Chapter 1

“Hey Ian, bad news but they added two more patients to your rotation.” said Sally, Ian’s fellow nurse friend.

“Seriously?! That makes 6 now! We’re only supposed to have 2 or 3 MAX cuz of how much care and attention these people need!” said Ian back, exasperated. “I know and I’m really sorry, but we got three more patients today alone and I can only take one more, so the other two had to go to you. With the pandemic, the other nurses here are doing overtime and floating to other hospitals to help out. So we’re stuck here getting dumped on left and right.” Sally said as she was getting herself ready to do her routine and tend to her patients - tying her hair into a messy bun before getting her cart and dashing away.

Ian sat his bag and coffee down at the nurses desk before looking at the two new patient charts and getting ready, letting out a sigh of defeat. He got his cart ready and started making his rounds.


“Hello!” said a now cheery sounding Ian - a sudden change from his demeanor just moments ago. Being in nursing, Ian had learned to hide his frustration well from his patients and would always put on a happy attitude before walking into their rooms - this earned him the title of Happy Go Lucky Ian.

No response came in from the room, which worried Ian. He entered the room and saw his patient still sleeping the day away - they’re always so drained and tired. Ian walked the cart and set it aside the patient's bed and he started taking vitals before walking them up to administer their medication. “Resting BPM 119, oxygen levels at 93%...” Ian then took a large sized blood pressure cuff and wrapped it around the patient's arm - it was a tighter fit than last time, Ian thought to himself; maybe it was the edema again. “Blood pressure at 160/108…” then Ian made his way to the end of the bed and pressed a red button on a screen at the side of bed and it flashed big red numbers after a few seconds…”Weight - 906lbs...that’s 5lbs since yesterday. Must be edema” Ian thought to himself again, making a note to have the doctor check the patient's Lasix dose.


After jotting down the vitals, he opened up the med cart and started pulling out blister pack after blister pack of medications - punching each hole open and throwing the pills into those mini dixie cups. The patient was taking a cocktail of medication to keep them alive, but they weren’t the only one in this ward and they were actually taking the least amount of meds than the rest. “Lipitor, Amlodipine, Lasix, Omeprazole, Montelukast, Lisinopril…” Ian listed off each med to make sure he was skipping any. “Alright, we’re good!” Ian said and he picked up the dixie cup of drugs and started to wake up the patient. “Mrs. Bakes...Wake up, Mrs. Bakes…” spoke Ian in a low voice next to the patient's ear, gently rubbing their shoulder causing the humongous arm to shake and jiggle. “Wha...WHAT?” said Mrs. Bakes as she came too, slowly turning her head to face Ian - having an obviously hard time moving her neck muscles to face him. “Morning Mrs. Bakes, I’m just here to give you your meds!” said Ian, sounding cheery again and handing the morbidly obese women her life extending drugs. She slowly reached for them, having a hard time with that as well, but Ian was patient. She took the cup of drugs from his hard and started popping one by one into her mouth and swallowing with a sip of water from a cup that Ian had ready.

“All done!” cheered Ian, wearing a big smile on his face. “I already took your vitals so I’m done here for the moment...unless there’s something you need?” asked Ian as he was packing up his cart to go to his next charge. “No no, I’m fine.” said Mrs. Bakes, smiling back to Ian. She, like many of Ians charges, enjoyed his cheery demeanor and his smile always lit up a room. “Bu..but I do wonder, when will breakfast be here?” said Mrs. Bakes. “The nurse's assistant should be here soon with breakfast, maybe 15-20 minutes. If not, I’ll make sure they do.” Ian winked and laughed, earning him a chuckle and a thanks from Mrs. Bakes before he left the room. Ian stopped out of the room and pulled out his chart…”Mrs. Geraldine Bakes, 46 years old, 906lbs. Notes: Edema still persistent. 5lbs weight gain overnight - increase in dose? Vitals are same, no changes.” Ian had checked off Mrs. Bakes from his chart and added notes before dashing with his cart to his next charge.


Ian, 27 year old, 6’2 blonde boy, worked as a bariatric care nurse, caring for the morbidly obese and even those who seem to have surpassed that. The smallest patient Ian has come across was 500lbs and the heaviest was a hair over 1000lbs. Each patient is different, but all have the same infliction; addicted to food. Fast food, junk food, greasy fried fatty food; everything but healthy greens and a balanced and nutritious diet. Each one blamed the food, their upbringing, their low points in life and every excuse in the book as to why they are so fat - except admitting they are the problem. Ian didn’t care though, he provided each of them with the care they needed. To him, taking care of them was normal and it brought him a sort of comfort - a comfort that started when he was young.


Ian’s father and mother were also obese and helpless like the patients he tends to. At the age of 5, Ian had to help around the house with chores because his parents had grown too huge to do things themselves. By the age of 10, Ians father passed from a cardiac arrest - clocking in at 540lbs at 42 years old. Seeing his father clutch his chest and groan in pain at the family table changed him forever. He devoted himself to care and treat his body as a temple from that day on. However, his mother didn’t get the same wake up call. Instead, the loss of her husband drove her to food even more. As Ian grew up, his mother grew too. By the time Ian was 16, his mother was over 800lbs and immobile at home. Ian cooked, cleaned and cared for his mother. They were too poor to afford an at home nurse, so he became responsible for feeding her, cleaning her - washing in between her folds and taking care of her waste. Ian had this heavy burden put on him at such a young age that it became the norm for him - caring for his obese mother was just a normal part of life. No matter how disgusting or how bad it got, he always did it with all the love he had for her. He really loved his mother, and she loved her son so much - the two were inseparable...until she too had a cardiac arrest. It happened during the night, doctors say - assuring poor Ian that she didn’t feel a thing. His world came crashing down from then and Ian moved in with his grandparents - who were pleasantly surprised to find that Ian was so helpful and caring. By the time Ian graduated high school, he went to nursing school; where he thrived. He thought that he might as well use all the real world experience he had and put it into practice to earn a living with. Which brings Ian to where he is now, working at a bariatric hospital caring for people that were just like his mother and father.