By Clara Roberts
St. Joseph Medical Center for Eating Disorders Admission Center March 21, 2004
My mom sits with me in a waiting room at St. Joseph’s Medical Center around 8:30a.m. I tap my feet to a manic beat and cry on and off because, at 5’4” and seventy-eight pounds; I’m too fat to be hospitalized. In the waiting room I pluck at my chair’s red and fuzzy cushion, then circumnavigate the wooden table filled with piles of worn wellness magazines. I want to burn calories, as many calories as I can manage in my wasted state before I become hostage to the Eating Disorders unit.
My mom pleads with my doctor to find a way to admit me into the intensive program. Now the doctor, who advised inpatient hospitalization for me in the first place two months ago, responds that it might be another week before my family’s inflexible insurance company agrees to cover the stay. My mom does not think I’ll live that long.
Even after my mom’s desperate request, I ask questions about my appearance. “Am I thin? Do I weigh too much? Can’t I wait a few more days so I can lose some more weight? Am I thin enough? Can we please go back home? I changed my mind – I really don’t want to go!”
I turned fourteen years old in February, and my body is already degenerating into an elderly woman’s. My hair falls out when I run my fingers through it, and I have the beginning stages of osteoporosis. I wish I was thirteen again. Life was better. Days thrived. My negative thoughts did not chain me. When a person gets this sick, she is so enveloped by the compulsive ritualistic actions of the eating disorder’s commands that there’s no end to the madness. I name the anorexia, “Ana,” a friend who never leaves my side. There comes a certain point in the starvation process when the victim starts to lose her mind. I am at that point. Deep down, I understand that I am not well and need to go inpatient, but Ana is making her last threatening orders: if I go into treatment I will have to eat, gain all the weight back that I worked my ass off (literally) to lose, and that is the last thing she wants to happen; surrendering to a treatment program will mean I have no control. I will lose my main reason to wake up in the morning—my mission, my identity as the sick skinny girl who has an obscene amount of willpower.
Around noon, our rigid insurance company finally agrees to admit me. Mom escorts me from the stuffy waiting room – where we both have been panicking for the past four hours – to the cafeteria near the Center for Eating Disorders. We have to wait until my room on the unit is ready. She watches me mash around two tablespoons of cottage cheese, then cross my arms, looking away from the plate in disgust.
“Why are you making me eat now? This isn’t right. I am about to be force fed!” I whine.
“Fine, have it your way. I can’t wait until they make you eat,” my mom snaps. I am shivering even in my heavy winter coat. My mom, who almost never cries, starts sobbing as we walk out of the cafeteria, toward the unit. She cannot get over the fact that she is putting her daughter away. I am a broken little girl who has been brainwashed by some nefarious force inside of her mind. But I am my own victim. I choose to wilt away.
A hefty nurse, mostly likely around two-hundred pounds, unlocks the door to the unit and takes me to a small white examination room with a scale and various contraptions that take my vital signs. She needs to document whether I am sick enough to warrant admission to the Intensive Care Unit, which is in a separate part of the clinic. She tells my mom to wait in the hallway as she scribbles numbers onto a chart. She shares some of the results: my heart rate is a healthy sixty bpm (beats per minute) while I am sitting, but upon standing the numbers leap more than double that number. This means I am severely dehydrated, and I cannot stand up without becoming lightheaded. An average anorexic body mass index is 17.5; mine is an unsettling 13.7.
The piercing fluorescent lights hurt my eyes and head. I want my dream world of numbers- on-the-scale-falling-downward and the caloric restriction to stay with me. I cannot comprehend that my body is deteriorating. I do not see that this oh-so-successful-diet is a regimen of death.
My mind dwells in a fogged-up jar the first few hours I am on the unit. I have fallen into a parallel universe where sterility and insanity tries to mimic a typical home. The Yeah Yeah Yeah’s song “Maps” is on a steady loop in my head. I can picture the singer, Sharon O, in the music video on the verge of tears singing, “wait/they don’t love you like I love you.”
Ana is the one I love. She motivates me to get out of bed in the morning. I wish everyone would let me be with my eating disorder – spend the remainder of my life with it – and leave me alone for good. No one would fight with me during meals, and I would not have to go to a hospital. I admit, life these days is difficult and narrow. All I am able to think about are food and weight. I am intoxicated by my best friend. And she who wants me dead.
Ana wants me to be conceited, to stare at myself whenever I can catch a glimpse of my reflection. Yet, no matter how diligently I follow her demands, she still finds me ugly. Ana reminds me that my work will, eventually, payoff:
“Everyone else in yourlife is fat compared to you. I promise to make you the perfect weight, to the point where you can dance between the raindrops.”
My family will have to bury me before I reach that weight.
Seven hours later, I arrive on the unit. I am one of twenty patients. Jill is the first person to approach me. I cling to my mom and squeeze her cold hand, latching eyes with this girl. Her face is angular and her eyes are blue and starved of light. She wears a navy blue Mount Hebron High School sweatshirt, so she is a few years older than I am. Her sandy-blonde hair, in a tight ponytail, is strained and pulled back from her scalp. The hair style seems headache-inducing.
“I’m Jillian Vanderlind, but you can call me Jill for short. You’re going to be okay,” she says.
My mom tenses at the sight of her because she thinks Jill is freaky. She sees Jill as a preview of my life if I stay sick—a life of missed adolescence, of withering away.
“Thank you,” I murmur, looking down at the carpeted floor.
“Everything is going to be okay.”
Even through my teary blood-shot eyes, I feel a little safer when she repeats those words. Yet she wears her baggy jogging outfit as though there’s a chance she could slip outside into the freezing cold to do rapid laps around the hospital. Later that night, my roommate, Whitney, tells me that Jill has been on the ward for two weeks and has barely gained any weight, despite the program’s rule of underweight patients needing to gain .2 kilograms per day (almost half a pound).
V “I admit that I sometimes break the rules here. I don’t recommend you follow my lead,” Jill says a few minutes after my mom leaves. My mom is able to visit again that night at 7:00 o’clock. but only if I eat all of my dinner at 5 o’clock.
“What happens if you break the rules or don’t gain weight?” I ask. I hope that maybe this place will not punish me too harshly if I don’t gain weight, or if they catch me hiding food inside my pockets or shoes.
“You lose all privileges. You aren’t allowed to take an eight-minute shower because it burns calories. The staff calls it “caloric conservation.” If you don’t make weight for three days in a row, on the third day they do let you shower.”
“Taking away shower privileges sounds pretty degrading,” I say. Although I hadn’t even thought of taking a shower as a form of burning calories.
“It is. I’m convinced that the people who run this program want to strip us of our dignity. You also can’t have visitors or make phone calls if you don’t make weight. You and your mom seem really close. It would be a shame if you misbehave and can’t have contact with her.”
“Are you close with your parents?”
“No. I live in my older sister’s shadow.”
Jill never gets visitors and gets scolded by the nurses when she attempts to sneak phone calls. She does not gain weight because she exercises in her bedroom at night during the fifteen minute gaps when a nurse is not peeking into the bedroom. Be it jumping jacks, jogging in place, or rotating her arms, she finds ways to burn off those extra calories. My heart sinks at the thought of getting into trouble and not having any contact with my mom, my confidante who is supposed to see me every day, who is supposed to be there to comfort and protect me.
I wish she did not have this power to tug at my emotions or else I would not be afraid to break the rules. Yet, my mom is not what my doctor would call an “ideal” weight for her age and height. She is 5’4” and one-hundred and ten pounds, about ten to fifteen pounds below what most doctors would deem healthy. I want to smack her for making me gain weight while she gets to maintain her low number. I want to stay thin. Getting to a higher weight than hers would be the death of me.
I get a brisk tour the first day of the dining area, the two therapy rooms, and my room. My luggage is ransacked by a nurse. She takes away my candles and incense because they are a safety hazard. She even rolls her eyes at me, saying I am not going to use “all of this stuff.” I have so many clothes and belongings because I have no idea how long I will be staying here. A nurse also confiscates the R-rated movies I thought I was allowed to bring because all of the best movies are R-rated. On my single bed I drape a pink, knitted blanket on top of the hospital comforters provided by the hospital, which are not thick enough to warm me. All of my clothes are folded and hung in the wooden armoire next to the tiny bed. I put my CD player, albums, and books into a neat pile on the nightstand. I notice that the room does not have a mirror, only a large framed picture on the wall where I can just barely see my reflection. It is only a clichéd picture of a rose, and the frame is built into the wall so patients cannot take it down and smash it.
While the nurse looks through my belongings, I sit and lay out some of my books. The bed is hard and uncomfortable, but I will eventually to be able to fall into a deep sleep with a stomach full of food and supplements. Later during my stay I will occasionally get night-sweats, which my nutritionist says is “normal” because my body is apparently starting to function again. My metabolism speeding up, a blessing in disguise. The one window in my room looks out into a garden and a parking lot. Since it is spring, the flowers are starting to flourish and blossom to life as though the blistering winter never happened.
On the right side of the room is an identical single bed and armoire where my roommate is already settled. Her name is Whitney, and I learn that is her fourth day. She makes sure to tell me her current stats: 5’2″ and one-hundred and one pounds, but she was ninety-seven pounds when she first was admitted. She says she lost thirty pounds in less than three months. Momentarily, I am glad inside because Ana is proud of how I am thinner than my roommate, but jealous because I did not lose as much weight as she did. Ana reminds me that if I had lost thirty pounds these past six months I would be sixty-eight pounds. That night, Whitney fills me in on who each patient is, which eating disorder they suffer from and how much some of them weigh. Whitney’s last name is Harrison, and I smile pointing out that she has the same initials as Whitney Houston. She says many people say that, but she still laughs.
Whitney gossips about Jill’s roommate, Nadia. Nadia speaks broken English and never snitches on Jill’s nightly workout regime. Even so, they do not get along. Nadia is twenty and initially sees America as an utter marvel compared to the Romanian orphanage she was forced to live in until she was sixteen.
“She has the mentality of a ten year old and it is hard to get through to her,” Whitney says.
Nadia wants to be a pop star. She trusts no one. I wake up in the middle of the night to Nadia’s screeching and sobbing because she is convinced Jill steals one of her stuffed animals while she sleeps. Whitney believes Nadia is delusional. The first time I walk past their bedroom, I see Nadia piling and then re-piling a mountain of those animals on her single bed. I wonder how she evens keeps track of each one. Nadia has blonde hair like Goldilocks and the body of a twelve year old ballerina. She twirls and picks up a handful of her animals, cradling them against the fuzzy angora pink sweater covering her bony chest.
“Thief,” Nadia yells at Jill, who is on the other side of the room. Jill gives her a blank stare and then paces around the bed.
Jill is not the only person Nadia accuses of being a thief. Anyone who invades her space while she beads jewelry gets the same treatment. In Nadia’s world, the jewelry she makes is highly valuable. I still have the pink bracelet she created for me, each plastic bead a precious “jewel” I would never be able “to get at American store.”
Nadia never makes jewelry for Jill. But Whitney knits Jill earth-colored gloves and maroon scarves to keep her warm. Jill is so underweight that she has lanugo (fine, downy hair which commonly appears on anorexics because of their lack of body heat) carpeting her cheekbones and limbs. I have lanugo going in a straight line from my sternum to my bellybutton and on the back of my arms, but not on my face. I wonder if I touch her face, would the surface feel like peach fuzz?
Whitney idolizes Jill. She raves about how talented and smart Jill is, how she is in school plays, student government, and all AP classes. Whitney also brings up again how Jill lives in her sister’s shadow. Jill’s solution to getting attention is getting emaciated.
Whitney rolls her eyes up at the ceiling when I ask more questions about Nadia, responding that she is only on the unit because she does not like American food. Nadia makes a scene during mealtimes because there is at least one item she refuses to touch. I burst out laughing when, later in the week, I first hear her protest lunch.
“Disgusting food. I take supplement!”
She pushes her tray across the table, crosses her arms tightly and pouts like I used to when I was in kindergarten and my friend did not want to play with me at recess. I do not mean to laugh, but I find it almost admirable that someone actually has the audacity to re-iterate to the entire group how shitty the hospital food is. Many other patients find her comments “triggering” because eating is challenging enough as it is. Nadia’s behavior at the table further convinces Whitney that this foreigner is an attention-seeker and does not actually have an eating disorder.
“All the food is awful. I worship devil now. I live in hell,” Nadia says.
No one says a word. Everyone looks down at their trays.
Aside from the cafeteria cottage cheese, I have not eaten a full meal since the day before. At dinner, I sit next to Whitney and across from Liz, the most emaciated girl in the program. When Liz sits down to eat her child-sized jeans hang off her. The pants look like they belong to a nine year old. She carries a blue plastic cushion (in the shape of a donut) with her all day so her coccyx does not bruise when she sits. My first morning (day two) Liz offers me one of her extra cushions, but I decline because I do not think my heavier ass warrants one. This is only one of Liz’s many rounds at this program.
My tray has a Styrofoam plate with two scoops of mashed potatoes, a roll with butter (the nurse watches me spread it), and a slab of unseasoned chicken. There is a bowl of watery broccoli and a cup of orange sherbet. The carton of two percent milk looks like the ones I used to drink back in my school’s cafeteria, back before I got sick, when I used to enjoy drinking them. The heat from the chicken and mashed potatoes waft into my nose while Vanessa Carlton’s depressingly hopeful song “A Thousand Miles” plays from the tiny stereo by the windowsill. The song is a part of what would become a soundtrack to my life – eating and crying at a table in a sterile hospital while my eating disorder yells at me. There is no way they think I can eat this whole tray of food. The people who run the program are bingers. Nobody eats this much.
“Just focus on one item at a time,” Whitney suggests as she takes tiny sips of her milk. “Right now you are not even on “standard meal-plan,” just “basic” since your body needs to get used to eating again. This is the smallest tray of food you are going to have during your stay here.”
“Do I have to eat everything on this whole tray?” I ask, trying to hold myself together as I open my container of milk.
I cannot hold back my tears. They drip onto my mashed potatoes, making them soggier and saltier, and onto the red shirt that is not keeping me warm. I want my sweater, but the nurses instructed us to remove all “double layers” before our meal began. Ana is absolutely furious. This is an obscene amount of food, and I will probably gain two pounds just from this meal alone. The loss of control makes me shake and sweat; I would do anything to see my mom right now, even my dad.
“It’s okay girlie. You’ve got this,” Liz encourages.
Vanessa Carlton’s voice echoes in my ears making me cry even more:
“And I would walk a thousand miles just to see you,
Just to hold you tonight…”
Still, at this moment, I would walk a thousand miles just to be able to keep my eating disorder and to get thinner again.
“I can’t do this!” I bawl uncontrollably.
“The first meal is always the hardest. But don’t you want your mom and dad to come visit you tonight? If you don’t eat dinner they won’t be allowed to come see you and you will be forbidden to even call them,” Liz says.
I want my mom to be with me, to hold my hand like she always does and let me know everything is going to be fine. I want her to repeat that I am not going to be in this hellhole forever—that she is not going to let the doctors make me fat, that she will take me out of here before I get fat. I stop complaining and gulp down each item, while a nurse monitors every bite I take. Each swallow hurts because of the giant lump in my throat. A year earlier, I would have had zero anxiety at the thought of eating a complete meal. I once ate three a day like a “normal” person.
But one of my friends from school, Angela, was an anoretic. She was so thin that she seemed to glide and walk on air because she weighed next to nothing.
“I have a model’s body,” she bragged.
I never felt overweight until I met her. I never thought my weight was too high. I seemed to take up too much space when she was around. The summer before eighth grade I began to worry about becoming heavier than ninety-eight pounds. I thought I could go on a temporary diet so I wouldn’t take up as much space anymore.
When I finish dinner my stomach feels full and strained, a sensation I have not experienced in almost six months. I cry on and off for the rest of the night, even when my parents come. Yet, I have no choice but to adjust to this scary and foreign routine.
When my parents visit, I realize Nadia must have other problems that justify her place on the ward. She flirts with all of the male nurses and visitors, including one patient’s husband. And my dad.
“Your daughter…She trying to get used to it here. I’m used to it here,” she says to my dad while batting her eyelashes and giggling. My dad looks shocked. After she waltzes away, he shakes his head and says he cannot remember the last-time he felt so disturbed and how she makes it seem like I am part of a full-blown loony bin. My mom ignores Nadia during the entire exchange, too focused on holding my hand and getting me to stop crying.
“Your father. He like me,” Nadia announces to me when my parents leave.
“Yeah. I’m sure he does,” I say, not to looking her in the eyes.
“No, he really really like me.”
Nadia brags to everyone how all men like her and want her.
Then, one day, in a group therapy session she runs her purple nails through her thick straw- blonde hair and screams, “I hate men!”
This explosion triggers her to confess: a young man at her orphanage in Romania raped her on a daily basis and when she arrived in America she had guys in school stare at her body. She feels like less of a target when she loses weight.
The dining area has a bank of windows overlooking the hospital’s campus. The nurse’s station is three feet away from the tables, making it effortless to walk over to patients during meals and hover over their trays. At those same tables I eat all of my meals, do my schoolwork, and play games. I have to ask one of the nurses to open the cupboard with the decks of old cards, board games and tattered magazines. No fashion magazines are allowed because they are “triggering” and might make patients jealous of thin celebrities. Before I sit down with my tray of food, a nurse calls my name and I walk over to the special table set up for her to watch me open my drinks, spread butter or another fatty condiment on my already soggy bread, empty out all of the dressing on the limp pile of lettuce, and remove the plastic wrapper from my utensils. Caffeinated coffee is never allowed because the doctors believe it is a “symptom”—artificially boosting the metabolism and retaining fluids in case a patient has not been gaining weight.
Nadia is right; the food is awful hospital gunk. Even the doctors and nurses know it because I never see them eating any of it. I know to expect my hot food to be cold or my cold desert to be warm (ice cream), especially if my tray is called close to last. I compulsively obsess over my menu, trying to follow the chart my nutritionist gives me: proteins, dairies, fat condiments, vegetables, caloric beverages, carbs, fruits, and desserts. Everyone pretends to dread the food after being there awhile, but our expanding stomachs come back to life and we begin to feel the body’s raucous hunger and the joy of satiating this appetite.
In this hospital vacuum, I eat breakfast, lunch, dinner, and a snack. During meals, I try to ignore the non-compliant patients, those who spread butter underneath tables and avoid lifting silverware to chapped lips. They always get in trouble anyway. I learn the songs that play on the tiny stereo so well that I mouth the words, as I try not to cry, between uneasy bites of food. 101.9 Light FM is the preferred channel and songs like “The Greatest Love of All” by Whitney Houston, and “Sunrise” by Nora Jones play constantly. I talk about trivial stuff like movies and celebrity news to other patients, while nurses scrutinize our eating habits. If I stir my mashed potatoes too much, mix my salad repeatedly, churn my ice cream, dunk cookies into the milk, cut up my chicken into too many pieces, or push the food around on my plate a nurse is sure to chime in: “That’s a behavior, Clara.”
When I am new I ask, “A behavior? But this is how I eat!”
When Jill sits next to me at meals she snaps at me if I wrap my hand around my wrist and upper arm; any sort of body checking is a no-no.
“Watch it, missy,” Jill warns, catching me in the act.
“Sorry,” I say and continue eating my tuna sandwich.
She is looking out for me, but habits like body checking are not going to be thrown out the window. I cannot just start ignoring my appearance and the additional flesh every day, the fat that I crave so damned hard to vanish. I know I supposedly do not see my reflection the way others do, but I cannot be so distorted that I am imagining my clothes tighten. Otherwise, I must see the world through purple sunglasses.
I sit there trying not to cry because Ana bitches at me, reminding me how I am a fat failure for breaking her regulations and giving in too easily to hospital rules. She tells me I am gaining weight too fast, that food is the enemy. I have to tell her to shut up because I am stuck at this place and there is no way out unless I am compliant. But Ana reassures me: You can lose all of the weight you gain when you get out of here. Don’t worry. I am here to make you skinny again.
By week two, at around 10:45 a.m., I sip thick Ensure Plus shakes and clutch my seemingly ruptured stomach with disgust. I must drink three a day, and there are 350 calories in each cup of this supplement. Then more meals come.
The same nurses are there every day on rotating shifts. Bathroom breaks are every two- to- three hours and, if it is an emergency, I have to ask one of them to unlock the door. During designated bathroom break the nurses stand outside one of the five stalls while I go and then flush the toilet with a key. God forbid they catch a patient purging or throwing food down the toilet; punishment is a certainty. My first day there minutes and minutes pass before I can urinate because I am too embarrassed to have someone listen to me. The nurse chuckles and says I have a “shy bladder” which is not uncommon in the beginning.
One of the bathroom breaks is right before breakfast. Girls make cordial chit-chat and turn to the mirror to continue applying make-up to their sunken eyes. Jill teases and curls her thinning hair every day as though she has somewhere special to go or people to impress. The most I do is comb the knots from my hair. Subsequently, I get a lump in my throat at the fact that the bathroom mirror is hung too high to “body check” my butt or even my waist. Instead, I have to focus on my slinky neck, shoulder bones, and cheeks. I think that the older girls overdo it with make-up so much because they have been meticulously refining their appearance since puberty. Routine must be maintained. Routine includes discussion of who gained or lost weight that morning. Maybe it is a way to deal with the cruel reality of spending that day and the next and the next on the first floor of the hospital, with no one to see us but the nurses and the other crazies in the hole. Routine, no matter the protocols, is life.
The air at the hospital is dry. My lips and skin chap quickly and if I want to use chap-stick and hand-lotion they have to be dispensed by the medication nurse only at a specific time when it is convenient for her.
Patients are to be as sedentary as possible. Pacing is something a patient gets “redirected” for by the nurses. Standing for what they judge to be an excessive amount of time guarantees they will tell us to sit down on a seat that hurts our bony asses. Patients even joke that shaking an Ensure is a form of exercise. The nurses’ voices still echo in my head:
“Could you please have a seat?”
“I need you to sit down now.”
“If you aren’t waiting in line for the bathroom, you need to have a seat.”
The place where we sit down the most is the common room. We call it “The Bubble” because of the foggy Plexiglas surrounding the circular room. When I sit in there for groups, or even to just watch TV, I stare through “The Bubble” and see the little eating room with the clunky clock on the wall. And my already cramped stomach churns. “The Bubble” is another reminder of our officially being locked away from the outside world. At night, I look at my reflection in the window, while the voices from the television echo throughout the room. I can see the baggy clothes I am wearing and my face, but otherwise it is too dark to do a thorough body check. The parking lot outside is bare and empty, except for the occasional nurse who is taking a cigarette break or heading back to her car.
Day eight, and it is that time again.
I lie in bed, quivering, as the clock ticks inexorably forward: 5:59 a.m., 6 a.m., 6:01 a.m… We get weighed every morning in the room next to mine. I feel throbs of panic as I step onto the huge metal scale that declares the day’s fate. .
Standing under the florescent lights of the weighing room, I try to ignore the urge to look at the intimidating number. I find it ironic that the scale looks like a treadmill since any form of exercise is prohibited on the unit.
Did I go up or down?
That day, Richard (the only male nurse on the unit) weighs me. I think he looks like a perverted Kevin Spacey. We have a brief chat, and he says that he understands what I am going through. He asks if I want to be destined for a life of disposable paper gowns, force-fed meals and ugly furniture to sit on. I do not say anything. He does not deserve a response because I know from his smirk that he does not really care. I am just another anorexic going through the revolving door of the consequences. Richard does not seem to mind the cold silence.
Tell me what I can do today; please tell me when I can leave.
I sneak a peek at the scale and immediately regret doing it. I gained over half a pound in just a day.
“You still have quite a long way to get to goal weight,” he says in a sing-song voice while he jots down my current weight on a thick clipboard.
My thoughts jumble: This place is a fucking hellhole. How am I supposed to recover here?
Why must I gain weight?
Just let me stay thin. I worked for six months to get to this weight!
I remind myself that if I do not gain weight I won’t get to the eight minute shower, have visitors, or get phone privileges.
I pray to go up .2kg, no more, no less. Yet, I feel awful gaining more than what is expected because it means I am getting further and further away from thinness.
We patients file down the hall each day for not only occupational therapy or relapse prevention group, but also art therapy. We make collages out of magazine clippings that are supposed to express our inner selves, mold clay and Play-Doh, decorate fabrics, and paint fake stained glass. But we occasionally participate in what the therapist calls body tracings. The art therapist tells us body image therapy is going to arouse significant anxiety. Our body contours are carefully traced onto the giant billboard-size paper on the chipped pink wall. Before the body tracing, we draw life-sized outlines of what we hypothesize our actual outlines look like. Almost everyone, including myself, over-estimates the size of our bodies. Jill’s “before” image looks like an average-sized teenage with a substantially thicker head of hair. My “before” image resembles what a physician calls a “healthy” weight. The descriptions “fat, grotesque, cottage cheese thighs” cover the outside of my tracing because “healthy equals fat”. When my actual body is traced over my distorted perception I see an alien; my tracing shows a wasted and fragile little girl. Still, Ana, tells me the therapist has made a mistake because the outline is too thin to be mine. I look around at everyone else’s outlines the therapist had traced and realize how accurate they are. Still, the eating disorder knows she made me thinner than I am.
The therapist stands over my shoulder and gently asks me to write what I am feeling and I do: Who could ever love someone like me? Someone who was so obsessive with her body that she did not care about anything or anyone else?
I tear down the tracing that day, roll it up, and put it in the corner of my room because it is an outline of the reality I did not want to face.
I am not even on the unit a full two weeks before Jill runs away. The morning starts off like any other: I am woken up by the pale gray bedroom lights and the nurse who has two different colored eyes (right eye green, left one blue). I mumble “good morning” back to her and stretch my wasted right arm out from the sheets so she can take my vitals while lying down. The machine makes a beeping noise like the one a digital scale makes, the alert for me to stand up and have her compare the results. She jots down some numbers on her thick clip-board and wheels the vitals contraption out the door and down the narrow hall. I have not gained weight that day, so I am on restriction. I lounge around the Bubble watching the morning news on the seventeen-inch TV until the carts with our breakfast trays arrive. I look around for Jill who usually sits next to me and Liz. I strain my eyes to see if anyone wearing a pair of jellybean-pink Sketchers and a paper gown is speed walking down the sterile hallway. The ensuing interruption by Richard stabs my neck. I already know Jill ran away the last time she was here, hopping into the laundry cart and hiding beneath all of the towels and sheets; it reminds me of the musical Annie because Annie does the same stunt. And nothing good comes out of it.
“Jill? Jillian Vanderlind?”
Worries rise from the rest of the patients, and one of the nurses is frantic because her key to the unit is missing. Jill is taking her disappearing act to the extreme. Hours go by and wild gossip seeps through conversations at each meal, group therapy, and leisure time until nightfall comes and it’s lights out. I wonder if she is still awake and if she has a place to curl up and sleep without freezing to death.
“I bet she doesn’t even have much money on her,” Whitney says to a group of patients gossiping about Jill.
“What the hell was she thinking? No one ever gets away with running away from here. I mean, she has nowhere to go,” Liz says. Even though we do not say it out-loud, we feel betrayed by Jill. She is the one who helps hold us together, even when she does not have the motivation to care for herself. Concerns for my own selfish comfort tick through my mind:
Who is going to hold hands with us when we get our blood-work done or talk the minutes away with us during meals?
Who is going to help me with my homework during study periods?
What if she loses a ton of weight? She will end up in trouble, but at least she will have gotten even thinner.
The sun goes down and still no sign of Jill. In the morning, she is hauled back to the unit in the morning. She looks gaunter than the morning before and bows her head, refusing to look anyone in the eyes. From that moment on she is on 24-hour watch. She has a nurse hovering a couple of inches over her shoulders with every step she takes. A nurse sits on a stool watching her while she showers and makes her keep the bathroom stall door completely open. The humiliation that plasters itself on Jill’s face never recedes.
After a few days of this intense monitoring, she refuses every meal and sits at the table the entire day. I watch her at breakfast placing a napkin over her bacon and ignoring her milk. She does drink the water that comes with each meal. At one point I come up to her and try to urge her to eat, something she would have done my first day there, but she looks away from me and says she is being transferred the next morning to another hospital to get tube-fed so there is no point in consuming calories.
People stand in line to say their farewells to her. Before she is put in an ambulance and moved, she flicks my dangling, blue earring and tells me to keep up my sense of fashion; it is way cooler than being thin. After the goodbyes, we watch her stroll down the hall. She never looks back.
My parents come visit me in the evenings on the days I gain weight. We try to avoid talking about where I am and play board games at the same table where I eat my meals and take my supplements. We do not talk much, especially about my changing appearance. I used to be a semi-normal girl with a normal life before I transformed into a patient, a case, a file filled with forms covered in numbers and health problems. I feel sorry for my parents for putting them through this, but the anorexia ate my old brain and turned me into an eating disorder. How could I explain to them the love I felt for the solitude that used to cradle my stomach?
Both of my parents are strong, but I do not tell them that I am hesitant to kill Ana; even they do not have enough strength to handle the possibility that she will kill me first. Death sounds so simple and fast. Every day I think about dying. I am too scared to do myself in all at once. Instead, I kill myself gradually so I will not feel as scared. I like when the sun sets early in the winter. Darkness is soothing and tricks me into thinking I have more time to sort out my problems. Darkness covers up cloudy and gray days. Darkness envelops my mind, highlighting everything wrong in life. Ana forms her own deceptive darkness within me. Like heroin, it feels like a heater and a lamp turns on inside of my bloodstream, until the original pain returns to my body and mind with a vengeance; I go from being cradled by my mom, to falling beneath the cracks, everywhere I step. I go to bed early because, when I sleep, I shut my life and the world out of my mind.
My mom visits me more than my dad, since he sometimes works late into the night at his job as a sales representative at Formica Corporation. If Formica had not hired him in February 2004, the new private school I got accepted to, let alone an inpatient hospital stay. He still visits quite often considering how demanding his new job is, but I do not expect his presence like I expect hers. I breathe in the aroma of my mom’s sunny blonde hair, her fancy perfume, and then hug her tightly as though it’s the last time I’ll see her. Other patients comment about how thin my mom is, and I get angry. I love my mom and I hate her at the same time. She has had anorexic habits my whole life, and it is not until I got sick that she started eating healthier. She would make a big deal out of eating a little bit cup of ice cream: “I’m sacrificing myself,” she continued to say even when she tried to get me to eat the same desserts. She is still bony and model-esque, and I do not want to take up more space than she does.
My dad calls her by her nickname: “Boney.” I am not annoyed by this until I saw my own body starting to develop into a curvier figure than my own mother’s. Mothers are supposed to protect their children. If I got physically bigger, the number on the scale would get higher than hers and I would take up too much room. She would not be able to shield me from the future.
Yet, any idea of a future is desiccated and useless in this place. Eighth grade resumes without me, and I wonder if I will wind up back here in ninth grade too. But there is the sense deep down in me—a part of my old self—knows I can keep working on things that could start to promise a future. I need to get outside so I do not disintegrate into a sad porcelain doll. Outside, life is moving along, offering an alternative that one could live, not merely exist.
Around my eighteenth day on the unit, I stand ten pounds heavier and am prepared to gain another 10. But after group therapy one day, my psychiatrist stops me in the hall and says that my insurance has terminated the covering of my stay; I have to transition to intensive outpatient treatment (three hours a day) and return to school.
There is a metallic taste in my mouth, a typical reaction when I experience shock. I panic. My mom pleads with the insurance company to continue covering my stay. The person handling the situation responds that I am not planning on killing myself so there is no reason for me to be there. My mom says I am still severely underweight and need medical attention.
“You can always take her to the ER,” they tell her.
This is not my last time inpatient. Two months after my discharge I relapse, keeping the numbers down just the way Ana tells me to.