• Amy Stephenson

On KP

Updated: Jun 12, 2019


a real twitter exchange i had with my former healthcare company

Everyone who’s met me for more than five minutes knows that in 2010 I fell down a(n entire) flight of stairs and wrecked my ankle. Probably you also know that I didn’t care for it properly because I had finally gone back to complete my degree, and I was in the middle of a semester, so I was afraid to miss any classes OH AND immediately after spraining my ankle I caught strep throat, and was warned off of visiting doctor’s offices where I might get vital and important things like MRIs and physical therapy instructions because of the open sores in my throat. (It should be noted that I took this advice seriously and cancelled an orthopedist appointment but also … kept going to school the second I wasn’t contagious, so, but that’s not the point.)


I know I talk about this ankle thing a lot but bear with me, I’m going somewhere with it.


Many MANY times over the next six years I went into a doctor’s office to ask what to do about my ankle, which not only still hurt, but had caused me a number of other bodily ailments as I continued to attempt to live normally on it. I had Kaiser Permanente through my job, which I was and am grateful to have. Kaiser, for the uninitiated (AKA the non-Californians among you) is an "integrated managed care consortium," which essentially means that you go to a sprawling medical campus for everything under the sun from routine check-ups to OBGYN to bloodwork to you name it in the same building, more akin to a hospital on an Army base than a regular doctor's office. You're not so much going to A Doctor as you are going to A System: Often my doctors would disappear into the ether and the next time I'd show up I'd have a brand new one as if by magic!


But back to me. The more time went by, the more my hip hurt, my back hurt, my shoulders hurt. One time, during the December rush at the bookstore, my back went out entirely and I spent two weeks crawling to the bathroom. I spent Christmas in the hospital.


But time. After time. After time. I was told, by several DIFFERENT Kaiser doctors, that physical therapy wouldn’t do me any good until I lost weight. They said I would be wasting my time. One even went so far as to say that there’s no way they could even tell that the fall down the stairs had caused the pain I was now feeling. I recognize the subtext now: being fat was causing my pain. Thankfully, at the time, I was too dense, or I might’ve given up forever.


an example of a totally normal kind of reader that kaiser sent to my home regularly

You might think I’m crazy. And for a minute, I did too. Doctors would know, right? But I forgot that it’s only at Kaiser where at least one wall in every office is dedicated to weight loss: glossy flyers for exercise classes so varied you’d think you were getting examined at an Equinox, pamphlets to quit smoking with a weight loss bent, diets of every stripe and flavor with KP health professionals available by phone to support you on your weight loss journey. I forgot that not every doctor in American finds it necessary—as though they have been directed to by some corporate overlord—to bring up a patient’s weight and diet AND exercise regimen every. single. time they walk in the door no matter what they’re there for. I forgot that there are doctors in this world who don't find it necessary to weigh you every time you enter the building even if you were just there last week.


Toward the end, desperate for relief and emboldened by my therapist’s rage, I summoned the courage to talk back to one of their doctors: “Thing is,” I said, “I gained all of this weight after I broke the ankle. I used to exercise like a maniac, every single day, and I miss it desperately, but I’m in too much pain to do it. I just want to fix my ankle SO THAT I can lose the weight.” THAT was the doctor who told me I’d waste my time. “You probably wouldn’t stick to it,” he said, "it's mostly stuff you have to do at home." I will never forget it. THAT subtext was not lost on me: you need willpower to do PT, something fat people notoriously lack.


After another year of crying and living a severely limited life, I went to a physical therapist, whom I paid $180 per session out of my bookstore salary because it wasn’t covered by Kaiser. I’ve never been so terrified to walk into an office in my life. I was more nervous walking into the PT’s office than I was even my THERAPIST’s for the first time.


The PT was a tiny woman, my worst fear. Barely over five feet tall, 0% body fat, a dancer (of course), curly hair like mine, a no-bullshit manner. She got her reputation as the best because she's from New York and spent her career working with dancers in the NY Ballet, so I believe her when she says there is very little that surprises her.


I sat shaking on the table while I told her my story. I cried twice. She didn’t budge, just kept asking gentle questions. I told her that it was Kaiser’s opinion that the fall down the stairs and the current pain might not be related, and she choked out a bitter, knowing laugh and told me that I wasn’t the first person they gave that line to.


She did some tests, palpating my ankle and checking for range of motion, something no person at Kaiser had ever done for me. (Let me just emphasize that: nobody had ever touched me. In all those appointments—not once. The absurdity of that didn’t hit me for years.)


When she was done, she told me she was astonished that I’d been able to walk on my ankle for six years.


do they make morphine but for rage

It turned out that my ankle had never healed: it had spent six years actively grade two fucking sprained. It was still swollen, the fluid having NEVER drained from the initial injury. I had developed arthritis in my achilles, which in turn aggravated the plantar fasciitis which I had ALSO developed. I was in agony so severe that I’d stopped feeling it, my brain just gave up sending signals because I wasn’t listening to them. That’s how I threw my back out.


I hadn’t imagined it, I hadn’t exaggerated it, I hadn’t used the ankle as an excuse to stop living my life, as I had begun to fear after being told for YEARS that my pain was my own fault.


At the risk of sounding melodramatic, I’m traumatized from this. I BELIEVED, by the end, that gaining weight was the cause of my problems, THAT’S where my physical and existential agony had originated: not falling down the stairs. I had internalized it so deeply that I’m still working to undo it.


And it’s worse if you consider the fact that I disclosed to Kaiser that I’d had severe anorexia as a teen—I know I did because it was in my chart, I’d mentioned it casually during a first visit and they pinned it right there at the top and it fucking stared back at me during every visit right next to “allergic to penicillin.” They looked at a person in recovery from an eating disorder and said “lose weight” a hundred times to her until she rearranged her whole brain around the idea, until she gave up on her life getting better unless and until she lost weight: a familiar and dangerous shift.


I was scared to see my first doctor in New York, the first one I’ve seen outside of Kaiser’s Geary Street campus since 2011. I literally rehearsed what I was going to say, so weakened am I from years of being ignored, dismissed, and bullied. We did a routine physical, and she said it, she said, “weight’s a little high,” and I stayed calm, remembered what I’d worked on, and I told her, “I wasn’t going to bring this up unless we discussed my weight, but I spent a good chunk of my teens and twenties with anorexia and yes, my weight is ‘high,’ but I exercise as much as I can, I cook for myself for every meal that I eat, I have a regular sleeping habit, I drink tons of water, I don’t smoke and I barely drink these days, and I’m honest to god the healthiest I’ve ever been.” (To add: I should not have to say this! But I can only fight on so many fronts at once!)


She smiled a genuine smile that actually reached her eyes and waited an entire, appropriate beat before replying: you sound like you’re in a great place right now. I’m happy for you.


And that was the end of that. Nobody even weighed me the second time I went in.


To say I’m mad at Kaiser is an understatement. Since this Twitter exchange, my rage at their outright dismissal of my pain, their insistence on never treating me until I cleared some moral or aesthetic bar for their precious doctors, hits me full force in the gut at random intervals and I want to scream until there’s no air left. If you can’t go to a doctor to fix an injury in order to do the exercise to lose the weight they’re constantly berating you to lose, then what's the point? The cruelty, as they say, is the point.


Oh and: physical therapy worked. I run now. Fuck you.



There you go, Chris From Kaiser, you're welcome to do whatever you like with it.

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