Some years ago, I wrote a book about my ten days in an eating disorder treatment center. It was never published, but now I feel like sharing some of it. I’m going to post random chapters to be enjoyed in little servings like this. –Juliana
I’ve never been in treatment before. For anything. I have always tried to take care of myself. I’m doing this for X. Well, for us. He wanted me to come here. And I want us to have a chance so I’m here. I’m “getting help.” I’m not in denial. I know I’m not well. I’ve lost too much weight and I’m terribly worried all the time and I’m miserable and I can’t eat and I’m losing X and it all feels out of control.
I can’t see clearly. I know intellectually that I’ve gotten too skinny but I can’t see it, exactly. I can hear it, hear others say, “Eat something! You’re too skinny!” and I can feel it, with my hand, in the deep dip, like a skateboard half-pipe, between my pelvic bones when I lie on my back; in the big empty space between my thighs when I stand with my feet together. But I have gotten so used to being this size that it seems normal to me; it’s the number that scares me. The number I see on the scale.
I pull the heavy wrought-iron door handle and enter. I have lived less than a mile from here for eight years and until now I never knew this place existed. There is a little reception desk on the left but no one is there. Across from this is a dark, ugly fountain sculpture with water trickling down a rock wall into a rock pool. It exudes a swampy, moldy smell. To its right is a big empty waiting area with three black leather couches and not much else. The room is gloomy. Deserted.
Just beyond the water sculpture and the empty reception desk is a glass door leading to an inner hallway. I open the door and walk in and it’s brightly lit and on the left side of the hall there’s a woman behind a glass partition — like at a bank — and she greets me hello. I tell her I am here to check in.
“Are you Juliana?”
“Yes,” I say.
She smiles. “Some flowers came for you.”
On the desk behind her is a small vase of lilies and a purple stuffed teddy bear. My heart speeds up and I think, X!
“Is there a card?” I ask.
She plucks one from the plastic fork-like holder stuck in the dirt and hands it to me.
It reads: “Good luck, Jul! We love you. –Jason and Cassie.” My brother and his wife.
My heart drops. Crashes. Breaks. Though it is sweet of Jay and Cass to have sent flowers here for my arrival, I so wish they’d come from X. I think that flowers, or something, anything, from X, might cure me, instantly, on the spot. And I could go home. If only he could be here for me, right now, in some tangible way, with some small gesture communicating his love and care and concern.
“You need to get well,” X said to me, the last time I saw him. He hugged me lightly and said he could feel all my bones. I said, “I know, I know. I’ve gotten kind of skinny. I–”
“Jul,” he interrupted, “You’re not just kind of skinny — you’re scary skinny.”
I tried to brush it off. “Yeah, I know. I just need to start eating more. Don’t worry.”
“No, Jul,” and he took my shoulders in his hands and made me face him full-on. ”You’re anorexic.”
It kind of hit me, then. That I might actually be in trouble. I was silent.
“You need to get well,” he said again.
Then I understood. He meant that I should go someplace. He was sending me away. To “treatment.” One of those places people go when they are “in crisis.” He wanted me to go, so I would. I would do it for him. For us.
In bed that night we only kissed a little before I fell into my sweaty, dark-dreamed sleep. He told me later that he checked on me throughout the night, putting his hand on my chest to make sure my heart was still beating, and that he cried after I left.
The young woman behind the partition hands me a clipboard with a pen — forms for me to fill out, questions for me to answer — and directs me to a little nook opposite her station, in an alcove off the narrow hallway, where there are four chairs — two backed up against each wall, facing each other. I park my suitcase in a corner, where it won’t be in anyone’s way, and take one of the seats.
There is a young woman sitting already, filling out her own questionnaire. (Answering: Are you allergic to any medications? What is the name of your health insurance company? Who is your primary care provider? What is your current height? Weight? etc.) Her legs, in their flared jeans, are crossed and therefore somewhat obscured from view but I can tell that they are skinny. She is pale, wan, feather-like; her skin looks almost transparent. There are faint grey-blue half-moons under her eyes. She looks frail in body but not in mind and that is why I pick the seat diagonally across from her, so I’m not next to her and also not directly in front of her. I give her as much space as possible. Her face is full of quiet defiance and determination — either to lick her disease or to defy their efforts to fatten her up, it’s impossible to know.
As I eye her discreetly, I think, “I’m as skinny as she is,” and this strikes me as a revelation. This girl is presumably here to be treated for anorexia which means that she is significantly underweight. And so am I.
She looks very young. Like a teenager. When the receptionist asks the girl for her birthdate the girl responds, “September 25th, 1983.”
She is twenty-five. Sixteen years my junior. On the phone they had assured me that the teenaged anorexics were housed on a separate floor — the building is four levels with the 16-to-18-year-olds on the third floor and above them the older girls. I was also told that at the present time there was both a 46-year-old and a 50-year-old in residence. Which was a relief to me.
A blond woman in a light pink sweater arrives and leads the girl away. I glance at the girl’s body as she walks away and I think, She’s definitely skinny but not skinnier than me. She’s not 75-pounds skinny.
For an anorexic — someone always trying to reach an impossible ideal of weightlessness — to compare herself to someone visibly underweight and to think that she measures up (or down) is, well, something. It is perhaps progress. For me to realize: I am one of them, one of the really skinny girls; I belong here — is a turning point.
A dark-haired woman of about fifty in a cream-colored wool skirt suit introduces herself and has me follow her to a private room down the hall. There, she proceeds to ask me many questions while writing things down and referring to the stack full of notes and papers in her lap. Her name is Seda. She looks Persian. She seems to be in charge. She is tough and direct. It’s clear she is not going to coddle me.
She asks me if I’m still menstruating.
I tell her that I am.
“That’s unusual.” It sounds like a challenge, like she is disputing the veracity of my (truthful) response. She looks up from her notes. ”Do you realize you are at 75% of your ideal body weight?”
I had been told the exact same thing — word for word — by the other treatment facilities I had called when researching suitable programs for me. Three times I was given the “75% of your ideal body weight” line. And three times I was told that I would have to check in to residential treatment. None of them would accept me into any of their day programs because my weight was — officially — too low for my height. Which is why I agreed to be an inpatient. No one would accept me otherwise.
It was surprising to be so immediately and categorically labeled. To be treated as a statistic, as exactly 25% underweight, by all the eating disorder professionals. I felt objectified. Why wasn’t an individual’s unique body frame or metabolism or energy expenditure levels taken into account when deciding what was an “ideal” weight? Who established these standards?
“Really?” I answer. “Wow.” I feel the need to defend myself for being this way, for being less than what the experts say is ideal.
“I don’t know why I’ve been losing so much weight. I mean, I was trying to at first but then I stopped trying but now I’m still losing weight. I just have no appetite. But I’ve been eating, I have. I’m trying to. Trying to force myself.”
I’m confused.
I feel I have gone beyond what it is to be a normal, food-refusing anorexic and morphed into something else — someone who is not tormented by the desire to eat but who no longer has any desire. This is probably what every anorexic ultimately hopes to achieve — a passive, effortless wasting away, freed from her agonizing war against eating. But having gotten to this state of no-desire, I was scared. It felt wrong. And dangerous. Very dangerous. And pathological in a way that refusing food with a supreme effort of the will doesn’t, really. (Hasn’t every woman been on a diet? Isn’t dieting a normal, universal, even banal experience?)
Seda continues her questioning; “What is a normal day of food for you?”
“It’s a lot. It’s a substantial amount.” (I’m still trying to defend my position and explain to her that I’m not like this on purpose. That it’s not my fault; that my metabolism has somehow kicked into overdrive, or something, and that I’m not one of those lunatics who eats an apple and a half-inch square cube of cheese — and nothing else — each day.) “I’m not trying to starve myself, I swear. I eat three meals a day. But it all just burns through me.”
She asks me to tell her everything I ate yesterday.
“Um, let me think. Yesterday I had a Clif bar for breakfast. And…for lunch,” I say, “I had some hummus with wheat toast and steamed broccoli,” (neglecting to mention that the hummus was just one spoonful and that the toast was only a couple of thin slices of a skinny baguette — two tiny rounds, which I shared with my dog) “and for dinner I had a brownie from the Hi-Rise Bakery. You know the Hi-Rise, over on Brattle Street?” I ask, again feeling the need to defend myself from the charge of being an out-of-control anorexic freak with a deathwish. (See? I ate a big fattening brownie — to put some calories into me, to fill me up.) “Their brownies are really big and thick. I ate the whole thing. It was really big.”
Seda says nothing. Her face is blank, neutral. Does she believe me? Anorexics, like drug addicts, are good liars — we have to be, to hide our self-destructive behavior from people who would have us stop the behavior when we don’t want to or don’t know how — and Seda has presumably had lots of experience listening to their lies. (“I’m not hungry.” “I already ate! I did!”) I’m trying my best to be honest but still Seda makes me feel guilty, paranoid, like I’ve done something wrong, like I need to cover my tracks and be careful what I say. I want to tell her: I’m here, aren’t I? I want to fix this. Can’t you see that? I came here on my own. No one forced me.
After a pause in which she scribbles some notes, Seda goes on.
“Do you ever feel faint?”
“No.” Weak, yes. Constantly fatigued, sure. But that is not what she asked me.
“Dizzy?”
“No.”
“Is your hair falling out?”
“No,” I say, remembering the little brown clump on top of the drain in the shower that morning. (It was such a small clump. Seda doesn’t need to know about it. Hair “falling out” is what happens to chemotherapy patients. My hair’s just a little thinner than it used to be, that’s all.)
“Do you purge?”
“No.” (This is the truth.)
“Are you depressed?”
“Yes.”
“Are you currently on any medication?”
“My doctor just started me on Celexa. I don’t think it has kicked in yet.”
“Have you ever tried to kill yourself?”
“No.”
At the end of our interview, after about a half-hour, Seda says, “We will call your insurance company now. You can wait in the lobby or you can take a walk around Harvard Square, whatever you want. We will call your cell phone when the insurance paperwork has gone through.”
I ask her how long she expects this to take.
“It’s hard to say. Insurance companies can be slow. It may take a half an hour or it may take four hours. We just don’t know.”
I had been assured that my health insurance would cover five days of live-in treatment here, to start. At the end of five days they would assess my progress and decide whether or not to pay for more time. But they won’t let me actually in until it is all officially signed, sealed, and delivered.
“I’ll just sit in the lobby.”
I don’t want to walk around or do anything. I just want to get in here, get started, get it over with. I sink into one of the cold leather couches and pick up a Newsweek from the side table and leaf through it, but Newsweek is so boring. The only other magazine choice on the table is Cookie (an odd title, I think, for the waiting room of an eating disorders clinic) — even more boring than Newsweek.
I set down the magazine, turn my face to the corner and cry. It is all I can think to do. I am alone and I’m scared. And I don’t know how things got so screwed up that I have to be here. I don’t want to be here. I want to go home. I want to be with X, but when we’re together even that’s no good anymore. I’m stuck.
I listen to the water trickle down the rock wall. The sound is probably meant to be soothing but to me it just seems sad and weak and pathetic and small.
I always enjoy your writing, Juliana. I’m sorry you went through this.
This was heartbreaking to read. You are so brave to share this with this world. As a male anorexic I would never have such courage. You rock.