Trigger warning: frank talk about eating disorder behaviours, specifically bulimia. [i]
Mental illness tends to think doctors are morons. Eating disorders and depression definitely do. [ii] Wrongheaded and arrogant positioning, to be sure, but doctors do it too. Their mistake is in thinking they know more than the patient, or even enough. They can’t be experts, especially on the front line. Those roles are for generalists who have to know little bits of everything. I wish they knew about listening.
It’d be nice if they could, because I’m pretty sure they’re shockingly clueless about the details of this or that disorder. I’m slightly hostile about doctors, and that might be influencing my opinion, but it’s also true that most doctors need to accept that experts in mental health, they’re not. Their first-year Introduction to Psychology and second-year biopsychology course makes them little more than interested dilettantes.
You should know when you know just enough to be dangerous. [iii]
Until I told, no one knew. Not only that, no one asked. About anything. I’m amazed at the behaviours I engaged in under people’s noses. And no one suspected anything, except for the people who guessed and didn’t speak.
We drown in silence. I was silent about so many things.
Bulimia isn’t cool. It’s also not sexy. This is unfortunate because the need to be those things is in there too. Anorexia is better: people are impressed. I can be anorexic for long periods. That is, I can compulsively starve myself and monitor my food until I drop big weight percentages. It’s not, however, my go-to: it doesn’t rock my world the way the bulimia did.
Sure, the bingeing is like an insane panic attack staring an amount of food outsiders always fail to believe; and the throwing up is gross and fatiguing, but for minutes afterwards, you exist in an empty, enervated space that’s peace and quiet in the soul.
Until the self-hatred and revulsion kick in, tormenting you in a miserably unrelenting fashion until you do it again. [iv]
If you’re lucky, “again” gets to be tomorrow. I wasn’t lucky most of the time.
Unfortunately, in getting rid of the litres of food you’ve ground into your gullet and parts south, you sometimes damage things other than stomach, esophagus, teeth, and toilet.
Canine teeth are annoying. They’re also sharp. That little bit of bone that gives us our omnivore status and enjoys ripping into a nice steak can be a real pain in the hand. Sometimes, with bulimia, you can throw up just by bending over. Occasionally, you’ll use chemical or mechanical help. [v] The usual course of action, however, is to shove some number of fingers down your throat to trigger the gag reflex, so you start throwing up.
How many fingers you use varies from person to person. I used three myself, the index, middle, and ring finger of the right hand. Bend over, move the hand down the throat to tickle the oropharynx, push on the stomach, and we’re off to the races. [vi] Sometimes though, your jaw will cramp or spasm and your teeth will cut or scrape your hand.
Which is the nice way of saying you bite yourself while making yourself vomit. Because saying it that way sucks. It makes it sound like eating disorders are bad.
Ripping the skin of your hand open with your canines hurts: the wounds don’t heal well. For one thing, they’re never left alone. Bulimia isn’t called on account of injury. There’s no time-out. The wounds are exposed to stomach acid over and over and over, every time you purge. Nothing stopped me. There was no chance that sores on my hand were going to do me in. Though I never did come up with a reasonable explanation for their existence.
Luckily, no one ever asked.
They’re called Russell’s signs, after Gerald Russell, a psychiatrist who noticed them once upon a time. It references the collection of sores, scabs, and calluses on the knuckles of one or both hands of people with bulimia or anorexia. I was singularly afflicted: I was never good at ambidextrous vomiting. Some people are a marvel.
I’ve bought a lot of bandages in my time. I’ve been questing for the best and most perfect bandages since forever. I needed bandages that would cover the Russell’s signs, and I needed bandages to cover the wounds from cutting. Ones that are the right size and will stay on no matter what to promote healing. Even if the “what” involves hydrochloric acid. [vii]
Apologies to Johnson & Johnson, but when it comes to bandages and the Band-Aid brand, I’m not a fan. [viii] They fail to stick, and really, that’s the most important thing. Elastoplast are good, but the ones I like come in a box with other, useless bandages I throw away.
B-side bandages. Not stellar in my year of limiting waste.
Nexcare are the best, which kind of bothers me because I think I’m supposed to hate 3M. Ethics or something. But the adhesive works to the point that it sometimes removes skin, and the hydrocolloid bandages suck up pounds of sebum and pus.
Nexcare also offers a line of coloured bandages I wore on the facial wounds I self-inflicted, thinking that they made me stylish and the cutting unnoticeable.
Nothing says “style” like neon bandages on your chin.
Almost no one asked about those either.
We don’t like to get into other people’s business. I’m not sure why. I used to blame it on coming from a long line of stiff-upper-lip British people, but other people who aren’t British in origin have the same reluctance. Our determined non-involvement is a problem. It might end up as our fatal flaw.
[i] I don’t usually add trigger warnings, but I feel I’ve been more blunt than usual.
[ii] Or rather, my eating disorder and depression does.
[iii] One of the fun things about bulimia is water retention. It’s a rebound response to the body being starved of essential liquids during purging. It’s very upsetting when you’re trying to achieve “skeleton with skin” status. I once talked a very nice and totally clueless clinic doctor into a large prescription for diuretics, which I took without following the direction in order to get rid of the bloat. Skirting death is part of the game. I was not going to put up with a moon face and fat ankles.
[iv] I’m all about the adverbs here. Stephen King would be so distressed.
[v] Occasionally, I’d use an emetic like Ipecac to induce vomiting. As for physical assists, if your hand gets tired, you might use a tool in your mouth to encourage the gag response and the subsequent vomiting.
[vi] Back of the throat. But saying it that way makes me sound like I know stuff.
[vii] Stomach acid is between 1.5 and 3.0 pH. That’s wicked strong. How cool would it be if we could spray that stuff at our enemies? Humans with death spit. What could go wrong?
[viii] Pretty sure I’ve mentioned that Band-aids are bad before; it bears repeating.