Unexpected Ambush

I had to stop by my university's student health center yesterday to get a referral for an outside doctor (damn mandatory student insurance restrictions...don't get me started). In a nutshell, I have to make an appointment with a campus doctor first, and then my insurance will only cover a specialist if the campus doctor writes a referral. I guess the policy makes sense in that it lets general practitioners screen patients first, but for someone with chronic medical problems like me, it just means a lot of red tape. Plus, I've had some not-so-great experiences with my student health center, and thus do not have the greatest confidence in their diagnostic abilities. Or their adherence to HIPAA.

In the past few months, the campus appointment has just been a formality - I tell the doctor which specialist (ophthalmologist, cardiologist, gynecologist, etc.) I need to see, and he/she writes me the referral. Once, I simply e-mailed the doctor and she left me the referral at the front desk without even making me come in for the appointment. So for the most part, I've been able to avoid dealing with the actual doctors and nurses there very much.

Okay, sorry for all the boring background. The point is, yesterday I was planning to pop in, get the referral, and leave. I'd scheduled the appointment last-minute with the only available doctor, one I'd never seen before, but assumed it would be the usual drill. This doctor, however, was not about to let me off that easy. She was very serious, very thorough, and very unwilling to send me on my way without covering all her bases. Basically, because of my weight. Before each appointment, a nurse brings you back to the exam room, weighs you, and takes your vitals. When Dr. C came into the room yesterday, she saw anorexia stamped across my file and told me that I had lost X pounds since my last (unrelated) appointment in January. Then she gave me a not-short, not-cheery lecture.

It caught me really off-guard, and it also made me really defensive. I'm still not sure if I was just pissed about it because I get pissed when almost anyone confronts me about the ED, or if because she truly was out of line. While she is a doctor and it is her job to address medical issues, I had clearly stated that I was already receiving outside treatment for the anorexia and that it was under control. Plus, I was seeing her for a completely unrelated reason.

She probably thought that I was in serious denial or something because I kept brushing off her questions about my eating and weight. I could have pointed out that her nurses are idiots and weigh everyone fully clothed, including jackets and shoes - meaning that a weight in January means something very different than a weight in May - but I refrained. Really, I was just trying to wrap things up. I kept politely explaining that I already have a therapist, a dietician, and an ED doc who are all fully aware of my other medical issues, and that I was only there to get the damn referral.

Then she said, "I don't think your current treatment is enough. You can bounce around to different specialists all you want, but nothing will be resolved until you deal with the eating disorder."

And then I got mad because frankly, this woman knew nothing about me. I do not appreciate being told that I'm not dealing with the eating disorder when treatment has monopolized a big chunk of my life for the past two years. And do not imply, Dr. C, that I'm wasting my time by seeing specialists for immediate medical problems. Whether or not the anorexia caused them, they exist, and they will not be cured with weight gain. If an anorexic girl had a heart condition, would you turn her away and tell her to come back when she's Recovered? Or would you send her to the cardiologist?

Might weight gain strengthen my immune system and bolster my body against future illness/injury/complications overall? Probably. But that doesn't change the fact that I have multiple, chronic health problems that require treatment now, not in the months or years it might take for me to fully recover from the anorexia. I'm not in denial; I know that I have an eating disorder. It's understandable that a new doctor might be skeptical about a recovering anorexic who downplays a recent weight loss; eating disorder patients are not known for their honesty or forthcomingness - I fully admit that. But I felt that Dr. C was making invalid assumptions about my body and my recovery based on limited, inaccurate knowledge, and was disrespecting me and my treatment team by presuming to know better.