The Hunger Artist

Michael Krasnow was one of the few male anorexics to leave behind a detailed account of his life. And his reasons for dying.

In it he lists some of the habits that helped make him an anorexic's anorexic, a king of starvation. Like most anorexics he had a drive to excel at fasting, to be the thinnest anorexic of all. What separated Krasnow from many of the others was that he truly had the strength of will to reach unbelievably low weights, and he had the constitution to function at them. These are some of the habits that set him apart, that made him the most devout anorexic his doctors had ever seen:

1.He never drank a drop of water in the fourteen years he was anorexic because he thought it would make it too easy to go without food if he was gorging himself on water. To him, drinking water would nullify his power of will.

2.He refused to swallow his own saliva, opting instead to carry a cup or paper towel with him everywhere he went to spit it into. He even kept something to spit into at his bedside while he rested.

3.While most anorexics eat low-calorie foods, Krasnow consumed small portions of fattening foods like peanut butter, for the same reason he didn't drink water -- to show himself that he was a first-rate anorexic.

His book wasn't a self-published vanity; Krasnow did more than just write about himself. It is essentially an indictment of the eating disorders treatment industry, a conviction of the doctors and psychiatrists he believed failed him miserably. He chronicles his journey from a confused boy "willing to do anything" a doctor or psychiatrist told him to do, to a young man hell-bent on starving himself to death and ultimately willing to fight bloody battles with doctors who tried to force him to eat. His story sheds light on the individual and systemic failures in the medical treatment of eating disorders, from the lack of comprehensive help available for most male anorexics, to the fact that some of the best specialists won't see the most dire patients, to the domineering methods of many psychiatrists that can backfire horrifically.

While doctors failed to save Krasnow, those close to him wonder if anything ever really could have helped him. Theodore E. Spielberg, one of the few doctors who ever gained Krasnow's respect, said the challenge in treating Krasnow was more than trying to get him to eat -- it was trying to get him to feel. He describes Krasnow's life condition as "total anhedonia," or the complete shutdown of anything that could cause him joy.

"I have never seen that in any other patient," Spielberg said. "He lived like a monk. He's an extraordinary case. I put the anorexia under the anhedonia. He just had no emotions, no feelings."

A true nothing man, a lifeless void, a walking skeleton, his face little more than a thin casing around his skull, the eyes framed in grotesquely visible sockets sunken deep behind sharp-jutting cheekbones. His massive-looking chin chiseled upward into his angular jawbone, also eerily prominent. His bony nose stuck out like a beak. Each of his ribs could be counted. His tiny shoulders were but a crux of pointy bones. His stomach sank down into his hip bones, the girdle under his torso like a huge salad bowl. His buttocks didn't exist.

He was so emaciated, it seemed he occupied a separate plane of existence, one teetering between life and death. He might fall to either side, depending on which way the wind blew.

Spielberg said he grew emotionally attached to Krasnow only through his own projection of emotions onto him, through bringing an imaginary light to those dead eyes. He wonders if anything could have been done to prevent those eyes -- once bright with boyhood -- from dying so many years before Krasnow did.

He called his own childhood typical. Krasnow was born in Rochester, New York, on April 27, 1969, and raised in Framingham, the son of a salesman father and a homemaker mother.

"I enjoyed being with my friends and family, loved to read and play sports, had a hobby (comic books) and a newspaper route, watched TV, idolized Larry Bird and Boston Celtics, and had no worries," he wrote.

Mrs. Krasnow fondly remembers her son, dripping from sweat after running and playing, wrapping his wet, affectionate arms around her. She also remembers a house full of friends playing and laughing. The pictures in her many family albums show a happy, healthy boy with a face dominated by a big smile, the eyes gleaming with pure joy.

Only one childhood trait seemed unusual to Michael as he looked back at his life: "I felt fat from as early as age eleven... When I speak of feeling fat, what I mean is that when I look down at my stomach, I see it as sticking out or being bloated."

Though he was already rail-thin, "sucking in my gut became a way of life." It may or may not have stunted his earliest attempts to form relationships with girls.

I occasionally danced with a girl my age, but not too often. Not that I didn't want to, I just lacked confidence around girls -- was too shy and too scared to ask. Because of the shyness, the fear, and the embarrassment caused by having someone's hands around my waist, I just decided not to dance.

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