Wasted: A Memoir of Anorexia and Bulimia (23 page)

Over dinner, they told me I had an appointment on Tuesday. We just want to make sure you're okay, they said. I was game. I didn't figure anyone
real
would be worried. We drove into the heart of Minneapolis, sat down in the waiting room of the TeenAge Medical Services (TAMS) clinic. Both of my parents were there, which felt funny. My dad had always been the one to take me to the doctors before I left home. We had always gone to McDonald's afterward.

It was something of an event. I remembered that I couldn't go to McDonald's anymore. I paged through magazines. I looked at the pamphlets on the wall: birth control,

STDs, Do You Smoke?, Getting Along with Parents, little sketches of smiling boys-n-girls. My father put his arm around me and felt my shoulder bones. He punched my arm lightly and then looked away, who—me? It was our old joke. I punched him back.

A voice from behind me: “Marya?”

Something was wrong. She pronounced my name right. Someone had been talking to her.

She was short, dark-haired, pretty, had a beautiful but worried smile. I put down my magazine, stood up, folded my arms across my chest, listened suspiciously as she greeted my parents, “Hi, Jay.

Judy.”

Jay and Judy
? What were they doing on a first-name basis?

She put her hand on my shoulder. I jumped. She dropped her hand and said, Come on back. By the way, I'm Kathi.

Mmm-hm.

We walked down the hall. She asked, Okay, do you know what's going on here?

I answered loudly: NO. I watched her pull out a thick file with my name on it. I'd never been there before. What the hell was in the file?

She said: We're doing an eating-disorders evaluation. You—

I interrupted: I don't have an eating disorder.

Okay, she said. Then this will be quick. In the meantime, you're going to see the doctor first, and then come up and talk to me. Sound good?

No.

She laughed. You're right, she said. I'll cut the Pollyanna act.

I smiled.

In the examining room, my feet were cold. My hands were cold.

I am convinced they keep doctors' offices at forty degrees. Even my knees got cold. The doctor came in. He was young, pleasant-looking, brisk. He put his hands at my throat, felt the swelling below my jaw.

How long since you've thrown up? he asked.

You're assuming I throw up, I said.

Yep.

Yesterday.

How many times yesterday?

Once.

How many times yesterday?

Once.

From the swelling here, I'd guess three, minimum.

I almost fell off the table. He was right. He moved in front of my face, shined a little light in my eyes.

Did you know your eyes don't focus?

Um, no.

They don't.

He wrote on my charts. He wrapped a cuff around my arm. It was too big. He pulled out a cuff that said, in big delightful letters, CHILD'S CUFF.

That pleases you?

What?

That an adult cuff is too big?

No.

You look pleased. Stand up.

He took my pressure. I began to get the idea that blood pressure had something to do with eating disorders.

I asked: Is it normal?

He said: I don't know yet. Lie down.

He took it again.

Nope, he said. It's not. All right, walk heel-to-toe from the door to me.

I went to the door. I started walking.

Don't look at the floor, he said. I looked up, took a step, stumbled, caught myself on the table, laughed nervously. I asked, How many tries do I get?

He didn't laugh. He said: Shut your eyes, put your arms out to either side of you, and touch your nose with your index fingers.

I said: You've got to be kidding.

He shook his head.

I couldn't do it.

He sat me on the table, tested my reflexes with his mallet. No response whatsoever. My legs hung down, limp. He tested again.

Nothing. He took one of my hands, peered down at the nails, chipped the polish off one finger. The nails were blue. He wrote it down.

He lay me down on the table, pressed at my stomach for a while.

You've got a good coat of fur here.

Thanks.

He weighed me, took blood, took a urine sample. As he scribbled his last notes on my chart, I asked cheerily, So, did I fail?

He glanced up at me and said: Pretty much.

Upstairs in Kathi's office, I curled into the corner of the couch and took test after test: Eating Disorders Index, Body Perception, this and that. I was relatively honest.
Do you think you need to lose weight
?

Yes.
What is your ideal weight? Eighty-four. Would you say that you'd
give any thing to be thin
? Yes.

Ask a woman in your life how she'd answer these questions and see what kind of answers you get. None of these things are so shocking. Statistically speaking, this is not so far from the norm. I didn't figure I had anything to worry about.

When I was done I chatted with Kathi, whom I rather liked. She was funny and sharp. We talked for an hour or so after she'd reviewed my tests and the lab results. We talked about life, food, weight, stuff.

She said, So, you don't have an eating disorder.

Nope.

That's not what your body says.

Excuse me?

Your blood is anemic. You have ketones4 in your urine, your blood pressure is completely unstable. Your heart rate is pitiful.

But I'm not skinny.

Not as skinny as some, no.

So it's not that big a deal.

It's a very big deal.

I started laughing. She smiled at me.

I'm checking you into Methodist Hospital.

WHAT?

Sorry. You need to be in the hospital.

4Ketones are a class of acid compounds. A ketone body is “a ketone-containing substance…that is an intermediate product of fatty acid metabolism. Ketone bodies tend to ac-cumulate in the blood and are excreted in the urine of individuals affected by starvation or
uncontrolled diabetes mellitus” (American Heritage Dictionary).

lost it. I started screaming. She sat there.

And then I was in the car with my father. I said, I suppose all I'll need to take is a nightgown, now that I'm going to lie around for a month. He laughed. He tried to make a joke: What does the dyslexic insomniac think about all night? (The existence of Dog), but it came out: What does the insomniac anorexic—wait—oh, shit—and we laughed and laughed.

That was on a Tuesday. The following Monday, I went into the Methodist Hospital outpatient clinic for a final evaluation. I sat on the table, freezing cold in my little paper gown, rubbing my feet together with a noisy
scritch-scritch
. There was a blanket in there—they were used to us—and I pulled it over myself. I put on my jacket. I lay down. The doctor came in. He said simply, “Cold or tired or both?” I sat up. He put me on the scale. He was gruff, didn't meet my eyes, ran through the battery of tests. My vital signs had fallen significantly since I'd been seen the previous Tuesday. He mentioned this to me. He checked me in. I watched my father sign the forms.

MARYA JUSTINE HORNBACHER. F. DOB 04-04-74
.

I. AXIS I:

A. Bulimia nervosa, 307.51 (w/anoretic features) B. Substance abuse, 305.00

C. Major Depression, 296.22

Interlude

September 22, 1996

I suppose you'd call it amnesia. I read the charts. I sit in a back office in TAMS, reading my charts. Medical and therapeutic. Charts (blue) regarding a person (sixteen, female, white) named Marya (chronic, total denial) who is clearly very sick. These do not look like my charts. I do not have charts. I am a regular person. Why would I have charts? This never happened to me. These look like my research. I am taking notes as I always do, flipping pages, footnoting, regarding the case at hand. I sit in my chair, suit and red lipstick, professional, smiling brightly as the doctor—my old doctor, the one who watched me get sick and get well and get sick and so on for years—comes in and asks, How are you? Wonderful, thank you. He sees me reading the charts. He says, It must be hard. I say, A little strange, yes.

Rain flings itself down at the pavement. Outside the window, a siren goes screaming by. The doctor smiles at me. I am a grown woman. I am married. I am employed, I am Recovered. I sit here in my suit, hunched over the desk, smiling redly. They are proud of me. It was a Long Haul, but I Made It.

And I read the charts. They make me sad. For the girl and for her family. A family trying very hard to understand, a girl trying very hard to die. The charts make me shake my head in disbelief that the family could be so obtuse, that the girl could be so insensitive, so wrapped up in her own little world, that she could be so blind to the ramifications of her own behavior. “The most striking character-istic of Marya [is] her complete disdain for any risks or dangers involved in her eating disordered…behavior. States that they might be dangerous for other people, but not for her.”

I am that girl, still. The ramifications occupy space in every cell of my body, every damaged organ and nerve, every memory tainted and skewed by the obsession that was and is my life, every plan for the future

that is highly speculative, qualified: Will there be a future? How long? I turn the pages, watch the weight rise and fall, listen through a din of years to the pleading, wheedling, delusional, lying voice of this girl.

Because, in these charts, even I can see that the girl is lying. And that she will fall again.

And again.

4 Methodist Hospital, Take 1

So, so, Herr Doktor, So, Herr Enemy. I am your opus, I

am your valuable, The pure gold baby That melts to a

shriek. I turn and burn. Do not think I underestimate your

great concern. Ash, ash—You poke and stir. Flesh, bone,

there is nothing there
.

—Sylvia Plath, “Lady Lazarus,” 1966

The hospitalizations at Methodist have a tendency to blur, one into another, since I was there three times in less than a year. Hospitalizations in general are blurry. The days are the same, precisely the same. Nothing changes. Life melts down to a simple progression of meals. They become a way of life fairly quickly. You used to be a normal girl with a normal life. Now you are a patient, a case, a file full of forms. You may welcome this transition. It may seem inevitable to you. You have been removed from the world. You have been found flawed and wanting. You could have told them this years ago. It is all right, in a way, because there is nothing so sure, so safe, as routine. There is nothing so welcome to the anoretic or bulimic, much as she protests and howls, as a world wherein everything, everything, revolves around food.

And there is nothing so wonderfully conducive to eating disorders as treatment.

There are the certainties. You will be given slippers—little socks with rubber treads on the soles—and a paper gown. From the doorway to your room, the room will have a bathroom on the left.

You will turn the doorknob, but it will be locked. To your right, built into the wall, a small

closet. Three drawers beneath a mirror hung too high to see your butt or even your waist. You will be forced to focus instead on your arms, your shoulder bones, the flesh of your cheeks or throat.

Ahead of you, on the left side of the room, two beds, a curtain shoved back to the wall in between. Apparently you will be sharing the room with another patient. Perhaps the two of you will conspire.

On the right side of the room, against the wall, sit two hospital chairs, vinyl-covered, gray metal frames. One of these beds is for you. It will be a hard bed, but you are exhausted. In the hospital you will sleep deeper than you ever have, or ever will again. There will be a little table by your bed with buttons on it. You can turn on the radio, call a nurse, flip the light. None of you ever use the nurse call button, even if you are having a heart attack, because you aren't really sick.

To call a nurse would be ostentatious, as if you thought you really warranted worry, as if you were so weak as to want to get well.

There will be a window in your room that will look out over rooftops and winding streets. Depending on what time of year you are there, the trees will either be full or bare.

There will be a main room, which will have a television and a long bank of windows looking out over the city on one wall. The rest of the walls will have Plexiglas windows through which you will be watched. The room will have one or two couches, end tables, institutional carpeting covering the concrete floor. You will carry your pillow with you everywhere, in its rough white case. You will sit on it, because the floor will hurt the bones poking out through your ass. Or you will lie on the floor on your belly and move the pillow frequently, from under your rib cage to under your elbows to under your pelvic bones. There will be decks and decks of old cards, board games, news magazines. There will be no fashion magazines, and your friends and family will be warned not to bring them to you, because they are bad for you. They may not bring food or drink. If you are lucky, you will be in a hospital where they are allowed to bring decaffeinated coffee. The coffee is never caffeinated—you might be using caffeine to artificially boost your metabolism, or if you are experienced, your heart rate. In Methodist, not even decaffeinated coffee will be allowed, because you might be using it to boost your weight, knowing as you do that you are retaining fluids.

There will be nurses, several of them, on rotating shifts. They will be nice, or they will not. There will be bathroom times, usually every two hours on the hour. At those times, a few nurses with heavy, jangling key rings will open the door for you and lean back against the closet door. Everything rests on the nurse: The very nicest of them will let you leave the door open just a crack, a token, and she will talk to you while you pee to keep your mouth too busy to lean down and puke between your legs. Most of them will stand there, door wide, but will avert their eyes and talk to you. They always cross their arms. They act nonchalant. Some of them are not that much older than you. You hope they feel horrible. Some nurses will let you turn on the water while you go, so that the noise of your piddling into the little plastic container—called a “hat”—which measures your fluid output is not quite so thunderous. There are also the awful nurses, who swing the door wide and
watch
. These are the ones who diet. You hear them talking on the nurses' station when they think you aren't listening—idiots, you're
always
listening—about their fat thighs. These are the ones who do terrible, cruel things to their hair, perming it into thin strands of curled straw and dyeing it colors not found in nature. And they stare at you, your pants around your knees, your arm folded over your belly to hide what you can, and when you ask them, “Can I please turn on the water?” they will say not simply no but “Why?” And you will say,