Big Fat Manifesto (15 page)

Burke seems satisfied. I feel him relax, and I turn him loose as Mom beckons for me to come with her.

"Later," he says, and plants one on my lips.

Somehow, I pucker back enough to make it pass for a reaction, then fake a smile.

NoNo's oblivious, like Burke.

Freddie isn't.

She's staring at me, her eyebrows doing funny-knitty movements.

"Gotta go," I say out loud.
Leave it alone,
I beg her with my eyes.

She does.

But she won't be leaving it alone for long.

The Wire

FEATURE SPREAD

for publication Friday, November 2

Fat Girl

Fat Boy
Chronicles: The End

JAMIE D. CARCATERRA

[insert photo spread here]

Drum roll, please.

May I introduce the new, improved Used-to-Be-Fat Boy?

He needs a new name. What say we go with Muscle Boy? Sooner or later we might get down to Slim or Stick or some other scrawny
nickname, but for now, just appreciate the sculpting.

[insert muscle shot here]

In forty-five days, Muscle Boy has dropped an astounding fifty-five pounds.

He's infection free, his wounds are healing, and he can eat about a half-cup of food at a time. It has to be pureed or apple­saucelike,
no major chunks, but he's gettin' it down. He's also walking and starting back with light strength training, and going on
some
major
shopping sprees. Best we can estimate, he's changing clothing size about once every week to two weeks.

Muscle Boy's on his way to a support group meeting, but he's graciously answering a few questions by telephone even as I write.

So far, is the surgery everything you expected?

Yes, it is. I know the weight loss will slow down. It's already slowing down some, but I hope everyone can see the results,
and I hope those results keep coming. One day, I'll weigh "normal" for my height and, baby, will I
ever
be ripped then.

You suffered through some serious complications,
hovered near death, and endured
severe pain, not to mention infections and a
longer-than-expected hospital stay. Would
you do it again?

Absolutely. No question.

Why?

Because it's my one big shot at never being fat again.

Worst moment?

The first time I frothed stuff all over the place. I'm getting better at controlling it now, though.

Best moment?

Every time I lose an
X
in my clothing sizes.

Pretty soon, no
X
at all—yeah, baby!

As you get thin, what things are you looking
forward to the most?

Flying on an airplane—you know, fitting in the seats. And fitting in seats at movies, and buying clothes from regular stores
and having them look good on me. I want to go parasailing and bungee jumping, and maybe run track, if I can get fast enough.

Will you play football again?

I don't know. There's not much research on contact sports after bariatric surgery. Put that in the we'11-see column.

Any regrets?

Nope. Not one.

Would you recommend this surgery to other
guys your age?

Hey, now, that's a tough one. Yes and no. If being thin and buff feels important to them, very important, then yes. If it's
no big deal, then no. It takes some major dedication, or at least it has so far.
What's your opinion of Barbara Gwennet's
report on this column and our Fat Boy spotlight?

That chick can eat my old, unwashed size 7X undershorts. Without ketchup. I'll save them out of the Goodwill donation bag.
Hey, Barb—come on over and chow down, baby!

Because of recent nonprint media hype, insanity, and inanity, this will be our last chronicle of Muscle Boy's progress. If
you want to know more, you'll just have to ask him yourself. Please direct complaints to Barbara Gwennet at WKPX.

CHAPTER

FIFTEEN

"Get undressed. Gowns are in the cabinet." The nurse points at a white bench with double doors on the bottom. "Get up on the
table when you're finished."

She smiles, then leaves and closes the door behind her.

I stare at the closed door and wish I could grow wings and fly away. I so need a day off from 77ie
Wiz
and homework and scholarship angst, and instead I'm doing
this?

Every year, a couple of weeks before Thanksgiving. Mom and her health maintenance schedules.

I've never been to this doctor's office before, because Dad's company changed insurance carriers last year, and I had to swap
doctors. So far, I hate this place worse than our last clinic, which is saying a lot. Our previous doctor's office was grimy
and busy and loud, and I never saw the same doctor or nurse practitioner or physician's assistant twice, and they
always
bitched about my weight. Every single time.

This clinic's high-end and spiffy, with salmon carpeting, textured paint, and health and wellness posters covering the walls.
Each one says something more stupid than the last. My least favorite is a shot of a giant man in a piano-sized coffin with
the slogan OBESITY KILLS.

The chairs in the waiting room all had arms, so I had to stand in front of dead piano-coffin-man while everybody stared at
me, and my back's hurting, and I hated getting weighed in the hallway in front of everybody. That stunk worse than OBESITY
KILLS. Especially the part where the nurse slid the bottom weight all the way to three hundred pounds before she even started
moving the top weight. At least she didn't shout the number out loud, but she might as well have, so many people walked by.

Then they took blood and of course couldn't find the vein the first time. Poke, prod, wiggle. Poke, poke.

I'm sorry, it's just a little harder with big people.

Yeah. I know.

More padding. More fat between the needle and the vein.

Would it kill doctors to get training for their nurses and techs so they could handle fat people better? Would it put them
in the poorhouse to buy different-sized needles for different-sized people?

I rub the bandage in the bend of my arm. Probably be bruised for a month.

A dull, washed-out sensation spreads through me as I start to take off my clothes so I can put on an exam gown.

Now I strip naked, alone in the new-car-smelling room, and turn five shades of red because I hate being naked anywhere for
any reason. I always feel like somebody can see me, even when I know they can't. As fast as I can, I fold my clothes over
one of the chairs and fish in the cabinet for the biggest gown I can find.

Great.

They're all the same size.

Regular. Standard.

Whatever.

One size fits all.

Except me.

I take out two gowns, put one arm in each, but my arms don't really fit. I can't pull them up enough to wear them, or even
fake wearing them.

Hot all over, hoping nobody comes to the door, I give up on the gowns, toss them in the dirty clothes bin, and search the
other cabinets until I find a sheet. It'll have to do. I am so not sitting naked in the exam room, or letting my ass and boobs
hang out of gowns that don't fit even when I use two of them.

When I step on the exam table's bottom platform, the whole thing tips forward. I half-fall, half-lunge to sit, and it crashes
back down. I squish hard into the little padded tabletop and tear the paper cover as I move. It takes some thought and a lot
of swearing, but I drag myself upright and scoot back far enough to keep the table from flipping again.

The whole setup feels too small beneath me, like It's going to teeter and plop on its side, but I'm pretty sure it won't.
Nothing new here. It's the same everywhere I've ever been.

They don't make medical clinics for Fat Girls.

After all my hurrying, I get to sit for a while, then a longer while. Cold, then hot. Sweating, then shivering. Staring at
this set of health-message posters. One of them shows a baby's head superimposed on a big fat man's body, with the words,
THE EATING HABITS YOU TEACH YOUR CHILDREN LAST A LIFETIME. Another shows how arteries harden and the effects of high cholesterol
on the liver.

I have to pee, but I am totally not wandering down the hall wrapped in a sheet. For a few seconds I see myself with a baby's
head on top of my big fat body. That's probably what the staff would see if sheet-me took off to piss.

By the time I hear commotion in the hallway, my eyes are floating, and I'm ready to bite somebody.

The doctor, a guy named Meacham, knocks once and zips into the room, towing his nurse. They stare at the sheet.

Say something,
I dare him with my eyes, but he doesn't take the bait. Neither does the nurse. She's all red hair and big smiles, while Meacham
reminds me a lot of Mr. Dun­stein, the way he's small and thin with big eyes that look even bigger behind huge glasses. Nervous
and twitchy, too. It wouldn't surprise me if he starts spouting stage directions or commentary on dialogue and presentation.

Instead, he says, "I'll need the big cuff," to the nurse, who whisks out, leaving the door open. She comes back a few seconds
later with the large blood pressure cuff, and Meacham wraps it around my arm. He pumps once, takes it off, and sends her back
out for the "thigh cuff."

Okay, first time I've needed the next size up, but at least they have one. Sucker's huge. And it
hurts
when it squeezes. The urge to bite somebody gets stronger.

Once the doctor finally gets my blood pressure reading, he seems surprised It's normal. "One eighteen over seventy-eight.
Good."

About a minute later, a tech rushes in and drops off my initial blood work, then takes off, slamming the door in her wake.

Meacham studies the numbers and looks surprised again.

"Well," he says. "All the values are within range. Normal. That's amazing, all things considered."

"I'm pretty healthy," I say, ignoring the all-things-considered comment.

"You're young." Meacham gazes at me over the rims of his big glasses. "This free pass won't last forever, not at your weight."

Well, that didn't take long.

I so wish I could grow fangs. Maybe if I could sprout fangs and claws, I could teach people how it feels to sit trapped and
helpless while somebody pokes holes in your skin
and
your feelings.

Dr. Meacham sits on his doctor stool, takes a PDA out of his pocket, and punches buttons as he talks. "What weight-loss programs
have you tried?"

I pull my sheet tight around me. Couldn't we at least start with what grade are you in? What school do you attend? Hobbies?
Even exercise habits?

But no. Straight to the weight.

Not for the first time in a doctor's office, I think I should just keep all my diet failures in a diary, bring my own gowns,
and save money for a portable exam table that actually fits me. Today, though, I'm Fat Girl with fangs, so I quote research
studies. "In my experience, diets don't work. They result in yo-yo body fat and weight gain greater than pounds lost."

More punching on the PDA. "So you're not interested in weight loss."

"That's
not
what I said." When I look over at the nurse, her smile freezes to petrified-fossil stillness. "I've tried low-cal, low-carb,
Weight Watchers, and three different plans from different doctors in the last four years."

Meachem looks up. "Did you stick to any of them?"

My cheeks heat. "Yes."

The doctor doesn't even slow down, and he's punching on his PDA again. "How long?"

I shrug. "I'm not sure. A few months each. I went to Weight Watchers for almost a year, but it didn't do much good."

"I find that difficult to believe, Ms. Carcaterra." Down goes the PDA. Up come Meacham's eyes, only this time, his gaze is
sharper, and lots less businesslike. "If you had truly complied with any of those plans, you would have lost weight."

"Look, I've
tried."
I clench my fist, but make myself let it go. "I want to be normal. I want to be thin. Nothing works for me."

Christ,
why am I getting upset with this dork? Tliis whole scene
is so old.

"Then you haven't tried hard enough. It's all about motivation, restraint, and nutrition, Ms. Carcaterra." Over-glasses-rims
stare. "We have nutritionists and behavioral medicine specialists on staff. Consultations are free for the first two visits."
He jabs the PDA, then turns his attention back to me. "I'll set you up."

He doesn't even give me the chance to refuse. I'm so hot now he could perk coffee on my shoulders. Meacham can see how red
I am. He probably knows I'm upset, but he doesn't seem to care.

"We also have ample information on bariatric procedures for young people." He beckons, and the nurse produces a stack of pamphlets
from her pocket.

She holds them toward me, but I shake my head. "Our insurance doesn't cover weight-loss surgery. We already checked."

Meacham frowns. "I'll see about appealing that. Your body mass index is over fifty percent, in the highest risk category.
Sometimes companies will make exceptions for cases with medical urgency."

Medical urgency? Oh for God's sake. I'm not bleeding out on the
damned floor.
If I could turn the sheet into a blanket, roll myself up in it, and bounce away down the tiled hallway, I'd do it "Don't get
your hopes up," I tell Meacham. "I'm not a cancer kid or anything."

This time I get an evil stare over the glasses rims. "Obesity is as serious as cancer, Ms. Carcaterra. If you changed your
mind-set, you might have better results with weight control programs. Do your parents take this seriously?"

"Yes—" I start, but he cuts me off.

"If they do indeed understand the severity of your condition, they might look into loans or second mortgages to cover the
surgery you need. I'll discuss that with them." Punch, punch, punch on the PDA.

My mouth falls open.

Mortgage—as in the house? Put our house at risk to get my gut stapled? Is he
insane?

He gestures to the table. "Lie back, please. Carefully."

What, like I'll break the friggin' equipment?

I'd rather kick Meacham in the nuts, but I do my best to settle back on the little table. Feels like I'll fall off, but I
don't, and It's hard to breathe. When he puts his hands on my belly, he looks disgusted, and I so wish I could puke on him.
If he pushes too long or too hard, I just might.

The nurse hovers as the doctor scoots the sheet around, and presses on my stomach some more.

"Of course I can't appreciate the major organs with this bulk," he says more to himself than to me. "No gross abnormalities."

Except the fat. Go ahead. Say it. Not much different from
bulk,
right?

"Since you're not sexually active, we'll omit the Pap smear for now." Shove, poke, push, glare. "I probably couldn't get it
anyhow. You'll need to see a gynecologist for that. They have better techniques for getting difficult smears."

I say nothing, even when he squishes my full bladder. Bastard wants to assume Fat Girls aren't sexually active—because of
course who would
ever
want a Fat Girl—let him. Who gives a damn?

When Meacham finishes pushing on my stomach, he does a breast exam, and wants to know if anything hurts.

I answer with, "No." Even if I was near going into shock I'd lie, because he'd just say I'm in pain because I'm fat.

Wiry don't you try harder?

Why don't you
do
something about yourself?

Poor girl.

Foolish, lazy fat girl.

My bladder aches. My skin turns strawberry red and every inch of me goes hot and sweaty and sticky. Seriously, I'm going to
puke, but I choke it back, because they'll probably make me stay for more tests if I blow chunks on the floor.

I finally lose it and glare at the man as I struggle up on his stupid little table. "If I threw up right this second, would
you say the fat caused me to vomit?"

"Very possibly." He doesn't look up from the PDA. "Obesity seriously raises the risk for gastroesophageal reflux disease.
Vomiting is frequent in patients with that condition."

My fingers dig into my sheet-covered legs. "Do skinny people get gastroeso—whatever?"

He still doesn't look up. "Of course they do, but that's beside the point."

So, if I piss on the floor, it's because I'm fat, and not because I
have to pee and you pushed on my bladder?

That question would probably make him look up, and throw me out, and upset Mom. So I say, "A doctor a few years back told
my mom I had cramps because of my weight. I had dysentery, and it didn't get treated until I almost died from dehydration."

Meacham sighs. "Ms. Carcaterra, as long as you're this overweight, any doctor will have difficulty examining you." He keeps
his attention on his PDA, punching away. "If you'd like another physician at this practice, I can arrange that, but I assure
you, they'll share my opinions about your obesity"

Another doctor?

Oh, thank you so much.

I just want Meacham and his PDA away from me, out of the room, and the redheaded nurse with him. I want out of the sheet,
into my clothes, and away from this place. Even if it does make Mom unhappy, I'm not coming back unless a body part rots off.
Even then, I'll give serious thought to amputating it myself.

When Meacham finally does leave, I cry, and hate him and hate that I'm crying and stuff my sheet way far down in the dirty
clothes bin, underneath all the gowns that would never fit me.

It takes a few minutes of splashing water on my face for me to get a grip, get my attitude strapped back into place, get dressed,
go to the bathroom, and get the hell out of plastic-stink hell.

Mom's waiting for me in the lobby like nothing's wrong, so I go with that.

Nothing's wrong.

I smile at her and she pays our co-pay, and out we go to the car, then hit the road toward the Pick-Sack and then to Burke's
to help Freddie and NoNo with the fliers.