A Modern Condition

Albert de Malville sat in his surgery reviewing his notes. He had seen twenty four patients already that day, each scheduled for ten minutes, with five minutes to write up, so he felt an odd sense of triumph to be only an hour behind, even if the cases were blurring together into an endless run of tummy bugs, asthma and sniffles.

Once, they had been allowed to schedule their own patients. Back then, he had allowed thirty minutes for a new patient and fifteen for a repeat visit. Now there were no repeat visits, and government guidelines seemed to suggest that he could take a history, make a diagnosis and prescribe a cure in the time it would previously have taken him to say good morning. Still, who needed rapport or bedside manner. Not when you had targets to hit. Albert sighed and checked his lists. One last patient for the day and then he could go home. He pressed the buzzer to summon them through.

The patient, when they arrived, tapped tentatively on the door and stepped into the room. She was tall, willowy even, and blonde, with pale skin the colour of an unripe peach. Her delicately glossed lips curled into a natural smile, but she seemed distracted, and any impression of lightness was immediately dissipated by her severe, black skirt and suit jacket that spoke of business meetings, clipboards and board reports crafted by the light of a laptop.

“Ah, Miss Stanton. Come in sit down. Tell me what the problem is.”

The lady took the proffered chair, and lowered herself demurely into it.

“Thank you for seeing me doctor. I’ll get straight to the point. I have an addiction.”

Well, thought Albert, so much for small talk. This was one patient where fifteen minutes might just well suffice.

“Okay,” Albert said carefully. “I’m sorry to hear that. But I’m sure working together we can come up with a treatment for your affliction. Can you tell me what you’re addicted to?”

“Food,” said the lady, and smiled. “Now, what do I need to do to wean myself off it. Let’s get this treatment plan started.”

Albert stared for a few moments, unable to comprehend what he had just heard. The lady was not portly, gluttony did not strike him as the problem, but neither did she seem to exhibit any signs of anorexia and he had seen enough cases in recent years to recognise the subtleties. If anything, she seemed well balanced and confident. He wondered if perhaps he had misheard.

“I’m sorry, did you say you have a food addiction?”

“Since birth I’m afraid. I always pretty much accepted it, but recently it’s begun to have a negative impact on my lifestyle. I blame my parents to be honest. They should have nipped it in the bud when they had the chance.”

Albert looked at his patient. She was young, maybe late 20s to early 30s, and moderately attractive. Her eyes were clear, her appearance well groomed, and if she was mad she was doing an excellent job of hiding it. Albert decided to try another tack. Perhaps this was a phobia.

“Do you not like food?”

“It’s delicious. I think that’s part of the problem.”

“You think eating food is a problem?”

“To excess yes. Everything is bad to excess. Television, red wine, sex. The fact that it’s pleasurable makes it bad.” The woman sighed, as if forced to state an obvious conclusion. “It’s habit forming.”

“Habit forming? Madam, if you stopped eating food you’d die.”

“Yes, the withdrawal symptoms are rather severe. That’s why I felt the need to seek professional help.”

With the young lady looking at him so expectantly, Albert found himself beginning to get flustered. He retreated into his notes, tapping purposefully at the keyboard to avoid catching her eye while he marshalled his thoughts. Anorexia was still a possibility. As was some kind of mania. None of it seemed to match any of the text books however. And then there was the confidence, the calm, the air the lady gave off of being somehow…balanced.

“Miss Stanton, can I ask why you are so focused on giving up food. You seem perfectly healthy, an attractive body shape, if I might be so bold as to mention. You haven’t mentioned weight as an issue, so I must ask…what is your concern over eating?”

For a moment, the lady’s calm demeanour wobbled. She looked into the air, past Albert’s left shoulder, as if trying to recall the remnants of a dream.

“I don’t have a concern as such. It’s…well, it takes up so much of my time. I wake up in the morning, I immediately start to think of breakfast. I’ve tried skipping it but by lunchtime, I find the cravings almost overwhelming. I then find myself abandoning whatever I’m working on, striding out almost single-mindedly to find a dealer, Waitrose maybe, or Pret a Manger, and then giving up a further fifteen to twenty minutes while I work my way through my purchases, stuffing them into my face until I can satisfy the craving, all the while knowing that it will maybe keep the demon at bay for a matter of hours, that by dinner time I will have to abandon my projects a third time, this time maybe even cook up for myself, taking up to an hour to prepare the dose, and a further half hour to administer the hit before sinking into a post-prandial bliss that can take out almost the whole evening. An evening which could, should, be taken up with working.”

“You think you should be working rather than eating?”

“Of course.”

“Do you have any hobbies?”

“Apart from eating?”

“Apart from eating.”

“I sleep on occasion.”

“But mainly you spend your time working?”

“Not always. As I’m rather keen to point out, there’s this eating problem I keep mentioning.”

Albert drew in a deep breath. Things were beginning to clarify. While not this precise manifestation, he had come across this problem before.

“Tell me,” he said gently, “do you have an important job?”

“Oh yes,” said the lady, “very important. The office would just fall apart without me.”

“And when was the last time you took a holiday?”

“Oh, I don’t take holidays. There simply isn’t time.”

“What about weekends?”

“Oh, I love weekends.”

Albert looked up, surprised. “Really?”

“Yes, the office is empty then. I can get so much more done.”

Albert sighed. The lady sitting across from him, by every measure, seemed genuine. There was only one recourse. Albert began scribbling incoherently on a notepad. When he had finished, he tore off the prescription and handed to the patient.

“To start immediately,” he added.

Miss Stanton read the note, and her eyes widened.

“You want me to turn off my phone?”

“Yes,” said Albert sternly. “For one weekend to begin with. And not just your phone: your computer, your iPad, even your fax if you have one. I want you to spend one weekend with no email, no texts, no spreadsheets, no Word.”

Miss Stanton looked uncertain. “And this will cure my eating habit?”

“I guarantee,” said Albert carefully, “that after a weekend abstaining from work, your problem will have vanished. You will no longer have to worry about the time sink of eating.”

The patient looked uncertain. Albert had many years of practice, however. His ‘doctor knows best’ face could have won awards. Besides, perhaps in the back of her mind she knew what he was really suggesting: that on return to the office on Monday, she would discover that nothing had broken, nothing was on fire, and the time spent recharging her batteries would make her more efficient, not less.

He watched the young lady leave his office, hoping he was doing the right thing.

Then, Albert turned to his paperwork. It had been a full day, but it was not over yet. First, he had the notes to write up, review, and file in the computer. Then, he had to check his lists for the following day, ensuring that no surprises were waiting, no return visitors with complicated follow ups, no double bookings, no gaps.

At some point, he would go home and, unlike his patient, enjoy a hearty meal of grilled chicken and a light salad. After which, he would probably browse his medical journals, looking out for new techniques or new treatments.

He was just contemplating his evening of relaxation, when he heard a commotion from the space beyond the door of his treatment room. The shouting rose to fever pitch, and then broke off. He heard footsteps approaching and, at the same time, his phone began to ring, the red light indicating an internal line from reception.

“I’m sorry,” crackled the receptionist as he lifted the receiver, “I couldn’t stop him. He insisted.”

And then the door crashed open, and a tall muscular man, dressed in sports gear, strode into the room. He was lithe, his physique was of a runner rather than a rugby player, and he stood panting in shorts and a t-shirt as the door reverberated behind him in its frame.

“Can I help you,” Albert said mildly, knowing it was best to deal with these situations gently.

The man glanced wildly around the room, before fixing a clear eye on Albert.

“Doctor, thank goodness,” he exclaimed. “You’ve got to help me.”

Albert smiled thinly. “I see,” he replied. “And what seems to be the problem.”

“I’m addicted,” said the man. “I’m addicted to oxygen.”