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.
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.