Figure

O my son Absalom, my son, my son Absalom!—2 Samuel 18:33

I don't need to plot this boy's weight on a growth chart to ascertain that he has obesity; the evidence is plain to see. He's tall for his 12 years, husky as well. I can tell that he's uncomfortable from the way he sits on the examination table in his briefs: hunched forward, arms folded across his chest, sitting on one foot; perfectly poised to hide what rolls of adipose tissue he can.

The old man in the chair by the door smiles when I introduce myself, but he doesn't get up. Perhaps he's tired, I think. He looks thin and pale, rather washed out, not quite as gray as the wisps of hair at the sides of his balding head.

“This is my grandson,” the old man says. “He needs a physical for school.”

“I see,” I say, examining the out-of-state form clipped to the front of the newly made chart. “He goes to school in Massachusetts?”

The old man nods his head. “He lives here in town with us. I drive him across the border every morning and pick him up after school.”

“That's quite a trek.”

“We're thinking of getting him into the local school system next fall. We thought it best if he stayed at the school he's been in for the present.”

“How long has he been living with you?”

“Two years.” The old man and the boy exchange silent glances.

I decide to shift gears. “How has his health been in the past?” I ask, leafing through the copies of medical records from his previous pediatrician.

“Okay,” the old man says. “Except—I've been concerned about his weight.”

“He is a big boy,” I muse, plotting the specific percentiles for height and weight on the growth chart. “Today he falls well above the 97th percentile for weight. His BMI is over 30.”

“We've been aware of his problem for some time. I asked his previous doctor to check his cholesterol—I have high cholesterol, have to take medicine for it, and I've also had bypass surgery—but his came back okay. Maybe we should check it again?”

“How long has it been?”

“Six months.”

“Probably not worth repeating at this point. What has he been doing for his weight?”

“Well, he eats healthy—we don't allow junk food or soda in the house. My wife buys low-fat and doesn't use salt in her cooking. He does tend to eat a lot—big portions.”

“You probably know that the more food you eat, the more calories you take in, even if you are eating good food. It's the calories that put on the weight. What does he do for exercise?”

“It's been tough over the winter. We joined a gym this month. We've been taking walks together in the evening now that the weather's nice. I can use the exercise myself. My doctor says I need to keep active.”

“That's a good thing.”

“Oh, I used to be quite heavy—before my heart attack. I've slimmed down quite a bit. My son—his father—was a big man, too. He weighed close to 300 pounds.”

Conscious of the past tense verb, I ask: “What happened?”

“Died in his sleep—massive heart attack. Only 36 years old. My grandson here found him the next morning.”

“When did this happen?”

“Two years ago. The boy was only 10 years old at the time. He's gone through a lot since then. That's why we elected to keep him in the same school—at least he's had some stability in his life.”

“I'm sorry.”

“Can't be helped now. But—we're working on things together, right, bud?”

The boy nods his head.

“He's the spitting image of his father,” the old man says, his eyes beginning to water. “Looks just like my son.”

No father wishes to outlive his son. The premature death of a child, no matter what the age, evokes a profound grief that most parents carry with them in some form for the remainder of their lives.

Momentarily, I pause; and in my mind that cry of grief comes to me, the words echoing down through the millennia—a father mourning the death of his son:

And the king was much moved, and went up to the chamber over the gate, and wept; and as he went, thus he said, O my son Absalom, my son, my son Absalom! Would God I had died for thee, O Absalom, my son, my son!