Thin Page 12

  I liked to think of my case as unique, I liked to think of my illness as having its own terms, I liked to think it was because I had that habit of over-thinking things. I endlessly intellectualized this illness and tried to make it my own. But as much as I try to deny it, I hear my very words spoken by other people who have experienced an eating disorder; the same metaphors, the same order of the same words and thoughts and events, almost as if we have read the same script. It is as if we have been invaded by the same virus, which transforms our words and our thoughts so that we are simply mimicking it in our own separate bodies. It is a terrifying realization, to hear what you feel to be parts of your self, who you are and what you feel as an individual, literally recited by other people. Pretending that you are somehow a rare and special person is an ineffective message to other people. It only propels the myth that anorexia is something over there on the margins of society, which can be ignored. I don’t think I am special just because I suffered from anorexia nervosa and I don’t think it was caused as a result of me being special in the first place.

  Words often used to describe the prevalence of anorexia nervosa are ‘epidemic’ and ‘plague’. As exaggerated as they might sound, they are an accurate reflection of the way it manipulates and intrudes into every facet of a person. In 1873, ‘anorexia nervosa’ was given a name. Ernest Lasegue, one of those who laid claim to discovering the illness, said that he found that those he encountered with anorexia were so alike in form and behaviour that he was able to see the resemblance and make his diagnosis without hesitation.24

  As I dropped below six stone, three months after diagnosis, things got to the point where something different had to be done. As with many anorexics, my illness reached a new level of physical seriousness. There had been some intervention, but at the same time I was still deteriorating – I had continued to make progress with my self-starving. I kept going because it was my intention to do so, and I firmly believed I could control and manipulate my single-minded intentions. It was true that as my body initially weakened and my muscles softened, I gained an immeasurable mental strength and focus, but eventually my body became so frail that it seemed to lose interest in its own cause, and it started to give up. At this level of severe weight loss, doctors can identify several physical symptoms of anorexia: low blood pressure, a slower pulse rate and a lower body temperature.25 With this physical collapse, which threatened all faculties (continuing and prolonged starvation can lead to a loss of fertility, osteoporosis and heart, gastro and kidney problems), I watched myself give in to it.

  As I had never wanted to be a failure at anything (good, better, best), I looked over the object of my body and I cried, because what I had controlled and perfected was now helpless, strengthless and shapeless. When people looked at me they could not recognize me. There was no one to recognize. But I had continued to say to the psychiatrist, ‘How dare you deign to know me? Don’t classify me, don’t box me up along with the others. I am an A student, an A-plus student. I am above this condescension, this reduction of my personality into this thing you call anorexia. You don’t even know me.’

  And he didn’t. And I didn’t.

  Because I had not fully grown up, because this illness had pulled me up from the roots, right in the middle of the time when I should have been carving out my own independence, I did not have an understanding of myself. I was like a blank sheet on which this illness had inscribed itself; child, teenager, anorexic, as if it was all I was and all I knew. And so shouting about how I was really something else was ineffective because I had not allowed that something else to happen, I had blocked it. I was an anorexic now and I was a girl again, in need of help.

  Part 3

  WHAT AM I NOW?

  Thirteen

  A control freak, obsessional, a perfectionist, I am all of these things and yet feel like none. If I am such a freak then maybe I should be put on show. A travelling show from a hundred years ago, where giants and dwarfs and fasting girls who defied the laws of nature, who appeared impossible, were gaped at by the public. They sat, a cage within a cage, aesthetic spectacles, awaiting the look, the flinch of horrified intrigue from the faces on the outside. I am not craving this strange attention; I am not seeking to be a focus. I want to stay in my own little world, my prison. Don’t come near my house. My body is my temple. Everything I do is under my own power. Don’t you see that? I’m just asking for some space. I feel claustrophobic, like the bodies around me are too close. I draw these lines around me and shut everything out. I shut you out. I close up my mouth and I am whole. Impenetrable. I feel too much of myself; I take up too much space.

  What am I?

  I can’t cope with the idea of them taking control away from me – of them locking me up with a bunch of girls who have scary pizza nights and make wall charts of their tomato fascinations. But it is what they keep suggesting. What if those girls do it better than me? At least on my own I am in charge of myself and I don’t try new methods to get thinner. I don’t think I want to talk about it with other girls. It would make me too jealous. The thought of some of them much below my weight – oh, the competition! And what if they talked about things I haven’t done, like laxatives or binge-eating or making themselves sick? I would have to try them. I know they would also be looking at me and measuring the size of my wrists and my tummy and my legs, because that is what I would do. I would feel like I am being spied on. I wouldn’t be concentrating on the white-coats, I would be thinking about the other girls. I get funny like that.

  I wonder if I was allowed liposuction, then maybe I wouldn’t be an anorexic. Then I would have thighs like a super-model and everything would be OK. But the books tell me that it is not about the fat, it is about the feelings. The whitecoats keep asking me about the feelings and I keep wondering what they mean. When they ask, ‘How are you?’ I wonder what they really want me to say. Things are a bit snowy-blind at the moment and, to be honest, I am not sure I know what a feeling is or how to really describe it.

  Mum says it is appalling that we have had to wait all this time to get specialist help (Dr Whitecoat is a regular psychiatrist, not a specific eating disorders one). Apparently I have been on a waiting list for three or four months for outpatient access to an eating disorders unit, and in this time I have been losing more and more weight, and this is not acceptable. This is what everyone says about me. Mum has now got a letter from a special unit at another local hospital, and there is a place for me to go and speak to a new lady doctor who is the expert on people like me. Apparently I am very lucky for this unit to be so close to my house, and for someone so specialized in this field to be available to me. Mum has been reading books and writing letters to people and campaigning for me. Dr Whitecoat isn’t happy with Mum because he doesn’t understand why she thinks I need to go somewhere special like that, when his general psychiatric department can cope very well, thank you. He thinks I might be avoiding things, and he doesn’t understand why Mum thinks he isn’t the best doctor for her best daughter. But I don’t like Dr Whitecoat and his sarcastic voice and his cynicism. I can beat him.

  Then I get the letter I have been waiting for, and no one is happy for me and there are heads in hands and slammed doors, but I feel like calling Dr Whitecoat up and shouting down the phone.

  ‘HA. There you go. Someone believes in me. Ha. Do you want to know what it says?’

  Dear Grace,

  We would like to make you an unconditional offer.

  From Queens’ College

  Cambridge University.

  I hold the letter in my hands and I read it over and over again. I call my friends who don’t/can’t mention my problems, and they tell me that I have done well. I didn’t even try as hard as I usually would in the interview because I was tired (and maybe hungry) and I still did it. I still did exactly as I said I would.

  See, I will be the best, I will prove you all wrong. I will go to Cambridge and I will get away from all the people who are trying to peer inside my head
and feed me foods that I can’t eat. People will be amazed when I say, ‘I go to Cambridge University.’

  They will say, ‘Ooh. A girl like you, how smart, haven’t you done well? You must be really clever.’

  I think they will be impressed and they will understand me. This label will be much better than my current one. This is my aim.

  When I get to see the new doctor in the new hospital, she is very friendly. I have to go with Mum and Dad because it’s a family session where she will try and see if it’s because of my background and things from my past that I have turned into an anorexic. Most of the questions go to Mum and Dad and I am there in the middle with my good-girl look and my ready-to-learn face on.

  ‘Did she play with dolls?’ the female psychiatrist glances towards Mum. I look at Mum while she answers for me. Is this to disempower me? I wonder. They talk back and forth about my body, my history, my feelings. I scarcely dare move. I don’t want them to think that I am interrupting their nice conversation.

  ‘You see, she has never been any trouble, we have never had any problems with her.’

  I listen to Mum talk about my childhood. I didn’t cry much as a baby. I did all my homework. I was very helpful looking after my brother and sisters. I was top of the class. I always did my best. They never had to worry. I got drunk a bit with my best friends (Dad had to take us home in his car, opening the car doors when one of us needed to be sick!). But I didn’t take drugs, or shoplift, or get pregnant, or get in trouble.

  ‘No, no, nothing like that.’

  Dad nods along. He is targeted by the doctor’s questions, he feels uncomfortable and he responds hesitantly, shifting in his seat.

  Mum interrupts, ‘He has never had to deal with anything like this before. This is probably the worst thing that has ever happened to him.’

  Do you see what you have done? Do you? Do you see how you have made them pale and shaky? Don’t you feel responsible for stopping them from sleeping at night? Do you feel bad? You should feel bad. You don’t deserve to get better.

  They finish talking and I conclude that this discussion has been most interesting. I don’t usually tend to dwell on things from the past.

  They want to test my body and check that my blood is still working OK. It is cold on the hospital bed. I don’t like the way they poke the sterile needle into my arm. It takes several attempts to get the blood out. I have big veins which stick right out of my arm, so I can’t understand why they can’t just get what they need and let me put my top back on my shivering body. They give me a big plaster when they finish and I roll up my sleeve. I hope that people will look at my arm and see that there is something really wrong. I wonder what they will think. See, I’m not making it up. There is something properly wrong. They even put needles in me. I think about what it would be like to be in a hospital bed, and have people come and visit me and bring me get well cards and flowers. People wouldn’t dare bring chocolates or grapes or anything, but we wouldn’t mention it (people don’t like to mention it now, it seems, not in a public way). I would just have more non-edible items in my room than the usual person, probably a room of non-edible flowers.

  Now I go every week to the special eating disorders unit to see the nice lady doctor. It is part of a big hospital so I don’t mind going there. I have to walk past Accident and Emergency, and wards where old people are staying, and the X-ray section. Maybe people will think I am visiting a sick friend or a new baby and no one will guess that I am heading towards the psychiatry unit. I always make a quick dash to get in there. Once I am in, I am not too worried as I am sure there are people with worse problems than me. I tell the receptionists that I am here for my two o’clock appointment. They smile at me and tell me to go and wait in the cramped waiting room, where every seat is filled. I try and work out what everybody is doing there, because there is a lot of waiting and a lot of lateness.

  Today I have read through every magazine in the room cover to cover, drunk two cans of Diet Pepsi and chewed through two packets of sugar-free gum. My back is stiff and my tailbone aches from sitting down in one place for so long. Every few minutes there are footsteps, which lead to the room, and occasionally someone is taken away. I wish someone would come and get me, weigh me and measure me, so I could go home or go shopping or go to the pub. After two hours of waiting I am apologetically jostled into the doctor’s office. My nice lady doctor blusters her excuses, rummaging through the files. She is friendly and bouncy. I try not to make her feel bad, so I smile and look at the pictures of her husband and daughter as she frantically searches through her paperwork. She thinks hard to remember my name or my illness.

  ‘We have had an emergency come in, I’m sorry but this will have to be it for today … You are OK? … Great … Make another appointment.’

  I don’t mind not talking, that is fine, and I would rather she didn’t weigh me because she will see that I have not gone up, and that I have not been following her instructions, but I HATE HATE HATE her wasting my time. I hate sitting in that small waiting room with strange pictures of African wildlife on the walls and the low, neutral brown coffee table, which has copies of obscure journals and travel guides and pointless leaflets lying on it. I hate sitting there with all the other people, squashed up. I hate the way people stare at me as I take out one piece of chewing gum from my mouth and replace it with another.

  It is none of your business, staring people. Leave me alone.

  I hate the way I can’t get comfortable on the hard chairs and the nervy feelings I have to sit with every time a person looks my way.

  How can I do this all on my own?

  I am obviously not the worst; there are people whose bodies are a much lower weight than mine, maybe a whole stone less; I am not as bad as them. There are girls in here who can’t move or walk, who sit in wheelchairs, whose teeth and heart and bones are demolished from all the sicking up and not-eating for years. I have seen them from afar at the other end of the corridor, and walking through town, when they must have been let out for an hour; away from the horrible foods they are made to eat. It is sort of fascinating, I think, even for me – how they end up looking like that. Perhaps that is what other people think too. Maybe that is why they can’t talk about it. Anorexia is a strange, secret thing and they can’t begin to imagine how or why it is done.

  I can’t get another appointment with the nice lady doctor because she is all booked up, like a really good hairdresser or posh restaurant. I am free all the time; I don’t have anything to do. I lie on my sofa day after day, and I sleep, and I don’t eat. She can’t see me for three weeks, not even for half an hour, and so I will keep dropping weight because I can. Even though I would like to make it better for Mum and Dad and for everybody, I don’t quite know where to start.

  When I do eventually go and see the nice lady doctor she seems to buy into my speech about ‘really trying hard not to lose weight’ and ‘feeling scared’ too. It’s not that I don’t try and mean what I say, it’s just that I can’t properly feel it. It’s like I am on the stage, looking convincing and talking about the ‘feeling’ things, but then I walk off and I am fine, back into my control. I just block what I said. At least I do talk to her a bit more than to Dr Whitecoat because I don’t want to appear rude to such a nice lady. I tell her about the way ‘I can’t switch off. I see and hear everything. I can’t stop. There is no stillness.’

  I know she is impressed by my articulateness, the fact that I still have a brain. She decides to tell me all about the damage I am doing to my body and the long-term repercussions. She tells me about the weakening of my bones and the way I am affecting my electrolyte balance, and how it isn’t normal for me not to have periods for over a year, and how I might not be able to conceive in the future, and how I definitely can’t have a boyfriend because I am not strong enough to cope. But I am nineteen and things are a bit out of focus, to be honest, and so instead of being scared by what she says I learn it, store it and think to myself, ‘I should make sure I
remember, just in case I am tested. I should be the expert on this.’

  If I was honest, and not performing to make her happy, I might say to the nice lady doctor:

  ‘Thank you for the books that you’ve given me. There are some interesting points, which I have noted on the possible causes of an eating disorder. I am glad to see I fit the mould. I am not so abnormal as one would imagine, although where I come from, people aren’t used to such spectacles, and so they stare and comment which makes me feel rather uncomfortable. The books I have read about American high school girls and college students, or stories from girls at posh boarding schools, don’t fit with me. It’s like reading Judy Blume or Malory Towers, not like my normal life in Durham. Maybe in other places anorexics are common, but they aren’t here, at least not visibly. Here, anything different at all is magnified and examined and whispered about.

  ‘I have noted the diet plans to which you have referred me and I honestly don’t think they are achievable. Do you realize that one of the diets actually suggests that I eat 1,000 calories in one day? Can you see that this is impossible and unimaginable? I eat 300 calories a day at the moment so this is a 233.3 per cent increase on my current level. Can you do your maths? Would you be able to increase the amount you ate by that amount every day, if I asked you to? I suspect you will tell me that it is different, and that you do not need to increase your intake. But I look at the list of foods, and I am afraid that they are not things I can currently ingest and certainly not all at once. Your strategy seems to be to make me eat as much as possible, as quickly as possible. Surely if I could do this, I would have done it by now? I know how to eat, I just can’t, something inside me won’t let me. You are very nice, and I like you and your Laura Ashley dresses and your cluttered office, but I am not sure you are understanding me. Your books with their diet plans might seem to offer quick solutions, and your probing questions about my childhood might provide you with the answers you are looking for, but they don’t give me any. I have done the spider diagrams, the life maps and all the funny psycho-analytical exercises the books suggest, and I don’t mind because I’m bored sitting on the sofa and it gives me something to fill my time. I find it interesting, the psychological side of things. I might study it one day.