ACEP ID:

Humanities at the Bedside

Boundaries - Session A

“Fat” is the first story in Raymond Carver’s collection of short stories, Will You Be Quiet Please? It is story of an unnamed woman who tells her friend Rita about her night serving an unusually fat man in her restaurant. Like in other stories by Carver, small actions and statements in “Fat” carry much more weight than they seem at first glance. On a first pass, it’s very easy to feel that nothing substantial has happened in this story, but on further analysis several deeper themes develop.

Link to the story here.

Guiding Discussion: 

  • What are your initial impressions after reading this story? Do you feel confused? Hopeful? Curious? Depressed? Do you like the story?
  • What do you think of the characters (the unnamed waitress, Rita, Rudy, the fat man)? Can you relate to any of them? Do you dislike any of them? Why?
  • What do you think are some of the major themes in this story?
  • Stereotypes and prejudice are major themes present in this story. Look at how each of the characters describe the fat man. Are there aspects of the fat man that do not line up with the stereotype described by the characters? Stereotypes are one way that we distinguish ourselves and create boundaries from “the other.” Think about stereotypes and prejudices that you or your colleagues may harbor while working with patients. Where did they come from? How do they impact your practice?
  • The narrator’s friend Rita does not seem to understand why the narrator is telling her this story. It creates another boundary between the narrator and Rita. Why do you think the author chose to write the story this way (as opposed to the narrator telling us the story directly instead of addressing it to Rita)? Do you ever feel this type of boundary when recounting your experiences at work to friends or family? How do you manage it?
  • At the end of the story, we discover that the narrator also feels fat, thus in some ways dissolving the boundary between herself and the fat man. Do you ever feel boundaries between you and your patients dissolve? How does it make you feel? Do you think it makes you better able to care for patients or less able?

Exercise:

  • Are there patient types or personalities that evoke a particular response from you? 
  • Can you list five details that contribute to these feelings? 
  • Do they serve as boundaries or barriers to their care--for example, is your body language different; do you interrupt prematurely; do you question their story in ways you don’t question other patients that shift; is your evaluation and/or treatment impacted? 
  • Take 5-10 minutes and write an honest letter to them explaining your feelings, behavior, etc. You may or may not choose to share with the group. Then, imagine you’re that person reading the letter. Take 5-10 minutes and write a letter in response.

 

 

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