Welcome to the ERbook.net:  the Web's foremost site for Emergency Room stories.
Discussing the specialty of emergency medicine, medical school, academic success, and unusual true Emergency Room stories.

Quick Search  
Advanced Search

Site map


Reviews of other ER books

Contact me

Submit a question

Submit an ER story

Have an interesting ER story?  If I use it, I'll give you a free book.

Question & Answer pages

For more Q & A, see my
www.er-doctor.com site

ER crossword puzzle

Interview with Dr. Pezzi


Test your knowledge of ER terms by solving my ER crossword puzzle that was featured in the Prudential Securities Healthcare Group 2002 calendar.  Or take the ER-MCAT to see if you have what it takes to be an ER physician.

My favorite ER memories

Pictures of me


My personal pages

Including my:
Medical Inventions page
Misc. Inventions page
Snowmobile page

Accelerometer page
Smart Seat page
"If I had a hammer" page
"Sheds I've Built" page
Dremel bit holders page

ER stuff
 ER stuff
A mold to make ER cookies and ER Jell-O!  Or how about a glow-in-the-dark chest x-ray?

My postings on ER forums

ER links

Bad news about Accutane

Amy's Corner

Amy reviews ER computer games

Tell a friend about this page by e-mail

Recent magazine interviews

Some of my other sites

Do you care if wild animals needlessly suffer and die during wintertime? If so, see www.shelteranimals.org.

LEAD-IN:  I sent an e-mail to a friend in which I lamented the difficulty of finding a slim woman to date.  My friend responded with the following e-mail, and my response to her follows immediately thereafter.

Dear Shallow Hal  :-)

Look, I'd rather have fat than men who are just out of prison or in jail, can't drive because they just got an OUIL (Operating Under the Influence of Liquor), or take you out to dinner and make you walk home in 18 degree weather because you won't have a twosome with his buddy, or are more interested in your daughter. I will take fat over asshole any day of the week.

I understand what it means to be fat. When I got pregnant with my child at 25 I was teaching aerobics and lifting weights hence the muscular body frame. I was a perfect size 9/10 and looked awesome. I weighed 155 lbs. and I was 5' 6", healthy as a horse. When I used to run I could get my weight down to 145, but I didn't look or feel healthy. At 155 I am a powerhouse of energy and motion. I was very sick with my pregnancy and spent 3 months in bed. When I had my emergency C-section I weighed a whopping 234 lbs. I now weigh 165 pounds and I can almost get into those size 10's. I understand the commitment needed to keep the body in shape.

But Doc, you may want to reflect a little on the "slim" issue. Don't you think it is more important to find someone who is balanced in the head at least? Love will find you if you are truly open to what life has to offer. Be careful what you ask for as beauty on the outside may mean ugly on the inside. What scares you about these women is the fact that they represent/reflect an aspect of you that you didn't like. Congratulations on your success in changing your body!!!

Right now my goals are not about numbers from a scale, but about longevity and living a relatively stress-free life . . . which may be a contradiction in terms considering I am a mother of a pre-adolescent girl :-)

I have a lot to offer a man. But I will never offer him "slim" I offer him a healthy mind, body, and spirit. I can offer laughter when he's sad, comfort when he's lonely, an exercise partner when he doesn't want to play alone, a mind that continues to grow in wisdom, a beautiful smile, integrity, honesty, a chick that looks hot when she's dressed to the nines or in jeans, etc.

Unfortunately, as you have so succinctly put you want the body first and maybe brains will come. Remember Doc, we all carry extra baggage you can just see it with some. Hmm, I think I found your Achilles' heal my dear doctor. By the way, I can prove that intelligence can be directly affected by a mood care to debate???  Chris

Hi Chris,

Shallow Hal, huh?

First, I never said anything that might plausibly lead you to conclude that I "want the body first and maybe brains will come."

Chris, from what little I know about you, I like you except that I prefer slim women. So do most guys. For women who aren't slim, here is the unfortunate reality they face:

FEW guys prefer large women.
MANY guys won't date a woman unless she is slim.
MOST guys will tolerate** some extra fat on their partner if:
1. They're not so hot themselves.
2. The woman gave birth to his child (or children).
3. He's married to the woman, and deeply loves her or isn't in the mood for shopping for another wife.
4. The woman is elderly, and for medical reasons cannot exercise (however, from a medical standpoint just about everyone would be better off slim.
** They may tolerate it, but they sure don't like it. I know, because I've heard what thousands of men have said when women aren't around.

As a general rule, guys with more to offer are more selective in choosing a partner, and guys with less to offer are less selective. Therefore, women who aren't slim are limiting themselves to the type of man they can get. The point I'm trying to make is this:  you're a quality person, but you could increase your desirability by losing weight. Men with a lot to offer who won't currently date you very well might if you were slim. Men are programmed (it's in our genes, so don't blame us for it) to be attracted to women with beautiful bodies. Some women attempt to combat this reality by saying that society has unrealistic notions of what constitutes a nice bod. Sorry, no dice. To begin with, the prevalence and severity of obesity in women today is far greater than it was a few generations ago, even though we now have so many things that are conducive to weight loss that either were not available or less available to women a few generations ago (such as low-fat/no-fat foods, calorie-free soft drinks, zillions of exercise machines and health clubs, weight loss drugs and herbs, doctors who specialize in weight loss, countless weight loss books and clinics, and so on). So if yesterday's women could be reasonably slim, there is no reason why today's women shouldn't be in the same or better shape. But instead of staying the same, today's women have ballooned. Secondly, even if today's tubbier-than-ever women don't give a hoot what men think, they should lose weight for the sake of their health if nothing else. You can euphemize your weight of 165 all you want, but it isn't helping you from a health standpoint. It increases your risk of heart disease, diabetes, cancer, and arthritis. And do you know what the bad news is? You're young. Just about everyone gains weight as they age. Most older women who now weigh 200 pounds were slimmer than you when they were your age. You might think you're on the right track, but from my experience as a doctor, the track you're on is the track leading to ill health. It's your body, and your future.

This same selectivity works against men, too. Let's say that I wanted to date Ashley Judd. She's unbelievably beautiful, slim, intelligent, and wealthy. Would she date me? That's highly unlikely, because she knows that the collective worth of her attributes surpasses the collective worth of mine. I'm in very good shape, but she's considerably more attractive than I am in terms of facial beauty. I'm probably more intelligent and creative than she is, but she is very rich, and I'm not. I can't comment on other attributes, such as personality, because I don't know her, so let's omit them from consideration. So, by my scorecard, her attributes or "dating value" or "desirability quotient" (or however you wish to term it), is greater than mine. If I was overweight, the gap would widen because I'd be less desirable. This isn't rocket science it's intuitively obvious to everyone who has ever dated.

How often do you see handsome millionaires dating plump, unattractive women? Never. That's true even if the woman is intelligent and has a nice personality. Believe it or not, but there are slim, attractive women with brains who are good people.

Look, I know the pain of being fat. When I was a chubby resident, I distinctly remember the "can't we just be friends?" rejection handed to me by Cathy Gielow, a nurse that I adored in many ways.

Women would no doubt prefer than men stop using appearance as a criterion for deciding whom to marry. Guess what? Men would no doubt prefer that women stop using how much money a guy makes as a criterion for deciding if that guy was marriage material or not. The oldest quid pro quo is for a man to trade money or other assets for a woman's beauty. Women love to bellyache about how men discriminate against them if they're fat. Well, women, are you any kinder? Don't you discriminate against poor men? If you truly believed this "inner beauty" stuff, wouldn't you totally overlook how much money men have?

We live in a very competitive world in which men compete for money, so not all men can be rich. However, there is no comparable competitive force preventing all women from being in good shape. This simple fact doesn't put me in a very charitable mood to feel sorry for women who think that men are too tough on them by wanting slim partners. Remember:  virtually all women could be slim, but not all men can be rich. Thus, the competitive pressure is worse on men, not women. Since women are such strong advocates of inner beauty, I'd like to call upon women to stop valuing men on the basis of their money. What does money have to do with inner beauty, right?

Obviously, I'm being facetious. It's nuts to think that women will ever stop salivating over rich guys, and it's also nuts to expect men to stop chasing after slim beauties. I had to work my butt off to make enough money to make me at least reasonably desirable to women. If you totaled up all the hours I spent in college, medical school, residency, and working, I've put an enormous effort into this "improving my desirability quotient." Do you think that I would have worked that hard if there weren't women worth chasing after in this world? Heck no! Wasn't there an old fast-food jingle something along the lines of "You're the reason why we do what we do"? Well, beautiful women of the world, you're the reason why I do what I do. You think I'm trying to impress other guys? No way.  If there weren't beautiful women worth wooing, I'd make just enough money to survive and spend the rest of my time having fun.  By the way, working 120 hours per week in the hospital is not my idea of having fun.  To the extent that I've tortured myself to get ahead in life, I did that for my future spouse not me!

If overweight women put even 10% of the energy into losing weight that I put into college, medical school, and busting my butt working 120 hours per week as a resident, then those women wouldn't be fat they'd be in great shape. Heck, even 5% of my effort would suffice. I've worked harder than a dog to get a few bucks to woo beautiful women who can't appreciate my inner beauty unless I have a thick wallet, so don't think I'm asking too much if I ask you to put 5% of the energy I did into making money into your efforts to lose weight.

Quote from Chris:  >>> Look, I'd rather have fat than men who are just out of prison or in jail, can't drive because they just got an OUIL, or take you out to dinner and make you walk home in 18 degree weather because you won't have a twosome with his buddy, or are more interested in your daughter. I will take fat over asshole any day of the week. <<<

So you're saying that I should prefer a fat mate instead of one who was recently released from prison, is an alcoholic, or is twisted? I appreciate your kind advice, but it is quite easy to find non-obese women who aren't ex-cons, etc. I never knew the choice was that dismal:  "Hmmm, should I date Jailhouse Jane, or must I settle for a fat woman?"

Another quote from Chris:  >>> But Doc, you may want to reflect a little on the "slim" issue. Don't you think it is more important to find someone who is balanced in the head at least? <<<

Evidently you believe that there is an inverse correlation between slimness and sanity. I know of no such association. In fact, judging from my years of ER experience, I know that fat women are more likely to be nuts than slim women. Hence, I'm not tempted by the prospect of dating a fat woman.

Another quote from Chris:  >>> Be careful what you ask for as beauty on the outside may mean ugly on the inside. <<<

Again, are you aware of some correlation that I am not? Except for a few women afflicted with the beautiful woman syndrome, I've never noticed that attractive people are somehow less beautiful inside. Unattractive people often like to slam attractive people by claiming that attractive people have less inner beauty, but this notion is pure hogwash.

Another quote from Chris:  >>> What scares you about these women is the fact that they represent/reflect an aspect of you that you didn't like. <<<

Your logic is flawed. I wasn't attracted to fat women even before I was fat, so the fact that I'm not currently fat doesn't make me dislike obese women out of some fear of blubber that's reverberating in my mind because it reminds me of the painful reality of my days of blubber.

Another quote from Chris:  >>> Right now my goals are not about numbers from a scale, but about longevity. <<<

You're not yet old enough to have a strong likelihood of your weight impacting your longevity anytime in the near future, but if you keep along the track you're on, you're statistically far more likely to find out that your nonchalance about your weight is unfounded. Keep on singing if you want, but remember that ignoring a problem in the manner of an ostrich won't make that problem go away.

Another quote from Chris:  >>> I have a lot to offer a man. <<<

I agree. I'm not trying to dispute that at all. My point is this:  you have a lot to offer, but if you were slim, you'd have even more to offer. Therefore, you could get a more desirable man.

Another quote from Chris:  >>> But I will never offer him "slim" I offer him a healthy mind, body, and spirit. <<<

Marriage isn't just about today it's about tomorrow, too. And a lot of tomorrows in the future. Obesity predisposes people to many diseases. Frankly, I don't want a wife who can't take a walk with me in the future because her knees or hips are arthritic. I don't want a wife who died years ago because of breast cancer or heart disease. I don't want a wife who is tethered to an oxygen tank, and I don't want a wife whose body is destroyed by diabetes. I don't have a crystal ball to peer into the future and see who will be healthy, and who won't. So I judge the likelihood of poor health in the future by looking for the underlying factor (obesity) that is the most frequent common denominator in the diseases most apt to kill or debilitate in the years to come. Therefore, being slim isn't just a matter of beauty; it's a strong indicator of long-term health. I don't have a crystal ball, but I do have common sense. Many other men have common sense, too, and their bias against blubber isn't some shallow desire.

Another quote from Chris:  >>> Unfortunately, as you have so succinctly put you want the body first and maybe brains will come. <<<

Nope. I want both. Now. Read the last paragraph I wrote, and then ask yourself if you blame me.

Another quote from Chris:  >>> By the way, I can prove that intelligence can be directly affected by a mood care to debate??? <<<

Of course intelligence can be affected by mood. So can the desire to exercise and diet.

In this long e-mail, I think I've demonstrated why it isn't a shallow desire to want a slim mate. Women love to disparage that desire, but it isn't a shallow whim it's a pragmatic and well-founded concern.

Coincidentally, a few days after I wrote the above e-mail I happened upon a hilarious, to-the-point explanation from Amy Alkon* who told one of her readers why it isn't unreasonable for someone to desire a nonsmoking mate:  

Your girlfriend dreams of spending her golden years walking hand-in-hand into the sunset with you, not jogging behind your stretcher as you're wheeled into the emergency room hacking with emphysema:  "You look especially sexy on your respirator tonight, my love."

* From the syndicated column, "Ask The Advice Goddess," by Amy Alkon, in over 70 papers across North America.  Reproduced with permission.

Chris was not swayed by my logic, and went on to assert that fat women are "more real" than slim women.  I thought that such a position was untenable, and fit into the category of wishful thinking.  Why would anyone seriously argue that women are "more real" if they don't watch what they eat and are couch potatoes?  Are women less real if they give a hoot about their diet and care enough about themselves to exercise?  I don't see why.  In my opinion, it's stupid to celebrate traits that make women "more real" (in Chris' mind) by decimating their health and appearance.  If anyone doesn't care about those things, that person must either learn to live without love, or settle for someone who isn't especially desirable, and hence can't be very picky.

Although Chris claims to be healthy, she has hypertension (high blood pressure) that spikes high enough so that she could have a stroke any minute.  The link between hypertension and obesity is well-known, yet because hypertension is "the silent killer" (inflicting its damage often without symptoms), obese people usually think they're healthier than they are . . . until it is too late, and they become just another statistic.  What's that saying about whistling past the graveyard?

I wish you luck, Chris.

A reader responds to Chris' Shallow Hal assertion

● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ●

You will have sex about 10,000 times during your life.

Doesn't it make sense to read a book that can maximize your enjoyment, and the enjoyment you give to your partner?

Cast away your preconceptions of sex books as being a rehash of things you already know and hence a waste of time.  By reading this book, you will learn many things that Dr. Ruth and other sexologists have never considered.

The Science of Sex
Enhancing Sexual Pleasure, Performance, Attraction, and Desire

by Kevin Pezzi, MD

Available in printed and Adobe Acrobat e-book versions (will display on any computer)

● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ●

Organize your garage beautifully.

If you want a beautiful garage that is easy to keep organized, see the GarageScapes web site:  www.GarageScapes.com.

ContactMeFree is a dream come true for anyone involved in online dating. If you have your profile posted on a personals site but don't pay for a membership, you know how limited you are in terms of being able to send or receive messages. You probably assume that those limitations disappear if you pay for a membership. Guess what? You are still far more limited than you realize. Frankly, if you knew how limited you were, you would be furious that the personals site was charging you $20 to $50 per month and still keeping the shackles on you! The person who created ContactMeFree was so outraged by those limitations that he decided to do something about it. So he did!

You know that writer's block you get when you sit down to write the essay portion of your personal profile for online dating? And you know the difficulty you have trying to think of a catchy headline? Well, MyProfileWriter allows you to create a profile essay and headline without typing, just by clicking!

Copyright © 1995 – 2011 by Kevin Pezzi, MD • Terms of use