Helena
re your link - I Had Cancer – And Medical Fat-Shaming Could Have Killed Me
That article is written with a rock solid conviction that had the writer not been overweight she would have been diagnosed in time to save her lung, and the delay in diagnosis was entirely due to medical professional view of her weight.
Such a conviction, particularly in light of specific facts, makes me suspect a HAES (or similar) influence on the writer's retrospective perception. Certainly there appears to be a slant that glosses over some pretty significant details.
The specific facts that I think may have had quite a lot more to do with the delay in diagnosis are:
-lung cancer in school children is incredibly rare. You'd need a medic to hear hoofbeats and think zebra to pick that up in three appointments that ended in, as the writer put it, "a reasonable recovery". (This is the point in time when her lung could have been saved, according to her specialist.)
-11 different doctors in 5 years, because like many of us, life meant the writer had to move around and that resulted in a lack of continuity of care. Which can be an issue when chronic, fluctuating symptoms are relevant to something rare and sinister going on.
-A lack of medical insurance. Meaning ongoing oversight of what had become a long standing, chronic state represented an onerous cost if provided based on need, rather than what could be afforded. Likely rendered worse when a lack of insurance was exacerbated by extensive debt incurred by ER visits.
To be honest the writer's own description of her treatment kind of rules out her weight as the primary cause of a lack of accurate diagnosis. She says herself that the one doctor she didn't feel fat shamed her -
-had access to her long history of diagnosis/treatment. (GERD, allergies, bronchitis and pneumonia)
-worked like a dog to try and work out what the underlying issue was.
-provided continuity of care
And even the non-weight mentioning doctor didn't hear hoofbeats and think Zebra. She was looking for a horse. As they do.
Pretty much it seems the only reason the writer got diagnosed at all was because she got pneumonia again and was ill enough that she saw a doctor in the ER, who generated a CT scan and a referral to a consultant.
So it sounds like until there was a serious ER requiring symptom, in combination with a long standing history chronic issues, to set off "possibly something sinister here, despite the youth of the patient" alarm bells, nobody thought "it's time to start ruling out Zebras".
I know fags/weight/booze/drugs/risky behavoirs can be factors that delay diagnosis because they are factors in so many health issues, and can send doctor after doctor up horse shaped blind alleys, again and again.
There's also the issue of the occasional doctor who has become blinded by their own prejudices and ignores the bleeding obvious.
But it doesn't read like that was a primary factor in the diagnostic delay in this case. I think the primary factors were how incredibly rare her condition was (given her age at onset) in conjunction with a lack of continuity in her medical care and her inability to pay as an uninsured person decreasing her access to healthcare.