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 addition to its spiritual uses, self-starvation was a form of a freak-show brand of entertainment at the turn of the Twentieth Century. Fasting men had shows where they'd sit on a stage and... well, not eat, sometimes for as many as 40 days. One of the most famous of these men was Claude Seurat, a Frenchman who allegedly weighed 72 pounds, about what Krasnow weighed during his final years, but Krasnow was three inches taller.

In 1922 Franz Kafka wrote a story called "A Hunger Artist," about a fasting performer who starves himself to death in a cage at a circus. The character's last words -- which have prompted some historical scholars to posit that Kafka, who was notedly thin and obsessed with food himself, was really writing about anorexia: "You shouldn't admire [my fasting].... Because I have to fast, I can't help it."

In 1860 a French doctor named Louis-Victor Marce published a tract on patients who refused to eat. "If the food refusal continues, the physician should employ intimidation and even force," he wrote, adding that, when necessary, the mouth should be pried opened violently.

If Krasnow's experiences are any indication, the philosophy behind the treatment of anorexics hasn't essentially changed much since then. Psychiatrists and medical doctors often make demands on their patients to reach certain weights in a certain number of days, using forced feedings as a final resort. Krasnow complains in his book that doctors seemed more interested in breaking him than in fixing him.

In his very first stay in a psychiatric ward in July 1983, he was told, after those initial eight days of fasting, that either he eat 500 calories, or he'd be sent to a hospital for a forced feeding. "I ate that morning. I really tried," he wrote. But he managed to ingest only 400 calories and was shipped to the hospital. "To this day, I don't know why [the doctor] was not satisfied. Perhaps he wanted to immediately impress upon me that he was in control."

That first fast, that first skirmish with doctors, gave young Krasnow a sense of control, too: "I had the willpower to diet. I was the all-powerful Michael."

When a doctor first told him he had symptoms of anorexia nervosa, "I automatically labeled myself an anorexic," he wrote. "It's hard to explain, but it almost seemed 'glamorous' to me... I was special. The anorexia gave me an identity."

Though Krasnow embraced his disorder, he also wrote that he wanted to get better and believed doctors to be "miracle workers." He began seeing a psychiatrist who, in his book, is referred to as "Dr. P." (The publishing house refused to publish the doctor's name, and Michael's mother refused to name him, fearing Dr. P would sue.) The mysterious Dr. P had an opportunity to work with Krasnow while he was still young and malleable.

Dr. P, who is the star of a chapter titled "The Silent Psychiatrist," was chronically late, and once he arrived, the real insanity began:

A typical session would start with each of us saying hello. Then we would sit down and look at each other. After doing this for 50 minutes, he would tell me that my time was up, and I would leave. This is the truth. I'm serious. He was getting paid around 60 dollars per hour, and we were staring at each other. That's all. No talking.

His mother still fumes at that chapter, which came as a revelation to her. Michael complained at the time, but she and her husband were told by other doctors that the psychiatrist had a wonderful reputation. She was afraid if she took Dr. P out of the picture, her son might get even worse. "I didn't know where else to go." She now knows it was a mistake to keep him going to Dr. P for nearly three years, after which, Krasnow wrote, his "depression increased to the point where it could not get any worse. It never let up. I just wanted to die."

Compounding this failure was the fact that anorexia in males is an ignored or hidden malady, while the mainstream media trumpets the disorder as a female problem. Males do comprise only a tiny percentage of anorexics, but experts in the field universally believe many more male anorexics are out there, yet to be diagnosed. For diagnosed males, there are only a few residential treatment centers in the country for them, none in Palm Beach, Miami-Dade, or Broward counties. The Renfrew, Fort Lauderdale's only residential treatment center for those suffering with eating disorders, is exclusively for females, though it recently began treating males on an outpatient basis.

Krasnow managed to maintain a weight of between 110 to 120 pounds through the end of high school, terribly thin but not life-threateningly so. It was his father's life that was threatened: During Krasnow's senior year, his father was diagnosed with Lou Gehrig's disease, an incurable and fatal form of muscular dystrophy. The grim truth was that his father would die, maybe in a year, maybe in a decade.

When Michael started commuting from his parents' house to a nearby college in the fall of 1987, he dropped breakfast from his diet, causing his weight to plummet to 96 pounds. His parents committed him to the psychiatric ward at Emerson Hospital in Concord, Massachusetts. He was told he could leave if he got his weight back up to 100 pounds. Instead he decided to kill himself. "Now I was (and still am) too much of a coward to shoot or stab myself or anything like that. The only way I would commit suicide is to fast and starve myself to death," he wrote.

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