Healthcare

I went to a healthcare appointment today. One that has been recommended for years by a trusted provider, that has been on the books for months, and that I did not want to go to at all.

I feel quite comfortable in healthcare settings. I even enjoyed walking around to try and find the place I was going to for my appointment this morning because there is much nostalgia in it for me. My dad was a primary care physician and my mom a physical therapist for her short career. I had to volunteer and intern many hours in my training to become a dietitian. I have known many truly magnificent healthcare providers over my adulthood, and being one now I have deep respect for my fellow healthcare providers, having some sense through my lived experience of what it is to have worked in the system through covid19 and the aftermath (and even before then, with the ongoing inequitable care, bu·reau·crat.ic mess with insurance conglomerates as a middle mess, lack of time, resources, and support to do what you feel is a good job, make a living, and take care of your mental and physical health while also understanding the privilege and access this job affords). So, getting there I had some nice feels on one level, and I know that this is far from the case for most. 

I also have the privilege of my ‘thin enough’ body, alongside my whiteness, cis-identity, and physically able body that all make this appointment accessible and safer; with my current body size, for a provider to make a comment on my weight their anti-fat bias would be pretty raging alongside being unchecked- certainly not outside of the realm of possibility- and that would be my cue to exit.

So, I had a lot of things going for me. 

And, I have a high trauma load that I’ve carried with me since before I can remember, before consciousness. That has contributed to some of my medical trauma, where I’ve often had things “wrong” with me (trauma responses) that don’t fit the books or boxes and are real head puzzlers but where providers’ egos can really get going. This provider was one of a handful of providers that allowed me to cry without getting visibly uncomfortable or just simply irritated at the time lost, welcomed and affirmed my grief in fact, discussed my informed consent and the way that she would run the appointment, listened to and affirmed my no’s and confirmed that I understood how I would communicate with her through the procedure.

!!!!!!!!!!!

And yet, my body has not yet released from the appointment because trauma, and also I have a similar felt sense to when I was starting a new relationship that felt like I could really lean into it for the first time, the sense being a holding but a holding where you have held it for so long you just don’t know how to release it- There is no neural pathway for really leaning in because now it is safe to do so. Like Holding is the normal and releasing it would feel like dropping into a void you have never been in.

Now that I know that I can work with this provider, that the level of safety that I need is there so far to do this thing that I don’t want to do but that maybe could provide some relief and open up something new for me. And because I can access that kind of care, now my only work is to walk the tightrope grapple of how do I engage in this process without holding tightly to an outcome, an outcome that could bring relief and open up possibilities but is also so tightly woven into a morality fixity perfectionism that I’ve been unwrapping from. I’ve been promised results before, a lot- it’s so deeply knitted into a capitalist healthcare system and wellness culture. And I know through my work and my own experience that bodies are wild. So, how do I invest some of my time and attention into something with a possibility of relief on the other end, without attaching my morality, worthiness, and peace to the outcome?

Anyone?

It’s a question my clients have asked many times because the overarching themes are the same: how do I engage in healthcare behaviors- that may or may not be of benefit to me, without relapsing into my eating disorder (ED)? We could replace ED relapse with mental health suffering, perfectionism and OCD rearing up, shame spirals when we don’t adhere to “the plan”, and likely many more dynamics where worthiness is on one side and shame is on the other. 

I joke with them about not having the 8-step handout drawn up yet. And the real thing is: I don’t know. I don’t know how we find these unique middle passages but I do know that our body sensations have some info to help guide us there. 

Another lesson I’m continually learning is how to trust that there can be difference in a sea of sameness. I’ve been open to new providers in the past, trusting they won’t cause harm or let their egos get in the way of my healing, and more times than not I get a less than satisfactory care experience and at times really harmful. And, I keep going because my body keeps needing attention and there are times when it’s different, times when I’m glad I took the risk, times when providers let their humanity and critical thinking and trauma-informed approaches take the lead. And something in this for me, working and living within the systems that be, that lights up my whole being because of the trust that resilience, right relationship, and deep knowing have a heartbeat that continually thumps throughout the centuries, decades, months, weeks and days within which we move forward.

There is a great deal that needs to change within our healthcare system. There is so much more justice and equitable access needed, truly trauma-informed care, community healing, adequate knowledge and access for those suffering with eating disorders, to name a few. Something that I have been grappling with a great deal over the last few years as a healthcare provider, is how do I operate effectively within this system that needs so much change, do my personal unlearning and relearning work, and hold trust that a different model is not only possible but coming. It’s a space where some days I don’t have answers, my burnout a cloud that consumes me, and some days where I am surprised in my own healing, or my work with clients, and I know that we are all in a process towards something different and better. And that change is hard, messy, complicated, unsettling, overwhelming, and necessary.