Authors: Harriet Brown
I didn't want to buy those things. I wanted to buy food full of calories to heal my starving daughter. But if Kitty promised to eat the frozen yogurt, maybe I
should
buy that instead of the ice cream, which I
knew
she wouldn't eat. Because, after all, it wasn't about the food.
I became obsessed with getting calories into her. Kitty said it was easier to eat in front of the TV, so we ate in front of the TV, something we'd never done before. Kitty said it was harder for her to eat in front of other people, so we stopped our casual potlucks with neighbors, didn't go out to restaurants, and told Emma she couldn't invite friends over.
I bought the ramen noodles, the Special K, the pretzels and air-popped popcorn, the light bread, thinking
Something's better than nothing.
None of it made a difference. Kitty still didn't eat, and her excuses for not eating grew less and less persuasive. She knew that we knew, now, that none of it was true: the food was neither too hot nor too cold, neither too spicy nor too bland. Her stomach
was
upset, but it was always upset now. She refused Tums and wouldn't
tell me why, but I thought I knew: each Tums contained ten calories. She knew that we knew that she wasn't full, she hadn't eaten at a friend's; in fact she had stopped talking to her friends weeks earlier. “I'm too upset to eat,” she said one night. We were sitting at the kitchen table, where it seemed we now spent the worst hours of our lives. Two fans blew hot air across the table, which was piled with sweet corn, chicken sausages, and tomatoes from the garden, none of which Kitty had tasted.
“We're
all
upset,” I pointed out, my voice rising. She said I didn't understand. I was pressuring her, which made it worse; my anxiety was making her anxious, too anxious to eat. Tomorrow would be different, she promised. She begged me to understand, to be compassionate. “I'll try harder!” she swore, and I wanted to believe her. But when tomorrow came, she ate three grapes, half a fat-free yogurt, a single slice of low-calorie bread.
Worse, I could see what it cost her to do even that. The façade of hostility slipped sometimes, revealing a deep, relentless anxiety that made my heart ache. “Mommy, is it OK?” she would ask, racked with guilt over a forkful of broiled chicken, and I would reassure her:
Of course it's OK, your body needs food and milk and nutrition. Food is good for you,
I would say.
Everyone needs to eat, including you. If you don't eat, you'll die.
These conversations took on a ritual feeling, a kind of stylized call-and-response that reminded me of the way a toddler will run two or three steps away and look back at her mother, seeking reassurance. Only nothing I said or did made eating easier for my daughter. In fact, my words seemed to have the opposite effect: the more reassurance I gave Kitty, the more fearful we all became.
One night in early July she lay down beside me in bed, sobbing, and it was as if her tears unlocked the words she'd been holding
back. “I don't want to die, Mommy, but I feel so guilty,” she cried. “I ate a whole Popsicle and I wasn't even hungry. I ate a piece of fish. I'm a greedy pig, Mommy. I ate and I wasn't even hungry. I know it's wrong to feel these things, but I can't help it, it's how I feel.”
I gathered her in my arms and rocked her, my teeth chattering with fear. “I'm not going to let you die,” I promised. “You're going to be OK. I'm going to keep you safe.”
But how could I keep her safe when I couldn't get her to eat a single french fry?
Kitty often cried herself to sleep now, with one of us sitting beside her, holding her icy hands, rubbing her back the way we had when she was a toddler. In bed later, Jamie and I looked at each other in despair. The therapist we'd finally found, Dr. V., would help. We had an appointment in three weeks, and then we would know what to do. Dr. V. would have the answers.
I tried to forget that I'd felt that way about seeing Dr. Beth, too.
That night and every night after for a long time, I went to sleep thinking of the sharp angle of Kitty's elbows, the shape of her bones under skin. I saw against my closed eyelids her hollow face, her enormous eyes, the unnatural point of her chin. I could not bear to see these things. I could not stop seeing them.
In the meantime, our health insurance refused to accept a diagnosis of anorexia from Dr. Beth because, as the “consultant” told us, only a psychiatrist can diagnose a mental illness, and anorexia nervosa is listed in the
DSM-IV,
the bible of mental illnesses. Once more I started on a seemingly endless round of phone calls. The only psychiatrist who could see us within six monthsâ
six months
âwas a psychiatric fellow in her last year of training whom I'll call Dr. Newbie, who had an opening the following week.
Our first visit was not auspicious. Kitty stayed curled in a fetal position, her head in my lap, while Dr. Newbie asked question after question. Her diagnosis, after forty-five minutes, was depression and eating disorder not specified, commonly known as ED-NOS. She prescribed fluoxetine (the generic form of Prozac) and weekly visits, both of which we dutifully began, neither of which seemed to help. Dr. Newbie was kind but more or less clueless; she spent most of our sessions telling Kitty she had to eat, which we were already doing at home. The fluoxetine gave Kitty headaches and upset her stomach, making it even harder, she said, to eat.
Worse, what I didn't understand then was that our mental health coverage was limited to $1,800 a year. Seeing Dr. Newbie, it turned out, cost us $200 a pop, using up our precious benefits on an exercise in futility.
Nothing seemed to help Kitty's anxiety and guilt around eating. Though we rarely cook red meat, one night I made lamb; Kitty's lab reports showed that she was anemic, and lamb is rich in iron. After an hour of cajoling, arguing, and yelling, she choked down two bites of meat. Afterward she ran into the backyard and curled up in the grass, where Jamie and I could see and hear her through the kitchen window. “Oh my God,” she cried, arms wrapped around herself, rocking in the grass. “That must have had three hundred calories in it! Oh God!” We sat at the table and listened to our daughter's agony, and did not know what to do.
I hoped the therapist would help. On the day of our first appointment in mid-July, she came out to the waiting room and said hello in a high-pitched, syrupy chirp that immediately set my teeth on edge. The old Kitty, a precocious observer of human nature, would have rolled her eyes at me. The new, withdrawn Kitty didn't even blink.
Dr. V. tried to get Kitty to come in alone, but I was done with
staying in the waiting room. So in we went, to Dr. V.'s blandly beige office, where she commenced interrogating Kitty in the same gooey tones. I didn't care how idiotic or patronizing she sounded, as long as she could tell us what to do and how to do it. If she'd come up with a workable plan, I would gladly have given her all our disposable income for the next ten years. If I'd trusted her, even a little, we would have been in her office twice a week. Alas, no plan was forthcoming, and trust was not an option after Dr. V. informed me that anorexia “isn't about the food” and was typically caused by “the mother's unresolved conflicts.”
“Now, Mom, don't be the food police!” she admonished me as she ushered us out of the office. I wanted to bite her head off. How in the world could Dr. V. be considered an expert on adolescents when she talked to Kitty as if she were two years old? She hadn't a clue how to relate to a teenager.
“What did you think?” I asked Kitty in the car. She shrugged apathetically, but I thought I caught the tiniest hint of somethingâamusement? sarcasm?âin her dulled gaze. It cheered me immensely, which I needed when I imagined coming back to Dr. V.'s office week after week, offering up our family's dysfunctional moments as Kitty grew thinner and weaker and paler. Dr. V., it was clear, was not going to save Kitty. But if she couldn't do it, who could?
That night, Emma ran away from home. She didn't go farâonly to the end of the blockâand she was easy to find, because she stood on the street corner and screamed, “I have the stupidest, most lousy parents in the world!”
Man, was I jealous. I wanted to stand on the corner and cuss someone out too. I just didn't know who.
Â
In the second week
of July, the weather turned even steamier, with three-digit temperatures nearly every day. One of those days was our city's annual opera in the park concert, which we went to every year, eating a picnic dinner on a blanket in the grass.
Kitty spent that entire afternoon in our sweltering kitchen, frying chicken and making carrot cake, the oven and range going full blast. The room was like a sauna, but she wore a long-sleeved gray sweatshirt over a T-shirt, heavy jeans, fuzzy socksâand still she did not sweat. Nor would she drink, even when I followed her around with a glass of ice water, begging her to take a sip. “For God's sake, it's a hundred degrees in here,” I said.
“I'm not thirsty.”
“Promise me you'll at least eat some of what you're cooking,” I said, my voice raised in frustration.
Kitty looked at me calmly. “Of course I will,” she said.
Of course she didn't, not really. She peeled every speck of fried coating from a drumstick and picked at the meat. She produced a small bag of red grapes and ate three, turning down the carrot cake, the potato salad, the apple juice. “My stomach hurts,” she said. “I'm not hungry.”
I got angry. Furious, actually. Furious enough to turn my back on Kitty in her sweatshirt, zipped up to the neck. I sat at the opposite end of the blanket, denying her contact, avoiding her icy hands, her now nearly constant need for physical reassurance.
Fine,
I'd thought.
OK. You want to starve yourself to death? Go right ahead.
The chicken and carrot cake were, no doubt, delicious. I don't know, because none of us ate a bite. I went to bed angry, feeling like things were about as bad as they could get.
And that's when Kitty came to me in the dark, her hand on her chest, her voice full of fear.
Â
I can see from
the look on the nurse's face that the news is not good. She ushers us back to the emergency room cubicle, where an earnest young doctor shakes my hand and opens Kitty's chart. He seems to be a long way off, his voice tinny and low as he explains there's a problem with Kitty's EKG. The electrical impulses that initiate each heartbeat are coming from the wrong part of her heart, a sign that her body is stressed. She's also dehydrated, and her heart rate is too low, only thirty-five beats per minute. The number penetrates the gray fog that's descending over my whole body. Kitty's heart rate has dropped since our visit with Dr. Beth two weeks earlier. This isn't good.
“I'm going to admit her,” says the doctor. He rubs his eyes as he speaks, as if the very sight of us makes him weary. I suppress the urge to apologize, barely, but it persists as I fill out the paperwork, as we wait for a bed to open upstairs, Kitty shivering in my arms now, fear shining from her huge brown eyes.
By the time we're ushered upstairs to the pediatrics ward, the sun is rising, lightening the pale green walls, the hospital bed, the chair beside it. A nurse opens the door, taking us in with a professional flick of her eyesâKitty, curled in a ball on the bed, her eyes closed; me pacing, my hair uncombed, my eyes red, literally wringing my hands. She sets to work, helping Kitty into a hospital gown and into bed, talking to her in a soothing voice as she inserts the IV line that will help rehydrate my daughter. Normally Kitty would put up a fuss; needles are the one thing she's scared of. But this morning she lies listlessly in bed, eyes closed. She's asleep by the time the line is in.
The nurse tidies up and leaves, the hospital door closing sound
lessly behind her. I sit in the chair beside Kitty's bed and watch clear liquid drip into her arm. Her face is chalk-white; her jaw is clenched in sleep. I take one of her freezing hands between mine and hold it, trying to warm her with my own heat.
There's relief in being in the hospital, after the weeks of going it on our own. It's cool and clean, and, best of all, someone else is in charge. My job is to sit at Kitty's bedside and talk to the endless parade of residents and interns, who want to hear her history over and over: How tall is she, how much does she weigh, when did you notice a change in her eating, when did she lose weight? I tell them she lost only a couple of pounds. I tell them she was fine until two months ago. I tell them our family is not dysfunctional, that we are reasonably happy, that Kitty has never been abused.
Actually I don't tell them that. I want them to believe it, but I see that they don't. I watch their young, transparent faces as they make notes in Kitty's chart, notes I am not allowed to read but that no doubt say things like
Mother in denial
. I don't care. I'll accept any judgment they want to offer, if they will make my daughter well.
I don't get it yet. I still think someone can make my daughter well. That this is a process that will take days, that there's some incantation that will reverse the damage, turn back the clock, remove the curse, and that, like Sleeping Beauty, Kitty will open her eyes and be magically healed.
If only.
After twenty-four hours with the IV, Kitty is rehydrated, but her heart rate is still too low. She's too dizzy to sit up by herself; it takes two of us to help her to the bathroom. She hates the hospital meals, and I don't blame her. The kitchen sends up mountains of steamed broccoli, little cups of Jell-O, bowls of consommé, all of it unappetizing, none of it with enough calories to sustain a caterpillar.
Although she's not on call, Dr. Beth turns up at the hospital that first day, a Sunday, and spends hours talking to the doctors on the ward and sitting with Jamie and me. She is our lifeline, our reminder of the world of sanity and light. And so, late the next afternoon, when the resident tells me that Kitty's heart rate isn't coming up and he wants to transfer her to the ICU, it's Dr. Beth I call in a panic. As the nurses wheel Kitty's bed to the ICU, I trot along beside them, arguing. Isn't this a bit extreme? Aren't we overreacting just a little? Can't we give her more time? She's a reasonable girl. She's going to come around, I know it. The ICU is for people who are really, really sick, isn't it? My daughter's not that sick.