Fat patients are driving me closer to the bottle daily I really, really hate fats. I have a female patient I'll call Jane. She's 34, super morbidly obese and confined to a scooter. She has a condition called pseudotumor cerebri, a condition of increased cerebrospinal fluid pressure that causes severe headaches and eventually blindness. But, since she's fat and noncompliant, the network's neurologist won't care for her and I prescribe her duiretics. She comes in the other day and complains that her symptoms aren't resolving. I tell Jane, again, that the first line treatment is returning to a healthy BMI (never tell them to just "lose weight." They'll just drop ten pounds and give up because they don't feel better.) That's when she hits me with it: she's been reading a haes blog and she wants the same treatment a thin person would get for pseudotumor cerebri. Every neurosurgeon in town has balked at opening this human bowling ball, so that's out of the question and I told her so. I said "Jane, at your size right now, surgery is out of the question. You aren't a candidate. All I can tell you is to lose weight. Would you like a dietary consult?" Of course not. She scooted out of the exam room in a huff, saying unlike my "skinny ass," she's a "real woman who needs real food."  Fantastic. She'd rather not only be immobile, she'd also rather have the Ray Charles experience than lay off the Wild Cherry Coke and Funyuns. I take that back, Ray Charles could walk under his own power and didn't need her boyfriend to wipe her ass.  And I'm sure she will whine to administration, because of course she will. Fuck this bitch and fuck fats.