“Good morning Mr and Mrs er…Wilson,” said Doctor Richard Richardson, glancing down at his appointment list as he spoke.
John Wilson was a slim middle-aged Mr Average. He had an average mundane job working in the local car factory. He owned an average two bedroomed semi in the outskirts of Hinckley, dressed averagely and went to the pub with his mates on a Friday evening for a break and a game of darts, just like his friends. John Wilson would not stand out in a crowd, in fact not even be noticed and he knew it. The only attribute of his that could be considered apart from the average man was that he loved his wife more than his own life, an excessive fondness bordering on uxoriousness. He doted on her and couldn’t imagine a life without her.
This is why he had finally managed to persuade her to join him for an appointment with Doctor Richardson, the Marriage Guidance Councillor.
He muttered a “good morning” in reply while preoccupied with the ludicrous name of Doctor Richard Richardson. What kind of parents would burden their son with such a name?
He glanced over at Janice. She looked nervous. He could see her fingertips trembling as she fiddled with the zip on her handbag. Doctor Richardson noticed also.
“This morning, we will just go through a few preliminaries in order for me to understand the main issues. Everything we discuss will be in the strictest confidence of course. If you have any questions please do not hesitate to ask.”
For the following ninety minutes John and Janice Wilson answered initially basic questions regarding their home life, work, children of which there were none, hobbies etc. The questions then slowly became more pointed, more difficult to clearly answer, such as sexual habits, their affection for each other and even their fantasies. Throughout the session Doctor Richardson remained calm and reassuring, finally standing up with a business-like, “well thank you for your openness. We will see each other at the same time next week, where I will explore the options with you.”
As they left and walked down the corridor the Doctor could hear Janice Wilson complaining in frustration, “I told you that it would all be a waste of time. It was just loads of questions at very high cost. It was no different than with the psychologist that you persuaded me to see last summer.
It all began after Janice became pregnant and the subsequent miscarriage five months later. The trauma and following inability to become pregnant again left her feeling inadequate and a failure to her husband. John tried everything he could to help her and convince her that she was the important part of his life. They could still be happy together even if childless.
As the months drifted into years and it became clear that they would never have children, something changed in Janice’s attitude towards life. John initially assumed it to be a mid-life crisis. She slowly became obsessed with being attractive, jogging every day, reading women’s health magazines and dieting to extreme.
John gradually became concerned that Janice was losing too much weight. He tried to talk over the situation with her on many occasions, but it was hopeless. She seemed to be living a life in akrasia, a state of mind which went against all her better judgement due to her weakened vulnerable situation.
“Don’t be so silly John. Everyone wants to be slim and beautiful. Don’t you think I am beautiful?” she would always end the conversation.
In order not to upset her he would just say insouciantly, “Of course you are.”
That was until she fainted on three consecutive days. The doctor advised her to see a psychologist to discuss her slimming obsession and loss of weight. She refused to go, causing a great row between them.
“John, just a few more pounds and I will have reached my ideal weight. What does the doctor know anyway? His wife is as fat as butter. Of course I would appear thin to him.”
“Darling, just listen to yourself. You are fainting regularly due to lack of energy. You are so thin that your ribs are clearly visible. You need help. This bloody slimming hype in those magazines is disgusting. They should be prosecuted or something.”
“There is nothing wrong with wanting to be attractive.” Janice always seemed to have the last word.
“Now stop being so damned hard on me. I don’t want to be excoriated all the time.”
John was at his wit’s end. He made an appointment with the recommended psychologist and insisted that Janice attends. He promised her everything in order to persuade her to agree. Most importantly that if she wasn’t happy after the first appointment she could cease to continue.
As they entered the practice the receptionist showed them through into the surgery. There sat a twenty stone psychiatrist lady. Janice at least had the decency to keep her thoughts to herself until the session was over, but John could see clearly that she was not going to take instructions or guidance from a fat person. That was the one and only appointment.
After that their relationship began to suffer badly. John had no idea how to help. Rows were regular and he began to look forward increasingly to his Friday evening with his mates at the pub.
He decided that only a final shock treatment could help his ever weakening wife.
“Janice, we need to talk.” He said one evening after dinner.
“No, not again. Not about the same old gripe. I am fine,” she countered.
“No, you are not fine. You are ill and I seem to be unable to help you. This monomania regarding weight loss is driving me crazy, therefore I am moving out. I am leaving. I can’t do this anymore. Kill yourself if you want to, but I am not going to sit by while you do.”
Janice argued, “This is ridiculous. There is nothing wrong with me.”
John took a deep breath and came with his well-rehearsed question. “Ok, let us assume just for a moment that I am wrong and you are in good health, not in need of any help. Let’s assume that I am the one needing help, because as sure as anything I can’t go on like this. Do you then accept that we, as a couple have a problem? “
Janice looked a little puzzled and squinted her eyes as though she was giving the question some thought. “Yes, I suppose we do, but it’s not so bad is it?”
“Janice, I don’t sleep. We haven’t had sex for over three months. We don’t kiss or cuddle any more. Even normal conversation has all but ended. Yes, it is so bad. I really can’t do this anymore”
“But you can’t just leave. We have been together eighteen years.” She burst into tears.
John seized the moment. “Then we must go and see a marriage guidance councillor. We must get help now, or it’s over”
Janice looked through tearful eyes, mascara running down her swollen cheeks and nodded. “Ok,” was all she said.
The second appointment was sombre. Doctor Richardson went through the content of the previous session to convince himself that he had all the correct information.
“The main problem that I can see here is lack of communication. John believes that Janice has a problem of anorexia.” This was the first time that the word had been used. John saw his wife wince at its mention.
“And Janice is convinced that John is overreacting to your weight loss and slimming regime.”
Janice was shifting nervously in her seat. Her skirt rolled up revealing very slender bony thighs. Doctor Richardson tried to take his eyes away from the red sores on her arm and legs. He knew that he would need to move quickly otherwise Mrs Wilson would become critically ill, may even die.
“John, would you mind leaving me alone with your wife for a while. I would like to ask some questions, which she may prefer to answer when you are not here.” He glanced at Janice. “Do you mind, please?”
Once John had left the room, Doctor Richardson stood up, went over to his wooden cabinet and opened a drawer. His hands were trembling. Janice noticed and also became quite nervous.
He took out a framed picture, stroked the glass gently with his thumb and placed the picture upright on his mahogany desk, before continuing.
“What a beautiful picture Doctor Richardson. Is she your daughter or relative?”
“She was someone I once knew,” he said, trying to act as though it was nothing special.
“She really is very beautiful. What is her name?”
“Janine,” he replied, almost too quietly to hear. “Her name was Janine.”
“Ah! Almost the same name as mine, just one letter changed.”
“Yes, quite. Tell me, Mrs Wilson, do you think that she is overweight or underweight, or just right.”
At this question Janice’s defences came rocketing up. “Now look here. I don’t know what you think that you are up to, but there is nothing wrong with me.”
“Please, Mrs Wilson. Please bear with me. Can you answer the question?”
Janice looked carefully at the picture of a slender, well bosomed woman in a sparking green tight-fitting dress. She was almost perfect. She was exactly how Janice dreamed of becoming. ‘Just a few more pounds’.
Still very reluctant to answer Janice replied “who is she?”
“My wife,” came a very solemn reply.
The fact that they were discussing the Doctor’s wife brought more respect into Janice’s voice.
“She is so beautiful. You must be very proud. She is perfect.”
“May I ask how tall you are,” requested the doctor.
“Five feet eight inches. Why?”
“Just one inch taller than my wife,” he responded.
Wearily Doctor Richardson stood again and returned to the drawer. He took out another picture. By now he was visibly shaking.
Before he placed the picture on his desk he said,” Now I will show you a different picture which may shock you. Please trust me.”
As he turned the photograph towards Mrs Wilson she was lost in a strange fascination of what was coming. Her first thought was a picture from a concentration camp during the Second World War, but then quickly realised that it was in colour. A woman was lying on a hospital bed. Her eyes were sunken and bloodshot. The nightgown was loose enough that her ribs could be clearly seen. Her high cheekbones seemed to be trying to burst through the tight skin.
Still staring at the picture, Janice gradually realised that she was looking at the same woman as before. In this picture the smile had been replaced by a tight-lipped grimace. The beautiful dark eyes with those long lashes had been replaced by empty glaring sockets. The tight-fitting green dress had been replaced by a blood stained baggy hospital gown.
Doctor Richardson, took a deep sigh and long inhalation before trying to speak.
“Mrs Wilson, you currently weigh six stones eight pounds. My wife, in the first photograph, weighed a little over eight stones. In the second photograph she only weighed five stones. That was a few days before her death. She was suffering from anorexia nervosa. Even being a doctor myself, I was not able to help her. She was in denial until the very end.”
“Mrs Wilson, I am so sorry to confront you in this way, but I cannot sit by and see this happen again. Your husband loves you so much. He will help you all you need but you must first accept that you have a big problem and a huge mountain to climb in order to recover. Anorexia is a killer, often blamed on the hype of the media, especially for people in a vulnerable situation, as you were after the miscarriage of your baby. Please listen to me and your husband.”
John Wilson knocked on the door. Doctor Richardson had discreetly pressed the buzzer for the receptionist. As he opened the door Janice came to her feet and ran into his arms.
“I am so sorry John. I am so very sorry. I need help. Please help me.”
John took his wife in his arms. She was frail and weak, but alive. He nodded in understanding to Doctor Richardson as they turned to leave.
No more was said on the way out.