* * Anonymous Doc

Thursday, March 24, 2011

I'm counseling a clinic patient this afternoon about obesity and her high cholesterol, and as we're talking she reaches into her purse...

And pulls out a hot dog.

Wrapped in foil, but still... a hot dog. And she unwraps it and starts eating. While we are talking. About her eating habits.

"I'm sorry, you can't eat that in here."

"I didn't get a chance to eat lunch."

"I'm sorry, you just can't. This is an office that a lot of doctors share, and there's a very strict rule against food. Plus, you can't eat a hot dog while we're talking about things you should and shouldn't be eating. You just can't."

"I didn't get the french fries. I'm trying."

"I know you're trying, but you really have to put that away. You really can't eat that in here."

"I'll be neat."

"No one's neat. If we let people eat in here, the office would be a mess. And it can't smell like hot dog in the doctor's office. It really can't. I don't know what else to say except that I have to cut the visit short if you don't put that away."

And then she stuffed the entire thing into her mouth, chewed it up, and swallowed.

"Okay, all done."

"That was not the right answer."

"You didn't give me much of a choice."

"I can't believe that just happened."

"Don't tell me you don't like hot dogs."

"I'm sorry. I have to go... check something... in the chart...."


  1. Oh gosh, how did *that* turn out?

  2. wow, clinic must be incredibly frustrating...

  3. Oh my god! I just burst out laughing so hard. That's unbelievable. I'm sorry you have to deal with that. And it's also pretty sad for that woman. It seems like she will have a really tough time adjusting her eating habits, if she can do so at all.

  4. if it was footlong, i would do an sti panel just to check on her past life as porn star.

  5. Three words: Low Carb Diet. It's not the hot dog, it's the bun that's the problem.

    Do you check for insulin resistance?


  6. M, she failed her test for hot dog resistance, her prognosis is pretty clear just from that.

  7. As a diabetic, I wonder if you'd relax the rule if I was having hypoglycemia and needed to eat something. Of course, it would usually be a small, discreet glucose tablet, or a piece of hard candy, but still....

  8. I think there's a very obvious difference between what the clinic patient did, and a diabetic needing a piece of hard candy....

    That said, I can't help but feel pity for the woman. I hope I'm wrong, but that seems indicative of a seriously unhealthy relationship with food, and one that probably won't change just from a conversation about diet (and consequences) with her doctor.

  9. I just found your blog - am an Addison's patient and have my own "doctor" horror stories, but I'm with you on this one! A patient who walks in to an appointment with a hot dog in her PURSE is fairly demented. What about the other patients who want to vomit at the smell of a hot dog? Sounds like she needs negative attention or maybe you were on Candid Camera?? Maybe you should've told her the Hot Dog condiments were down the hall at the bottom of the trash can, under the vomit.

  10. Okay, well since I'm maybe the only one here who has insulin resistance (IR) and spent lots of time with others who are insulin resistant...

    IR can look like an uncontrolled food addiction. Any amount of sugar begets more sugar. It's just food, food, food all the time, like an itch.

    The default assumption here is that there is a lack of will power or some psychological issue. You would be surprised how reducing insulin can turn that kind of food behavior around. It is dramatic.

    Cutting refined sugars out of the diet, I can walk past cake and not care. If I'm eating lots of refined carbs though, I will attempt to swan dive into the icing.

    The sad thing is not that the woman ate the hot dog, but that nothing appears to have been done to try to find the root cause.

    Granted I never did anything like that, so maybe there is an underlying psychological issue, but she is also very likely IR in addition to any mental illness.

    I don't think insulin resistance is well addressed with the current medical system. The comments here pretty much prove that point.


  11. A-

    Yes, Really.


    It's amazing how doctor's don't check for it, people keep eating, and everyone thinks that the hot dog is the think killing people when it is the bun.

    Low carb. It solves a LOT of problems.