Your Body Needs No Apology
On the small moments of shame patients bring into exam rooms, and the responsibility clinicians have to make care feel safe.
Editor’s Note: Welcome to AWSIM’s monthly column by Sarah Halter MD, published on the last Friday of each month. In this series, Sarah reflects on the small but meaningful moments that shape clinical care, patient dignity, and body liberation.
It happened again the other day. I had a patient up in the stirrups, and she apologized to me for not shaving. Usually, I try to lightly brush off these concerns. “Please don’t worry,” I say. “Hair’s totally normal!” Depending on how long we’ve known each other, I might make a joke. “No worries! I went to a women’s college. Nobody shaved.”
As is my wont, I ruminate over these encounters when they’re done. I feel sad that my patient felt like they had to apologize for a normal bodily process. Depending on where my “anger at the world” level sits - and let’s be honest, when am I not at least a little angry these days? – I feel bitter towards society and its pressures. On other days, I take it too personally and wonder if I’ve done something that makes my patients worry that I’ll judge them.
People don’t just apologize to me for their body hair. They also beg pardon for their “ugly” feet or the weight they’ve gained since their last wellness. On one hand, I understand this impulse. I too have apologized to my dentist for the coffee stains on my teeth or to my primary care physician for how much I sweat. And I know that many of my patients aren’t necessarily struggling with self-loathing in these moments. Most of them probably just think they’re being polite, or they’re brushing off mild embarrassment. It’s awkward to sit in a flimsy robe and bear your soul and your skin to your doctor. It’s my job to soothe and move on, not make the situation worse by monologuing angrily about the harms of cultural body ideals.
But I’m still bothered that so many of my patients feel the need to apologize for their bodies. “Please don’t apologize to me,” I want to say. “It’s your body.” We only get one, after all. Some bodies have bad knees or the tendency to retain cholesterol. Some take to sports like a duck to water, and others need help controlling blood pressure or sugar. My job isn’t too judge.
My job is multifold: to help my patients stay healthy when possible and mitigate symptoms when it’s not; to help people transition through seasons of life; to change the things that can be changed, or to find treatments or work-arounds; to pursue “health,” although that can mean different things to different people. This job would be a lot easier if my patients left their shame at the door – if they felt empowered to do so. But that’s not an easy ask. The doctor’s office (unfortunately) isn’t always a safe space.
So I do the best that I can during my limited appointment times. I may not be able to change medical culture as a whole, but I can do everything within my power to make my practice a safe place for people to exist without apology.
We would love to hear from you. If there are topics you would like Sarah to explore in a future column, or if you have questions, reflections, or comments, please reach out to us at info@awsim.org.
In case you missed it, you can also read last month’s column here:
Who Wouldn’t Be Fatigued Right Now?
I think a lot of primary care providers would identify fatigue as one of the most challenging chief complaints. Personally, I’d prefer some diabetes to manage, or maybe even chest pain. At least for the latter complaint, the differential is limited. But fatigue? That’s a doozy. And, besides, who
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