Can a seventeen year old patient be allowed to die?
Can a seventeen year old Anorexia Nervosa patient be allowed to die?
Are we not supposed to save lives?
Could doctors be held to ransom? By?
Here is a Play: Let Her Die!
Father used to run a business security agency specialising in industrial counter espionage. Or was it espionage? I cannot be sure.
Too often there is this bizarre desire by some parents to make sure that if they cannot do it, no one else should either. We need to recognise it early enough. We are doomed otherwise, and so is the patient.
The patient: Nicola
It was really quite painful to sit there and talk to someone who looked worse than the worst they showed from Auswitz. Why could Nicola not realise that if she wanted any man to like her she would need to look a lot better, which involved doubling her weight for starters.
This was a family given up even by Dr Hillman, my most fervent supporter of family therapy. Father used to run a business security agency specialising in industrial counter espionage. Or was it espionage? I cannot be sure.
I did not go round looking like a hippie or pretending that I liked the music the teenagers listened to. I told them to me it was trash. I did not pierce my ear or have a tattoo. I certainly did not wear trainers to work.
In short, you do not have to gain respect by becoming like them or worse, by pretending that you are like them.
I spent one session with them and agreed with Dr Hillman. They were good. We looked like a bunch of amateurs dealing with professionals. None of the family therapy tricks work, Minuchin or Haley.
The NHS Trust & GMC
To me, suspension on full pay is a risk every doctor takes nowadays, as the basis is no longer limited to bad practice. It is no longer a reflection on whether you are good or bad clinically. Many psychiatrists are no longer prepared to use techniques that might upset their patients or parents of their patients.
The Main Action:
A family meeting was called and it lasted only a few minutes.
I was in top form.
“Nicola has been eating but after two months has not put on any weight. I cannot see any reason for her to continue to stay here. She might as well do the eating at home. She can then sort out for herself why she is not gaining weight without the pressure from us.”
I tried to put it in the calmest way possible.
“You mean you will let her die?” Father sounded a bit annoyed.
With that father got up and left the room without saying another word.
“What do I do now? You have upset him!” said mother.
Good, something got to him at last, but I did not say it.
Nicola gave a wry smile to me as if to say, “You found me out.”
She turned to mum, “Let’s pack and leave this dump.”
We all kept still.
Six months later, one of the nurses bumped into Nicola in a nearby town. She was kicked out by father and moved in with another ex-anorectic. She was with a boy friend. More importantly she was wearing a very sexy dress to show off her then very good figure.
She did not die.
Based on an extract from my book The Cockroach Catcher