Everything smells of antiseptic and iodine. The counters are graphite but it doesn’t feel sterile or polished or professional. The lighting is distracting trying its damnedest to resemble sunshine but failing miserably. He is uncomfortable and concerned that the two extra large surgery gowns they gave him still don’t cover his girth in any way that counts.
“I’ve been waiting for almost an hour,” he huffs into his cell phone. She’s called him twice since he came in. She doesn’t believe any doctor’s visit is routine. He has to ‘pinky promise’ to call her back the minute he’s seen the doctor in order for her to agree to not call back again or to call the doctor office and ask for Dr. Milhouse herself.
He’s been ‘pinky promising’ his sister things since they were 7 years old. At they time it was a lot easier than the blood swears he wanted to commit to but she recognizing that they shared a womb for nearly a year figured enough blood had already flowed between them. So the ‘inky dinky pinky promise’ was made. At 15 it was embarrassing especially when she made he commit to it in front of his friends to keep him from drinking with them but it worked. It worked again on his behalf when he got her to ‘pinky promise’ not to have sex with that idiot who turned around and got their cousin pregnant. So their was no reason not to believe he wouldn’t remain committed to the promise at 42, when they both knew it was his life on the line.
She doesn’t even knock to announce her arrival. Shaking her head, Dr. Milhouse enters, “What news do you want first? Bad or worst?”
It’s not a joke. He knows its not a joke but he can’t help but tune her out. What difference does it make anyway. His father died at 56. His grandfather died at 58. Three of his uncles didn’t make it to their 60th birthday. Why would he be any different?
“Bad or worst, Marvin?”
He looks at her and for the first time notices, Dr. Milhouse is a pretty woman. “Just tell me what I need to know.”
“You need to loose weight.” Her face is grim. Her hands grip the clipboard as though it were the lifeline Marvin needed to save himself.
At 402 pounds, Marvin knew his weight was THE problem. But hell he was four hundred and two pounds. “Tell me something I don’t know.”
“This is serious, Marvin. Your glucose is ridiculous. The blood pressure medicine is not working. Diabetes is creeping on you so fast when it catches you its gonna lay you flat on your ass.” She was angry with him. They had had these consultations on 4 different occasions. She was frustrated and could not longer hide it behind a professional demeanor. She wanted to slap him. Anything that would help shock him out of this slow suicide.
“What else can I do? I’m on blood pressure medicine. I take anti-depressants. I got the stuff for the apnea and cholesterol. I take more medications than a geriatric war veteran and still here we are.” He’s sweating. In a room that never goes above 76 degrees, Marvin is sweating like a post marathon athlete.
She reaches in her pocket and hands him a pamphlet. “Call them. I will give you a formal referral so your insurance will be more responsive to the recommendation. The nurse will come in with your prescription refills,” she pauses and places her hand over his, “You can be different, Marvin. You don’t have to repeat your family history.”
“Yeah, I know,” he’s dismissive and her touching him has only made him more uncomfortable. Dr. Milhouse leaves the room and Marvin looks at the pamphlet. Surgery. Major surgery. That’s what she wants him to do. Choose to go under the knife. He starts to toss the pamphlet in the trash, when he remembers the ‘pinky swear’. His sister will skin him alive if he doesn’t at least show her the pamphlet.
It takes effort but he lowers himself off the bench and starts the arduous task of putting his clothes back on. The nurse is a kind woman, a mother of 3 if he remembers correctly. She calls in his prescriptions and helps him on with his shoes.
Once he’s settled in his car, he gives his sister a call.
“What’d she say?” she pounces.
“I need to loose weight.” He’s out of breath and rushes to get his air conditioner going.
“Marvin. What did she say?” Marquita is not a patient person.
“She said I need to loose weight and then she gave me this brochure-”
“Bring it over,” she interrupts. “We’ll look at it together. Mama here too. We can all look at it together.”
Shit. First Dr. Milhouse is on him now he got to go deal with two of the most outspoken women he know. Can this day get worst? Marvin is frustrated. Why is this happening to me, he thinks.
“On my way,” he hangs up. Marvin contemplates a couple of big mac’s before getting to his sister’s house. He’s hungry and that would at least settle his stomach before the showdown. Big mac’s are 2 for $3 so he adds a super size fry and diet coke. They’re gone by the time he pulls up in his sister’s driveway.
The door is open and his mother is standing in the frame waiting for him. Retirement just gave her more time to ride my ass, Marvin thinks and takes his time getting out of the car. When he gets to the porch, his sister is standing behind his mother and they’re both waving their hands like seals reaching for a beach ball.
“Where’s the brochure?” Marquita gets it out first but its his mother that he hands it to.
“Gastric bypass!” They both holler.
“They want you to slice your stomach?” His mother’s worried face goes to panic. “How much will that cost? Can your heart take that type of surgery?”
“Mama, let’s just read the material and then we can see what to do?” Marquita leads them to the kitchen. With the exception of the color Marquita’s kitchen is a replica of the one they grew up with from the white stove and refrigerator to the green linoleum and walnut cabinets. She even has the same giant spoon and fork set on the back wall just like their mother’s. Staring at him with their hands on their hips, they are mirror reflections of each other. Marvin feels like he’s seeing double.
“You been eating that McDonalds, Marvin. I can smell it on you.” His mother was always good at finding out exactly what he was hiding.
“I was hungry.”
“Just not for food,” she adds under her breath.
What does that mean, Marvin wonders. They sit down at the kitchen table and Marquita pulls out her laptop and opens it up.
“What’s the doctor’s name, Mama?” Marvin is already out of the conversation.
“Krinshaw. But with a K. Say’s he’s a specialist in weight loss, maintenance and management.”
“I found him,” They both look at the computer screen. Marvin is staring out the kitchen window. “Well the website says there are options.”
“What kind of options?” their mother asks.
“You could get the bypass surgery or the lap band. And they have a registered dietician that teaches a nutrition class…”
“All that sounds nice, but will Marvin do it?” Their mother turns toward Marvin. Her face is twisted with anxiety. He thinks she may be near tears. “I’m just so worried about you.”
Aww hell, now his mama’s crying, Marvin thinks, it would be better if I’d called her from jail.
“Mama don’t cry.” Marvin places his arm on his mother’s shoulders, careful not to lean too much on her. “What else does it say, sissy?”
Marquita is happy that Marvin at least sounds interested, “They have an information session scheduled for…” she looks more intently at the screen, “tonight. They have an information session scheduled for tonight at 6 o’clock at the hospital. I’ll go with you.”
“What about the kids?” Marvin asks.
“I’ll watch the kids. Y’all go to the meeting.” His mother volunteers.
Marvin sits up straight, staring out the window. He can’t decide but his sister is already on the phone RSVPing their attendance. They move too fast. They have always moved too fast for him. More than anything Marvin just wants to go home and lie down right now. He looks at his watch and knows that is completely out of the question. It’s 5 o’clock. She’ll want to leave in 15 minutes.
Marquita gets up and grabs her purse. “Mama the casserole is in the oven. It should be ready in 10 minutes. Charles will be dropping the kids off at 5:30 so he can make his shift by 6. His lunch is already packed and ready to go in the frig. The lady said the meeting only takes an hour so I’ll be back to put them to bed. Let me go put on some shoes.”
They move way too fast.
Marvin already knows what’s coming, “I buried your father, my father and my two brothers. I never met your father’s father but I was there when your daddy buried his brother. I don’t want to bury you.”
She doesn’t look at him. She gets up and goes to the refrigerator and opens the door. Even though Maquita has already prepared a meal to feed her family and probably a few more, their mother pulls out eggs, milk and some leftover chinese rice cartons. She places them on the counter and goes to get the sugar from the canister on the shelf. She knows where everything is in Marquita’s kitchen because Marquita’s kitchen is her kitchen.
“Marquita never thinks about dessert. You should always have dessert with your dinner.” She grabs a bowl and starts putting together a simple rice pudding.
Growing up dinner at their house always included a main dish, a vegetable, a starch, something to drink and dessert. She believed in balanced meals and not snacking between meals. It’s that sentiment that has keep her at her wedding weight of 132 pounds since 1968. Marquita is the same. Exactly the right weight for their height and age. Control freaks is what they are, Marvin believes.
“I’m ready.” Marquita announces. What she meant by ‘shoes’ was a complete outfit change, a comb through and a little more make up. The only women Marvin knows like his mother and sister are his mother and sister. They run their homes like clockwork and never is a hair out of place or an outfit out of order. They have stations even for the things they throw away.
“Let’s hit it.” He stands up and hears his mother sigh.
Marquita doesn’t say much on the drive to the hospital. She fidgets with the radio and asks that he not run the air so they are driving with all the windows down because Marvin feels like he’s suffocating. Once they arrive its takes 15 minutes to maneuver all the signage. Settling in at auditorium B, Marvin tunes out and lets his sister take notes.
“Did you hear that?” she nudges him.
“Hear what?” he’d almost dozed off.
“That man just said he lost 120 in the fist 90 days after his surgery,” her whisper is urgent and in her eyes their is hope. Marvin would rather be sleeping.
“That’s nice,” he manages and goes back into his thoughts.
The nurse completing the session sends around a molten mound of ‘pretend fat’ and a stomach sculpture with a rubber band around the top of it. Marquita is fascinated. Marvin wonders if there will be refreshments.
A tall, slender woman the color Marvin likes his coffee rises and begins addressing the audience. “That’s her.” Marquita huffs.
“Who?” Marvin is actually curious.
“Together we can create a plan that will work for you. I promise,” she finishes. People clap. Marvin feels like he missed something important.
“We should talk to her.” Marquita nudges.
“Alyssa. My name is Alyssa,” she’s talking with another patient but Marvin waits. He’s thinking Alyssa must be another word for fine when she turns toward him, that’s when he remembers, ‘I’m fat.’ Before she can turn to talk to him, Marvin feels himself shrink away.
“Hello. Do you have a question for me?” Alyssa is looking directly at Marvin. Her eyes are kind and concerned. He stands up taller but Marquita beats him to the punch.
“When can we meet with you to get him started on the supervised diet?”
Alyssa looks directly at Marvin, “Is that what you want? Do you want to work with a dietician?”
For a moment his voice is stuck, no one this pretty has ever look at him with anything but disgust before. Unless you count mama and sissy, Marvin thinks. Swallowing he admits, “I’d like to try. I just don’t know where we would start,” Marvin gestures at his waist.
Alyssa looks around and notices they are the last people in auditorium B. She waves at the chairs and they sit. “We’ll start small. Small steps that mean something to you are the best way to get going and get motivated.” She smiles at him and it is the kindness in her eyes that does him in.
“I have to loose 200 pounds,” his shoulders slouch. Marquita excuses herself for a bathroom break. He confides in Alyssa, “I have no idea how I’m going to loose 200 pounds. That’s like 2 people.”
“You’re not alone. Marvin, right?” He nods. “You saw how many people were in this room tonight. Nearly 50 and all of them have at least 1 person or 100 pounds to loose. You also had a chance to hear people who’s been there and done that-”
“I have to admit, I wasn’t listening,” Marvin confesses.
Alyssa laughs, “It can be overwhelming. Well there were three patients here tonight all who’ve lost more than 100 pounds. Two used surgery and one followed a weight loss plan with me. Its not impossible, Marvin. Its hard, but it’s not impossible.”
She looked at him with such hope and expectation he starts to think maybe she was right.
“When can he set something up to meet with you?” Marquita had returned, all business.
“I have appointments mostly in the morning. The earliest I can see you…”she turned to consult her phone, “is day after tomorrow at 10 o’clock. Will that work?”
“He’ll make it work,” Marquita assured her.
Marvin tired of being pushed, “Marquita please wait in the lobby so I can get my appointment scheduled.”
Surprised Marquita left the auditorium. Marvin turned toward Alyssa, “They’ve been pushing me around all day. I’m a little tired of my sister and mother and doctor thinking they can say anything to me.”
Marvin goes to wipe his brow, becoming self-conscious he reaches in his pocket for a tissue. Alyssa hands him a napkin. “It sounds like they are very concerned about your health.”
“Concerned is one thing. Nagging is another.” Marvin thanks her and wipes the sweat from his face. “I know I need to loose weight. They have dragged me to Weight Watchers, Overeaters Anonymous, Jenny Craig, Nutri-system. It’s too much. They are too much.”
Alyssa places her hand on his shoulder, “This is a journey you’ll have to take by yourself.”
He looks up at her, intent on hearing what she has to say.
“But you can’t do it alone. Having a support system is crucial. Having the right support system essential,” Alyssa reaches into her purse and pulls out a picture. Its of an obese woman. Staring at the photo, Marvin imagines the woman in it weighs more than he does. “This was me, 6 years ago.”
His jaw drops.
“I know,” Alyssa tells him. “I don’t often tell patients that I use to be a patient. But it’s true. My family did everything short of disowning me in an effort to get me to lose weight. But the pressure from them was not helpful.”
“What helped you?”
“Me,” she rolls her eyes. “I know it sounds corny but one day I just woke up pulled my 350 pound ass out of bed and after sitting down because I was already too tired for the rest of the day, I decided, I’m taking a walk. And I did.” She looks at him and the look is so kind and tender, Marvin thinks it might make his heart stop, “I wanted it to be different. I wanted to be different. I started walking and then I called Dr. K. I got on a plan and by the time my surgery was scheduled I was already 100 pounds down so I just kept going. Then I got so sic’ed I started taking classes and volunteering at sessions like this. Now look at me.” She stood up and he did.
“You’re beautiful,” Marvin told her.
Leaning over she looked him in his eyes, “So are you.”
That’s when Marvin felt his eyes tearing up. Alyssa stood up and reached her hand out to him.
“I will definitely be your dietician if you show up on Thursday. But I can also become your friend.”
Marvin takes her hand asking, “Pinky promise?”