Reached my saturation point with an obeast today [Mini Rant] Got called to see an obese patient today with an extremely painful but not life-threatening condition in my field of expertise. Going to keep this vague because my subspecialty is very small. I walk up to said patient and start the encounter the way I always do: extending my hand and stating "Hi, I'm Dr. SurgicalShitlord, I was asked to come see you about . . ."  Eatbeast stares at me as if I was a panhandler asking for change. "I don't shake hands." Beat. "I'm sorry, do you have a religious reason for this?" "No, I just don't feel like it." I stare at her for an uncomfortable (for her) period of time as my hand resumes its position at my side. Finally: "You know, I was asked by Dr. ReferringPhysician to handle your case because of your [insert painful problem which I can easily address via an elective surgery] . . . but I'm afraid that we won't be able to do so because of your weight". Lights click on in this buttergolem's dull eyes. She realizes, far too late, that I'm not a resident. "But it hurts all the time . . . it's making me depressed . . ." "Mmm hmmm. That's due to your obesity. We can revisit this issue once you've reached a normal BMI. Have a nice evening." Turn around, walk out. Unintelligible reeeeeeeeeeeing commences behind me and fades as I walk down the hallway. I take the stairs down and head over to my office. Type a quick consultation note and print it out, circle the pork orc's name and medical record number. Walk over to to my chief administrative assistant and hand it over. "This patient is not to be given a followup appointment with me until they reach a BMI of less than 25." She smiles quietly and files it in the folder I've created for just such an occasion. I anticipate seeing Elvis walk into my office before I see this particular mayochugger again.