Brave Girl Eating Read online

  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.

  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.
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br />   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 months—six months—was 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 something—amusement? sarcasm?—in 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 far—only to the end of the block—and 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.

  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 socks—and 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.

  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.