hoping for the best

"Problems have solutions. A lifetime of fucking things up fixed in one determined flash."

You know your life has problems when your hairdresser can see something is wrong when you show up for a ten minute fringe trim. Skye has been the first person in a long time to recognise how hard I'm working, and that yes, it is fucking difficult. That's what happens when all your other friends are doctors, when you're all working the same fucking job, you don't want to be the one loser to complain about it. 

I book in to see her in another 4 weeks. She looks at me, and I know that I don't need a haircut in 4 weeks time, even with my high maintenance cut. But I'm near tears at this point and she comes and gives me a hug and books me in anyway. I walk out as fast as I can, because if she hugs me again, I will cry. I feel angry and upset that I'm still fucking working. I've only got 7 days left in my marathon month of work, but I'm growing impatient. 

I feel like such a whiney ass. I just need to suck it up, box it in, man up and get on with it. This is no different from any other doctor. I hate being this frail when everyone else seems to be so strong. 

My weight is...I have no idea. I've been way too scared to weigh myself. Given that the last time was 118lbs, and I know I've gained all the weight back since then, I just know I'm going to have some sort of mental break down to see a number back in the 120s. 

I had another sort of wake up call today. My Vivienne Westwood dress has arrived. It's IT40 in size, which is my usual size. But it doesn't fit. It's too small. I can't button it up past my waist. It fucking sucks. It FUCKING SUCKS. It's an expensive dress. And maybe in 10lbs time, I will be able to fit it. I should be able to fit it. Fuck. It makes me wonder how much I actually weigh. My only hang up is that, it doesn't button up over my boobs. Now, my boobs are one of the only good things about me. 

When I say that, I mean, my boobs are the only thing about me that I think guys like. I'm not pretty or skinny, or anything. But I have a great rack. I wear a 32DD size. Which I find absolutely ridiculous, it doesn't feel like a real size at all. I do feel that I would rather be skinny, and ditch the boobs, but I'm so torn because men so obviously like them. 

That last sentence sort of makes me feel like I will end up as some serial killer's victim. Which tells me that I should stop my serial killer documentary marathons. 

I'm hoping night shifts works its magic on me again. I'm hoping and praying. I dropped 6lbs in 4 nights last night. I'm working 7 nights this time. I'm praying I lose at least 10lbs. If I'm up for it, I might try to do some exercise at the same time, but realistically, I know that probably won't happen. 

All this, all of what is going on makes me feel like I'm more depressed than I give myself credit for. And I know I need to get some sort of help for it. But really, when do I have the time. If I had the time, I'd get enough sleep for a start. 

On top of all that. Joe. Ugh. I was going to say that I don't know where to start but the truth is that's is because I have nowhere to start. Nothing has happened. I text him a few times, no reply. Fuck. Okay then. The logic tells me he's just too busy, sees the text and forgets to reply but it doesn't feel great. 

And the more I think about it...well. I remember seeing a patient with him, one with a history of self harm. He saw her scars, she said, I used to self mutilate and his response to that was "what gives you that?". I mentally facepalmed so hard. What gives you that? Fuck. He's too unobservant to notice my scars, either that or he doesn't think I'm capable. Fuck. Makes me realise I don't think I'll be able to tell any man about this, ever. Only one of my friends knows about it. And besides her, only the professor. 

There is a whole other story about the professor. But this post is full of enough self pity already without me going that way. 

NOTHING IS GOING RIGHT. I fucking hate it. This has to change. I need something to start going well. I don't know how much longer I can carry on like this. I need something. ANYTHING. I need something to go well, I need something in my life to be right. And please god, let that be my weight. 

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.

half the calories and be still my beating heart.

Several rather different topics to rant about...please bear with my schizoaffective self. 

I've often heard people say that eating slowly halves the number of calories that you take in. I've always thought that it was such a ridiculous notion, but even so, rather a cute thought in itself. Today I discovered that it is very much true. SO TRUE! WHY DIDN'T I LISTEN EARLIER! My calorie intake has been hovering at 800-900cal per day. Today, we had some friends over to our place and so I ate dinner slowly, and I only had about 350cal before I felt really full and decided to leave the rest for tomorrow. 

I was so surprised at how full I was. This really explains why I always eat less when I go out with my friends. I'm usually too distracted by conversation to eat properly and even though I know I'm eating less, I always feel much more full. Gosh. Who would have though that conversation would literally halve my calorie intake. Magic. Can't wait to keep utilising this. 

Also, so much for recovering from my bout of illness and eating 3 meals a day. Back to one meal a day and it feels great! I'm still pretty light headed but I don't feel so guilty anymore. Am I just incredibly stupid to be coming across this eat slowly thing now? Honestly, if you haven't tried it yet, try it. It works without you realising it is working. 

And now for something completely different!!!!!

A few days ago I cut a treble cleff into my left ankle. Today my flatmate saw it. She asked me about it. She's getting really suspicious. I passed it off as scarification and now she thinks I'm really weird and I'm not entirely sure if she believed me. 

Another issue is that we now have 4th year students and we have been doing quite a lot of teaching with them to prepare them for their surgical exams. But this is their first ever hospital rotation and they want to practice on us instead of real patients. It's actually a really reasonable request seeing as the "patients" in their exam will be final year students like us. But the surgical exam is the surgical abdomen exam and I cannot show them my abdomen. Or they will see my scars. 

Sometimes this habit is incredibly annoying and isolating. 

And now for something completely different again!!!!

My scumbag brain has decided to strike again. Yesterday, it decided that I was to have a crush on one of my surgical registrars. And I am less than pleased about it. He's a really nice guy, as most surgeons are, contrary to popular belief. And I like him because he's only a first year registrar and he's really quite playful. Spare time is spent teasing everyone in sight. Yesterday he hit me over the head with some patient notes and stuck patient labels all over me because I was using his dictation log in. 


And he's pretty damn ripped as well. It seems that I have a very specific type. Guys with totally ripped bodies but rather cute and sensible looking faces. Kind of like, he must be strong but also smart enough to make enough money to support me! Not that I'll need it though because I will hopefully be making buckets of money myself. 


Ah, he's so cute and sweet. *sigh* stupid, stupid, scumbag brain. I loathe having crushes on people! I shall stop writing about him now. Don't want to bore your ladies with my trivialities. 


Hope you are all doing well and dropping weight and dress sizes! I love you all. 

Dr. St Valentine

Fat Piggy, LittleMissFairy, Zapfire, Anafly and Christina - my beautiful ladies! Thank you for your lovely comments on my last post. So encouraging! I feel so loved! 

I honestly can't say how much your support means to me. It really, really means a lot. So, seeing as it is Valentine's Day I thought I'd write a different sort of post. Also, seeing as I just started General Surgery, I thought I'd update you girls on what has been going on. 

The days of medicine are over. No more 7 hour long ward rounds. No more stopping off for coffee. No more gossip with my girls. Welcome to the quickfire world of General Surgery, where the theatre days are tough, the long days tougher and the bosses tougher still. Yesterday I was dropped into the world where the days start at 7am and end around 7pm, you stand up all day, run around and run up and down stairs. No more 8 patients on our lists being considered a long list. Today we had 25 patients. And this is the shortest the list has been in a month. 

This is a world where nobody gives a fuck about who I am or where I am. I could go home and chill out or I can work myself into the ground. The only person who gives me the time of day is Dr. St Valentine (no, that's not his name, it's a literal interpretation of his name). Like the little girl I am, I giggled when I heard his name. 

There are chocolates in his pigeon hole, he offers them to me, "Happy Valentine's Day". We do the ward round with me chewing on chocolate. He treats patients the way I want to treat them when I'm a doctor. Watching him work is like watching a vision of a perfect doctor. He's smart, funny, incredibly understanding and comforting, he's handsome and he puts his patients first. 

It is a privilege to meet someone like him. It's much too hard to find someone to look up to in this world. Hopefully I lose some weight on this run. I'm already shirt tired after 2 days. So very tired. There is never enough sleep, or enough down time. Or enough people who give a shit about me. The only person who talks to me is Dr. St Valentine. And when I see him, I make a mental note that I swear to always treat my juniors nicely. 

Before any of you perk up, Dr. St Valentine is very much married. But my favourite doctors have been married men who I got along really well with. Still, it's some sort of strange motivation. Seeing someone so perfect, it makes me want to reach for perfection even more. I want my future students to think that of me. Beautiful, thin, smart, caring. That's what I want to be. 

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. 

stick thin

Heigh-ho, heigh-ho, it's off to work I go. And work is work is work is work is work! Apart from feeling like I don't know jackshit about medicine, it's all going quite well. Medically. I won't bother you with the details of my clinical incompetence. 

The weight loss was also progressing. I got down to 121lbs last week. Still not quite as low as I was, but I'm at least losing the Singapore weight. It's very easy for me to not eat breakfast and lunch, however, all I want to do at dinner is binge. Maybe I will have to start spreading calories around. 

Bad news for today is that my team mates have started force feeding me. Today it was only a small apple, which isn't bad at all because I was planning to eat an apple anyway. But still, the registrar sat down and put it in front of me and said that she bought it for me and so I had to eat it. 

Then my house officer piped up and said that when she was a student, her team used to buy her lots of food and she gained weight. 

By the by: the hierarchy goes me (the student), house officer, registrar, consultant (the boss). And where I work, the doctors get free food so "buying" me food means spending some of their food allowance on me. 

The thing about all this is my house officer and registrar are both stick thin. And when I say stick thin, I mean STICK thin. They are SOOOOO thin. I feel that them forcing me to have food is a little bit hypocritical, although they both eat quite a fair amount of food. I think that when I start working, I might have lunch as my only meal so that people don't worry about me not eating at work. 

My calorie count for today is still below 600cal, and I'm about to go to the gym to take a class in muay thai boxing so that should burn off some calories. But I'm still unhappy about eating that apple and all the food that I had for dinner. The only good thing about this is that I can tell the professor that my team are force feeding me to make him worry even less. 

I hope to lose 2lbs this week. I don't have a scale here so I will weigh in on Friday and see how things went. Fingers crossed I'm losing weight again! 

love is just a camouflage for what resembles rage again

Christina, Domino, Jackie, be_thinspirational: you girls rock! Thank you for your lovely comments on my last post! So encouraging, you really made my day. 

Well I'm settled in to my new home and tomorrow is my first real day of work. It's going to be a shock to the system! I'm still jetlagged and I'm pretty darn sure I don't real a thing about general medicine. Some of my other colleagues who have already started in other cities have been thrown in the deep end so I'm really bracing myself for something quite harsh tomorrow. I think I will stay up and study lots. 

If I'm tired tomorrow, I can blame the jetlag. At least the studying will make me feel better, even if it doesn't actually make a difference. 

I binged again today. Well, it's a different sort of binge. There really isn't much food in the house and so each binge is quite small in comparison. I'm pretty sure I did about 800-1000cal today. It was all in one meal, so you know, big binge but all in all, not an absolutely disastrous intake. 

I'm struggling to recover from the Singapore binges so I'm counting today as progress. Hopefully by next week I will be able to start cutting down on my intake a bit more. I'm hoping to have a daily intake of maybe 300-500cal. This isn't hugely easy however. Somehow my flatmate and I have been sharing the cost of food. And so in some sort of deranged default setting, I've been eating half the food. 

I'm doing my vegan diet soon so that should hopefully put a stop to that! 

Do you remember me saying that moving out might be better for my mental health? Well, it's sort of been like one step forward, one step back. While I'm free from my parents, the prospect of facing them every weekend is a bit daunting. Also, my flatmate, who is one of my best friends, has come back from her summer in Africa changed. 

Very subtly so, but there is definitely a shift in her personality. I am totally and utterly guessing here, but I'd say that she fell in love with a guy in Africa. She's acting in a strange way, not quite her usual. And the things that she wants to do now are not what she would normally want to do. He calls her most nights and she texts him a lot. Considering that he's in Togo (somewhere in West Africa), the money that they are both burning through is amazing. Plus, she's paying him money to tutor children in Africa in order to supplement his income. 

The whole thing makes me feel very uncomfortable for some reason. Also, it makes me feel very lonely. She's normally so silly and fully of antics and keeps me entertained but now, this new her, it's just not the same. She's still a delight to flat with, but I feel much more lonely. Even though she is here, somehow it feels like she is in Africa with him. 

So now, I really feel like I don't have anyone to talk to. Also, I found out that 3 of my friends failed last year and are repeating it. This all makes me feel sad. Part of me can't wait to go back to see the professor. Part of me thinks that if I just hand all control over to him, everything will be okay. But all of me won't let me do that. 

Part of me wants to email him all this just so I don't feel so lonely. But I can't let myself do that either. I really didn't think I'd feel this alone. Even my parents would be welcome company right now. But in the words of Slipknot: If I'm alone I cannot hate. I don't deserve to have you. My smile was taken long ago, if I can change I hope I never know. 

Thank goodness I only have 2 days of work this week. I still haven't found a suitable gym. But I'm working on it. I already can't wait for the weekend because really, what happens this weekend is going to set the tone for how this year might progress. 

blood diamonds

Thank you to Zapfire, Jackie, Domino and Fiona for your comments on my last post. Thank you all for being so supportive of me, and for all your kind words. I appreciate them all and I love reading them. 

I look down at my finger and I see them sparkle like the sun on the sea. 3 dainty little diamonds sitting in a little platinum heart on a thin platinum band. I slide it off my pudgy finger. Such a beautiful thing deserves a more worthy bearer than me. Ungrateful little bitch. My ring cost more than any of the engagement rings of my married friends. I should be happy. Why aren't I happy? 

It means nothing to me. It symbolises the hollowness and ego boost that comes with any consumerist comfort. My father proudly paid for it but it makes me think of all the torment and all the tears and blood that I have spilt on his account. Blood diamonds, that's what they are. Tiffany&Co hearts might be a symbol of love but I don't feel loved at all. It's all a bit too little, too late. 

In a strange way it is better than any cut I could ever make on my body. It's a tauntingly, hauntingly beautiful reminder that I am not enough, that I am not worthy, that I am not beautiful. 

This house holds no sentiment for me. No place ever has. It's just a roof to sleep under, shared with people who all want something from me. It's all I've ever known. I do not feel safe here. I do not feel loved here. I do not feel I belong here. 

I used to want to make it work. I wanted to feel what every child should feel from their parents. I want to be loved unconditionally. Loved for all my faults and all my deficiencies. I used to want a happily ever after. I wanted a fresh start. To go back to zero and forget all the hurt and start new and be a proper family. 

That's not possible. They would never understand. They aren't capable of giving me what I want and what I need. The only option is to go. 

Some people tell me that the professor cares about me. If this is what it feels like to be cared for then it is nothing short of absolutely terrifying. I was hoping he'd forget all that I said to him. I was hoping to let it slide on by into the cold depths of my memory where I would file it under "near misses". But he wants to see me this weekend and I don't know what to do. I don't really have a choice. All I can try to do is damage control. 

Just thinking about it makes me want to cry. Opening up is not easy and I don't want to do it. I have been so judged and held up to ridicule for being Asian and for being fat, for things that aren't exactly bad per se that I can't even imagine what evil I will be exposed to if I confess to what I have been doing. I might be kicked out of medical school. I might be told to take a year off and sort my shit out. 

She's got a ticket to ride and she don't care. I'll be humming this as I wait for my train if that is what it comes to. I don't care about doing something good and leaving behind reasons to be missed. I don't want people to miss me. I don't want people to remember me. Ideally, everyone would just get on with their lives and if I'm lucky enough I will be scattered into the ocean that I love so much. 

But the professor doesn't know any of this. If he did, I'd probably be under psychiatric hold right now. 

Perk up fat bitch. Perk up and say that you are okay. That things will work out this year. Happy and healthy, that's what you are, tell him that's what you are. 

He keeps telling me, in every email, that he wishes me a happy and healthy 2012. It's a very deliberate thing. Happy and healthy, two things that he definitely doesn't think I am. Is it possible to suddenly become happy and healthy in a week? Can I even negotiate new terms? I have a feeling this matter is a very non-negotiable one to him. 

But how will he check up on me? Seeing me once a week isn't going to stop me losing weight. I dare not imagine what threats he might make to force me into compliance. 

This wonderful little world of control that I've meticulously built for myself is crumbling. The professor is blowing away my castle in the clouds. I don't want to let go. 

What am I afraid of? Is it losing my job? Is it the professor? Is it gaining weight? Or is it simply the uncertainty. 

List of things to do this week:

Move out of home to my new city where I will be training this year.

Join the gym. 

Start a new diet and exercise plan. 

Lose some freaking weight! 

See the professor. 

I wish you lovely ladies all a wonderful 2012. I hope it is everything that you want it to be and more. In the words of the professor, full of happiness and health. I love you all. 

things that make me think

Today I got some bad news. In one of my clinical rotations, a bitch boss hated me and borderline passed me. Which sucks because she only saw me 3 times in 6 weeks and everyone else there thought I was great. She also called me unprofessional, incompetent, not having enough knowledge, immature and told me the day before my exam that she thought I would fail. Nobody has ever had such a low opinion of me. Except my parents of course.

So I'm effectively "tagged". This is totally unfair. It means that next year, my probationary year of practice, I will be watched like a hawk by my bosses. Thankfully I passed everything and with decent marks and so I have passed the year and I don't have to do extra work, but it's the principle that matters here. It makes me feel not good enough, even though I've done nothing wrong. It makes me feel like people don't think I'm going to be a good doctor. And it makes me feel very angry, and very insecure.

But aside for my rant, a message for you girls.

As always, thank you all for the lovely comments. Even though I've never met any of you, I can totally all the support that you lovely ladies give me and when I feel down (which, to be honest, is a lot of the time), reading the words of encouragement that you leave for me, it's about the only thing in the world that has the power to lift my mood.

Having an eating disorder is such an isolating experience, I can't talk to anyone in my life about it and I have to spend a lot of time and energy hiding it from people who suspect or could suspect something. I very firmly believe that it is not possible to fully understand what it is like to have an eating disorder until you have had one yourself, which is why I value the company of you girls so much.

Furthermore, the advice I get on here, and the different points of view, they get me thinking. Here are my replies to the comments that you have left me.

Fat Piggy, Jackie, Alice ana and outside in to thin: I wish I could live away from my parents and for the most part, I do. I undertake most of my training in another city and I only come home on weekends. But I am sooo far in debt (more than $100,000 in debt) that once I graduate, I will have to live at home with my parents. I won't be able to afford to move out, at least not for 2 years.

I'm hoping that once I start working, I will be able to take extra shifts, not only to earn the extra money, but to be out of the house as much as possible and so I want to have 2 years of constant work to pay off my debt. After that, I will hopefully get a pay rise, be out of debt (or at least very close to it) and then I will move out of home to my own little apartment or something like that.

I really wish that I could ignore their comments and just take them in my stride, but in a way, since I've lived with this all my life, it is so much a part of my life that I hardly need them to say it. I already believe it all, it's just all the more hurtful when my own parents tell it to my face. At each family meeting, it's like playing a game. If I don't cry and stay defiant the whole time, then I win. And I've won sometimes. But last time, sadly, I lost the game. Still, I live on to play another day.

There really are no words to express how low my self worth is and these family meetings have the effect of a sledgehammer, hammering the remnants of the self worth and confidence into the ground. Oh what it is to weigh 121lbs and have my father say the most I should weigh is 100lbs. Crap isn't a strong enough word.

Alice ana: I've had suicidal thoughts since I was about 13. But at the time, all that consisted of was "I wish I was dead, I'd be better off dead, everyone would be better off if I was dead." I've come a long way since then. I have several different plans, most of which have been relatively "docile" up till now. For years I thought I would do a massive overdose. Until I learnt that many, many people overdose and still come back from it if they get to hospital long enough. My overdose would have to be of many different drugs, in huge quantities and I really am not sure if I can physically swallow that much. And I'm not sure if I could get to hospital fast enough and onto life support fast enough to live through the OD.

Whatever I do, it really must be the end of me, because I just couldn't face the consequences of living through a suicide attempt. The being declared unfit for practice, the mandatory institutionalisation in a mental health ward, the stigma and the being watched for the rest of my practicing life. Not to mention facing up to my family and friends. Chances are, my friends will be the ones trying to work out what drugs I've taken, pumping my stomach, putting me on life support and monitoring me.

Then I thought I would tell people I was going away for a weekend, then on the Friday night, run myself a hot bath, take a big, big dose of sedatives and painkillers and sit in my bath and slit my wrists and simply bleed out. By the time the working week started again and people realised I was missing, I would have bled out long ago.

But then I thought, even though there is a lovely, lovely way of dying, there is always that one in a million chance that someone might find me in time. I'd also have to not have a flatmate. So that's how I suddenly though, well, being hit by a train, that sounds very...final. And so I thought, if I'm going to be cremated anyway, I don't need to look good dead and so being hit by a train, that would be a very good way to go. And fast enough for me to not have a chance to change my mind. As you can see from my previous post, it is really a well developed plan.

I must be honest, I've never been more serious about killing myself. And I'm starting to get more of an urge to do it too. I always thought that I'd wait until I had done all my training and become a consultant, but I would be at least 35 years old. But I have always thought 27 was going to be my time to go. So maybe I will spend the next 5 years of my life just clinging on,

Fat Piggy, Leonie and Jackie: I am totally committed to losing the weight. Totally. But with each bit of weight I lose, I have a wee panic about what the professor will say. I don't want to upset him, really I don't. Because I am terribly fond of him, and he also has the power to halt my career whenever he wants to and force me into treatment.

But in saying that, in a strange way, I yearn for him to notice. Part of that is because I don't want him to forget about me from a career point of view, the other side of that is that I want him to care about me and if he's concerned about my weight, it makes me feel like he cares. But it is such an internal battle. What makes it worse is that the eating disorder is sort of just the tip of the iceberg. It may be the most evident one, but he has no inkling whatever of the depression, the self harm and the suicidal ideation. If he did, omg, I think he'd admit me to a mental health ward immediately.

When I worked for him earlier in the year, I was pretty upset for a variety of reasons, principle of which was my father losing his job. And he noticed. Immediately. Not only did he notice, he didn't let it go. When it was just the two fo us, he was constantly checking how I was, and trying to feed me. If he knew about the cutting and the suicidal ideation, I'd be lucky if all I got was beaten into the ground.

I live for his little compliments wrapped in love. Makes me feel cared for, and for a fleeting moment, makes me feel thin. Which, at the end of the day, is what we are all shooting for.