Brave Girl Eating (4 page)

I knew even then what I wanted to see: that Kitty was all right. That she didn't have a problem.

I just couldn't make myself believe it.

 

By the end of
June the summer had turned hot and humid, the kind of weather that constricts your lungs and slows everything down to a dreamy, underwater pace. Our house had no air-conditioning, but Kitty wore a jacket and long pants, even to bed. We were all fractious and tense. More than once Emma ran from the dinner table, hands over her ears to block out the sound of us arguing over what Kitty was and (mostly) wasn't eating. These were battles, now, and we lost every one. We never got Kitty to eat even a bite more than she'd allotted herself.

Once upon a time, family dinners had been a ritual I looked forward to, a time when we came together to talk and laugh. Now I
dreaded them. I developed a Pavlovian response to the approach of the dinner hour—headache, churning stomach, sweating palms—and by the time we actually sat down at the table, I couldn't eat either.

I was glad when Kitty was at the gym, even as I worried about her. I went to sleep worrying and woke up worrying, and by the day of our appointment with Dr. Beth, my anxiety was nearly as high as Kitty's. Hers was now undeniable. She fretted for an hour over what to wear to the office, what would happen there. “Dr. Beth is going to help us help you,” I told her, over and over, and hoped to God it was true.

As we waited in an examining room, Kitty clutched my hand and I held on, feeling as though we were on a raft heading out to sea and Dr. Beth had the life preserver. She came in with her usual smile, took Kitty's pulse, looked at her chart, and sat down across the room from us. “Now tell me why you're here today,” she said with her characteristic directness.

“I think Kitty has anorexia,” I said.

There it was, the terrible word, out in the world. Pandora's box, opened now, never to be closed again.

I ticked off the symptoms. Kitty was way too thin. She avoided eating. She cried a lot. And now there was something else, a sour smell I'd noticed in the last week or two. A smell that reminded me of our elderly cat shortly before she died of kidney failure. Ketosis—the smell of the body digesting itself.

Dr. Beth turned to Kitty. “What do
you
think?” she asked. Eyes closed, my daughter moved her head a fraction. It was the first time she'd acknowledged that she had anorexia. And it was the last time, for more than a year.

There was no leaving the room this time. Dr. Beth examined
Kitty, talking soothingly as she listened to Kitty's heart, took her temperature, felt her glands and belly. Kitty's heart was beating only forty-two times a minute (normal is sixty to eighty). She weighed six pounds less than she'd weighed the previous December, and she'd grown half an inch. Suddenly she was at least twenty pounds underweight.

After Kitty pulled her sweatshirt back on, Dr. Beth took one of her ice-cold hands. “I know this is hard,” she said. She looked at Kitty, but she was speaking to both of us. “I know you don't feel well, and you're scared. I won't lie to you. Anorexia is a very serious disease, and there's no quick fix for it. But I promise you, Kitty, that a year from now, you'll feel better.”

Of all the gifts Dr. Beth gave us over the next year, this was the greatest: she gave us hope. Her words kept us going through the nightmare that was still to come.

She spent a long time talking to Kitty that day, reiterating why and what she had to eat. She encouraged her, talked to her about what was happening in her body, how much better she would feel if she ate. She held Kitty's hand, stroked her shoulder, smiled into her eyes.

Afterward, while Kitty waited in the exam room, Dr. Beth talked to me in the corridor. She had two pieces of advice: try to get Kitty to eat, and find a therapist, fast. What she didn't tell me, what I read for myself later, was that the average length of time for recovery from anorexia is five to seven years. That most people with anorexia bounce in and out of hospitals, recovering and relapsing. That anorexia is the deadliest psychiatric illness; close to 20 percent of anorexics die, about half from starvation and the other half from suicide. Nearly one-fifth of all anorexics try suicide; many succeed.

There was relief in having Kitty's illness out in the open—on
the table, so to speak. But I still couldn't see the path to recovery. I was numb and terrified; I felt like a block of stone with a tiny crack in one corner. The crack would widen, with stress and time, and the stone would come apart. The only questions were when and how.

Dr. Beth sent us downstairs to the lab for blood work and to check Kitty's vitals, including her heart. She said she wasn't too worried because Kitty was a gymnast, and athletes have slow heart rates. I was reassured by her words, though later I learned that anorexia can cause cardiac arrhythmias and heart attacks.
^*
I wondered, later, if Dr. Beth, too, was in denial about how serious Kitty's illness was. Or maybe she was simply trying not to overload us with terrifying news.

The lab technician lifted Kitty's sweatshirt, and for the first time in weeks I saw my daughter's naked chest. The sight made me want to howl. Her skin stretched tightly over her sternum. I could see the arching curve of each rib, each nick and indentation of her collarbone. Her elbows were bowling balls set into the middle of her matchstick arms. She looked like a concentration camp victim, right down to the hollow, hopeless look on her face. My bright, beautiful daughter lay broken on the table, her eyes dull, her hair lank. I could not bear it.

And then the tech smiled at Kitty and exclaimed, “You're so nice and slim! How do you keep your figure?”

If I'd had a gun in my hand, I swear I would have pulled the trigger.

My daughter closed her eyes and turned her face to the wall. This wasn't the first compliment she'd gotten on her slenderness,
just the most inappropriate. That spring, strangers stopped us on the street all the time, wanting to tell Kitty how attractive or darling or stylish she was. In a shop one afternoon where I was trying on clothes, the saleswoman turned to Kitty and said, “Aren't
you
lucky—you got the thin genes!”

Every one of these comments made my skin crawl. Yet how could I protest, when people were just, as the tech insisted later, trying to be friendly, offering a compliment? What could I say, when I, too, liked to be told that I looked thinner, prettier, sexier?

That night, after Kitty's diagnosis, I spent hours online and came away bleary-eyed and confused. The next day I called a therapist I knew, retired now, but who'd treated eating disorders for many years, and asked for her advice.

“Anorexia and bulimia and cutting, problems like that, are always about the great crisis in a teenager's life, the onslaught of sexual feelings,” she told me. “Anorexia is a way to stay small, to not grow. It reflects a teenager's conflict about growing up. It's not about the food.”

Just about every parent of an anorexic hears this somewhere along the line:
It's not about the food.
And the next comment is usually something like
So don't make an issue out of her not eating/binging/purging/fill in the blank
. It's a hell of a mixed message. Kitty's illness wasn't about the food, but we had to try to get her to eat. It wasn't about the food—but she was starving to death.

Though I respected my friend the therapist and her years of experience, her words made no sense to me. With each day that passed Kitty was disappearing, mentally as well as physically. She was hysterical, emotional, fragile. She couldn't think straight, couldn't sustain simple conversations, let alone express or “work through” feelings. If it wasn't about the food, then why was she so irrational
about eating? Why, then, would a relatively innocuous comment from one of us—“Kitty, have another bite of pasta”—send her rushing from the kitchen, screaming and crying?

If it wasn't about the food, what was it about? I didn't care. What I really wanted to know was, How was Kitty going to get better? She needed to eat.
That
was clear to all of us. What wasn't at all obvious was how to make her do it. I felt both helpless and utterly responsible. If only I could find exactly the right words, the right tone of voice, surely she would see the truth. Surely, then, she would eat.

I started reading everything I could find about eating disorders, beginning with
The Golden Cage
by Hilde Bruch, long considered one of the classics on anorexia. Bruch portrayed anorexics as attention-seeking and manipulative, purposefully self-destructive. And she painted a devastating portrait of the “anorexic family,” one where parents (especially the mother) were critical—expecting outward perfection, quick to pick apart a child's looks and weight, highly controlling—and also emotionally negligent, shutting down any expression of a child's true feelings, forcing the appearance of conformity and pleasantness and refusing to acknowledge difficult emotions.

I felt sick, reading this. Was it true? Was Kitty seeking attention? That didn't feel right. On the contrary—Kitty avoided being the center of attention. She was a classic “good girl” whose fear of screwing up led her to be too pliant, if anything.

Were Jamie and I critical of our daughter's appearance? Did we shut down her feelings, give her the message that she had to conform to our ideas of who she should be? I would have copped to any family dynamics, no matter how bad, if it meant finding a way to fix Kitty, but I didn't recognize our family in Bruch's book. We
had our issues, certainly, but overly controlling and hostile? Again, it didn't feel right.

I grew up in a house where how people looked was the major topic of conversation. Where my mother weighed herself daily, recording the number on a chart that hung on the bathroom wall. Where the highest compliment you could pay anyone, anytime, was “You look so thin! Have you lost weight?”

I'd worked hard not to perpetuate this obsession with appearance. I was careful to praise Kitty for her intelligence, her empathy for others, her sly wit, her love for books. One of our often-told family stories was about an encounter we had in an airport when Kitty was just learning to walk. She was dressed in blue pajamas, handed down from a male cousin, and a woman sitting beside us said, “Ooh, what a big strong boy you've got there!” When I told her that Kitty was a girl, she immediately cooed in a high-pitched voice, “What a pretty little girl!” Jamie and I rolled our eyes. For years we've used that story as an example of obnoxious gender stereotyping.

So no, I didn't recognize myself in Bruch's characterization; nor did I recognize our family. But I was coming to mistrust my perceptions. Maybe, I thought, I was in denial about this, too. Each time Jamie or I urged Kitty to eat a little more, to take another bite, I felt not only the anguish of watching Kitty shake her head, push away the plate, disappear bit by bit; I also felt the shame of trying to get her to eat, of
needing
to try, of not being able, as the books said, to just ignore Kitty's eating, talk about other things, steer clear of the subject.

Dr. Beth said we needed a therapist as soon as possible. I called our health insurance company's referral line and, after much wrangling, got the names of three therapists. One didn't see adolescents.
One wasn't taking new patients. The last couldn't see us for five weeks. I made the appointment and put our name on her cancellation list. In the meantime, we were back in all-too-familiar terrain, trying to get Kitty to eat. Mealtimes were intensely unpleasant and unproductive. “Dr. Beth says you need to eat,” Jamie would say as she pushed away her nearly untouched plate.

Kitty's responses were always the same: “I'm full!” “I had a big lunch!” Or, more and more, “Just leave me alone!”

But we were more stubborn now than we'd been a month ago. “Come
on,
Kitty,” I would say. “Are you
trying
to kill yourself?” Anorexic behavior is the very essence of self-destructiveness. Humans have to eat; I couldn't understand how Kitty didn't see that. Fear and frustration made me desperate, and the more distressed I got, the more Kitty dug in her heels. “Why don't you just eat?” I shouted one night. “I don't understand! You're a smart girl! You know you have to eat!”

The look that passed across her face was nothing I recognized. It was the look of a cornered animal, something with fangs and claws and wild medusan hair. The next second we were back to what passed for normal these days—me wheedling, pleading, and ultimately shouting, and Kitty refusing. Refusing food. Refusing, now, even milk and water. She would take only a few sips of vitaminwater, then insist she wasn't thirsty, she was fine, she was tired, she was going to bed. As we went around and around in the awful circle that had become our lives, that other look haunted me. Had I imagined it? I was exhausted, not sleeping, anxious and antsy and haunted by what Kitty did and didn't eat. Had I hallucinated? Was I now projecting my anger and fear onto my daughter?

That must be it, I told myself. I was losing it. I should try to chill. Still, the vision of my daughter's face, distorted and alien, rose
up at odd moments. I dreamed about it one night—a mask of fury superimposed over her familiar and now terribly sad eyes. I could not forget it.

Every day was fraught now, strewn with minefields and tears. The most ordinary activities were emotional mountains we could not scale. Every trip to the grocery store with Kitty had become an agonizing series of negotiations. And she always wanted to come along. Each time I reached for a gallon of milk, a box of cereal, a piece of fruit, Kitty would argue: we should buy skim milk instead of 1 percent, packets of ramen noodles instead of soups, fish instead of chicken, pretzels instead of corn chips, Special K instead of Cheerios, frozen yogurt instead of ice cream.