over onto a plate as a means to measure a single portion, and The Dinostaurant was no different.  How am I supposed to eat all of this?  Purge halfway through my dinner into the porcelain Velociraptor head in the bathroom?  I guess the restaurants are only giving people what they want, only doing what they need to do in order to keep people waddling into here, as opposed to there, where the mound of mashed potatoes down the street is only chest high as opposed to head high here.  Though looking around the restaurant, it looks like most of the people dining would say that this was an appropriate portion for one.  The three hundred pound bearded guy seated next to our table just got up from his booth with a grunt, and all that was left on his table was a plate of chicken wing bones, a platter with steak gristle aside a few smears of mashed potatoes, a saucer with a shallow puddle of melted ice cream and chocolate syrup, and three empty beer bottles.  It seems what people want to do at restaurants is to gorge and gorge on three thousand calorie meals in a race to over-satiety.  It is as if the primitive biologic urge to store calories that existed during man’s times of food scarcity has only accelerated as food has gotten more abundant.  Everyone seems to be storing fat for some Armageddeon.  It is an entirely American concept, though.  I cannot think of another worldly cuisine where the serving plate is so large, and sits underneath a mound of meat with a just sprinkling of vegetables.  Plates are undeniably smaller everywhere else in the world, and meat is used more as a garnish than as the meal entire.  Most have to get by with what we would consider weeds and bugs, spending most of their days procuring and protecting their non-guaranteed meals.  Food here is an entitlement in excess.  It must be offensively odd for others to watch the average American at a buffet -- plates overfilled with food, much of it going uneaten and cleared from the table as a routine into the waste bins of busboys.  It is no accident that the domestic health perils of obesity, like heart disease and diabetes, start developing in new immigrants from cultures traditionally without those ills, a result of their increasing assimilation to their new homeland’s cuisine.  And those conditions continue on in their proceeding generations as their plates grow more American with every bite.  Looks like the food arriving to the table had created a natural pause to Kate’s update.  Damn.  The food just got here.  This is no time to sit in silence.  Better rev back up her train of thought.