"I could wire your jaws shut so tight that you can't move your jaws to talk, and if you can't talk you can't eat."

An article in the New York Times discusses problematic experiences that some patients have had with their doctors. The title quote is what a doctor told someone whom she thought was slowly committing suicide by putting on weight.

Fat people say they know that problem well. It happened last summer to Tina Hedberg of Conover, Wis., who saw a doctor when a diet she was on was no longer eliciting drastic weekly weight loss. The doctor, Ms. Hedberg said, told her that she had a mental problem because she weighed 400 pounds. Ms. Hedberg was trying to commit suicide by getting so fat, the doctor informed her. Then the doctor said Ms. Hedberg had two choices. She could be admitted to a mental institution, or, the doctor said, "I could wire your jaws shut so tight that you can't move your jaws to talk, and if you can't talk you can't eat."

Being morbidly obese puts a person at risk for heart problems, for sure, but did the doctor really need to say that? Could a different, more caring approach have been better?

I've worked with hospitals and doctors (although mostly psychiatrists) in one form or another for a total of over eight years. Although the majority of doctors I've encountered have been genuinely caring and respective of patient needs, it is a slim majority. I have observed terrible attitudes some doctors have towards patients (as evidenced by their statements about patients, sometimes made in front of them), especially those who have a mental illness or a substance abuse problem. Numerous people whom I've talked to at my worksite have complained about how little time their doctor spends with them.

Ms. Wong had come across a bane of the medical profession: the difficult doctor. These doctors may be arrogant or rude, highhanded or dismissive. They drive away patients who need help, and some have been magnets for malpractice claims. And while such doctors have always been part of medicine, medical organizations say they fear that they are increasingly common - doctors, under pressure to see more patients, are spending less and less time with each one and are replacing long discussions with laboratory tests and scans - and that most problem doctors apparently have no idea of their patients' opinions of them.

The moral of the story? Talk to your doctor or nurse staff, demand better treatment if you don't believe you are getting proper care, and if you are able to do so, by all means see another doctor.