my last message ever to the haters.

Let me be brief about this, because this is not the first time that I've left a message to haters who comment on my blog. But it will be the last time.

I've tried, time and again to reason with you all. I know that having a blog like this, and putting my opinion out like this will inevitably attract the attention of those who do not agree with me. Yes, I know this will be most of society. I'm not saying that my opinion is "correct", but it is my opinion, and it is the reality that I live in. 

I don't ask anyone to agree with me (although it is nice when you do) but I do expect common courtesy. If you disagree, do not blatantly attack me with comments. What do you think that will achieve? That calling me a selfish, senseless, ignorant bad doctor will suddenly make me think "oh gosh! they're right! I've decided not to have an ED after all!" 

If anyone thinks that, well, God help them. You may detect that I've got a hint of resentment in this, and that's because I'm sick and tired of repeating myself. Leaving me, or any pro-ana blog comments like that is not caring, it does not show compassion or empathy, it's not anything good. It's just an attack, nothing more. And it's juvenile. 

If you are clearly not pro-ana, if you do not want to lose weight, if you do not have an eating disorder, please, please, please do not waste your time on my blog, or any of the other blogs. Time is precious. I spend time here because it's a release for me. If spending time here angers you, angers you enough to leave such hateful remarks, do yourself a favour, don't waste your time here, making yourself miserable. 

Feel blessed that ED isn't one of the things that haunts you, and leave this world of ours alone. 

So let me just say this: any comment left on my blog that is derogatory, insulting, rude, aggressive will be deleted on sight. 

Yes, it still hurts me to read those comments, they were the reason I deleted my blog earlier in the year after all. But now I've learnt that if I let them get to me like that, then I will lose my only outlet. If my last attempt is any indication, I will then rapidly spiral into depression, increasingly suicidal ideation, and with a job, I may just do it this time. 

And finally this leads me to a message of thanks. 

Firstly, thank you to all my followers, I can't believe there are now 100 of you. Thank you for your continued support through all my ups and many, many downs and your kind and patient words. 

Secondly, thank you to faithandmeow. I know that we do not see eye to eye on this whole issue. But I really do appreciate the fact that you show me respect in your comments, you have never attacked me in them, and have yet been able to make your point clear, standing on the opposing side. I wish all the hecklers were as mature as you. 

a follow on from "curvy girls" - aka a rant.

Miss Fat Piggy's "Curvy Girls" post...has inspired this rant. And warning girls, this is a RAAAAAAAANT. 

I could rant about overweight people all day, every day but really, I try to hold it in most days, but reading Fat Piggy's post has really triggered me off, not to mention some of the responses to it. Here is my comment on her post, plus a little more elaboration.

Here is my stance on being "curvy" and being overweight and "having a low metabolism". Sure, there are metabolic disorders that PREDISPOSE you to being fat, but at the end of the day, it's all intake vs. output. There are only 3 disorders in the whole world that I think will totally excuse you from being fat: Angelman's, Prader-Willi and leptin deficiency. 

Let's get this straight. Some of the thinnest people I know have PCOS, and NOBODY can blame being fat on having a LOW metabolism because metabolic rate is directly proportional to weight so the more you weigh, the HIGHER your metabolism. Exercise only changes your metabolic rate by a small amount so all that shit about HAVING A LOW METABOLISM IS JUST BULLSHIT. People who are overweight and think they have a "low metabolism" generally are counting their calories wrong. There was a study on these "low metabolism" people and they were compared with those thin people with "high metabolisms" who thought they were thin because they had a "high metabolism". 

GUESS WHAT???? They gave everyone radioactive double labelled water, which measures the number of calories that you eat, and those "low metabolism" people ate roughly twice as many calories than their "high metabolism" counterparts. And GUESS WHAT???? The "low metabolism" people actually had metabolisms that were 30% higher than those people who were supposed to have higher metabolisms. 

And also people, I give this speech to each overweight patient who tries to sell me the "low metabolism" bullshit. I went through 6 years of medical school bitches, you think you can fool me with that mainstream bullshit??? And yeah, sure, you might have the "obesity gene", the greatest excuse for being lazy any generation has ever had. But GUESS WHAT, only 10% of overweight people have that gene. So 90% of them are just overeating. 

Fat people use it as such an excuse for being fat. "Oh I have a low metabolism because everyone in my family has a low metabolism." Bullshit. The reason your whole family is fat is because you all eat the same shit. 

I do think that overeating is a behavioural issue, and that is is taught by observing other people's behaviour or is developed as a coping mechanism and you can't really blame people too much for that. However, it is their choice whether or not to continue their pattern, or to make a change. 

And NOOOOOOO, weight loss DOES NOT depend on WORKING OUT. So all those people too fat to move, or actually physically disabled in some way (perhaps they lost a limb due to the diabetes they gave themselves from being too fat) have no excuse. 80% of weight loss is diet related. And working out generally makes people more hungry, so they eat more. It's all about the food people. IT'S ALL ABOUT THE FOOD!!!! 

No, it's not easy to diet and lose weight. Of course it's not. If it was, nobody would be fat. And yes, food tastes good and food comforts us when we're upset. That's why it's so easy to be overweight. I'm not saying "fuck fat people, it's their own fault so tough titties". I'm not saying that at all. What I am saying is that until they start to really recognise their own eating and behavioural patterns as contributing to them being overweight, they will not be able to lose weight. 

If being overweight was really just simply metabolic, I'm sure medical research would be pouring billions of dollars into finding a step in that metabolic pathway to block and then BAM! SKINNY PEOPLE! But that's not happening, because it's not metabolic. 

And Angelman's, Prader-Willi and leptin deficiency? BOOM! CHROMOSOMAL DISORDERS! No cure, sorry. But when you don't have the ability to feel full, yes, of course you keep eating. 

Don't get the impression that I have a thing against fat people. Not at all. Yes, they might sometimes make my heart sink because they make my job harder. And yes, sometimes all their excuses make me want to beat my head against a wall. But the only reason I feel like this is because I've been on the other end of it. 

You only have to witness one failed resuscitation, of a young woman in her 50s, who had a heart attack because of her eating. Doing CPR on this lady, three times my size, while her family stand around me, crying and wailing, her children begging her "mum! wake up!", I only had to see that once to know that I would happily whip and beat every overweight person I come across to avoid that happening to another family. 

You only have to go to the amputations ward once, see the young men and women in their 40s and 50s, missing legs due to their diabetes, waiting on super large wheelchairs, going blind from their diabetes, crying about how they are dying because they can't stop eating, yet eating chocolates at the same time to comfort themselves. You only have to see that once to know that you will never care about making a fat person angry, or making them cry if that means that there is a slight chance of the message getting across. At night I weep for the people who are blind from their diabetes, who will never be able to look at their children again. 

Yes, I'm harsh. I'm the same with smokers. Seeing one lung cancer patient will do that to you. And I used to run lung cancer clinics. And by the time they get to me, I know they are going to die. These wonderful people, these wonderful caring people, RUINED by eating too much and smoking too much. So yes, I'm harsh. Because I'm trying to save them from themselves. If I don't tell them, then who will?

If women have a natural hourglass, curvy figure, great. If they are fat, then fuck, their fat. And if they don't face it then I will happily see them in hospital after their heart attack or stroke at 45 years of age, or when they are 50 and their knees are worn out because of the massive strain on them. And you know what, then they will have to face a lifetime of medication, and then they will have to face themselves. 

What goes around comes around sisters. And if people choose not to do something about their weight today, then they can face the consequences of that decision later.

I've drunk a lot and I will now write!

"Now there are thoughts like these that keep me on my feet."

Read the title of this post, you have been warned!!!

What have I drunk? I don't really remember. I know it all started with a lovely, deliciously fresh and refreshing glass of viognier and then 2 bourbon and cokes and at least another 3 scotch on the rocks with a twists. Man, it was good scotch too. It was the 47 year old single malt that I bought for my dad in Scotland. And cost a pretty penny. 

Why am I drinking? I don't really remember. But hey! I'm sure that was probably the point of it all so as far as I'm concerned, it has been a very successful venture. But the last thing I need is a drinking problem on top of all my other problems so this is the last time! Mind you, I did say that after the last time I drank so much. 7 drinks at dinner in London. And I managed to get myself home on the underground perfectly fine. I thought I was super lucid, not so sure how true that was...but I got myself home and it was all good and fine. I'm sure there are bosses who would fry my ass on a stick if they heard that story, but that's why they don't know!

Today I have taken my high maintenance to a whole new level...with semi-permanent eyelash extensions! They are beautiful and now I don't feel bad about my natural short-ass stubby, ugly eyelashes. And they cost me $230 with an upkeep cost of $70 every 3 weeks. I'm slowly, one aspect at a time, improving myself. 

First the eyelashes. Well, first the piercings and tattoos and then the eyelashes. And the very little headway that I've already made with the weight loss. And I am seriously starting to think about cosmetic surgery. Well, first the liposuction, and then to get my nose and eyes fixed. 

Maybe. But then again, I could just spend the money at the swish pilates place that I've been eyeing up and hope to carve myself a new body. Maybe. 

One way or other, I will get there. Just realised that I will have enough money to speed up the process. But I feel I should do the pilates option. It will be better deserved that way. 

And with all that going on, I don't know how I'm going to manage to buy myself my first house. I'M BUYING A HOUSE MOTHERFUCKERS!!! Don't get me wrong, I'm not going to live in it. It'll be rented out, and added to my family's collection of houses. That way, when I've paid off my debts and I'm gone, my parents will still have my houses keeping them comfortable. Apparently I talk like I'm made of money. I wish!

But now, with all swiftness, back to my body. And yes, I AM that vain. I'm currently not monitoring my calorie intake (officially). And I probably will never count my calories ever again. Woop! Woop! Holla dat! Right. Now there is a reason for this. I'm about to start work. EVERYONE drops tonnes of weight when they start work. EVERYONE. 

And now I know the key to losing weight. Step 1. Pile on the weight of the earth in stress. Step 2. Add one incredibly understaffed and overworked hospital. Step 3. Add disgusting cafeteria food and long hours. Step 4. Add me. 

As long as I throw myself into the work that is about to throw itself at me, I will be busy enough to not eat. And I will be at the hospital for breakfast, lunch and dinner which means that I will be there for no meals at all. If I don't lose on that regime, then I will never lose weight at all. 

I will weigh myself in the morning of my first day, and then I will weigh myself every week to see what happens. In a way this is an experiment. Let's see what happens. 

and then we came to the end of all things. (and a message to haters who comment)

PRIMUM NON NOCERE

6 years of blood, sweat and tears (all literal) boiled down to one moment that was over in a flash, but also seemed to last a lifetime. I almost cried when I took the Hippocratic Oath. I blew my family a kiss as I walked across the stage. My feet felt like death on daggers in my heels, but I felt amazing. 

It got me thinking, what does this mean for me? I have been heckled, time and again online for writing this blog, with my background. Does it mean I cannot be a good doctor? Does it mean I am a danger? Does it mean I should know better? No, no and yes. Yes. I should know better. But then again, none of us wandered down this path thinking that we would be glamazons. We all know what lies ahead of us or with us. 

And, to make it clear to any of my harshest and most vocal critics, DO NOT THINK I CHOOSE TO BE HERE. I found myself here. Maybe it didn't creep up on me, and maybe I did see it coming but I didn't wish for it and when I saw it coming, I feared it. And now that I am here, I will do everything in my power to prevent another girl from ending up here. This is not somewhere anyone should be. It's the 7th level in Dante's Inferno, we're down here, freezing with the devils in our heads who tell us every second, of every day that we are fat, ugly and totally undesirable. 

Maybe I should have done something about it sooner. But in the same way that deer freeze in headlights, I froze. I was too ashamed to go for help, and now I am too ashamed to go because I don't look thin enough to need help, and I am far too old. You may say that I am resigned to my fate. I see it as embracing the inevitable and trying to do the most good with whatever time I have left. 

Having an eating disorder doesn't make me a bad doctor, nor does it make me a danger. Surrounded by other doctors, they would drag me kicking and screaming to recovery before I became either of those things. 

I hate it when I am judged online by people who have only read one post of mine, and already think I will be a bad doctor. 

There are people in my class with substance abuse issues, there are people in my class who have attempted suicide (and one who succeeded), there are people who are alcoholics, there are people who sleep around like you wouldn't believe, there are others with eating disorders, anger issues and relationship issues, people who are racist, sexist and worst of all, people who are only in it for the money. So don't tell me I'm going to be a bad doctor. We all have our demons, but they are ours, and I'd like to think that most of us would rather take a bullet than let it interfere with patient care. 

All it means is that I can probably spot an eating disorder before most, and it gives me patience. I understand when patients don't listen to advice because it stops them getting what they want. I understand when they try their best but can't seem to succeed. I can spot the lies, but I do not hate them for lying to me. I totally get it. 

Yes, I know I am expected to be super human. I am not supposed to have problems, I am not supposed to have issues, I am not supposed to forget things, I am supposed to be always happy, cheerful, full of wisdom and I am supposed to take all the racist and sexist abuse that patients hurl at me with a large tub of salt and smile and love them like all the other patients. I am supposed to have a wonderful boyfriend, a perfect family, no debt and perfect teeth. I am supposed to be an angel of life. I am none of those things. I'm just a normal girl, with my own demons, trying to do my best. 

I will probably battle my eating disorder until I die. But why should I be greeted with such hate and disgust, why me and not the patient with heart disease because they ate too much? Why me and not the patient with lung cancer because they wouldn't quit smoking? Why me and not the schizophrenic who stabbed his own father? Why does my profession mean that I am not allowed to have a disease?

I wish people would remember that while being in hospital might be a once in a lifetime thing for them, I have 60 patients, 60 patients that change every day. Much as I would love to, I cannot devote a full day to one patient, and all I can do is my best. I am only human, but I shall, like all my colleagues, do my best to be more than that.

They say that you are not a real physician until you have killed a few patients. And that is what they told us on the first day of medical school. So I will enter the killing fields on Monday. Hope to never see you on the frontline, my friends. 

I have old lady hips

"Love is like a bomb, baby, come on get it on!"

I'm exhausted on several levels. Just back from an awesome trip to Hong Kong. Went to Disneyland for the first time in my almost 23 years of life. It was just as magical as I thought it would be! I bought the Minnie Mouse ears and rode the Cinderella Carousel and I've never been happier in my life. 

Made myself a playlist of old rock music on the flight (which is what inspired the opening line) and listened to it for 6 hours. After listening to ACDC and Def Leppard and Black Sabbath and Guns'n'Roses and Queen and all of that, I just thought 'what's happened to music?'

Justin Bieber and Nicki Minaj and One Direction just doesn't seem to measure up. I had a great time just bathing in good music. Food wasn't so much a problem, I walked all day, everyday and didn't stuff my face like I thought I would. Still, I am constipated and I have a food baby so I'm too scared to weigh myself. All in all I think I'm pretty much the same as when I left. I'm desperately hoping to lose weight when I start work in a week's time. 

After 3 straight days of walking and a miserable 10 hour flight with lots of tossing and turning, my right hip feels terrifically unstable. Like it's going to dislocate at any moment. And my back is aching. I'm not yet 23 and my body is already falling apart. Sometimes I tell myself that it's because I'm so lazy and fat that it's too heavy for me to carry around. 

Hip and back troubles. I'm such an old lady. All I need is some gin and some stairs and then the transformation will be complete. I have no idea how I am going to walk up stairs, across a stage and down stairs tomorrow in towering platform stilettos but I shall definitely let you know if I end up face planting in front of my entire class. 

Meanwhile I am preparing myself for work and for impending weight loss. Hoping that my too small clothes will finally fit me! I would love to have clothes hang off me. Everything feels too fat. Makes me wonder if I will ever feel skinny? I don't even know what it might feel like to be skinny. Does it feel glorious? Does it feel better than sex? Does it feel better than the taste of hot buttered toast with clotted cream and jam? 

ice queen at the ball

"And your heart is a stone buried underneath your pretty clothes."

Disclaimer: I'm a wee bit tipsy at the time of writing this post.

Cinderella at the ball, that's what SPM calls me. Cinderella with her glass slippers and Prince Charming and pumpkin carriage. I don't think I'll ever feel like that. My shoes were killing me by the end of the night and I wasn't about to take them off and go barefoot on the alcohol soaked dance floor. 

And I had to be on the dance floor to soak up all the calories that I ate. I left half my dinner, but it still felt like too much. 

Dinner is finished and most people are dancing. I'm sitting with Rich. Sitting, in the loosest sense of the word. We are sort of on chairs, I'm lying on him mostly, one of his hands is squeezing my left boob and his other hand is sliding up and down my thighs. His lips are glued to my neck when we're not whispering to each other. And no, I haven't had a complete turn around in my personality, he's only allowed to do that stuff to me because he's gay. He's my gay best friend and we are whispering about his boyfriend. 

He's telling me about how much he loves my boobs and my legs and how one day I will make some guy very happy. It's obvious he's just started having sex and now wants everyone to experience it. The sentiment is rather sweet but the thought of it makes me ill. 

There are a few guys trying to get close to me but I give them a look. Apparently that look of mine is infamous and it makes guys cower. None of them are allowed to touch me, but they still try. I'm pretty cold to them. I hate them. Nothing sickens me more than the thought of men grabbing all my fat. It makes me feel so disgusting. 

Everything about the night makes me feel fat. The food, the champagne, my tight dress and my skinny friends. 

"You're getting too skinny," Rich whispers in my as he squeezes the fat on my thighs. "Don't lose any more weight, you are skinny enough." I imagine how skinny I'd be if I hadn't lived with German guys who force fed me. Fucking hot German guys who I would've happily fucked if I had ever been drunk enough. 

How did I ever get to this point, almost 23 and never had a boyfriend, never been kissed, let alone have sex. Being felt up by my gay best friend is the most sexual experience I've ever had. Another one of my guy friends is trying to get at me. He's got his arms around me whenever he is around and nuzzles into my neck. I'm not flattered. I know how blind drunk he is. Blind being the operative word. 

All in all it was a night of binge drinking, beautiful shoes (but painful feet) and more male attention than I've ever had. Still, fat was everywhere. 

Stupid fat. Literally gets in the way. 

knowledge is power

"We give and take a little more, the eternal game of tug and war. Power and control."

The endless pit that is my stomach rumbles shamelessly and the noise seems to echo through my ears. I'm convinced that the whole room can hear it. Ramming my fist into my abdomen in a vain attempt to curb the sound, I stubbornly continue to flick through my stack of x-rays. It's a test and a woman stands over my shoulder, listening to my every word. It is the final test, in many ways I am already qualified. 

The words spill from my mouth in such rapid succession that my fellow clinicians look concerned. I'm so mechanical in this, I barely know what I'm saying myself, my voice sounds like a far away drone and in my state, the words mean nothing. "PA erect chest x-ray of an elderly female patient of good penetration and minimal rotation. There are no obvious bony defects or soft tissue swellings. Gross cardiomegaly is present with increased interstitial markings, blunting of both costophrenic angles and septal lines. There is peribronchial cuffing in both lungs as well as upper lobe diversion. All of this is consistent with congestive heart failure."

The woman behind me nods and moves onto the person next to me. I release a breath that I didn't know I was holding. I'm done. Next time I walk into a hospital, I won't be a student anymore. Fully qualified, holding lives in my hands. I think back to the first lecture I ever had at medical school. The opening line of this lecture was "as doctors, you will all kill patients. Hopefully none of you will do it deliberately. This is something you have to accept now or you will have a hard time." I don't know if I've ever come to terms with this. It scares me to the bone. 

I try not to think about it. Try to get on with what I need to do. 

"Oh my gosh, you're so thin!" But I'm not. Most of the other girls have lost much more weight than me. In England, I got down to almost 50kg. Then I got back up to 57kg. I think I'm hovering around 54kg to 55kg now. I have lost a bit of weight since I got home and away from that recovery house. I can feel that I'm thinner, but nowhere near as thin as I was when I was in England. Not as thin as I was when I was in control of my own food. 

But this just goes to show that I can do it. I can lose a lot of weight very quickly. I can also put it back on very quickly, but I can lose it, and that's a relief to know. A little discipline is all I need. And it does come off. I had the faintest of thigh gaps for a while there. So it's possible. Now all I have to do is to get back there as fast as I can. 

Tune out the hunger, it means nothing. Tune out the headaches. It means nothing. It's so simple when you boil it right down. At the be all and end all of any conversation, when I don't eat, I lose weight. So if I want to lose weight, all I have to do is not eat. It's very, very simple.