Brave Girl Eating_A Family's Struggle with Anorexia

chapter two

Home Again, Home Again

Hunger is experienced not just in abdominal ache but as a heaviness in the limbs, a yearning in the mouth.
—DREW LEDER, The Absent Body
Five days later, Kitty is discharged from the hospital. I’m anxious about bringing her home, because as awful as the hospital has been, at least we weren’t alone with the anorexia there. It wasn’t just Jamie and me at the kitchen table, locked in mortal combat with our starving daughter. Kitty’s eating about a thousand calories a day now—not much, nowhere near enough, but probably twice as much as she was eating before the hospital. What will happen now that we’re going home again?
On our way home we stop for groceries, the first of the nearly daily shopping runs we’ll make over the next year. Kitty rests in the car with Jamie while I blow through the store at top speed. Just last week I wished I could shop without Kitty’s intrusive presence. Be careful what you wish for.
As I steer the cart through the produce section, I’m reminded in a curious way of what it feels like to begin a diet: the special preparatory shopping trip, the sense of hopefulness undercut with past experiences of failure. The sense of wiping the slate clean. The feeling that this time, things will be different.
Will they, though? I want to believe Kitty’s hospitalization will change things, though I don’t, yet, understand how. I can’t see my way from where we’ve been to where we need to go. And I’m a person who needs to be able to see the path ahead, to see what I’m up against and what I have to do, no matter how tough. Right now, not only is there no clear path, there’s no suggestion of one—just a seemingly infinite slog through the darkness that has swallowed up our daughter.
If she was ill with something else—if she had diabetes, or pneumonia, or strep—her doctors would prescribe medicine, bed rest, fluids, and we would give her all those things. But this—this is like battling a many-headed monster in the dark. It’s like fighting darkness itself, a darkness that is inside my daughter, that’s somehow part of her. To fight it feels like fighting her.
Dr. Beth has explained to us that we need to increase Kitty’s calories by about three hundred every couple of days. And that’s why I’m here, to prepare for the battles that are coming. I rip up my shopping list and any concept of a budget and speed-walk down the aisles, piling the cart with cookies, Muenster cheese, alfredo sauce, ranch dressing, buttery crackers, ice cream, potato chips, candy bars—all the foods Kitty used to love. Before anorexia, I didn’t buy much processed, packaged food. I was a conscientious and health-conscious mother in twenty-first-century America, where we all understand the words healthy food to mean low-fat, low-calorie food, and not too much of it. Standing in front of the Pepperidge Farm display now, I have the sense that the world as I know it is tipping, elongating, growing as strange as an image in a funhouse mirror. I grab an armful of Milanos and keep going.
At the far end of the store I stop at the shelves of high-protein and high-calorie supplements, which Kitty drank in the hospital with every meal. I tried one once; they taste nasty, a revolting cocktail of chemicals and artificial flavors. But each Ensure Plus packs 350 calories, more than a quarter of Kitty’s daily requirement right now, and Kitty has perfected a way to drink it: she holds her nose and pours it down in less than five seconds. I load the cart with chocolate-flavored Ensure Plus and move on.
Kitty’s asleep in the backseat when we get home. As a toddler, the only way we could get her to nap was to drive her around until her eyes slid shut and her head drooped. Then we’d carry her into the house, car seat and all, tiptoeing so as not to wake her. Now Jamie unbuckles her seat belt, scoops her into his arms, and carries her upstairs to her room. He looks at me, and I know what he’s thinking: it’s been years since he could lift her this easily.
I call the friends who are keeping Emma today to let them know we’re home and to talk to Emma, who says she’s been invited for dinner and wants to stay. Over the last few weeks, she’s found ways to avoid all of us as much as possible, and I don’t blame her. Emma’s world has been turned upside down. She’s watched her sister suffer and starve and her parents morph from reasonably functional adults into obsessed, irritable wrecks. I wonder if we should send her to stay with my sister for a while, to get her out of the house. Not yet, I think. If things get really bad. Then I laugh to myself. How much worse can they get?
I tell Emma of course, we’ll pick her up later, and then I take my time putting away the groceries. I stow the Ensure in the basement pantry, tucking the small square bottles behind cans of chick-peas and lentil soup. Their sell-by dates read two years from now. Where, I wonder, will Kitty be then? Where will we all be?


On our first posthospital appointment with Dr. Beth, three days after Kitty comes home, she’s still shaky and dizzy, but at least she can walk now, leaning on one of our shoulders. The nurse has her pee into a container in the bathroom and put on two hospital gowns, and then weighs her, standing her backward so she doesn’t see her weight.
Dr. Beth is gentle with Kitty when she comes in, taking her vitals, talking to her in the kind of low, soothing voice you might use with a frightened animal. After the exam, as Kitty is dressing, I ask the doctor what we should do next.
“I’ve never had a patient this sick before,” she says, and I feel a now-familiar frisson of guilt run up my spine. Dr. Beth tells us that other families send their children to hospital inpatient units or residential clinics. The nearest clinic is at Rogers Memorial Hospital, an hour away. Lots of teens from our town wind up there, she says. On the plus side, Kitty would probably gain weight there. She’d be in competent hands. We’d have a breather, a break from the relentless drama and terror of anorexia.
On the other hand, says Dr. Beth, Kitty might learn to be a better anorexic at Rogers. I don’t understand what she means.
“Right now, Kitty’s being fairly straightforward with you,” she explains. “But kids teach each other all the tricks in places like Rogers.”
What tricks, I want to know. Dr. Beth ticks them off on her fingers: Water loading, the practice of guzzling dangerous amounts of water before a weigh-in. (That’s why Kitty’s urine is analyzed before weigh-in, to make sure it’s not too diluted.) Sewing weights in their underwear. Making pessaries out of coins. Stuffing food in their cheeks at the table and then spitting it into a napkin when no one’s looking.
I try to keep my face blank, but inside my head a voice is screaming No!
Not my daughter. Not Kitty, whose face, until recently, I could read like my own. Who can’t bear the feeling of having done something wrong. Whose sense of right and wrong has always been overdeveloped—for years Jamie and I have been trying to break her of the habit of apologizing fifty times a day. Who still, until recently, left me little notes saying “I love you, Mommy.” That Kitty would never do the things Dr. Beth describes. If we send her to Rogers, will that Kitty vanish forever?
Dr. Beth goes on. There are residential clinics all over the country; there’s a place in Utah that’s supposed to be very good, if you can get in.
Utah? Jamie and I look at each other. We don’t know anything about eating disorders, but we know that Kitty needs us. And we need to be with her. She panics when we’re out of her sight for more than a minute, and, at the moment, so do we. How can we send her to Utah? How can we send her anywhere?
“What if it’s her best chance for recovery?” asks Dr. Beth.
That’s the million-dollar question: What will give Kitty the best shot at recovery? Is a faraway clinic her only chance? Are we irresponsible to want to keep her close?
I’m a journalist; my usual coping mechanism is to gather information. I’d begun reading up on anorexia, and the statistics terrify me: A third of all anorexics stay sick forever. A third to about a half will truly recover. The rest stay on the brink of illness, living diminished lives: they have trouble keeping friends and holding down jobs; they cycle in and out of hospitals. They spend years on the outside looking in, unable to live fully or wholly.
That’s not what I want for my daughter.
And there’s no consensus on what true recovery means. Everything I read suggests that anorexia, like alcoholism or drug addiction, is a disease with no real cure, a disease you have to “manage,” one day at a time, for the rest of your life. Once an anorexic, always an anorexic.
I refuse to believe that.
But I don’t know what to believe. I can’t read the dozens of books and articles piling up on my desk. They paint such bleak portraits: Anorexics are dying for attention; their parents neglect their true needs, so they take drastic measures to get what they need. Or: Anorexics are dying for control; their parents are so dominating that controlling what they eat (or don’t) is the only way they can express their normal adolescent need for autonomy. Or: Anorexics are conflicted about growing up and becoming sexually mature, so they try to keep themselves small and childlike by starving. Choose A, B, or C—the message is the same: anorexics (and their families) are seriously f*cked up.
Maybe I’m in denial, but our family doesn’t seem particularly pathological. We’ve got our issues, like all families. I’ve had panic disorder since I was a child, which I manage through therapy and medication; Jamie grew up in an alcoholic family where emotional self-expression was not encouraged. We bicker sometimes. We’re grumpy sometimes. We’re far from perfect. Still, I don’t recognize us or Kitty in the literature. Each time I read another chapter, another article, I feel worse, not better. Reading has become another exercise in self-flagellation, and I don’t need any more of that, thank you very much.
And so I stop reading, and Jamie and I move through the hours in a stupor of barely suppressed terror and confusion. We’re back in the same boat we were in before Kitty was hospitalized, only now she’s eating a little more. The hospital scared her. It scared all of us. But I can see that it won’t be enough.
Dr. Beth calls the day after our appointment with an idea: she’s talked to the head of a new adolescent psychiatric hospital in town, and although the hospital doesn’t treat eating disorders per se, the director has agreed to what’s called a partial hospitalization. Kitty can spend eight hours a day at the hospital, going to classes and group and individual therapy, but come home at night. It might be a good compromise.
The next afternoon, I help her into the car and we drive across town to see the hospital for ourselves. A storm breaks as we pull in, complete with thunder and lightning and pea-size hail, which pelts us on our dash from the parking lot to the building—a fitting demonstration of Sturm und Drang.
The receptionist buzzes open the front door; every door in the hospital, it turns out, is kept locked. We wait in a growing puddle for the therapist who will take us around. Dr. N. is young and friendly, greeting the teenagers we see as we walk slowly through the building. Most are oddly dressed—bathrobes over blue jeans, hair unbrushed, eyes dazed or combative or both. Kitty squeezes my hand and I squeeze back.
Dr. N. leads us to a small conference room for the intake interview. Kitty, she tells us, will come to the hospital at nine each morning and stay until five. She’ll have individual and group therapy; the group will comprise other teens struggling with illnesses like depression and bipolar disorder. Kitty can also attend the hospital’s “school.” “Like right now,” she says, turning to my daughter, “the eighth graders are learning about volcanoes and building birdhouses. You can sit in on a class if you’d like.”
Kitty physically recoils, and for the first time in weeks I feel like laughing. One of her long-standing complaints about school has always been the slow pace and endless busywork, especially in middle school. Spending the rest of the summer building birdhouses and learning about volcanoes is about the last thing she’d want to do.
Besides, the other kids here are really messed up. Kitty’s not like that.
But isn’t she? Isn’t she, in some profound way, like the other teenagers, with their disoriented eyes and odd behaviors? Yes and no. Eating disorders affect a person’s thinking and cognitive abilities, but only around certain subjects. Kitty can rattle off a quadratic equation, speak eloquently about World War II, play a violin solo. Her intelligence is unaffected by anorexia—until the subject of food or eating or body image comes up; then she’ll eat two bites of turkey and spend an hour sobbing because she’s eaten so much and she’s going to get fat. When this happens, as it does every time she eats, I want to say, “Don’t you get it? You need to eat or you’ll die.”
I’m only just starting to understand that she really doesn’t get it. That her perceptions are genuinely out of whack. Much later, another therapist describes anorexia to me as a kind of “encapsulated psychosis”: someone with anorexia suffers under a set of delusions just as powerful as the delusions of a schizophrenic—but only when it comes to food, eating, and body image.
Dr. Walter Kaye, director of the Eating Disorders Program at the University of California–San Diego and one of the leading researchers on the biology of eating disorders, once found a way to make this dissonance clear to his students. He invited two anorexic women to class and asked one of them to describe how much she weighed and how she looked. The woman said that she weighed seventy pounds and that she looked fat. Then he asked her to describe the other woman. “She said, ‘She looks terrible; she’s so thin; she looks like she’s going to die,’” Kaye tells me. “And I said, ‘But look, you’re seventy pounds and she’s seventy pounds and you’re the same height. How do you put this together saying you’re too fat and she’s too thin?’ And she just looked at me and said, ‘I don’t know, but I feel too fat.’”*
That’s how Kitty feels too.
Dr. N., meanwhile, is talking about rules. There seem to be a lot of them, especially with regard to eating. Kitty will eat breakfast and lunch here, so we all have to know, for instance, that no long sleeves are allowed at the table. “Sometimes they hide food there,” she says matter-of-factly.
They? I think. There aren’t any other eating-disordered children here. Who is she talking about?
“No clothes with drawstrings,” continues Dr. N., ticking off points on her fingers. She eyes my daughter’s shoulder-length hair. “She’ll have to cut her hair or pull it back.” So they can’t hide food in their bangs? I wonder.
Dr. N. goes on: “You’ll open your mouth after every bite so we can make sure you’re not stuffing food into your cheeks. No bathroom for an hour after each meal. Oh, and you get thirty minutes to eat. If you don’t finish, you’ll drink Ensures to make up the calories.”
A clap of sudden thunder shakes the window; lightning cracks across the steel-gray sky. If this were a horror movie (and it’s starting to feel like one), the next flash of lightning would reveal the therapist’s bloody fangs. Or maybe the door would swing open to reveal Nurse Ratched in a starched white cap, syringe at the ready.
I’m not the only one feeling the melodrama. When Dr. N. steps out of the room for a minute, locking the door behind her—locking us in, or locking others out?—Kitty grabs my arm. “Don’t make me go here,” she begs.
The therapist returns with a folder full of paperwork, which I toss into a trashcan on our way out.
When Kitty was a baby, Jamie and I both freelanced—him in photography, me in writing and editing. For most of Kitty’s first year, she went to work with one of us. She was popular at magazines and photo studios all over New York City. I became adept at typing and marking proofs with one hand while nursing her with the other. Jamie mastered the front carrier and entered the often-lonely world of hands-on fatherhood. Our parenting strategy—born out of both necessity and the instinct to keep her close—worked when she was an infant.
We’re hoping it works now.


In some ways, our lives now feel similar to those early parenting days. Jamie and I divide and conquer, one of us taking Kitty and the other handling Emma, which means we rarely have the time or energy for a sustained adult conversation. We both have the same sense of heightened experience, trauma waiting around every corner, the same sense of helplessness and ignorance. Kitty cries nearly nonstop. Her tears turn to rage whenever we confront her with food. Our cajoling moves more quickly now through explaining and pleading and into yelling—for all the good it does. Arguing with Kitty about food is like debating someone in a foreign language: no matter what we say and how we say it, she seems not to understand. She refuses to eat more than the bare minimum she ate in the hospital, and sometimes not even that. Stony or tearful, her opposition remains steady. She will not eat and she will not eat.
Daytimes are a bit easier than nights, especially when Kitty comes to work with me. My office has a door, and I use it, telling my colleagues that Kitty isn’t feeling well. I feel a sense of distance from them, as if I’m standing at the edge of a precipice, watching the world as I know it fall away. I need to be near Kitty as much as she needs to be near me. She eats the lunches I pack, watching DVDs on a laptop behind my closed office door as I try and mostly fail to work.
By calling everyone I know and following every lead, I’ve found another therapist, Ms. Susan, whom we all like. Ms. Susan is a clinical specialist in psychiatric mental health nursing—a nurse psychotherapist, as she puts it. Her office, in a business park ten minutes from our house, is small and friendly, with soft lighting, candles, and a comfortable couch big enough for Kitty to stretch out on, her head in my lap. After our disastrous meeting with Dr. V., I feel a certain amount of anxiety about therapy, but Ms. Susan speaks in a low, musical voice, makes eye contact with Kitty, and speaks to me easily. Her calm feels contagious.
In our first session, she asks Kitty what anorexia feels like to her, and Kitty actually responds. “It’s like a voice in my head,” she whispers. She’s lying on the couch next to me, her head in my lap, so it’s hard to hear her words.
Ms. Susan doesn’t press her, just says, “Lots of people describe it that way, like a voice in their heads that can get pretty scary. That will get quieter and eventually go away as you recover.”
I can feel Kitty’s relief as much as my own. Ms. Susan, too, thinks Kitty can recover.
Ms. Susan tells us Kitty will improve with time and food. She also says that she runs a twice-weekly lunch group with a group of young women who are recovering from a variety of eating disorders. Kitty lifts her head from my lap and asks, “Can I go?” It’s the first sign of interest she’s shown in weeks.
Ms. Susan smiles, and her whole face lights up. “We meet on Tuesdays and Fridays,” she says. After the session, she sends Kitty out to the waiting room so we can talk for a minute. “I’ve seen a lot of teenagers with eating disorders,” she says. “Your daughter is unusually open. It’s rare for someone this age and who’s this sick to have any insight about the illness.”
Really? I think. Kitty doesn’t seem terribly open to me. But over time I come to realize that Ms. Susan is right. Most teens with anorexia turn away from their families, a process that’s encouraged by most therapists and treatment providers. Kitty turns toward us, and toward the people she trusts—Dr. Beth and Ms. Susan. Which doesn’t mean that her recovery is easier than others’ recoveries, or that the voice is somehow less powerful in Kitty’s mind. But it does mean that she accepts our help on a fundamental level.
I hope this will carry us through the worst times and help us repair our family once the anorexia has gone. I can’t stand the idea that we might ruin our relationship with Kitty in the process of helping her recover. But I accept the risk. It’s better than the alternatives, way better.
I thank Ms. Susan for the encouraging words and arrange to bring Kitty to the next lunch group. We leave with a few weeks of appointments set up.
These days of keeping Kitty close represent an oddly peaceful interlude in the surreal world we now inhabit, Jamie and Emma and I and this new Kitty, with her pointed chin and enormous eyes and will of iron. I try to remember my daughter as she was just a few months before, dancing through the house, laughing and affectionate, talking on the phone or going out with friends. Already this new Kitty, gaunt and tense and slow-moving, seems normal. Human beings can adapt to anything, from infinite riches to the horrors of Auschwitz. I don’t want to adapt to the way things are now. I want to scream, howl, tear the hair from my head in mourning and rage at what’s happening to my daughter. I can hardly muster the energy to cry.
A few days after Kitty comes home from the ICU, a neighbor drags me to a support group meeting she’s read about, for friends and families of people with eating disorders. In the hospital meeting room we find no other parents, only two young women in recovery from eating disorders themselves. I don’t want to talk to them; I want to avert my eyes, put my fingers in my ears, and chant la la la so I don’t have to see or hear them. I want to run to the car without looking back.
But that would hurt their feelings. They’re here to help us, after all. And so we stay and talk to Abby, a lank-haired college sophomore whose smile does not reach her tired eyes, and Sarah, a high school senior who fingers the end of her curling ponytail. I glance across the table, trying to see, surreptitiously, how thin they are: Abby is skinny, too skinny, but not as thin as Kitty. Sarah wears a bulky sweatshirt and pants, so it’s impossible to see what her body looks like.
Sarah tells us she’s been dealing with anorexia for four years. She’s just come home after several months in a hospital eating-disorders unit, where she landed, she tells us with disarming frankness, because she tried to kill herself. “Actually, I tried a couple times,” she says, lounging in the plastic chair.
I sit beside my neighbor, nearly mute with fear, imagining my daughter with this air of weariness and quiet despair. My daughter trying to kill herself. My daughter succeeding.
I turn to Sarah; I can’t bear the look of exhaustion in Abby’s eyes. “What’s it really like?” I ask. “What does it feel like?”
Sarah swings one foot, considering. “It’s like having an angel sitting on one shoulder and a devil on the other shoulder,” she says earnestly. “And it’s like they’re fighting all day long.” Her foot goes back and forth hypnotically under the table. “And it gets so bad I can’t concentrate on anything else, you know? It’s like I’m watching a movie, only I’m in the movie too. The angel says, ‘Eat this chicken, you know you should!’ and the devil says ‘Don’t eat it, you’re already gross and fat and disgusting.’ Honestly, I don’t remember very much from when it was really bad. Just that feeling.” She twirls a strand of hair around one finger and grins, and suddenly she’s an ordinary teenager with a dimple. She might be talking about a bad date or a bummer of a math test.
My neighbor and I walk out the revolving door an hour later. I feel like all the words have been drained out of me. The night air is humid and thick and seems to press on my chest, making it hard to breathe.
I never talk about the evening again. But I think about it often, imagining the angel and the devil on Kitty’s shoulders. Kitty’s head twisting from side to side as if she’s watching a tennis match, her shriveled body jerking as if she’s in the grip of something electric. I try to feel what she’s feeling, my own head twitching, my mind jagged and disconnected, and wonder if I’m getting a glimmer of what she’s going through—not just what we can see from the outside, which looks nightmarish, but her inner experience. I can hardly bear it: my firstborn, the child of my heart, suffering like this.
I have to bear it, though, because she has to bear it. More than anything I want to make it better. That’s been my role and Jamie’s role for fourteen years—to make it better for Kitty, whether “it” was a skinned knee or hurt feelings. And we’ve always been able to. Until now.
Later that night I lie awake for hours thinking about Kitty in the ICU, hooked up to monitors and wires. How did this happen to our daughter? What have we done, and how can we undo it? No, that’s not right. What have I done? Because my husband has no issues with food. He eats when he’s hungry and stops when he’s full. He’s never counted a calorie in his life, and, as far as I can tell, he doesn’t care how much he or anyone else weighs.
I, on the other hand, grew up in a household obsessed with food and weight. I went on my first diet at fifteen, the first of many where I would lose, and then gain back, the same twenty-five or thirty pounds. Maybe Kitty’s fear of fat is really a fear of being like me? Maybe if I were thinner, she wouldn’t have to be so thin?
Or maybe it’s my own obsession with food and being thin that’s infected her. I’ve tried, I’ve really tried, to be a good role model for Kitty and Emma. I’ve tried never to make disparaging comments about my own body (or anyone else’s). I’ve tried not to say things like “I feel fat!” I’ve tried, but I know I’ve slipped up. I know I’ve failed. And maybe my own ambivalence about my body lies at the root of Kitty’s illness.
Or maybe that’s an unbelievably egocentric perspective. Maybe Kitty’s illness has nothing to do with me.
To be honest, I’m not sure which scenario I prefer. If she’s sick because I screwed up, maybe I can do better, and she’ll get better. But if Kitty’s anorexia has nothing to do with me, then I’m powerless to fix it.
Of course, maybe I’m powerless anyway, regardless of what’s caused Kitty’s illness. And maybe that’s exactly what I cannot bear.


The week after Kitty comes home from the ICU, I buy every book I can find about anorexia, mostly first-person accounts. I read only a few pages of each before stuffing them into the back of my closet. Despite the bright covers, the implied triumphs, the books radiate despair. Or maybe that’s what I’m seeing now, because of Kitty. The young women (and they are all written by women) are dealing with so much more than anorexia: abusive or neglectful grown-ups, hostile peers, drugs, alcohol, cutting, thoughts of suicide.
I can’t believe that’s where Kitty is heading, or maybe already is. OK, she’s sick; she’s very sick. She spent two days in the ICU, where she might have died. I’ve been slow on the uptake, but I get it now. I’ve been watching her behave in baffling ways—self-destructively, counterintuitively, without logic or reason.
But Kitty’s not like the teens we saw at the psychiatric hospital and she’s not like the authors of those books. She wasn’t troubled or oppositional or defiant as a child. She doesn’t smoke or drink or cut herself.
I know how Kitty reacts to pain and to pleasure. I know her ups and her downs, what pisses her off and what lifts her up. I often know what she’s thinking; we’ve always been able to read each other. We still can, most of the time.
I don’t think I’m kidding myself about these things. I don’t think I’m one of those mothers who believes she’s close with her child when actually the child loathes her.
On the subjects of food and eating and fat, Kitty’s delusional. Obviously. On every other subject, though, she’s the same girl she’s always been, sharp-witted, insightful, quick. She’s a perfectionist, yes; an overachiever, definitely. But she isn’t crazy, for God’s sake. She has an illness, like diabetes or pneumonia or meningitis. With the right treatment—if only we can figure out what that is—she’ll get better. She isn’t losing her mind. She isn’t standing at the top of a slippery slope of self-destructive behaviors.
These are the conclusions I draw from observing Kitty. To me they seem reasonable; given the history of eating-disorders treatment, though, they’re downright revolutionary. Back in the 1600s, people thought you could catch a mental illness by touching someone who had one. We haven’t come very far from that idea. We treat people with mental illnesses like lepers, stepping over them in the street when their disorders lead to homelessness, poverty, drug addiction; we shun them when they turn out to be people we know. A few psychiatric disorders have lost a little of that stigma—for example, people talk more openly now about depression and bipolar disorder. But with few exceptions we still don’t want to hear about the most severe cases of depression, or about the inner lives of people with schizophrenia or personality disorders. Once the label is slapped on, you enter a world made nightmarish not just by whatever disorder you’ve got but by the stress of being marginalized in a society that fears and loathes any hint of mental differences.
Classifying eating disorders as mental illnesses piles even more stigma and judgment onto sufferers. This categorization shifts assumptions around cause and treatment from the realm of the physical to the psychological. And it paints someone like Kitty all one color—the color of mental illness; whereas I see her as a complex person whose thinking and behaviors are distorted in certain crucial areas, but whose mental processes are working fine in others.
Semantics? Maybe. But the words we use to think and talk about the world often shape the way we see it—literally. I decide right here, standing in front of my closet, that I will never refer to or think of Kitty as mentally ill. She has an eating disorder. She, Kitty, the whole person. The eating disorder is a small part of her. It doesn’t define her, even now.


One afternoon about five days after Kitty comes home from the ICU, I’m sitting on the end of her bed, holding a frozen protein shake, the kind she ate in the hospital. Kitty sits propped up on pillows, crying. “Come on, Kitty,” I say encouragingly, moving the spoonful of chocolate shake closer to her. I want her to take the spoon and feed herself, but so far she hasn’t. In the last half hour I’ve managed to get three spoonfuls into her mouth. The shake has long since melted; chocolate now stains the front of my pants and Kitty’s blanket. My hands aren’t all that steady these days.
I’m waiting for Kitty to be able to eat, but she says she can’t eat, she can’t drink. She says her throat is closing, she’s a horrible person, she’s going to get fat, she’s the worst person in the world. She says she’s never felt this way before. “What way?” I ask, still holding the spoon.
Kitty’s hand shoots out, knocking the spoon to the floor. “I’m sorry!” she cries. “I can’t help it! It’s pressing on me!”
“What? What’s pressing on you?”
But she’s done with words, she’s curled up on her pillow, sobbing, as the milk shake melts in its paper cup. I sit on the end of her bed, stroking her foot, waiting for the tears to pass.
I’ve spent so much time over the last few weeks waiting. Waiting for Kitty to have her IV changed. To cry herself to sleep. To finish chewing, with exquisite slowness, an infinitesimal bite of bread or egg or tomato. Waiting for that tiniest of bites to pass between her lips, down her throat, into her stomach. For the calories in that bite—two? five? fifteen?—to seep into her bloodstream, to circulate through her body and into her brain. To make her better. I’m so tired, I’d love to curl up on the end of her bed and sleep myself. But then where would we be? Still right here, with Kitty starving.
I force myself to sit up, let a little edge slip into my tone. “Kitty,” I say firmly, “you have to drink this milk shake. The doctor said so. Come on now, sit up. I’ll get you a straw. It’s melted anyway.”
Amazingly, Kitty sits up. She lifts her tear-streaked face toward me and I nearly drop the spoon. I know my daughter’s face far better than I know my own. I’ve stared at it, examined it, admired it, loved it for fourteen years. I know every look in her repertoire, every expression. But I’ve never seen this face before. Her eyes have gone blank; her mouth turns downward in almost a caricature of a pout. Her tongue pokes out, and for a second I think she’s sticking it out at me. Then I realize with horror that it’s flicking like a snake’s forked tongue.
Then she opens her mouth, and her voice, too, is unrecognizable. She speaks in a singsongy, little-girl tone, high and strange and chillingly conversational, the creepy voice of the witch in a fairy tale. “I’m a pig,” she says, not to me, exactly; it’s almost like she’s talking to herself. “I’m a fat pig and I’m going to puke. I’m going to puke up everything because I’m such a pig.”
I can’t say anything because my teeth are chattering. The hairs on the back of my neck stand up as the words pour from Kitty’s mouth. No, not from Kitty’s mouth, because this is not Kitty. It’s not my daughter who looks out of those dead eyes, who rocks on the bed, her bone-arms wrapped around her flat chest, who says the same words over and over as if her brain was reduced to a single thought. Somehow I’m up and off the bed, calling for Jamie, and then the two of us listen in horror and incomprehension as Not-Kitty spews a sickening litany of poisonous, despairing threats.
I don’t know how long it goes on. A long time. I pray that Emma, in the next room, stays asleep. Over and over Jamie or I put our arms around Not-Kitty. We speak quietly in her ear, we shout, trying to break the hypnotic trance, trying to get her to see us, hear us. But it’s as if we’re talking to a ghost. No matter what we do, Not-Kitty keeps rocking and talking, her tongue flicking in and out.
Hours later, her eyes close suddenly and she doesn’t so much go to sleep as fall out of the world. The veins in her neck stand out, as if even exhausted and unconscious she’s straining against something. That’s how it seems to us: as if the Kitty we know is being held hostage by—what, exactly? We don’t know.
We creep out of the room without speaking, taking the long-melted milk shake with us. We lie together in bed, trembling. Was I wrong about Kitty? Is she, in fact, deranged, possessed, mentally ill beyond our ability to help her? The next time she opens her eyes, who will we find: our daughter, or the demon who now seems to possess her?


In the morning, unbelievably, Kitty is back to her normal self, or rather back to the version of normal we’re getting all too used to. She eats breakfast without complaint and goes off to work with Jamie. I’m too rattled to go in to the office. Thank God for a boss who understands about families, because I need this job. We need this job, not just for the salary but because it supplies our health insurance. Such as it is.
That night, Emma’s theater camp gives a performance of Midsummer Night’s Dream. Kitty doesn’t want to attend, but we insist. We’re trying to maintain some vestige of normal family life, especially for Emma, who stood with us at her sister’s bedside in the ICU. Who sits at the dinner table, hearing the poisonous words that pour from her sister’s mouth. Whose life has already been profoundly altered by anorexia.
Jamie takes Emma to the theater early, and Kitty and I arrange to meet them there. In the car on the way over, Kitty tells me she feels funny again—dizzy, tight in the chest, floaty. It’s been another hundred-degree day, suffocatingly humid; we’re all feeling a little ill. In her fragile state, Kitty’s probably dehydrated and overheated.
I could turn the car around and take her home, but I know how disappointed Emma would be. And suddenly I’m angry—no, enraged—at the idea of upsetting Emma. She’s important too, damn it, and I’m not going to let her down. I pull in to the parking lot, grab Kitty’s hand, and half-pull her into the building, where I jam change into a vending machine. “Drink this,” I say, handing her a twenty-ounce bottle of fruit punch.
“I’m not thirsty—” she begins, but I interrupt her.
“This is not negotiable,” I say, my voice tight. “You will drink this, all of it, and then we will go inside. And if we need to go back to the hospital, we’ll do it after the play is over.”
Kitty’s mouth opens in surprise and hurt. Tears spring into her eyes and roll down her cheeks. Remorse prickles in my chest; I ignore it. “Drink,” I say. She drinks, all of it, as we stand outside the theater, watching families stream in, laughing and talking, going about their lives on an ordinary summer night.
By the time Kitty finishes, my anger has dissipated, leaving me both appalled at my behavior and encouraged by its results. I take the empty bottle from Kitty’s shaking hand and put my arm around her shoulder. “You did good,” I tell her. I put two fingers on the artery in her neck, the way the nurses in the hospital taught me, and take her pulse: forty-one beats per minute. We’ll call the doctor. But not until after Emma’s show.
In the auditorium, I wind up sitting next to an old friend, Lisa. Kitty took dance classes with her at ages four and five. I wonder if Lisa knows what’s going on with Kitty. We haven’t kept it a secret, but we also haven’t broadcast the news. I’m grateful when the lights dim and the show begins, and I can sit in the dark, my face hidden, and focus on something other than anorexia for an hour.
The show is a success, and Emma, a fairy swathed in bright gauzy scarves, has a moment in the spotlight playing the harp. She’s been taking lessons for six months, and it’s thrilling to see her absorbed in the music. And a relief to hear her pull it off without a wrong note. Jamie snaps photo after photo from the audience. At the end of the show, as the cast take their bows, Kitty and I slip away; Jamie will wait for Emma and bring her home, where we’ll celebrate her stage debut.
Before that, though, I call the pediatrician’s office and find that Dr. Beth, bless her, has left instructions for just this scenario. I ply Kitty with Propel and ice cream and rub her back until she falls asleep. When Emma and Jamie get home, the three of us eat chocolate ice cream and giggle at Emma’s backstage stories. For a little while we are a family again, though we each feel Kitty’s absence.
Later, as Jamie sleeps beside me, I think about what I learned tonight. The last three months have been one long and painful lesson in inadequacy—our inadequacy in the face of our daughter’s mortal danger. Tonight, out of fury and despair, I stood up to the eating disorder and won, at least for a moment. Tonight I learned that I’m not helpless. We’re not helpless.