The Skeleton Cupboard (22 page)

That was about twelve thousand words, and I'd only written about a third of that so far. Plus it was Rosie's birthday the coming weekend. I'd have no time.

“OK.”

Chris nodded. “Good. Next, I want a breakdown of the stats you are using to crunch your data so we can get that out of the way.”

Oh massive shit.

“Chris, stats and me. I…”

Chris smiled. “I know stats. Send them to me and I'll work it out.”

Really?

“Really?”

“Yeah. You are a clinician, not a statistician. If this is your hurdle, I'll get you over it. I can do stats.”

“Well, if you're sure … I mean, I will have a viva—I will have to explain my stats to the exam panel.”

“I can coach you. Just shut up and trust me. I want you to read the following papers relating to systemic and structural family therapy so that you can get on top of this family and finish this placement with a flourish.”

This all seemed too much—it was my final year and I was totally overwhelmed, more than at any other time in the past two years of training. Chris stared at me while I wrote down my reading list and broke into a cold sweat.

*   *   *

The grind of the ward continued. Mollie and I would meet and talk regularly in order to, as Mollie once pointed out, build “our therapeutic relationship.” She always seemed to need to be up there with me pointing out the process of the therapy, the psychology of what we were talking about, interpreting my questions. Clearly this was because she was a therapy veteran, quick-witted and intelligent, but it also felt very controlling.

Some days she wanted to debate the ethics of enforced feeding. Then there was the endless curiosity about my relationship with food. Had I ever food-restricted?

“Why,” Mollie asked me sweetly, “should I trust you if you feel unable to let me know something about you?”

“How would it help you to know something about me?” I asked.

“Why wouldn't it?” Mollie replied with a smile.

While our conversations were challenging and interesting, I often left them wanting to tell this young woman that she needed to stop talking, listen and accept my challenges rather than throw them back at me. I had an urge to reprimand her, to say I was the grown-up and that's all there was to it. Yes, like her parents, teachers and the ward staff, I was struggling with this powerful young woman.

The following week the girls were given spaghetti for lunch and I discovered just how threatening pasta could be, as I walked into a ward of crying, hyperventilating young women. The nurses seemed barely compassionate; the head psychiatrist was sleeping off a hangover in the ward clerk's office.

It was another lunchtime of plate-scraping and food hide-and-seek, and I briefly considered braiding the cold, congealed strands of spaghetti and hanging myself with them.

But then it was action stations! Victoria, the career bulimic, was doing her after-dinner trick of self-induced vomiting. She was a pro: no fingers down the throat, no trying to break into the toilet or the cleaners' cupboard to hide and purge. This girl just blatantly stood in front of us after clearing her plate of pasta and made her diaphragm and core muscles dance.

“She's off!” cried Linda, and, joined by her other nurses, she tried to hold the heaving young woman. Spaghetti vomit thundered poetically out of Victoria and found its way through the smallest window opening and onto a tree below.

I needed to be with Mollie. Sitting upright in her bed, tube up nostril and down into gullet, she was the only sane person in the place.

Curtains pulled around the bed, I sat down.

Mollie smiled. “What was that all about?”

“A postmeal incident.”

Mollie reached for her sketchbook and opened it. “Look at this.”

I looked. It was me, perfectly drawn.

“Blimey, Mollie! Why this picture?”

Mollie shrugged her tiny shoulders. “I dunno.”

I paused. Was this bright girl manipulating me, or was I just being an idiot who needed to catch up?

“You dunno, Mollie? But you are so bright. I'm sure you know.”

Mollie closed her eyes and took a huge breath in. “Well, d'you know what? Work it out.”

Feeling stumped by this intelligent, articulate, yet tight-lipped young woman, I was relieved when the doctor and a nurse arrived to remove Mollie's nasogastric tube.

“Good afternoon, my dear,” said the doctor.

Mollie nodded, and the nurse smiled.

“So, the day has arrived. Nice steady weight gain—well done, you—and time to get going on proper food.”

It was all very businesslike.

“Would you like me to leave?” I asked the doctor.

Mollie grabbed my hand. “No, please stay.”

Oh God, I really didn't want to.

“Sure, no problem. That OK?”

The doctor nodded while he looked at Mollie's charts. Mollie went pale, and I started to feel sick.

“OK, Mollie, I'm going to pull out your tube very gently, OK? It won't hurt, but you will feel a tugging and you may cough or gag a bit. OK?”

Mollie shook her head and her eyes welled up.

“Great!” said the doctor. “Let's go.”

The doctor washed his hands and put gloves on, while the nurse laid a towel across Mollie's chest.

“You OK?” I whispered.

Mollie looked at me wild-eyed and shook her head.

“Come on now, it'll be over in a minute.”

I did not like the jolly bedside manner of my colleague.

The tube was unpinned from Mollie's gown, and the tape securing the tube to her nose was removed. Mollie winced.

“Oh come on, that doesn't hurt!”

How does he know?

As if reading my mind, the doctor continued, “I had this done to me at medical school, so I know it doesn't hurt.”

Well, that's that, then—if it didn't hurt you, it won't hurt any other mere mortal, especially not a frail, frightened seventeen-year-old. Arrogant man.

The nurse turned off the suction and disconnected the nasogastric tube, while the doctor pinched it near Mollie's nostril.

“OK, deep breath and now breathe out … and out…”

The tube snaked out as the doctor pulled it and Mollie erupted into violent coughing and gagging. I had to swallow back my own nausea.

A brisk wipe of the nose and face, a sputum bowl offered and they were off.

“Make sure she sips water, won't you.”

“I guess that final instruction was for me, Mollie.”

Mollie nodded. “He's a moron.”

Soon she was lying back on her pillow, her breathing calming.

“Thanks for staying.”

I smiled.

“Disgusting, isn't it?”

I nodded. “Pretty grim.”

The sound of footsteps approached and then the curtain was flung open, revealing the arrival of Robert with Eleanor behind him.

“Well, well, look at you, love. You're tubeless!” Robert boomed into the space, and gave his daughter a bear hug.

“Careful, Robert!” Eleanor was poker-faced. “Be gentle, can't you?”

Mollie smiled. “It's OK, Mummy—I won't break.”

“That's my girl!” Robert squeezed Mollie again, setting off another fit of coughing.

“Robert, stop.”

As Eleanor pulled her husband off their daughter and pushed him aside, Robert grabbed her hand and, squeezing it, said to his wife in a low voice, “Eleanor, you have to let go.”

What a multilayered comment.

“So,” said Robert, sitting heavily in a chair next to his daughter, “how's she doing?”

That was a question for me.

I looked at Mollie. “How are you doing, Mollie?”

Eleanor smiled to herself.

“I'm doing fine, Daddy.”

Another nurse appeared with what looked like a large toddler sippy cup full of thick beige liquid; the process of weaning was to begin immediately.

“Bottoms up, darling!”

Mollie smiled and looked at the cup.

“Come on now, Mols, down the hatch!”

“Daddy, I'll drink it later.”

Robert sat forward; he was a big man. “Mollie, you will drink it now.”

“Daddy, I…”

Eleanor stood up. “Robert, a word, please.”

Robert sighed and sat back in the chair, closing his eyes. “No, Eleanor, no ‘word, please,' love. Let's just get our Mols to drink, shall we?”

Eleanor was still standing. “Robert, I said I'd like a—”

Robert's heavy hand thumped on the arm of the chair. “Sit down, love.”

Eleanor stood still.

“Please, love. Sit down.”

Eleanor sat.

Robert sat forward again to address his daughter and took the cup from her hand. “Let me try some of that.” He took a sip. “Delicious. A good 1972 vintage, I think.”

Mollie let out a tense, strangled giggle.

“Come on, love. Get it down.”

Watching this was worse than seeing the nasogastric tube come out. As much as I wanted to, it felt wrong for me to intervene, as I needed to see this scene play itself out, although somehow I felt horribly voyeuristic.

Eleanor remained expressionless as Robert sat forward coaxing his daughter to drink, and she did. It was excruciating.

“Come on, love, keep going.”

Mollie wiped her mouth as she gagged slightly. “I am, Daddy. I'm just not used to doing this.”

“Well, the quicker you drink it, the easier it'll become.”

I couldn't stay silent any longer.

“Robert, it's great that you are encouraging her, but…”

“Back off?”

He was quite intimidating.

“Well”—I laughed—“not the words I would use, but it would be OK for Mollie to take her time here and drink it without anxiety—you know, so she feels comfortable feeding herself again.”

“Fine.” The big man stood up and leaned down to kiss his daughter. “Darling, I've got to go—business calls. Well done. Keep it up!”

With a nod to me, Robert left the curtained area, patting his wife on her shoulder as he passed. You could have cut the atmosphere with a knife.

*   *   *

Mollie was tired and needed to rest, so I took Eleanor to the small counseling room on the ward. She sat down stiffly and accepted a glass of water.

I knew that I had to proceed boldly.

“Eleanor, I am concerned about you. How are you doing?”

A tiny, thin smile. I felt that I had gone in too fast, too abruptly. This beautiful poised woman patted nervously at her throat.

“Is Mollie doing well?” she asked.

“She is doing better. She has put on a little weight. Independent eating is a good next stage. But how are you?”

Eleanor smiled and patted her pearls. “I'm fine if my daughter is doing well.”

Long silence. Eleanor looked intently at me.

I couldn't sit this out.

“She is doing well, but I wanted to talk about how you are doing.”

The hands continued to flutter one minute at the pearls, next in the lap.

“I am fine. Why do you ask?”

“I ask because you seem…” Words failed me.

Eleanor's hands fluttered again.

“I am concerned you might be struggling and I want to support you.”

Hands stopped fluttering.

Again silence. I tried a different approach.

“You have a wonderful daughter. Mollie is so bright and beautiful, and, well, I just love spending time with her.”

Suddenly hands were sat in lap. Body upright. Total focus.

“What do you love about her?”

“I love her brain. Oh my gosh, she's so challenging!”

“Yes.” Eleanor smiled broadly. “She doesn't suffer fools gladly! She is challenging, always has been, the most of the four.”

That last statement felt passive-aggressive. Who thought I was the fool, Mollie or her mother?

“How have you found her challenging?”

“Mollie was born at thirty-four weeks. She wanted to come out early. She was ready for the world.” Eleanor took a drink and I noticed that her hand holding the glass was shaking. She continued on: “She was tiny but the most lusty. Oh my goodness, that girl could cry for England!”

We exchanged a smile.

“As you know, she wasn't planned, but when I held her, I knew she was very special. She was my little gift. A tiny present.”

“Wasn't she in pediatric intensive care for two weeks?”

Eleanor looked down. “Yes. I couldn't feed her. She was so tiny, and my milk just didn't come in. She latched on, but I didn't produce enough milk for her, and so she lost weight.”

“That must have been hard.”

Eleanor stared straight at me. “Do you have a baby?”

“No, Eleanor, I don't.”

She nodded and smiled. “Yes, that was very hard.” Eleanor looked away as she continued. “It was so hard because I fed the other three very well.”

Another layer to the story. I made a mental note: early maternal feeding anxiety; eating-disordered daughter.

“You felt guilty?”

Another long, long pause.

“I felt guilty. And I felt old.”

“Old? You gave birth to a beautiful little girl. Your body was still…”

Eleanor put up her hand. “I wanted her, but Robert didn't. We were too old. The other three were doing well and so he quite rightly reasoned that there was no need. But I wanted her.” Hands patted pearls. “He was too busy for another one, but I wanted another one and so I made it happen.”

This felt huge.

“How?”

Eleanor looked at me and gave a small snort.

I reddened.

“I don't mean how, but…”

She sat up. “But you mean how. Well, how was, he believed I couldn't and so I duped him. I told him I couldn't and then I did.”

“But you knew you could?”

Eleanor took a long drink of water. “Of course I knew I could. What woman doesn't? Of course I could.” Her tone changed. “For goodness' sake, what did he know? When was he there to know? For ages I told him I was menopausal because that explained my lack of interest.” Eleanor blushed but doggedly continued. “But then I thought I needed another and so I made another happen.”