Brave Girl Eating (24 page)

“Are you proud of me?” she asks.

I grab her hand and squeeze it, feeling how solid and warm and strong it is, feeling the tingle of electricity that passes between one human being and another. To anyone else, this would be a non-event. But she knows, and I know, that the paradigm is shifting. The demon is in retreat.

It hasn't disappeared entirely. There are still days when Kitty
balks at eating, when she castigates herself and, once, lies to me about drinking an Ensure. She has panic attacks, which she never had before. Her relationship with food is still fraught, though it's better. So much better.

I don't believe in fairy tales, but still, I want a happy ending. I want the child I knew before. Before starvation and longing, before guilt and terror. Before these interminable months of heartbreak and misery and woe.

One night I dream that I'm in a big Victorian house, searching for Kitty. I run up and down steep flights of stairs and finally find her taking a dance class on the second floor. From outside the room I signal her frantically—
Come here, get out of the class
—but she ignores me. I vault a railing, grab her, and yank her angrily out of the room. I'm furious in the dream, and getting angrier by the second.

“What did you eat for dinner last night?” I bark. Not-Kitty smiles, a nasty, insincere smile, and says nothing. I shake her by the shoulder. “You didn't eat dinner last night, did you?” I shout. “What did you have for breakfast?”

Not-Kitty leers at me. “A teaspoon of air,” she says prettily. I wake with my heart pounding, my arms trembling as if I really was shaking her.

I want a happy ending, but life isn't that clear-cut. It's only when we look back over a period of time that we see—or think we see—an orderly shape emerging from the chaos of everyday living. Except for death, the only endings we get are the ones we impose on ourselves and the world.

So maybe it's enough for me to say that Kitty could have died but didn't. That all year she's been unspeakably brave; she has done the most terrifying thing imaginable to her, over and over and over. That if there's no happy ending, there's no unhappy one either.

 

And then one morning
in June—just about a year after Kitty's diagnosis—I answer the phone at work and hear her voice sing out, “I'm hungry!” I'm speechless. But I don't need to say anything, because Kitty's so excited. She knows what this means as well as I do. She says she can't wait for me to come home for lunch—can she drink a can of Ensure now? I tell her of course, I'll come home early. I'll bake cupcakes in her honor. I tell her,
I'm so happy for you
. What I want to tell her:
Thank you for telling me. Thank you for sharing this moment with me, after all we've been through. Thank you for not hating me, for still trusting me.

Now
I could weep with gratitude. But I don't. I turn off my computer, grab my car keys, head for home. For now, this is as close as we're getting to a happy ending.

Relapse, Recovery, Renewal

As I wrote this
book, I became conscious of how many times I mentioned Mother's Day—how much a part of this story Mother's Day has been. It happened to be Mother's Day when our family took the bike ride that alerted us to trouble, when Kitty shared her anxieties for the first time. Mother's Day was the beginning and so became a landmark, a measure of time gone by and progress made, or not made.

It's fitting in a book like this, about a family's struggle with a child's mental illness. So many narratives on this subject wind up focusing on mothers, and not in a positive way. Every serious ill
ness that affects a child affects his or her whole family, whether the illness is cancer or AIDS, cystic fibrosis or depression or an eating disorder. Every family that goes through such an illness is changed by it. Every family that comes through that fire presents a different face to the world and to one another.

We live at a time and in a culture that seems obsessed with establishing cause and effect, and in some ways that's good, feeding the spirit of inquiry that fuels scientific progress. If Alexander Fleming hadn't become curious about what made a dish full of
Staphylococcus
turn blue and why the bacteria beside it were disappearing, we wouldn't have penicillin. But sometimes our urge to know, to assign blame and responsibility, backfires. Families aren't petri dishes, and the millions of events and interactions that make up a family's collective life are not easy to categorize. Bad things happen in families, certainly; so do good things. So do many things that are neither bad nor good but just are.

Nearly every family whose child must deal with a mental illness knows the experience of being dissected and analyzed, taken apart with an eye toward judgment and blame. The thing is, the experience of being judged also changes a family. It makes parents feel defensive. It makes parents behave in ways they might not ordinarily. Blame and judgment change the dynamic nearly as much, sometimes, as the original illness.

When anorexia chose Kitty, it also chose me, and Jamie, and Emma. It chose our family; it called into question many of our deeply held beliefs and traditions. It challenged our assumptions, our way of being with one another. When it built walls between us, we put in doorways. When it let grief into our house, we opened every window and shooed it out. When it called us names—
jailer,
torturer, liar
—we answered
mother, father, sister
. Kitty was the one diagnosed with anorexia. But it happened to all of us.

 

After that terrible year
of refeeding, things got better—for Kitty and for the rest of us. She took up her life again. She spent time with friends, acquired and then de-acquired a boyfriend, found a new sport. She seemed happy some of the time, and when she wasn't, her sadness or anger or angst seemed like normal teenage emotions to Jamie and me.

It took us longer to recover. For months I burst into tears for no reason. I flinched at any mention of eating disorders. My panic attacks, which had been under control for years, started up again.

One night I dreamed that Kitty was sitting next to me on our living room couch. One of her arms had turned into a kind of flipper grafted onto her shoulder, with three fingers attached to it. Her other arm was crooked at an odd angle, fingers dangling uselessly, just the thumb cocked and moving. In the dream a disembodied voice said, “Isn't it great—they were able to save part of both hands!” My screaming woke Jamie, who put his arms around me and said maybe the dream represented my anxiety that Kitty was not fully recovered, that something was still wrong. True enough. But far worse than the damage to Kitty's arms and hands was the voice telling me I should feel grateful, even happy, about something I could view only with horror.

I will never be grateful for anorexia or its legacy.

At times the shadow of the demon did seem to pass over Kitty again. That December, for instance, when she'd been at a healthy weight for six months, we took a ski trip to the Porcupine Moun
tains, on the edge of Lake Superior in Michigan's Upper Peninsula. It's gorgeous country and very isolated; the only place to eat was our hotel, which served mediocre food, and the rustic ski lodge, which served snacks.

We spent the first two days on the slopes. By midafternoon on the second day, Kitty's mood had begun to slide. She became apologetic and guilt-ridden; she had an anxiety attack about getting into college, two years away. She came off the slopes in tears.

When I suggested a cup of hot chocolate, she accused me of having a one-track mind. “Every time I'm upset you think it's all about food!” she said. “You think my whole life is all about what I eat and don't eat. I'm sick of it.” She stormed across the lodge's great room and flung herself into a chair by the fire, her back to me.

She was right, of course; I did associate her mood with her food. I sat by the window and thought back over what she'd been eating for the last week—or at least what I'd seen her eat. It seemed to me, watching skiers come down the slopes through the floor-to-ceiling windows, that I'd seen Kitty start to restrict. Nothing major—just choosing, say, a plain baked potato over French fries, fruit for dessert, fish instead of meat. I hadn't seen her eat cheese in a while. Was this normal eating, or was I inventing a problem? Was my anxiety a sign that I was one of Hilde Bruch's overcontrolling mothers after all?

I crossed the room and sat on the arm of Kitty's chair. With her back to me, she said, “I'm really not trying to restrict,” and it was this more than anything else that made me realize the truth. I bought a Hershey's bar and a mug of apple cider and insisted that she eat and drink. That night at the hotel's dinner buffet, I nixed the broiled fish she wanted in favor of shrimp scampi with a side of French fries and a slice of pie. She was furious, stabbing at the
food with her fork, complaining more or less continuously that her stomach hurt, that I was making her eat too much, that this was my problem, not hers.

The next day she was fine: self-possessed, making jokes, helpful. She came back to the lodge a little early, saying she was tired, and without any nudging on my part ate a large protein bar and drank a carton of milk.
Remember this,
I thought: the more she eats, the more willingly she eats; the less she eats, the harder eating becomes. There appears to be a self-reinforcing quality to both the act of eating and the act of restricting. I told myself to trust my instincts, that even if I couldn't articulate the symptoms, I'd come to recognize the altered state Kitty got into with even the slightest bit of undereating, whether it was intentional or not.

There were other incidents like this, and I wondered whether time would help or whether, maybe, Dr. Beth was wrong. Maybe Kitty was going to have to be vigilant about what and how much she ate for a while. Maybe forever.

By her junior year of high school, she was stopping by Dr. Beth's herself for weigh-ins every couple of weeks. She would get on the scale and have a nurse record her weight and call us with the number. Keeping her weight up still seemed to present a challenge, especially because Kitty, ever the athlete, had discovered a new sport, cycling. And she was good at it: in her first year she won a couple of national championships in her age group. As she put on muscle, we adjusted her target weight up, to make sure she wasn't losing body fat as she gained muscle mass.

“Why can't you take up embroidery instead of sports?” I asked her one afternoon, smiling to show that I was joking. But I wasn't, not really. In 1986, Walter Kaye did a study showing that people with anorexia need more calories than usual for months after weight
restoration; eventually, he believes, their systems return to normal. In the meantime, Kitty's hypermetabolic state combined with cycling meant that she had to keep on eating about thirty-five hundred calories a day just to maintain her weight.

Something else troubled me, too: Was Kitty's drive for competitive athletics good for her, or was it a sign of ongoing pathology? Was she biking to purge calories, or because, as she said, it made her feel good? She saw her athleticism as part of who she was—the most important part, to her, at least for now. Jamie and I accepted that. But we still wished she'd expand her passions. Before anorexia, her dream was to go to law school. When I asked her about that now, she shrugged.

Most of the time, she ate with enthusiasm and hunger and pleasure; most of the time, except for our nightly family dinners, she ate on her own, like a normal teenager. When her weight dipped a pound or two, we offered support as tactfully as possible. I might walk into the kitchen as she made lunch—she still came home for lunch, by her choice—and say, “I think you need another slice of turkey on that wrap,” or “How about if I make you a couple of grilled cheese sandwiches?”

How far should we push Kitty? We weren't sure. I thought we were in Phase 2 of family-based treatment, where parents gradually return control of eating to the teenager. That's what we were trying for anyway. And Kitty's weight was good; her BMI was around 20, solidly on her growth curve, and it stayed steady over her last two years of high school. But she still seemed vulnerable in ways that surprised us. She still sometimes seemed too close to the edge.

But we were the only ones who felt that way. Dr. Beth invited me into the exam room at the end of Kitty's sixteen-year checkup. There she told me that Kitty was in a good place, she was ready to
move on from the anorexia, but that my continuing anxiety over Kitty's eating was “inappropriate” and holding her back.

Over the next few days I thought hard about what Dr. Beth said. Was she right? Was I hanging on to the anorexia in a way that was holding Kitty back? Kitty's relationship to food still felt tense and controlled to me. Both Jamie and I noticed that she still shied away from foods she used to love, like pizza, cheese, chocolate. She
said
they upset her stomach; it seemed a bit too coincidental that they all contained fat. She was often emotionally volatile; then again, she was a teenager. Her weight was good for her height but not high. She told me she was having regular periods.

Her urge to exercise still felt excessive to me, especially when I discovered by accident that she'd added running to her workout routine, after we'd agreed she wouldn't run. When I confronted Kitty about it, she said running helped her deal with stress, that it wasn't part of an eating disorder, it was just who she was. That she wasn't doing it to burn calories.

I believed her. But I didn't believe anorexia. And I didn't know who we were talking to.

In some ways it was easier to know what to do when Kitty was in crisis. Things were black and white then: the hospital, the medical emergency, the physical manifestations of malnutrition all inspired a sense of urgency. In Phase 1, all our efforts focused on getting Kitty to gain weight. Now the goals were more complex and more individual.

Maybe Dr. Beth was right. Maybe I did have issues about letting go. I couldn't tell anymore. My anxiety boiled down to a feeling that Kitty wasn't there yet—wherever
there
was.

In my anxiety about being anxious, in my wish to respect Kitty's growing independence, I argued with Jamie. Kitty was still nervous
about getting weighed; she wanted to know a day in advance, so she could, as she put it, “prepare herself mentally.” Jamie thought this was suspicious and wanted to be able to pop her on the scale randomly—not in a punitive way, just to do the occasional spot check. I said I could understand her anxiety; after all, we put a lot of emphasis on her hitting the right number on the scale. I was trying hard to let go of my anxiety, as Dr. Beth had suggested. I didn't want to be one of those neurotic mothers who couldn't let their child grow up.

I won the argument; we gave Kitty advance warning when we were going to weigh her. In retrospect, I wish I'd lost.

 

Every parent worries when
a child strikes out on her own. We're not like birds, who push their fledglings out of the nest. We worry about who will be there to comfort our child, to help her learn to take care of herself. And when that child has special needs, whatever they are, the process of becoming independent is that much more fraught. The stakes are that much higher.

Kitty graduated from high school a semester early. She'd been accepted at a small midwestern university for the fall, and she wanted to spend spring of her senior year living in Colorado, training and racing with the rest of her cycling team. She said she knew lots of people in the area; she could cook, do laundry, hold down a job in a bike shop. She couldn't wait to be independent.

She was close to her new, slightly higher target weight, a couple of pounds shy, and said she could reach it on her own. “I've left anorexia behind, Mom,” she told me. And I wanted to believe her. I wanted Dr. Beth to be right about Kitty being one of the lucky
ones who recover completely, go on with their lives, never look back.

So she went off to Colorado, with certain conditions: She had to stay in close touch with us. And she had to find a doctor's office where she could be weighed, and where the nurses would send us the weight, at least every two weeks.

At first things went well. Every time we talked I asked if she'd found a doctor's office for weigh-ins, and every time she said, “Not yet.” And every time we hung up, Jamie and I muttered to each other about making some calls and finding a doctor for her. Setting it up.

But the truth is, Kitty was eighteen, and part of the point of this gap semester was for her to become more independent. So we didn't make any calls. The weeks passed, and she said she was doing well. But I noticed that she sounded a little fragile on the phone—a little more high-strung, more prone to tears. “Are you eating?” I asked, over and over.

“Yes, Mom,” she said in an exasperated voice.