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.
{ chapter three }
There Will Be Cake
Studies indicate that…dramatic calorie restriction can result in an impairment of competence…. Investigators have noted that patients, often with no previous history of psychiatric disorder, may manifest megalomaniac and persecutory delusions, auditory hallucinations, somatisation, dissociation, suicidality, and confusion.
—D.M.T. FESSLER, “The Implications of Starvation Induced Psychological Changes for the Ethical Treatment of Hunger Strikers,” Journal of Medical Ethics
The last day of July is Emma’s tenth birthday. Kitty’s been talking about it for a week now—not because she’s excited to celebrate her sister’s birthday but because she knows there will be cake. She bargains with us: if she doesn’t have to eat a piece of cake, she’ll eat an ear of corn, an extra slice of bread.
But underneath the drumbeat of Kitty’s anxiety, Jamie and I both hear another note, a whisper of longing that surprises me, then horrifies me because it surprises me. In just a few months, I’ve grown used to the idea that Kitty fears and hates food, that she doesn’t like to eat. I have, without meaning to, changed the way I think about her and eating. Of course she doesn’t want cake. Of course she doesn’t want butter on her bread, or cheese in her sauce, or any food with more than fifty calories. I’m already thinking about Kitty’s fears as if they’re perfectly understandable, if not rational—like Emma’s picky-eater aversion to chili. Some of my reaction is an instinct to avoid conflict, a strategy I can no longer afford; we’ve been forced into conflict, like it or not. Some, I see now, is a kind of insidious accommodation. I, too, am a “good girl” personality, given to internalizing rules and playing by them.
Suddenly I can see how the very human propensity to make order out of chaos, to come to terms with change, to adjust, can inadvertently enable an eating disorder. Kitty’s been sick for only a few months, but already it’s as if I’ve forgotten who she is without the anorexia. Of course she doesn’t want cake. Months from now, Dr. Daniel le Grange will tell me, “There’s something about anorexia that makes parents and clinicians think in different ways than they would have. I don’t know what it is about this illness that gets us to think, It’s not such a bad illness.”
I wonder if our twenty-first-century ambivalence about food is to blame. I can’t think of a single woman friend who has never dieted, never deprived herself of food in the name of something bigger than appetite—health or fashion or sexual attractiveness. And where do we draw the line between anorexic food restriction and other kinds of restricting? We live in a culture where many of us feel shame over eating anything but grilled chicken, lettuce, and fat-free dressing. A friend once told me she wished she could scrape the taste buds off her tongue, so she didn’t have to choose between the pleasures of eating and being thin. I’m guessing she’s not the only one who feels this way.
When I look at the rich dark chocolate cake, I feel not only Kitty’s fear and shame and longing but my own. Kitty wants to eat the cake and she’s afraid of it. In a fundamental way, I know how she feels. Doctors harangue us about eating too much and being too fat. TV, movies, and magazines present stick-thin women as attractive, and after a while, we begin to buy in to that image. We reinforce it in casual conversations in the grocery store, on the phone, at our children’s schools, at restaurants, walking around the neighborhood: I’m so bad—I ate a piece of cake. Or I’m such a pig! Or Look