
last tuesday, i suggested to
resident doctor #4 that a well known prescription diet pill could be a useful tool for treating my illness. he did not fall out of his chair, rather, he listened to the presentation. after finishing, he told me that the gut reaction was obviously to say no, since he had no experience prescribing my requested medication, and to give him a week to think about it. tonight, i walked in for my appointment and immediately asked him to counter the argument.
resident doctor #4 said that my future treatment (for anorexia nervosa, with strober) is apt to be very specific. doctor strober and his associates at ucla will offer a solid plan and then expect me to follow a structure of explicit directions. my independence and education are profound, thus receiving "rules" provided by someone outside of myself/anorexia, is expected to stir many frustrations.
resident doctor #4 came to understand long ago that due to my strict rule system, he can never be a person who tells me what to do. i unknowingly try to get him to write rules, but he can usually recognize the situation as it develops.
he has said such things as "that clenbuterol you were taking scares the living ---- out of me" but will never say "stop taking that clenbuterol." when one considers that "strober, for the treatment of anorexia" will be much different in that it will provide rules and authority,
resident doctor #4 thinks it is important for his own role to continue to hold the end of ambivalence.
due to the holiday season, our next two therapy sessions are disrupted. though my request was for diet pills, it's "the idea behind them" and not their pharmacology which would be considered dangerous. it may sound bizarre, but the pharmacological component is actually beneficial to digestion. either our untethered time, or strober's imminent involvement, would have been reason enough to hear my access to these pills was restricted.
a secondary concern is how our three week vacation affords a huge lack of structure. so far, only anorexia fills this type of loss. if
resident doctor #4 decided to give me the prescription, could this action come to feel as though he gave me a structure to follow? we look to avoid that, but cannot have anorexia overcompensate for the lack of structure, either.
AND so, after airing these concerns, he told me i presented a strong case for the pills. "how should we proceed?"
i had spent the last week thinking how weird it felt to be intending to succeed at a food plan (positive structure) during a vacation where a negative and crazy time was usually allowed to thrive.
i went on to tell how everything encountered recently has been infuriating-- all people who intersect my life allow themselves to appear inconceivably lazy -- and how this repetitive terror and complacency of ineffective people constantly reminds me of my own ambivalence. if planning to use diet pills as both a safety and another catalyst for digestion, i am fueled, and this feels like the time to act.
he wrote out the prescription, but in doing so, needed to strangely adapt his role. since "strober, for the treatment of anorexia" will follow a specific plan, and these diet pills are distributed under the guise of a tool, they require rules. the stipulation is to use the pill for three nights in a row, and then take the fourth night off. AND absolutely no ________ can take place on the night off.
consider how this rule, which was created for me, from someone other than me/anorexia, will unfold? at first, i must doubt the rule. in this case, is
"absolutely no ________ can take place on the night off" even attainable? AND also consider how, a few days from now, i will be enraged to find myself jumping through another person's hoops, yet still creepily perfect in regard to adhering to those leaps.

or, the way mental illness thinks:
you are so fat you can get prescription diet pills! not just
resident doctor #4, but the entire world is lying to you about being severely underweight. what does it matter if anorexia responds to cues of hunger and satiety differently than a non-eating disordered person? if you had less than an ounce of weight available to lose, nobody would entertain the possibility. your doctor did not write this prescription thinking it would get stuck in your shoebox pharmacy next to unopened samples of
zyprexa and abilify.