How to Fail at Building a Relationship with a Patient, or, This is How Professional Fitness Cheerleaders Discourage People

With the current car-free situation, I have been walking at least 2.5 extra miles each day, often more. This is objectively good for me – as long as I avoid cars that don’t bother to stop for pedestrians and too much sun. It’s a positive thing.

Based on my recent experience with folks whose job it is to motivate people to be healthier, I should just be worried and OMG and am practically about to drop dead. Because my blood pressure was 120/70.

No, really. It was a weight and blood pressure check thing, and I was curious about whether the walking had changed my weight any. I should have known better. I already know what ZOMG-GONNA-DROP-DEAD! BMI category I’m in. So this lady looks at my weight, and immediately asks, before the blood pressure cuff even went on, “Do you have any problems with hypertension?” You know, ’cause I’m fat.

I told her no. She took my blood pressure, which was respectable. Especially after this lady’s attitude. Did she ask me if I’d taken any cold medicine or other drugs, like birth control? If I’d had a high sodium meal? If I was a smoker? Did she take a second measurement? Nope. She just told me repeatedly that the top number, 120, was “right on the line.” That’s right on the line of the lowest value of possible “prehypertension,” by the way.

It’s true that the current guidelines now suggest that the top number should be “less than 120.” With a second measurement, mine might have been lower or higher. I’ll be happy to get it measured every so often to make sure it’s still in a decent range, and not higher. But having someone – who is not my care provider, who does not even bother to ask relevant questions – tell me *three separate times* that my blood pressure is “right on the line?” There was no discussion of the bigger picture of my health, just a subtext of “overweight, so let me be smug while looking for something else problematic I should be finding.”

That makes me think that somebody just doesn’t know what to do with somebody who is higher than normal weight yet not explicitly way hypertensive and ZOMG BOUT TO DIE! And it makes me question whether the folks doing the measurements have my actual health in mind or might be fat-phobic a-holes who need to find something, anything, to be judgey about if a person is not a BMI-chart-normal-weight. That’s not exactly a charitable reading, but I can’t properly convey to you the “looked at my weight on a card, and then thought they knew everything there was to know about me” exhibited in this brief interaction. In just a short minute, instead of forming a partnership in which my blood pressure could have been calmly monitored for more information, a hostile relationship was created in which I assume the measurer and her cohort are more interested in stereotypes than health.

Not much good for patient engagement, that.

Filed under: Heart Health