Thursday, February 4, 2010

Revealing The Impostor (Part I)

My general pediatrician friend stopped me in the hallway, in the middle of my self-congratulatory sponsorship announcement to my colleagues, to ask if I remembered the patient Brenda I consulted on last week.

Brenda (again not her real name) was the last patient of an otherwise uninspiring clinic the week prior. She was seeing me for a six month history of amenorrhea. Because she was heavily involved in sports, I remembered her well. "The basketball player. Planning to join crew in the spring. Real skinny girl. Yeah, what about her?" I asked.

My friend had that smirky half smile that smelled trouble. "I just got off the phone with her school principal. One of her teachers caught her purging in the bathroom after lunch today."

"Really?" I offered, somewhat astounded by the news.

"Turns out this wasn't the first time. Some of other kids on the basketball team have reported seeing her doing the same thing when they're out eating after away games."

"But she's such a good kid." I replied, flipping through my internal patient log to review what red flag questions I might have failed to ask that would have pointed me toward anorexia.

"They always are. They always are. They're imposters. They get perfect grades. They have perfect friends. Their parents sees them as perfect kids. And they also learned how to give perfect answers in doctors' offices too . Yet, underneath all that perfection, hides a little girl with a very dark secret and an eating disorder."

I nodded, humbled by own inability to make the right diagnosis.

"Don't feel bad, you weren't the first doctor that she's duped." My friend said, patting me on the shoulder as she spoke.

"But I spent an hour with her last week talking about her periods. AN HOUR! How could I not have seen it coming?"

"You see this?" She said as she holds up a chart the size of a medical textbook for me to see. "She's gone through everybody. Nobody suspected. Nobody knew. I'm got a psychiatrist to call and an eating disorder clinic referral to make so I'll see you later."

She walks away as I gave her a short wave. Luckily, my colleagues have all since gone way too, leaving me to wonder if Brenda had indeed fabricated the details of her life when she gave me her history last week or if I wanted to buy into her perfect life for more personal reasons.

Later that night out on the park roads as I was pounding out 5 sets of Yasso 800s at 2:55 pace with the omnipresent moon my only witness, I thought alot about Brenda and how, as an honor student and a star athlete, she must have felt so much pressure from all her peers, her family and her teachers to do the right thing from an early age. She must have gotten so used to doing the right thing and acting the part that she lost all sense of self she ever had. Maybe I am extrapolating, but her double life seems so sad to me. I can't help wondering if her anorexic symptoms was her body's way of letting go, all along a planned escape, a masked cry for help. Maybe getting caught and being forced to deal with her issues before she got really sick or done something worse IS the best thing that could have happened to her. I just wished I could have seen this coming, I wish I could have known. If I ever have the opportunity in the future, I would ask her if it was all worth it, to play the part of a perfect life but lose your sense of self in the process?
I want to know: What's life like living as an impostor?

(To be continued...)

22 comments:

Jen said...

I work in Youth Ministry... we see this all of the time... and parents, schools, and friends have no idea.

Stick with her though... she needs you!

Jocelyn said...

Wow. That is so crazy. I'm sure anyone with an eating distorter has figured out a way to hide it from everyone, but I understand your shock. Its always so crazy to find out people you think have everything together really don't.

DeAnna said...

I think you are right on with this. At least that's how it was for me. I had it all together on the outside, great grades, involved in all the activities, great friends. It looked perfect. But the pressure was too much. And once something happened that I couldn't handle on my own I was unable to ask for help. Asking for help meant admitting I didn't have it all together. It meant disappointing my parents, who thought I was the perfect kid. That's when my usual girl hangups about body turned into bulemia and then later anorexia. I wish I had a doctor that cared the way you do because an eating disorder is very lonely.

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marathonmaiden said...

what a shocking story. unfortunately it's probably too common. i think that anyone with as big a secret as an eating disorder is good at hiding it especially if that's coupled with the pressure of maintaining a "perfect life".

Julie said...

Hi Lam,
Great post and it takes me back to my own senior high school year. I was a cheerleader and ran track. I was also under so much pressure to be perfect. I ended up wanting to look skinny and beautiful...so I just stopped eating. I lost seven pounds in one week. I went to a basketball game and ended up fainting. I never went and talked to anyone about it. A light came on in my head after I fainted! I was like "What and the hell am I doing, this is so stupid!" Thankfully that was my last attempt to starve myself for the perfect image! Todays teenage girls have so much stress and are under so much pressure. I see it with my own daughter and I am doing my best to make sure she knows that I think she is beautiful and loved! You will handle this one like a pro...I have faith in you Lam:) I hope that you have a wonderful day!

Sharon said...

I've only read a few of your posts, but it's evident that you're a great, caring doctor. Best of luck with this case.

pen said...

Great post. And don't beat yourself up about it...she sounds a lot like I was in high school and I lied and lied and lied my way through doctors appointments. I knew exactly what to say and how to act (and to drink lots and lots of water before a weigh in...) It really took someone (my coach in my case) who saw me day in and day out to crack me...

But, honestly, what is important is that you care about what happens to her. I wish that I had more people like that in my life back then...

Stephanie Nichole said...

That's a crazy story and I was all around in awe... but-- is it bad that when I read "2:55 yasso" I damn near jumped out of my chair. That's awesome... I have a hard time doing 3:20's!

runningcommentaries said...

Great post. Eating disorders are really hard to track down and diagnose as you know-- I definitely had a period of disordered eating and NO ONE knew. Not my roommates, not my family-- you're right, it's all about hte pressure to be perfect.

I am so glad that stories like this still have the ability to cause you to think-- means you haven't stopped caring!

Ms. V. said...

Excellent post. People with ED are the BEST at hiding who they are...It's a family dysfunction, so look to the mother...this will give you real answers.

There are many diagnostic tests that don't look like ED tests...so you too (or the test) can be an *imposter*.

It's most excelletn

Jenn said...

I was Brenda for most of my high school and part of my college career. I was a tennis player, dancer, cheerleader, pageant girl who got straight As and was never in trouble. Even though I was 5'9" & weight 115 pounds, I thought I was obese. I turned to bulemia and then later anorexia when I didn't feel like I was loosing enough weight.

It was a scary world inside my head. I was fortunate to find a physician that cared enough to catch the signs and get me some help. I'll forever be greateful for him, as I'm sure Brenda will be to you and the others that help her on her path to recovery.

lindsay said...

i think a lot of people have things they hide from everyone else in their life... some things are worse than others of course, but still it happens. you just don't want to "be different" or don't know how to convey your true self/feelings.

don't feel too bad for missing it - at least it surfaced! i hope you can find a way to break through and truly communicate with her and help her.

Anne said...

I always appreciate your posts and don't always comment, but as a clinical psychologist, I just need to tell you that these girls really do know how to make us all believe that they are doing great. Getting caught is almost always the only way for them to get the help they need. You sound like an amazingly caring doctor...

carpeviam said...

You must be an expert on periods. Anyone who talks about them for an hour MUST be an expert. At least in my book. Yeah, yeah, it's your job. I KNOW.

And, damn, Yasso's at 2:55; nicely done.

Scott Brown said...

Keep up the good work Lam. We/people need eachother. Now do something for yourself.

Come to Japan and run a fast race. I promise to pace you to whatever time you want.

http://samurairunning.com

Betsy said...

That poor girl. Thank goodness her teacher caught her so she can get some help.

J said...

It truly is amazing how people can hide eating disorders. I played with two girls who had disorders and I never even knew until they came out and told me. Girl athletes are so much likelier to have eating disorders which I really didn't know. I think all girls in athletics have dealt with eating problems and body image issues. There sometimes is just too much pressure put on to be faster and better and skinner. i think some girls think that by being skinner they can be faster and better.

Julie said...

Hi Lam,
I just wanted to let you know that I rented the entire first season of Glee. I had seen the previews on TV but with our crazy schedule there simply is not enough time for TV. I remember that you mentioned it in one of your posts and thought, well if Lam liked it I probably will too! News flash....I loved it and I am addicted:) What a great show! My daughter loves it and my husband thought it was good too!! I really enjoyed the music productions, I loved the humor and the drama:) Thanks for the heads up!! I hope that you had a great weekend:)

Irish Cream said...

Lam, please do not question yourself as a result of this. The fact that you wrote this post proves how wonderful and caring a doc you really are.

As everyone else said, these kids are absolute pros at hiding this stuff. I've never really talked about this on my blog, but I was Brenda in high school and throughout much of college. I don't think ANYONE--not even my parents--knew (or at least weren't willing to admit) how sick I really was until I finally came clean to my basketball coach. Confessing I had an issue was by far the most difficult thing I've done in my life. So please do not feel discouraged that you "missed" the diagnosis. You are an incredible doctor . . . no doubt in my mind.

And hey, not so shabby with those Yassos either, are ya? :)

Julie said...

Ummm Lam, did you just call me an older folk? Don't you make me come to New York and prove you wrong!!! I am only a few years older than you...right??? Ha ha, I got a good laugh out of that one:) I hope your week goes well. Keep smiling:)

Mile Posts by Dorothy Beal said...

Thanks for sharing this with us....definately gave me alot of food for thought for today. It's so sad that SKINNY is the perfect in our society. And for what? Honestly my husband would be happy if I gained some weight! I think it's other women/girls that make us feel that we need to strive for this crazy ideal, which isn't so ideal in my eyes. I'm sure this girl was not purposesly trying to decieve you...she might not even realize she has a problem.....

 
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