VALENTINE, Neb — He still is a mound of a man, but his blue eyes widen with delight as he presses his chest with his fingertips, smiles mischievously and makes the grand announcement: He can FEEL his ribs.
To Patrick Deuel, this small moment is huge. Headline huge.
Man Can Feel Ribs — A First in 25 Years.
One year ago, Deuel weighed 1,072 pounds. He was so enormous that his bedroom wall had to be cut out to extract him from his home. Then, he was rushed to a South Dakota hospital in an ambulance with extra-wide doors and a ramp-and-winch system that had to be dispatched from Denver.
One man. More than a half-ton. Mind-boggling.
So, too, were the grim realities of Deuel’s life. He hadn’t left his bedroom in seven months. He’d barely been outside in seven years. He couldn’t sit up. He couldn’t roll over by himself. He had heart trouble and diabetes and needed oxygen.
Patrick Deuel was dying. A photo taken last June shows a pneumatic-like figure sprawled helplessly on his stomach looking like an inflated balloon.
Now 12 months after being hospitalized for gastric bypass surgery, Deuel sits on a love seat that is propped up on cement blocks. He still looks like a plus-sized Buddha. But he is less than half the man he used to be and that, his doctor says, is amazing progress.
The patient concurs.
“I’m used to looking in the mirror and seeing the Michelin man,” he says. “All of a sudden ... I look a little more like a human being and I say, ’Ooooh, my God, where did HE come from?”’
Deuel does a quick inventory of his shrinking, yet still massive body: He touches his ribs. He stretches his fingers like fans to see bones and tendons.
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But thrill No. 1 is the magic number on the scale: 499 pounds.
He pumps a fleshy arm in triumph. He hasn’t been south of 500 in two decades.
Deuel now goes out almost every day, walks a bit, exercises and thinks about all the things he hopes to do someday.
“Life,” he says, “is infinitely better.”
Patrick Deuel’s weight was off the charts before he even knew it.
Before he could walk or talk, he says, medical records defined him as obese.
By the time the ambulance pulled into his driveway in this tiny town more than 40 years later, Deuel had long been a prisoner of his many pounds. He couldn’t work, attend a college football game (a Nebraska banner hangs on his living room wall), or — for a time — even sit in his parent’s home.
And he wasn’t shy about talking about it.
When Deuel arrived at Avera McKennan Hospital in Sioux Falls, S.D., he welcomed the spotlight, determined to prove he was no Guinness Book footnote but a man with a message: Obese people suffer because the health care system and insurance companies don’t do enough to help them.
He also didn’t mind being an inspiration.
“If I can lose weight, anybody can do this — and I mean ANYBODY,” he says. “My willpower is basically zero.”
In the year since, Deuel’s story has brought him more than 2,000 e-mails and letters from as far as China and Saudi Arabia. He has acquired an agent (he has been paid to appear in a British documentary and on German TV magazine shows). And he has talked openly — and often humorously — about his obesity.
“My dad says I was supposed to be 8-foot-4,” he likes to joke, “but I quit growing.”
Deuel, 43, says it has been frustrating not to be able to lose weight and humiliating to be called names — ’Fat Pat’ was a common childhood taunt — but he’s not one to analyze a life defined by obesity.
“I always thought it was a problem that some people had and other people didn’t like,” he says simply.
Deuel was a fast-food junkie hooked on pizza, chips, beef jerky and chili dogs. He also gobbled down cherry blintzes and ambrosia (a creamy fruit, marshmallow and coconut concoction). Even now, his face brightens when he mentions his favorite foods.
While those days are over, Deuel doesn’t believe in total deprivation.
He exercises with bar bells and weights, but still smokes (he’s cut down to a pack a day), saying he can’t kick two bad habits at once. And he defiantly refuses to consider any foods taboo.
“If you have a craving and don’t take care of it, it’s going to grow and grow and grow and it’s going to make you do something stupid — binge,” he says.
About twice a month, Deuel indulges in foods most dieters would consider off-limits: a small piece of chocolate, an ice cream bar, Taco John’s nachos on his van ride home from visiting his doctor in South Dakota.
“I’ve lost 102 pounds in 70 days, eating what I wanted,” he says. “Tell me it doesn’t work. ... For me, the easiest way to stay on my diet and not go absolutely crazy to is eat (to satisfy the craving), get that out of the way and get back on the program.”
The Atkins and South Beach faithful might shudder, but not Dr. Fred Harris, the Sioux Falls surgeon who operated on Deuel last fall.
“Patrick is over 21 and he can do what he wants to do,” he says. “He’s a free individual who has to enjoy his life.”
Harris’ empathy has some personal history. Three years ago, he had bariatric surgery and is 100 pounds thinner. He declines to be more specific.
“An occasional indiscretion is OK,” Harris says. “Every once in a while you have to have a piece of chocolate, providing you’re not carrying the bag around all the time.”
Harris suspects Deuel is a lot more careful about his diet than he admits.
“He’s a naughty boy when he’s trying to show off,” he says. “I think he has made up his mind he wants to be more mobile.”
Practically speaking, Deuel can’t eat as he once did. Surgery initially reduced his stomach size from two to three liters to the end of a thumb. Now, with the swelling long subsided, he can eat four to eight ounces of food. Anything more, he’ll likely feel pain and vomit.
Deuel concentrates on high-protein, low-salt foods: cottage cheese, refried beans, spinach, asparagus, non-breaded shrimp, steak, roasts, cheese. He avoids potatoes and bread. And milk makes him sick.
So far, so good.
Some doctors say bariatric surgery works if a patient loses more than 40 percent of excess body weight — something Deuel has done.
“Any way you slice it, we did what we set out to accomplish,” Harris says. “If Patrick wouldn’t lose another pound, I’d think he had been a success. ... Anything else I get out of him is gravy.”
Or, Harris says, look at it this way: “He’s lost two NFL defensive linemen.”
When Deuel loses more weight, Harris plans to remove his panniculus, an apron-like layer of abdominal fat. It makes walking feel like he’s carrying giant sacks of flour. That surgery could trim another 40 to 70 pounds.
It was Deuel’s hometown doctor who called Harris last year after she arranged for her patient to get emergency care for neglected dental work and realized he needed more help.
“It was clear we had a dying patient,” Harris says. “I told him, ’We don’t have weeks. We have days or hours.’ I said he could die in the bed ugly or accept admission (to the hospital).”
Even now, Deuel says he thinks he could have lost weight without surgery.
At the hospital, Harris’ medical team had to design extensions for an operating table.
By last October when Deuel had surgery, he had dropped more than 400 pounds, a lot of that water.
Harris says Deuel’s weight problems are not simply from overeating.
“I’m absolutely convinced the basic, overlying cause for morbid obesity is genetic,” Harris says. “There’s some nature, some nurture. But it’s like wanting to have blue eyes and having brown eyes. You can’t fight it. We desire food more, we get hungry quicker. ... Every gene in your body says, ’Feed me now.’ “
Dr. Samuel Klein, director of the Center for Human Nutrition at Washington University’s School of Medicine in St. Louis, says it’s likely there’s a genetic predisposition to obesity, but that has not been proven. About 40 percent of weight variability, he says, is related to genetics.
To hear Patrick Deuel tell it, his troubles began when he was still in his baby carriage.
Deuel says he was 3 months old when diagnosed as morbidly obese (some medical experts say there’s no way to make that assessment so young.)
He clicks onto childhood photos on his computer and, in his high-pitched voice, narrates a life story measured in alarming numbers: The kindergartner in cap and gown, 90 pounds. The chubby-cheeked Boy Scout, 240 pounds. The thick-necked, 13-year-old, holding a whipped cream confirmation cake, 275 pounds.
Deuel points out the less obvious, too: His little red wagon had extra sturdy wheels, his pants’ legs were rolled up because he could fit only in men’s clothes.
His mother, Betty, said doctors offered little guidance beyond suggesting nonfat milk but recalls one telling her son: “If you don’t get some of this weight off, you’re not going to live to be very old.”
Neither parent was fat, though one of Deuel’s grandfathers weighed more than 300 pounds.
Deuel’s mother worked in a health-food store and says she prepared healthy meals — lots of salads and squash — and they tried the Weight Watcher’s diet, but it didn’t help much.
She knew how abnormal the situation was, but “there’s a point where you say, ’Am I nagging so much where I’m making things worse?’ I did believe you can overdo it,” she explains. “I had someone ask me one day, ’Couldn’t he just eat less?’ Well, he did.”
By high school, Deuel was 300 pounds, but found his niche, lending his tenor voice to choirs and his trombone-playing talents to bands. He only lasted one semester in college, then began working a variety of restaurant jobs where meals were free.
“There was too much to choose from and I made a lot of rotten choices,” he says.
All kinds of diets
Deuel tried all kinds of diets — and lost 300 pounds on one, but quit because he couldn’t afford the supplements.
“I just thought one of these days somebody is going to come out with a diet that works or one of these red-hot science fellers is going to come up with a pill ... you take and lose 100 pounds,” he says.
Deuel knows how Pollyannish that sounds. “Every dieter,” he says, “is wishing for that day.”
In the mid-1980s, he fell and hurt his back and ended up on disability, making him even more sedentary.
But there was one positive turn in Deuel’s life. Through a newspaper personals ad in which he described himself as “physically challenged,” he met Edith Runyan, a divorced school guidance counselor.
On the phone, he bluntly told her he weighed about 700 pounds.
When they met, she found his sense of humor appealing. “He had a positive attitude about life even though he had been kicked in the teeth a lot emotionally,” she says.
'Laps' around his house
They married a decade ago — Deuel weighed 750 pounds — and his weight gain continued, his waist expanding up to 90 inches. Vertically, that would be about 7-foot-6, or the height of Yao Ming, the Houston Rockets star.
Deuel had to be weighed last year at a feed mill on a scale designed for trucks.
Now, he can move gingerly with two walkers; he does ’laps’ around his house, moving from the living room to the kitchen to the laundry room and back.
He still can’t attend church. “I don’t do steps yet,” he says.
Deuel hopes to become a motivational speaker and though he first talked about reducing to 240 pounds, he now says maybe he’ll settle for more — it depends how he feels.
He already has plans for the future: He’d like to go fishing, attend a football game, and yes, drive to McDonald’s for an Egg McMuffin.
“Just being able to go out and do what I want to do — when I get to that point,” he says, “I’ve reached my goal.”
And his timetable for that?
“At least 15 minutes before I die,” he jokes.
He pauses, smiles and reconsiders.
“Maybe a half-hour.”
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