Brave Girl Eating (21 page)

I realize how much like an anorexic I sound—competitiveness is a hallmark of the illness. The truth is, I want this to be over. For fourteen years my daughter has been a daily part of my life, and I miss her. I miss the small moments most. Occasionally we'd walk arm in arm to the grocery store or park, our legs moving in sync, and Kitty would give a little skip so we'd be off beat with each other—her right leg moving with my left leg. I'd skip again to put us back in sync, and then back and forth we'd go, hopping and adjusting until finally we were standing on one spot jerking and hopping and laughing so hard we couldn't breathe.

I miss her clear-eyed way of looking at the world. It's funny: before Kitty was born, my biggest fear about becoming a parent was having another person in the house, seeing everything I did. I felt
abashed at the thought of a child who would see me at my worst, most disheveled, crankiest. I worried that this baby would grow up to be a child who judged me harshly. Who held my heart in her two hands and found it unlovable. But all my self-consciousness and worry fell away once she was born, because she wasn't a faceless watcher, she was Kitty, who was known and loved and loving. Parents and children are hardwired to love each other. But I liked Kitty. I like her.

And I want her back. I want her healthy and well so we can keep getting to know each other. So we can think about other things, travel and plan and be spontaneous in ways we can't right now. And I don't understand why it's taking so long for her to gain weight.

Though I do, really. Her goal weight has gone up since August because she's grown, and I think there's more to come. So we're aiming at a moving target. And she's become more physically active over the last month or two, with Dr. Beth's encouragement. She's started taking a weekly class in Israeli dance. And she's spending more time with the guys.

One December afternoon, Martin rings the doorbell to see if Kitty wants to hang out. She's working on a milk shake, and I offer to make him one. “Thanks!” he says enthusiastically.

He
doesn't
say, “Oh, I really shouldn't, I'm too fat.” He doesn't say, “My butt's too big already!” He doesn't say, “Do you have any frozen yogurt instead?” He sucks up the milk shake in under two minutes, then turns to Kitty.

“Yo, hurry up with your ten-million-calorie milk shake!” he says.

I hold my breath, waiting for Kitty to snap or fall apart. Instead she giggles, finishes the last of the shake, and jumps off the couch. “I'm ready,” she says, and off they go. And that's it. Not that they
don't talk, she and the guys—they just talk about different things. And they do things. They take apart bikes and ride them. They play foursquare in the street outside our house. They do homework together. They go to the movies.

We couldn't have arranged anything better if we'd tried. Which comforts me, and reminds me that I'm not in charge, thank goodness, of every aspect of my daughter's life. That she's a resilient, savvy kid who's good at finding what she needs a lot of the time.

We still have to be vigilant. Her irrationality about food is matched by her hyperactivity. She'll push herself way beyond the comfort zone physically and then pay the price. One evening, right after dinner, Jamie takes her rock climbing, an activity they've done together since Kitty was four. She comes home a mess, refusing the bedtime snack, rocking back and forth on the sofa, literally wringing her hands.

“Kitty, I love you,” I tell her, holding a pumpkin chocolate chip muffin on a plate. “And I expect you to eat this snack.”

She turns her face away from the plate and keeps rocking. “You don't understand,” she chokes out. “You don't understand how hard it is.” And then: “Please love me no matter what!”

“Of course I do,” I say. But something has tripped the switch again. I think back over what she ate today, and realize that dinner—fish, broccoli, squash with butter and brown sugar—wasn't especially high-calorie. It was a good meal, a nutritious meal; but maybe Kitty's metabolism is so sensitive right now that we need to match every “extra” outgo of calories with an equal intake. Or, clearly, more; she's been stuck at the same weight for six weeks now.

A few nights later, we replay the same scene. It's not the demon, exactly—more like its shadow falling over Kitty. She sits at the
table, refusing to eat, and I sit with her, trying to project patient firmness. “Part of me wants to eat, but part of me doesn't!” she says. I'm impressed that she can articulate this so clearly; if only saying it out loud made that shadow disappear.

For my part, I've learned to stay on-message, as politicians say. No matter how articulate Kitty is, it's best for me to keep on reiterating the basic truths. So now I remind her, for the hundredth time, “Food is your medicine. You just have to eat.”

“I can't, I can't,” she says, sobbing.

“You can,” I tell her. “You'll feel better.”

Later that night I sit beside her as she falls asleep, looking at the glow-in-the-dark stars on her bedroom ceiling. And as I lie there it's as if a movie starts to play on the dark screen of my mind. I see Kitty in the ICU, her eyes closed, her arms limp at her sides. I see the long, snakelike tube sliding up her nose, disappearing into her body. I see a faceless nurse, her body radiating anger and irritation, unable to tell the difference between my daughter and the disease. I touch the skin on Kitty's back, which is smooth and warm, flesh over bone; but I feel the ridge of her shoulder blade, sharp enough to cause a bruise. I see her sticklike arms and legs, her shrunken features. I shake my head, put my fingers in my ears, chant silently:
No no no
.

What's that corny expression? “Do you curse the darkness or light a candle?” I'm groping for the candle, but I can't find the matches, and my hands are shaking so badly that no matter how many times I try, I can't strike a spark. I'm hoping that the act of groping itself will somehow bring on the light.

That's how I feel right now. Other times, I feel sure we're on the right track, that Kitty will be OK. And still other times, the knowledge and reality of what she's going through takes up every bit of
space inside my body. The pain of it washes through me like blood, flares when I breathe. My skin feels tender and hot and bruised; my brain feels swollen and slow. Those times I literally want to jump out of my body. Like Kitty, I want someone to make it stop.

And Emma does too. Emma, who calls me from school the next day, sobbing, saying she can't stop thinking that we're all at home, dead, and she's supposed to save us and can't. Ten-year-old Emma, who feels powerless and overwhelmed and scared just as we do. Who cries at the dinner table later, saying she's not hungry, she can't eat.

A shaft of pure ice lodges in my chest when I hear this. Anorexia's heritability—meaning how much of it is caused by genetics rather than environment—is hard to pinpoint. The ongoing Genetics of Anorexia Collaborative Study, sponsored by the National Institute of Mental Health, is creating a repository of genetic information about people with eating disorders and their families. “We now know that [eating disorders] occur when there is a perfect storm of events that include genetic vulnerability and a culture that is promoting thinness through dieting and exercise,” says Craig Johnson, director of the Eating Disorders Program at Laureate Psychiatric Hospital in Tulsa, Oklahoma, and one of the study's principal investigators.
^*

Emma is clearly at risk. Her sister has anorexia; her great-aunt, my mother's sister, had bulimia for many years. Anxiety, perfectionism, and eating disorders overlap and coexist in ways that aren't yet clear but are undeniable.

Knowing all this, I wish there was a way to prevent her from falling down the rabbit hole. We can't change her biology; all we
can do is wait and watch for signs of trouble. At least now we know what to do if we see them. At least now we know we not only can do something—we have to.

 

New Year's has never
been one of my favorite holidays. The collective frenzy of self-criticism, the communal fantasies of starting over (this time for real) with whatever it is we wish we were doing differently—none of it appeals to me. As a friend once said, “We do exactly what we want to do.” Yeah. When it comes to behavior, talk is more or less irrelevant; it's what we actually do that matters.

I will admit, though, that I can't wait for this year to officially end. I know time is an artificial construct and nothing will change when the clock hands hit midnight. Still, this year I need the feeling of a new beginning, even if it's an illusion. I need to believe that next year will be a better year for us, that it will contain the tipping point I've been waiting for, the moment when we glimpse the demon's back, retreating, when the fog clears from Kitty's eyes and everything goes back to normal.

Alas, this is magical thinking, and I know it. Life isn't a play, with a predictable arc, clear moments of conflict and resolution. Life is muddled and disorderly, proceeding in fits and starts. There's nothing linear about it.

I think by now we've at least seen all of the demon's tricks, but, as usual, I'm wrong. On New Year's Day, Kitty struggles with lunch and cries so hard afterward that she throws up. She begs us to believe that she didn't do it on purpose, that it was, as she says, “an accident.” She says she's sorry she violated our trust, which suggests that there was an element of intention.

But I don't know what to believe. Kitty sobs herself to sleep,
napping for an hour or so; when she wakes up I give her an Ensure Plus, to make up some of the lunch calories, and she drinks it without complaint. Later that afternoon, she eats cookies and milk for her snack, then announces that she's going to the bathroom upstairs; do I want her to not flush the toilet after? Because this is so uncharacteristic I say, yes, don't flush the toilet. She comes out of the bathroom saying, “I'm sorry, I didn't mean to, I don't know why I did,” and I run for the bathroom, bracing myself for the worst. I look into the toilet and see not vomit but an unidentifiable object, floating in the water.

“I've never done it before, I don't know why I did,” Kitty cries outside the bathroom door. Eventually she tells me she'd spit the last bite of cookie into the toilet. My knees go shaky with relief. “Now you won't trust me,” she sobs. “How can I win back your trust?”

“I trust you,” I say (which is not a lie: it's the anorexia I don't trust). But I'm on my guard. And a few days later, it happens again. Kitty has come to work with me, for something to do during winter break. We eat lunch together—chicken salad, potato chips, milk, and, for her, a Hershey's bar. When she gets up to throw away her garbage, I have a feeling, like the feeling I had the day in the park, and I say, “Give it to me.”

She hands it over wordlessly, pulling the napkin off the top of the pile to reveal half the chocolate bar, which she proceeds to eat without fuss. Afterward, she says, “I don't know why I did that.”

“I know why,” I tell her.

She says, “Because you always know.”

I say, “Yes, and you want me to know. You want to make sure I'm paying attention, that I'm watching and taking it all in. You want to make sure I'm taking care of you.”

She stares at me for a long minute. The look on her face is one of relief.

That night, as I'm making her bedtime snack of two pieces of buttered toast with cinnamon sugar sprinkled on top, she asks if both pieces need cinnamon sugar.

“No, but they both need butter,” I say. “Do you want to butter them yourself?”

“No, you do it,” she says, but as soon as I've buttered both pieces she says, with despair in her voice, “Oh God, I should have done it myself, I had a chance to get away with eating much less.”

“You know I would have been watching,” I tell her firmly. “You wouldn't have gotten away with anything.”

I hand her the plate and we sit down on the couch. She looks up at me. “I love you Mommy,” she says. “You always know just what to say.”

And that's the last of the demon's tests. For a while.

 

It's coincidence, really, that
just after New Year's I set out to buy a calorie counter. Kitty's weight has been stalled for nearly seven weeks; obviously we need more information. I'm unprepared for the embarrassment I feel, walking into a bookstore and asking for the calorie counters. I'm sure the bookseller thinks I'm embarking on a New Year's diet. I want to say, “It's not for me, honest! It's for someone who needs to
gain
weight!”

Instead, I slink upstairs to the nutrition section, where I stand in shock, gaping at shelf after shelf of diet books. There are at least a hundred different diet books here, and their names range from the pathetic to the absurd: The Prayer Diet. The Coconut Diet. The Paleo Diet (raw meat? really?). The Slowdown Diet, the Fat Flush
Diet, the 3-Apples-a-Day Diet. The After-40 Diet. The Starch Blocker Diet. The Big Flavor Diet. The Real Age Diet (mine would be around seventy-five by now, I fear). The Soy Zone Diet, The Acid-Alkaline Balance Diet, the Super Foods Diet. The Potatoes, Not Prozac Diet. The Warrior Diet. The Uncle Sam Diet (hot dogs, hamburgers, apple pie?). The 5-Day Miracle Diet.

Losing weight has become our national obsession, our holy grail. I watch part of a talk show one afternoon at the health club, without sound. The segment covers new diet drugs, and the on-screen graphic shows a three-dimensional model of the brain with lots of animated capital A's swarming toward one particular spot in the brain and being magically repelled. The drug purportedly brings about weight loss by chemically suppressing appetite. Judging by the looks on the hosts' faces, this is excellent news.

The cultural assumption seems to be that there's something wrong with wanting to eat. Appetite is something to be fended off, with willpower or chemically. We're locked in a war with our own hunger, which is the primal force that sustains us. Of course the talk shows and magazines aim mainly at women, who make up the vast majority of those with weight issues. We're socialized to fear our appetites, whether they're for food or sex or power. We're taught from birth to make ourselves small and dainty, to not take up room. Can this kind of acculturation cause anorexia? I don't think so. Can it trigger someone who's vulnerable? No doubt about it.