An Enduring Teacher

“She sits there all skinny, smug, and condescending.”

That’s a real online review from one of my patients—written more than fifteen years ago. It’s still there, buried deep beneath dozens of newer reviews. Yet despite the passage of time, those words continue to sear a small hole in my otherwise intact heart. Skinny is not my favorite descriptor, but I can handle. But smug and condescending? That pierced something far more personal.

My first reaction was defensiveness. How could she say that? I have dedicated my entire life to medicine. I pride myself on empathy. I come from a long line of superb physicians. I don’t remember my twenties because all I did was work. Medicine isn’t just a job - it’s my calling. 

With time, though, I’ve come to see that her words revealed something deeper. This patient had a long history of depression, anxiety, ADHD, and substance abuse. But what consumed her most was her inability to lose weight. What I saw as calm professionalism may have read to her as judgment. As an endocrinologist, my treatment scope is far reaching—from menopause to adrenal and pituitary tumors, from thyroid cancer to diabetes. However, after more than two decades as a doctor, I have realized that weight gain and obesity are the most complicated conditions I treat. 

Weight, unlike most medical concerns, carries an enormous emotional charge. It is bound up with identity, shame, control, and longing. Addressing it requires a sensitivity that goes beyond the science of calories or metabolism—it demands an attunement to the pain behind the numbers. 

That review, as much as it stung, has become one of my most enduring teachers. It reminds me that how we see ourselves as doctors often diverges sharply from how our patients experience us- and that true empathy lies in bridging that quiet, invisible gap