I want to have control. I want a perfect body. I want a perfect soul.

It's 5am. The world is quiet but for the endless pounding in my head. I binged last night, bad enough to give myself nausea. There is so much food in my system that my body can't process it fast enough. 

I know that I must sleep. It's going to be Monday morning ward round soon and I need to be awake for that. But in my head I'm there already. Patient lists fly across my mind, what needs to be done for each one to make them stable enough to shove out the door. Clear hospital beds. I see now that's why I don't like medicine and I prefer surgery. 

When a frail elderly woman sits in front of me, unable to cope and full of problems, I cannot bring myself to force her out just because she is considered "medically stable". Just because some bureaucrats who haven't spent half an hour at a medical school want to shorten hospital stays and clear beds. They teach us the art of medicine is almost all compassion. "It is the physician's love that heals the patient." Then they teach us to ignore it. 

Patient lists, patient names, discharge summaries race before my eyes and in an instant I've already lived the upcoming week. Then in my head, I'm going home for the weekend, home to my parents and my dog, home to where things will be okay. So different from how I felt about home before, but I am so lonely. So lonely that all I want is mum's embrace. 


Slowly, slowly but surely I am losing weight. It's only about a pound a week, sometimes less. But with around 800cal a day, that's as fast as I can lose it. So much for cutting down calories, it's not possible. Not possible without it becoming vastly dangerous. 


Even as I am now, 1000cal today and hugely PMSing, I have a day long headache. I'm shaking. I'm losing focus, I'm forgetful. Then when I'm admitting patients, when I'm ordering tests, when I'm looking up results, everything is a haze. 


I'm so scared I'll miss those subtle signs, the subtle facial droop of an evolving stroke. The small difference between someone who has Alzheimer's and is talking rubbish and the one who is talking rubbish because they are psychotic, and the one who is talking rubbish because they are having a stroke and their brain connections are wrong. The chest pain of reflux and the chest pain of a heart attack. The myriad of tests to order for the elderly lady who keeps collapsing. I can't focus, I'm scared I will miss something, forget to order something, chart the wrong drug. If I do, someone will die. 


And so I fill myself up. I don't want to kill someone. But I refuse to eat enough. I'm going to the gym. I'm losing weight slowly but surely. Slowly, but it is enough for me to notice. Clothes are slightly looser, I'm buying tighter clothes. I'm going in the right direction. Safely. 


Safely, for the sake of my patients because they are the ones who give meaning to my life. But for now, I am sick, nauseated, bloated and miserable. Wanting to chuck it all in and just stay at home, starving myself and exercising. 


I want to. But I am a doctor first and foremost. And my patients come first and they should not have to pay for my incompetence and fatness. I can lose weight slowly, I will get there. But my patients come first.