The Four F’s: Fat, Female, Forties, and Fertile

“Remember that. It’s the telltale signs: A woman, who’s overweight, in her forties, and hasn’t gone through menopause yet. Basically a recipe for gallbladders stones, if you can check off the Four F’s and there’s any pain in the abdomen then it’s pretty much an instant diagnosis.”

My informant told me this saying in an Operating Room where we both watched her husband perform pro-bono gallbladder surgery on a woman who had no insurance and a classic case of gallbladder stones, thanks to the Four F’s. In addition to being a memorable piece of folk speech for diagnosis, the Four F’s in name alone sounds like a recipe for something bad. Even if you didn’t know that fat, female, forties, and fertile referred to potential gallbladder issues, the list infers trouble.