Okay Aaeth, here is my end of the deal for you getting the rest of Shinigami’s Song written and posted. ^_^ This chapter is dedicated to you for motivating me with such a wonderful story!

Title: The Price of Perfection 4/?
Author: Syn (mistress_syn@hotmail.com)
Archive: GW Addiction http://www.geocities.com/fenris_wolf0/ (Thanks Tyr! ^_^ )
Category: Angst
Rating: ?
Pairings: 1x2, 3x4 implied
Warnings: angst, shounen-ai
Disclaimer: Not mine. Don’t sue.
Author’s notes: I would like to thank Diane for betaing this part for me. She has been of great help with this story as has been Bonne. Thanks. I would also like to thank everyone who sent their condolences and their appreciation of my story. I really appreciate it! ^_^
Sorry for the cross posting.

NOTE: I am going by info that my sister, a nurse out in CA, and online medical info, and some of my own personal experiences with bulimia/anorexia to go by for the signs that are described in this part. All the online sources are listed at the end of this in the footnotes. I apologize if there are any discrepancies. Please don’t flame me on them, rather be constructive of them. I am trying my best here. Thanks.

/……./ = thoughts
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Part 4
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(Heero’s POV)

God I feel like I was hit by a freight train. I slowly open my eyes and have to shield them with my arm from the glare of the..florescent lights? Where am I? Without sitting up I take in my surroundings. I am sprawled out across a few chairs, which is none too comfortable, in a waiting room of sorts. Wait. Waiting room? I start to get up when Wufei steps into view.

“Heero, you’re awake.” He says as he reaches out to help me sit up. “They are taking Duo..” Duo?

“DUO?! Is he okay?” I try to say calmly but the rush of emotions takes over and I clutch my hand to my chest. He can’t die on me now or ever. I won’t let him. I love him. I promised to protect him.

“Is he okay?” Hearing an echo, I looked up to see Sally standing there. “I have to go check out Duo and see if they have started the blood workup.” She said and I merely nodded not trusting my voice at the moment and watch her jog off to the back examination rooms.

I turned back to Wufei to see if he had any information as to why I was also out, but my body answered for me as I began to yawn. “What happened?’ I asked him as I glance back in the direction that Sally ran off.

Wufei sat down next to me and began telling me all that he knew so far, which sadly wasn’t much. “You fell asleep in the car on the way over and I didn’t want to wake you so I got one of the orderlies to carry you in. You haven’t missed much as we got here only a few moments ago and they just took Duo back to run some tests. Duo did wake for a moment in the car, but then fell back asleep. I called Quatre and Trowa, they said that they would contact the docs about the situation and then get over here. That is all so far.” He looked at me, concern openly written across his face and gave me a hug. I melted into it feeling nothing left of the adrenaline that had been keeping me going. My emotions came to the forefront. I let them, and cried.

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(Sally’s POV)

Entering the area where they had brought Duo I audibly gasped at the sight in front of me. His face seemed sunken, dark bruise like marks under his eyes, his lips pale in the artificial light. They had removed his shirt exposing his chest, the skin taught against the visibly showing ribs. He looked like a walking corpse. How could the other’s, especially Heero, not notice such a drastic change in appearance? There was an IV already in him that was reintroducing some much-needed electrolytes/potassium back into his system.

I approached him slowly, trying to convince myself that this is all but a nightmare. I see him slightly stir and watch as his eyes slowly open. They barely focus and then close again. He seems overly exhausted, nothing surprising knowing what they are, but still, there are too many other signs for this to be merely due to exhaustion. One of the residents working the ER came in cutting off my train of thought.

“Dr. Po?” He asked as he strolled in handing me a chart. “Here are the results from the tests you asked us to perform. We double checked them when one of the tests came back abnormal.”

“What were the results?” I looked from him back to the fey creature in the bed and back confused, yet not that surprised.

“There was a very noticeable drop in his electrolyte count and so we already put him on an IV for that. The abnormality showed up in the hormone tests. There is a marked elevation of the hormone vasopressin [0]. I checked up on what could possibly cause this, and found that this occurs in patients suffering from an OCD (obsessive-compulsive disorder), anorexia, or bulimia. The last two would correlate with the marked drop in his level of electrolytes. Until he wakes fully, there is nothing else we can do for him.” He said trying to be as helpful as possible. I could tell that this affected him. He was still young, and still just getting used to all the horrible things one sees while working the ER. This is not that bad compared to a lot that one can see.

“Thank you.” I say giving him a reassuring smile, and he leaves. There is one more thing that I want to check on before I go talk with the others. Wondering over to Duo’s bedside, I gently pull his lips open to expose his teeth. Oh Duo. Why? This is going to be harder to handle than the usual gunshot wound. This is going to take a lot more. Sighing, I make my way out of the room. I guess I had better go talk to the others and see what they can tell me. They are not going to like what I have to say.

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Quatre and Trowa arrived at the same time Sally came back out to talk to them. There was silence as they surrounded her for information.

“So what is the diagnosis?” Wufei asked, still slightly holding up Heero who seemed to have not recuperated from his earlier emotional breakdown.

“Well there were two things we found. One, an extremely low electrolyte count and have put him on an IV for that.” She took a breather, watching carefully to see what effect her information is having on them. “Two, I do have a few questions I would like you all the answer as best you can before discussing this. Why don’t we continue this conversation in the conference room? Okay?” She said giving them a reassuring smile and led them away.

They all sat down around the table and waited for Sally to begin. “Have any of you noticed any changes in his eating habits?” She looked to Heero first, but is was Quatre who answered.

“They haven’t seemed to change that much at least from what I can tell. He still stuffs himself on a regular basis.” He said with a sad smirk. He thought he had an idea of what she was getting at and verbalized it. “Is his condition typical of people with eating disorders?” Quatre’s question caused a stir in the room.

“He couldn’t have an eating disorder.” Heero argued. “He eats enough food to feed a small army. There has to something else.” He looked at the others then to Sally.

“Well, actually Quatre is correct.” She said waiting for the outburst from Heero, but none came. Heero was looking at her in confusion. “Before I decided that this is indeed true, I would like to know a few other things. Does he binge eat? Yet seem to never gain weight?” They all nodded slightly, wishing it weren’t so. “Does he seem to ‘disappear’ right after eating? Sometimes reappearing having showered, or with his teeth brushed or even keeping from close contact where his breath can be smelt?”

Heero looked like he was in hell. He remembered so many times where Duo would wander off to the bathroom, claiming he needed to brush his teeth. ’Don’t want to get anymore cavities!’ He would say. Then there were the times when he couldn’t brush his teeth and would yet ‘disappear’ only to find something to drink and/or not get close for a while. “Yes.” He replied weakly and noticed the others all slightly nod in agreement.

“That is what I was afraid of. The second finding was an elevated level of the hormone vasopressin. I also noticed that many of his teeth are ragged.”

“But he didn’t have dental care as a youth, so that could be that explanation. And what is this hormone you are talking about?” Quatre interrupted. He didn’t want to believe it either and couldn’t fathom what could have caused the fun loving boy to resort to this.

“The raggedness is not due to improper dental care. It is from too much exposure to gastric acids. Vasopressin is a hormone normally released in response to physical and possibly emotional stress, though it may contribute to the obsessive behavior seen in some patients with eating disorders [0]. Our best guess right now is that he is suffering from bulimia, but until he fully awakens, we can’t know for certain.” She said not looking at any of them, knowing that she was feeling very emotional about the situation. Thankfully Duo had regained consciousness and it seemed to be only a fainting spell. Anything worse could lead to brain damage and possible death. That, she decided, was not an option.

“So you are telling us he is suffering from bulimia? What exactly does that entail?” Trowa finally asked.

Gathering her strength, she met his gaze and answered his question. “Bulimia nervosa is characterized by binge-eating and inappropriate methods of weight control accompanied by excessive shape and weight concerns. A binge is defined as an episode in which one eats a much larger amount of food than most people would in a similar situation and experiences a sense of loss of control. There are two types of bulimia nervosa: purging and nonpurging. Individuals with purging bulimia nervosa self-induce vomiting or abuse laxatives, diuretics or enemas to counteract the effects of binge eating; Individuals with nonpurging type fast or exercise excessively following episodes of binge eating [1].” Saying all that she looked at the others to see their response.

“But isn’t it true that in cases of this the person suffering from it usually maintains a typically average weight? Duo was looking pretty thin.” Heero said, surprising the others at his knowledge.

“That is correct, that is why we are also guessing that he may suffer from Anorexia nervosa too. That could only explain the dramatic weight loss.” Not wanting to upset them any more than necessary, she prepared for the responses to her next question. “Did any of you notice the change in weight and wonder about it at an earlier time?” All eyes turned to Heero on that one.

“I noticed a bit of a change a few months ago, but due to missions, I have had little exposure to him up to the last couple weeks. I didn’t think anything of it when I returned, thinking it was just due to the arduous tasks of the missions. There are times where we are unable to get all the food we need on long term missions that may go awry.” He was amazed at how neutral his voice was considering his insides were threatening to tear him apart. He had to use all his strength to keep from wallowing in his own guilt and misery of the situation.

“What about the rest of you?” She added looking at each one of them in the eye, noticing the guilt plainly shown on their faces.

“Shortly after Heero left on his mission, Wufei was called off for a solo mission, then Duo left for a while on his own. He only returned a few weeks before Heero, and actually kept himself busy. We rarely saw him unless he was trying to get us to go out with him or to just hang out. I noticed a change in his appearance, but when I asked him about it he dismissed it as just one of the side effects of a long hard mission.” Quatre shook his head solemnly. “I should have gone with my emotions and pursued him on the issue, but he stood his ground on it, so I dropped the issue.” Looking over at Heero, “I am sorry I didn’t follow my feelings on this.”

Heero merely nodded in understanding. It was really only chance that brought them all together. They were trained to work independently, an aspect of all their personalities that would allow such a situation to occur. They all liked our space at times, and that is one thing they all tried to respect. Too bad this time it could have killed a friend and lover. That wasn’t tolerable.

“Is there anything else you can tell me?” Getting no response, Sally concluded the conference. “We will talk about possible treatments and find out the full details from Duo once he wakes. In the meantime, you should all get some rest. I will contact you when he is conscious.” With that said she exited the room leaving them all deep in their thoughts.

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Notes: These are the sites that I got the information used at those points in the story.

[0] - http://www.mentalhealth.com/book/p45-eat1.html#Head_6
National Institute of Mental Health:1993
This is a great site full of information and links.
[1] - http://www.nyspi.cpmc.columbia.edu/nyspi/depts/psypharm/eating~1/bulimia.htm
Created by Jerald Block, MD
Copyright © 1996 [New York State Psychiatric Institute]. All rights reserved.
Revised: September 06, 1996.
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