Tales from the Practice of Medicine: Bulimia (Part I)

Yu Ling

PureInsight | March 21, 2005

[PureInsight.org] There are many medical risks associated with eating disorders. One of them is the development of bulimia, Bulimia is characterized by episodes of rapid food consumption followed by inappropriate methods to expel the food in order to control the weight. Inappropriate methods to expel the food include vomiting, fasting, enemas, excessive use of laxatives and diuretics, or compulsive exercising. A binge is an episode where an individual eats a much larger amount of food than most people would in a normal situation. Binge eating is not a response to intense hunger. It is usually a response to depression, stress, or self-esteem issues. What makes a person bulimic -- as opposed to anorexic -- is not the purging, but the cycle of bingeing and purging. Stomach ulcers, ruptures of the stomach and esophagus, irregular heartbeat and, in severe cases, heart attacks have resulted from bulimia and may be life-threatening.

A doctor who treats a bulimia patient often feels at loss because the patient will keep showing different symptoms while the root cause is still hidden somewhere deep in the patient's mind. The bulimia patient is manipulated by a stubborn notion and has terrible difficulty letting it go. There is no effective treatment for bulimia. Unless the patient has a very strong will to overcome bulimia or the patient receives a treatment in an isolated environment, the doctor often gives up on a patient before the patient responds to the treatment.

Heidi is a senior consultant at a large corporation. She is in control of everything. She is in control of her relations with others. She has the final say on the projects done by her colleagues. She may be an expert in business administration, but she is completely lost in terms of improving her lifestyle or diet.

Heidi first came see me at my clinic because she was severely addicted to smoking. After many visits, Heidi successfully quit smoking. She also learned a lot about my family, my personal background and work experiences during those visits.

Next Heidi came see me to quit drinking. Heidi was more thorough in her "investigation" this time. She even found out my social security number and saw my filings of tax returns. I did not know she was checking me out at the time. I was trying my best to be a responsible doctor for my patients like always.

During a therapy session, Heidi finally told me that she was capable of finding everything out about just about anyone. I did not feel intimidated. I gave her a little smile and replied, "There are so many people in this world. Isn't it tiresome to try to find out everything about everyone?"

Although Heidi finally quit drinking, I felt she was feeling distressed about something that she was not ready to reveal. I suspected it had to be with her health or she wouldn't keep coming to see me. Judging by her appearance, Heidi is a very fashionable, physically fit and very well-mannered woman. She is the type of woman who attracts people's attention and is well respected everywhere she goes.

Finally, Heidi brought the medical history of her hidden illness to me. She said, "I have been tortured by this type of illness for a very long time. I have no one to blame but myself. I wear multiple masks. I live in two different worlds day and night. I have fought this illness for 35 years and have tried every type of therapy I could think of. I have seen many famous doctors and college professors. I always ended up lying to them and convincing them that I had overcome my problem even though it was not true. After spending a long time in therapy with one doctor, I would learn his or her therapeutic techniques so I thought I would treat myself. After I realized it did not work, I would look for another expert in the area who practiced a different type of therapy. No therapy has worked because this is a very stubborn illness."

"When I found you, I tried my best to find fault in you so that I could find an excuse to call you unqualified and then escape from the therapy. By doing this I could justify my excuse of fleeing from the therapy. I could tell myself, 'Look. I have been looking for a way to treat my illness, except no doctor is qualified to treat me! It is my prerogative as a patient to see only a doctor whose morality level matches my requirements!'"

"To be honest with you, I can easily find all the information about you, including when you last visited the INS (Immigrations and Naturalization Service.) I did not come to quit smoking and drinking. I was testing you. For some strange reason, because of your peaceful yet serious attitude, I could not help coming back to you."

I know the human mind is very complex and I have learned patients' many different types of mentality, but I have never met a patient who would go through so many troubles to test her doctor.

I quietly watched her in silence. Next, Heidi told me a story.

"I started to suffer from this illness when I was fifteen…"

(To be continued…)

Translated from: http://www.zhengjian.org/zj/articles/2004/7/18/28220.html

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