Beggaring All Description

Beauty is many things, I suppose, and attempts to define it are fraught. It seems to vary between societies and eras, with some cultures deciding it is appearance, and some opting for demeanour. One such view, influenced by the Greek diaspora following the conquests of Alexander the Great, Koine Greek, used an adjective for beautiful: horaios, which derives from the word hora -or hour. There was a delightful description of this in (sorry) Wikipedia: ‘In Koine Greek, beauty was thus associated with “being of one’s hour”. Thus, a ripe fruit (of its time) was considered beautiful, whereas a young woman trying to appear older or an older woman trying to appear younger would not be considered beautiful.’

I find this useful, because it suggests that beauty -at least in a person- resides in being recognized for what one actually is -not what artifice may try to disguise. Admiration, in other words lies in more than appearance. I am reminded of Shakespeare’s Helena in A Midsummer Night’s Dream: ‘Love looks not with the eyes but with the mind.’

And yet, whose eyes -one’s own, or that of others? How we see ourselves is almost as important as how we are seen. Think of the agony than can be inflicted by acne in the teenage years -a time when self-identity is often linked to group identity, and self-esteem is dependent on the approbation of one’s peers. It is a time when we are defined by others, because we have not yet defined ourselves.

Memories of my own speckled past were awakened, Phoenix-like, by a short article in the Conversation on the beauty -or not- of skin: https://theconversation.com/beauty-is-skin-deep-why-our-complexion-is-so-important-to-us-91415?

As the author, Rodney Sinclair, Professor of Dermatology, University of Melbourne observes, ‘We’re all attracted to a beautiful face. We like to look at them, we feel drawn to them and we aspire to have one. Many researchers and others have investigated what we humans identify as “beautiful”: symmetry, large evenly spaced eyes, white teeth, a well-proportioned nose and of course, a flawless complexion. The skin is of utmost importance when people judge someone as beautiful.’ There may be an unintended bias on his part, of course. A dermatologist would see the world through a lens of pores and complexions, but I suspect he is merely tapping into the current ethos -one that seems characteristic of an era of Snapchat, and Facebook posts where ‘Even the best facial structure can be unbalanced by skin that is flawed.’

I’m not certain I agree with some of his views about how much we value complexion. For example: ‘When choosing a mate, men rank female beauty more highly than women rate male appearance. Female beauty is thought to signal youth, fertility and health. Beauty can also signal high status. People with “plain looks” earn about 10% less than people who are average-looking, who in turn earn around 5% less than people who are good-looking.’ I suspect there has been a bit of cherry-picking of studies that bolster his opinions, although I suppose we all do that.

But his point about the importance of the cosmetic industry nowadays certainly seems spot on: ‘People spend a lot of money in attempts to regain their youthful appearance. The global cosmetics industry is worth about US$500 billion. Sales of skin and sun care products, make-up and colour cosmetics generate over 36% of the worldwide cosmetic market. We use foundation makeup to conceal freckles and blemishes, moisturisers and fillers to hide dryness, concealers to disguise broken capillaries and pimples.’

And yet, I find myself inexorably drawn to that Greek idea of beauty residing more in ‘being of one’s hour’, than in forcing one’s time. Accepting the ineffable allure of the moment in which each of us lives.

Many years ago, I met Dora, a woman with quite visible facial scarring from long-ago acne. She was probably in her early thirties, and was employed as a receptionist in a doctor’s office. But she was so gregarious and friendly, I had ceased to see her face whenever I had occasion to visit. A warm smile would emerge like a puppy bounding from the woods and greet me from across the room. Her eyes were alive, and sparkled even under the unremitting glare of the overhead fluorescent lights. But she would have lit a path to her desk even in a power failure.

So overwhelming was her presence that I would never have remembered what she was wearing, had I been asked. Everything was subordinate; she ruled the room like a queen and the radiance lingered even when she was on vacation, or had taken a sick day. It was as if the empty the space was holding its breath. Or so I thought.

One day, when I arrived for my appointment, the office seemed smaller. Duller. It had been more than a year since I had been there, and so I couldn’t immediately decide what had changed. Dora was not there, unfortunately -I had been looking forward to seeing her again, but I assumed she had taken a few days off.

As I approached the desk –her desk- I was tracked by a set of razored eyes as if I had inadvertently chosen the wrong door. The wrong office. There was a smile, of course, but it was cool, and applied like the makeup on the rest of the obviously impeccable face. Long blond hair fell in ringlets to her shoulders onto a dark blue silk blouse -a very attractive person to greet the entrant, I suppose. But it was not Dora.

I forced a smile onto my lips and introduced myself. The woman immediately checked her computer screen and her face marginally softened at what she found. I took this as an opportunity to ask about Dora.

I could see her pupils momentarily contract and something tensed in her cheek.

“Dora no longer works here,” she said with a forced affability, and as if she were tired of having to explain.

I couldn’t hide my disappointment, I’m afraid, and the woman noticed.

“The doctor thought she was a bad advertisement for his practice,” she said with an obviously rehearsed face.

“Oh…” was all I could think of to respond.

The face perked up briefly. “He did offer to help…” she stared across the empty room for a moment. “But she said she was happy with who she was –‘with who she’d always been’, was how she put it…”

And then, although she tried to disguise it, she rolled her eyes and sighed. “Anyway,” she said, unrolling her eyes and resting them on my cheeks, “she decided to resign.”

But when I continued to stare at her, she shrugged, as if everybody was better off with Dora gone. “He gave her a good reference, though,” she added at the persistence of my disappointed expression, and shifted her attention back to the screen in front of her with a little smile.

 

 

 

 

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Hi, Heels!

I find it interesting that I can be so blind to something I see every day. How it can fade so completely into the Gestalt, that it is invisible. Not there.

Is it just me, or do we as a species, always attempt to accommodate to that which is constantly present –block it out like persistent odours- to make room in our heads for other sensations that may be more important for our survival? And yet, we don’t seem to be able to block all things out –patterns for example. We see patterns everywhere –we even invent patterns where there aren’t any- so it strikes me as odd that we can afford to ignore other things which might be even more malevolent. Is it just a matter of getting used to them, once we decide that they mean us no harm? Or, like taking off a pair of glasses, do we simply defocus them so they blur into the background with everything else?

It’s the unpredictability that bewilders me, I think. Why do some things persist, perhaps with only minor variations, while others seem to feel the need to change attire at the slightest whim -or even jump ship entirely? Disappear so thoroughly from sight that what once was common becomes laughable on review? Creepy –until, Phoenix-like , they rise again from their still-smoldering ashes, and mutton-chop sideburns, bell-bottom trousers, or even Afro haircuts are flaunted as if they were newly invented, and we get used to them all over again.

But do we ever get tired of beauty? Or does it have to dress itself up in constantly changing fashions to get our attention? So we don’t take it for granted? So we still regard it as having beauty? Is fashion just a trick to keep us on our toes? And, when is fashion no longer fashion? Is it just when we fail to notice anymore? Then what is it…? Invisible again? There’s something suspiciously circular in that. Suspiciously desperate. Meaningless.

Do I seem petulant about this –or at least leery of being clasped in fashion’s capricious arms? Perhaps it’s my age –although I seldom succumbed to the siren call even in my youth- but I remain genuinely puzzled at its grasp. Some things –like the styles of dresses or ties, as examples- seem sufficiently banal or entertaining to accept with little more than an inquiring glance and perhaps a shrug, while others… Others verge on the bizarre, the dangerous –all, no doubt well-intentioned, seemed-like-good-ideas-at-the-time inventions, and yet in the often unkind light of retrospect, unwise.

The Victoria era corset springs readily to mind. Worn by both sexes to slim the waist, it is better remembered as a device to mould women’s figures into some arbitrarily ideal hourglass shape. And in extreme cases, or with extended use, had deleterious effects on health by restricting the diaphragm, and unduly constricting the abdominal organs. Fortunately, in Western societies at least, they now seem to be confined to museum manikins labelled and planted behind glass like old photographs. Lesson learned…

And yet we may not have learned. There is another fashion as accepted as the corset in its time, and unless exaggerated, as invisible. As unremarked. I refer, of course, to heels –high heels. Once in the exclusive domain of men, they shifted into that of women, as I learned from a CBC article: http://www.cbc.ca/news/health/high-heels-health-and-popularity-1.4458020

‘[..] high heels have been popular for centuries, and were originally worn more by men than by women. “I dated the origin of the heel as far back as the 10th century in Persia,” said Elizabeth Semmelback, senior curator at the Bata Shoe Museum in Toronto. “They seemed to have been invented to keep the foot in the stirrup,” she said. “It allowed men on horseback to wield heavier weaponry, to be more successful at warfare, and so they really were a military tool.” From soldiers, the high heel eventually became the footwear of kings. But by the end of the 19th century, the style became fashionable for women only. Over the decades, high heels, and especially stilettos, became synonymous with sexuality […].’

There are those who might defend their use as a way to even out uncomfortable height discrepancies –my first date to a prom with an even shorter girl, for example- but by and large they are just a fashion statements. They are expected in certain circumstances, impractical in others.

But ‘Long-term wearing of high heels can have long-term medical effects for the entire body, said foot specialist Kevin Fraser, a pedorthist at Sunnybrook Health Sciences Centre in Toronto.  “Wearing high heels is going to force us to flex our ankles downward, a downward direction, straightening our knees as well as extending the back,” Fraser said. “That can create a whole host of complications within joint levels in the back all the way down to the feet.” People can experience problems ranging from bunions to osteoarthritis, he said.’

I suppose the reason I was even tempted to read an article on high heels stemmed from an incident on a bus –or, rather, off a bus- a few days ago. I was coming home from an evening meal at a downtown restaurant and it was raining quite heavily so people on the sidewalks were being careful about where they stepped. Sidewalks can be dangerous even at the best of times, especially for the elderly –there are cracks and uneven surfaces lurking in shadows cast from street lights at night, or under puddles in the rain.

My particular bus travelled past a seniors home in a posh neighbourhood, and that evening there must have been a concert that had lured several elderly ladies downtown in the evening despite the weather. The bus was noisy and unusually crowded for that time of night, so there were no seats available -the only place I could find to stand was in the aisle opposite the door.

There were two especially well-dressed women seated beside me, chattering excitedly about the music they’d heard, when one of them noticed they were near their stop. As they got up to leave, the bus was still moving, and I noticed one of the ladies wobbling as she stood. From her expression, I don’t think it was alcohol, so much as her unfamiliarity with the length of the heels she had chosen to wear. I suppose they were fashionable, but she seemed rather unstable in them, so I reached out to steady her as she exited the bus onto the curb. As soon as I let go, however, her ankle seemed to give out at an odd ankle and she fell, screaming into her friend.

Unfortunately the door to the bus closed at that point and the bus began to pull away, despite my efforts to notify the driver and keep it open. I was left watching through the window at her being picked up by her friend, unable to put any weight on her foot.

The point of the CBC article was to point out discriminatory dress codes in workplaces such as restaurants that require their female employees to wear high heels. They are considered a sign of being ‘dressed up’, and so prevalent that it is usually unquestioned. Like a tie on a man, the heels on a woman may be an expected accoutrement in some circumstances. Fair enough, I suppose, and yet I wonder if that poor woman on the bus might now have second thoughts about what should be deemed appropriate… I think I would.

Let Every Eye Negotiate for Itself

We are very attuned to patterns, aren’t we? We see them even when they aren’t there, filling in the lines, reading the shadows to complete the image. But does the face we see in the play of light on forest leaves, or the finger in the sinuous beckoning of the windblown grass really fool a mind that can do mathematics in its head? Or is it just a brief dalliance, a foray into a theatre for a moment or two? A titillating fantasy that fades when the eye moves on to other, more important, things?

A stereotype is a pattern too, but more deeply etched, and coloured so convincingly it is mistaken for the thing itself. Not recognized as a simulacrum, it is treated as archetypal, requiring few, if any, revisions –so self-evident it is almost a causa sui. And yet, hic sunt dracones, to continue the Latin –here be dragons- for stereotypes are, by default, fancifully-charted territories. Like incomplete maps filled in with imagined beasts, they are not reliable guides. They do not help.

And yet they are so prevalent, it is often difficult to recognize them, let alone extract them from the gestalt. So they persist, and like a Where’s Waldo face, only emerge from the background if we make a concerted effort to find them. But usually, there has to be a motivation to look –something that shakes us from our apathy. Our indifference.

It’s so easy to slip into somnolence, isn’t it? So easy to let things pass us by unexamined as long as they don’t threaten to disrupt our day. And yet, to escape the pastel hues in which our waking hours are often painted, it is sometimes an adventure to search for the chiaroscuro hiding in plain sight.

There was a delightful article I noticed a while back that managed to open my eyes again: http://www.bbc.com/news/world-latin-america-38132503

It recounts the story of a a 19-year-old woman from Guatemala who designs clothes for people with Down’s syndrome. The thing is, ‘Before she was an internationally-recognised designer, Isabella Springmuhl says she was rejected by two fashion schools in her native Guatemala because she has Down syndrome. “They said I would not be able to cope,” recalls the 19-year-old. But that rejection was exactly what Isabella needed to turn her life around […].’

So, instead, her mother took her to a sewing academy that would accept her. ‘While learning how to sew, Isabella was asked to design outfits for worry dolls – traditionally hand-made dolls originating from Guatemalan and Mexican folk traditions. The tiny dolls are usually put under children’s pillows in the hope that they will take away their sorrows while they sleep.

‘Isabella took a different approach.

‘”Isabella didn’t want to design clothes for… finger-sized dolls,” says Mrs Tejada [her mother]. “She created life-sized dolls and dressed them in the colourful embroidered jackets and ponchos that she’s now famous for.”

‘Isabella moved from designing for dolls to people, and soon enough produced a collection that gained the attention of the fashion world. Earlier this year, she became the first designer with Down’s syndrome to take part in London Fashion Week.’

But it didn’t stop there. Isabella points out that her main inspiration for designing arose after a struggle to find well-fitting clothing for her body type.

“It was difficult for me to get clothes,” Isabella says. “We have a different body constitution; we are shorter, wider, or very thin. My mother always had to fix the clothes she bought for me. So I decided to design clothes that fit people with Down’s syndrome, plus I really love Guatemalan textiles and the diversity of colours and textures they represent.”’

Wow! I get a shiver down my spine when I think of the odds that Isabella was willing to tackle. But, I wonder if she ever thought of them as odds, or merely as challenges that needed extra effort each time they arrived. Not only are there rivers to ford as a young person hoping to succeed in a highly competitive field, but the water sweeps all but the most determined, the most talented, downstream with barely a ripple.

But what am I? asks Tennyson, An infant crying in the night, An infant crying for the light, And with no language but a cry. I doubt that Isabella ever thought of herself like that. From time to time, there arise those exceptional people who do not understand the concept of failure. Who do not doubt or lose their way. Who are so confident in themselves, no matter the circumstance, that they press on and build on what they know they have, and are ingenious about what they don’t.

Stereotypes fail these individuals, as they do anything unique. How can you epitomize a Caesar, or cage a Churchill? How can you oversimplify a courageous person? How to paint the journey of a cloud? Tennyson, again from In Memoriam A.H.H:

The hills are shadows, and they flow

From form to form, and nothing stands;

They melt like mist, the solid lands,

Like clouds they shape themselves and go.

And so, how to stereotype a syndrome? In Down syndrome, or trisomy 21, there is an extra (part or whole) chromosome 21, which causes an assemblage of physical and intellectual features, including a characteristic, recognizable, but variable facial dysmorphia. It is the latter that may prejudice unthinking employers into feeling that they couldn’t cope, that the individual could never fit in, or perform like the rest of their employees –or other students, in Isabella’s case. But they were wrong.

Creativity knows no boundaries; we all fit somewhere on a spectrum –individuals with Down syndrome included. And imagination, like courage, does not stop at the edge of a chromosome.

Let every eye negotiate for itself, says Shakespeare’s Claudio in Much Ado About Nothing, And trust no agent, for beauty is a witch against whose charms faith melteth into blood.

I think Isabella is a beautiful person, don’t you…? And how do you stereotype that?

 

 

Eternity Gazing at Itself

We see what we think others see; we see what the mirror sees. And yet, I prefer to see what Kahlil Gibran sees:  Beauty is eternity gazing at itself in a mirror. But you are eternity and you are the mirror.

Body image is such a mutable thing. So mood-dependent, so soul-laden, it sometimes seems to defeat all words and define us -despite our pleas for mercy, our hope for acceptance in a world gone mad with self. And beauty is what satisfies the fickleness of the group. There is no objectiveness to allure, no criteria to fulfil; it is a feather that flutters briefly through the landscape like a butterfly in the wind. “You are that vast thing that you see far, far off with great telescopes,” says Alan Watts. You are the magic that is you –unique, and special.

But for some of us, the strangeness of our difference is hard to bear. It is something to be hidden, not celebrated. A BBC article I found a while ago told the story of a woman’s courage to change –she couldn’t alter the permanent damage from a previous life-threatening accident, so, instead, she decided to change who she’d become in the intervening years. http://www.bbc.com/news/magazine-40862546

‘Sylvia had spent ‘most of her life trying to conceal the extensive scars which cover her body –the legacy of a childhood accident. […] at the age of 48, she decided it was time to stop hiding and come out into the open. […] My mum was boiling water in saucepans for our bath. She would pour the water into bowls and she put the bowls on the bathroom floor. We were just playing around, me and my siblings, and I ran into the bathroom and shut the door. We were told not to go in there. I went in there and my sister pushed the door, and that’s when I fell backwards into the bowl of boiling water, causing very bad burns.’

The scars from her third and fourth degree burns were extensive: ‘“There’s not actually any part of my body apart from my face that is normal. My burns start from the top of my neck all the way down to the top of my bottom, and then around the front of my stomach and down my left leg. And then on the rest of my body I’ve got lots of little pinprick holes all down my arms and my legs from where they took skin. […]I went into shock and was having fits. Then the ambulance arrived. They gathered my family together and told them that I wasn’t going to make it through the night. They baptised me and I had my last rites.

‘“When I was growing up a lot of people used to tell my mum, “Oh, she’s beautiful, she’s pretty.” But in my head I always thought, “Why are they saying, ‘You’re pretty’? I’m not. Underneath my clothes I’m burned.

‘I always felt ugly, so it’s affected me mentally as well as physically. Children would call me different names like “witch” and “snakeskin”, and they were really nasty. I was told that I would never have boyfriends, never get married, never have children. Showing my back was always going to be a negative thing.

‘I loved swimming – once I was in the water I was in a different world, it was great – but I was terrified about people seeing my body. When everybody got out of the water I’d wait until they went to change and be the last one to sneak out.

‘I got to a point where I was attacking everybody around me and it was the only way that I could deal with my emotions. I’d literally call people up, like my sisters, and be really nasty to them, a really vile, nasty, horrible person.”’

But Sylvia did eventually find a loving partner, and yet her fear of others seeing her scars persisted. One day, after being photographed at the swimming pool with her mother like an animal at the zoo, they decided to leave and go to the beach instead. But her mother seemed so upset, Sylvia decided to do something she’d always been afraid to do.

‘At that moment something just clicked in my brain and I decided that I was going to draw a line and make her happy. I took my dress off and I walked down to the edge. People were looking at me and I looked at my mum and I smiled, and I went, “Mum! Look! Look at me!”

And she started to smile. I put my hands on my hips and I started to pose on the water’s edge and she was so happy. I went over to her and I said, “From now on I’m going to let people take pictures, and every time they do I’m going to smile and I’m going to pose.”

‘I think that moment on the beach was just a turning point where I realised that no counselling, nothing on Google, was going to help me. It was time for me to help myself. I went out and bought a swimming costume – it had a big hole in the back – and then I set up my swimming classes at my local pool in Highbury, north London. I invite people with disfigurements to come and swim. When I’m in the water and I’m swimming I just feel at peace, I feel calm, and I can think of lots of wonderful things. […]

‘It’s been such a long journey. It’s like taking off a coat and saying, “This is me now, and I don’t care what people think.” I’ve noticed a big change in my life and I’ve been able to accept the way I look.’

As Jean Cocteau said, ‘Mirrors should reflect a little before throwing back images.’ And so should people. It seems to me that there are at least two types of courage. The first, and most obvious, is the type that risks bodily harm –soldiers in combat, firefighters, and so on. It’s the one we can all see, the one that makes newspaper headlines, and wins awards. Medals. Accolades… And yet perhaps that’s really just the outward trappings of the other type –the inward struggle to overcome the fear that we are not who we want to be –need to be, with whatever hand Fate has dealt. Both require bravery –and while one may confront an external challenge, the other, no less brave, defies far more nebulous and malicious ghosts.

But the triumph over unseen odds, however unfortunate they may have been to the recipient, is seldom met with applause, or acknowledged with praise. It is an inner contest, a silent war that few can see, let alone appreciate. It is an unrecognized philanthropy of self to self, and so perhaps its rewards are even greater, although they may pass, unnoticed in the larger scheme of things. The determination to act, and the bravery to succeed, need no commendation really. It is enough to have succeeded in accepting oneself, and reveling in the affirmation of all around. It is no small thing, although it may seem so.

Sylvia may never receive a decoration, nor mention on the local evening news, but in a way, she already has her medal –she can wear herself on her lapel at last.

To measure you by the smallest deed is to reckon the power of the ocean by the frailty of its foam – Khalil Gibran again.

Weight and See

 

Obesity and dietary issues have been seen as major contributors to diabetes and cardiovascular health for some time now. No longer regarded as outward manifestations of status or wealth in most societies, they are now often subjects of disparagement, and those carrying extra weight frequently stigmatized and derided. As if the very fact of being overweight was an act of moral depravity, or at the very least, a manifestation of weakness. Self-neglect.

Smoking –especially in North America- suffered a similar fall from grace when it became evident that it was a cause of major health problems. But it is much easier to hide a smoking habit than an overweight or frankly obese body. And whereas public measures to stigmatize smoking and outline the health risks may have some effect on smoking behaviours or smoking persistence, they seem to be counterproductive in successfully encouraging exercise for weight loss according to a large study from Britain: http://bmjopen.bmj.com/content/7/3/e014592

This was a long term study starting in 2002 of 5480 participants of both sexes, all at or over 50 years of age, and carried out by Dr. Sarah Jackson from University College London. ‘In summary, these results provide evidence that weight discrimination may be associated with lower participation in regular physical activity and higher rates of sedentary behaviour. Through this mechanism, weight discrimination may be implicated in the perpetuation of weight gain, onset of obesity related comorbidities and even premature mortality.’

The BBC News also reported a perhaps more easily assimilable summary of the study: http://www.bbc.com/news/health-39191100. The point being, evidently, that shaming or drawing attention to the weight a person is carrying is less likely to get them to exercise than a welcoming and supportive attitude. And environment -‘Exercising when you are overweight can be daunting, and the fat-shaming attitudes of others do not help.’

I suppose this study is much like carrying coal to Newcastle, but nonetheless it is important to hold a mirror to societal attitudes and prejudices. It’s often not so much that we mean to denigrate people who hold different values, or who do not seem to espouse the image we find attractive but rather that we hold ourselves apart. Withholding approval can be as devastating as active discrimination and, at least in this case, seldom leads to positive changes.

Unfortunately the problem of excessive weight sometimes slips by in a gynaecology office as well –noticed, but unmentioned- because of fear of upsetting the patient. Occasionally, an opportunity will present itself, however. One has to be alert –and sensitive.

Janina was a new patient to me. I first saw her in the waiting room sitting in the corner seat which was partially obscured by a large, leafy Areca palm. Her head and face were further hidden behind a magazine whose pages never seemed to turn. A large lady by any estimation, she attempted to camouflage it as best she could with an extra-large, loose fitting brightly patterned sweat shirt and bulky jeans. The effect was really quite beautiful –and so was Janina when she finally lowered the magazine. Her large, brown eyes were captive birds that fluttered delicately behind the bars of exquisite eyelashes. Her face was soft and her smile, although timid and infrequently offered, was captivating. She wore her hair long and auburn waves flowed slowly and gently over her shoulders like water on a beach whenever she moved.

She made a show of being nice in the waiting room, but I could tell that she was uncomfortable as she followed behind me to my office. She closed the door quietly behind her but before she sat she moved the chair as far away from the desk as the room allowed.

I smiled at her in an attempt to put her at her ease, but she had already dropped her eyes onto her lap and refused to retrieve them.

“Dr. Blackstock says you are having some problems with your birth control pills,” I said, when it became evident that she was not going to volunteer any information.

She sat perfectly still, her hands clasped motionlessly where her eyes still lay. Finally, she took a long, slow breath, looked at me, then slowly nodded her head. It was a sad movement, and for a moment, I wondered if she was going to break into tears. But she remained silent.

“What kind of problem are you having, Janina?” I asked, after another sepulchral moment.

She sighed again, but her face changed. “Isn’t it obvious, doctor?”

I raised an eyebrow to indicate that it wasn’t.

“Ever since I started on the pill, I’ve continued to gain weight,” she started. “I was never this heavy before…” She paused briefly to let that sink in. “Never…” She let her eyes drift around the room for a moment, finally settling them on a terra cotta statuette of a seated woman with a begging bowl that I’d placed on a little oak stand in the corner. “I don’t want to end up like her,” she said, pointing at the woman. She sent her eyes back to perch briefly on my face. “But even she isn’t as fat as me…”

As the words sank slowly into silence, a tear began to run down her now quivering cheek. I rose from my desk and walked across the room to hand her some tissues. She seemed to appreciate the gesture and her face softened for a moment. In fact, she used the opportunity to examine me as I walked back to my desk.

“You have no idea how people look at a fat person like me…” she finally volunteered and then her eyes focused on a wooden figurine on my desk behind a plant; it was a woman holding a child and peering out as if she were hiding. “I feel like that woman,” she said, nodding at the plant with her eyes.

I must have let a worried expression escape onto my face, because Janina seemed to focus on it. “It’s a different world when you’re fat, doctor. That’s all people see…”

I sighed. I couldn’t help it; she seemed so sad. “I see beauty,” I said –it just escaped from my lips. I hadn’t planned it…

Suddenly she smiled, and her hair danced once again over her shoulders. She straightened herself on the chair, and then with a gentle shrug stood and moved it closer to the desk.