Purge

by Nicole Johns

  The scale is waiting when you come home from school. The scale is always waiting. You tentatively step on, and red neon numbers blink back at you. Down three pounds. Hands shaking, eyes red, you’re breathing rapidly and your heart is on overdrive, thumping against the confines of your rib cage.

  You wake up in the night, almost every night, terrified that you’ve gained weight. At three o’clock on a frigid winter morning, you leave the nest of your blanketed bed and slide out of flannel pajamas. Shivering, you pull the scale out from its hiding place under your bed and step on. You haven’t gained ten pounds in your sleep. You go back to bed.

  1 The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, published in 2000, includes the following diagnostic criteria for EDNOS:All of the criteria for anorexia nervosa are met, except the individual has regular menses.

  All of the criteria for anorexia nervosa are met, except that despite substantial weight loss, the individual ’s current weight is in the normal range.

  All of the criteria for bulimia nervosa are met, except binges occur at a frequency of less than twice a week or for a duration of less than three months.

  An individual of normal body weight who regularly engages in inappropriate compensatory behavior after eating small amounts of food (e.g., self-induced vomiting after consuming two cookies).

  An individual who repeatedly chews and spits out, and does not swallow, large amounts of food.

  Binge eating disorder; recurrent episodes of binge eating in the absence of the regular use of inappropriate compensatory behaviors characteristic of bulimia nervosa.

  The Last Year

  (OF YOUR LOVE AFFAIR WITH EDNOS)

  You are twenty-two and have never lived in a big city or the Midwest. You come to Minnesota armed with your BA in English and gender studies from Penn State Erie, and a history of winning scholarships and awards. You think you’ve left the past behind, hidden in the mountains of rural Pennsylvania. You couldn’t be more wrong.

  You build an impressive facade, claiming that you aren’t home-sick, that you are happy and love Minnesota. These are all blatant, flagrant lies.

  There are times when you can almost love Minnesota for its vast flatness, its strange breed of liberalism, and the immense blueness of its sky. But you can’t get past the crackheads on the corner of Franklin and Clinton Avenues; you can’t get past the fact that it is never quiet and never dark in this strange, flat land where people butcher their vowels when they speak.

  You turn awkward and quiet, again.

  Buy a scale at Target. See the numbers and go into shock. Buy diet pills. Screw the heart problems—you’ll get thin or die trying.

  The Incredible Shrinking Woman act begins, again.

  Restrict, tabulate, and calculate calories. Pop ephedra-laced diet pills like candy. Any time you go over your self-imposed caloric limit, purge. At first the limit is one thousand calories, then eight hundred, then six hundred, then five hundred. Begin purging constantly. You think you’ve hit bottom, but you haven’t.

  Start running by the Mississippi River because it’s the closest thing you have to Lake Erie. Run until you’re spent. Then it starts snowing and you have to stop running.

  At 8:00 AM, catch the number 20 bus and go to school. The Somali women on Cedar Avenue wrap themselves in scarves and flowing fabrics. You are almost jealous. You wish you could hide your body in folds of flowing fabric.

  The University of Minnesota is loud and sprawling, with traffic and swarms of people. Scurry to Lind Hall; the English department is your refuge. Type away in the graduate-student computer lab. Story after story, lesson plan after lesson plan, poem after poem.

  Make it a goal to not eat at school. And don’t. Instead, wash down diet pills with large coffees diluted with five Equals. You shake a lot, your pupils are always dilated, and dark circles ring your eyes. Your body is exhausted but your mind is on overdrive.

  You pull off this plunge because everyone is unaware. It takes a while for the questions and confrontations to start.

  Meanwhile, you are losing—yourself, your mind, and, most important, weight. You have condensed your life down to two things: weight loss and school.

  The baristas at Caribou Coffee on Washington Avenue know you by name because you spend your weekends there, grading papers and writing in your journal while consuming strong coffee. If you’re not at Caribou, you are downtown on Nicollet Mall, wandering through the streets, staring up at skyscrapers, reminding yourself that you live in a city and never have to go back to your isolated hometown in Pennsylvania.

  But you do go back. In November you break down and buy a $300 plane ticket you can’t afford, to Erie, Pennsylvania, where you went to college. You have a fabulous time there. It hits you how much you miss Erie. You take a guy home from the bar to make Carla jealous. Carla is in love with you and you are in love with Carla, although neither of you will ever act on it because she is forty and married. Your ploy works. Carla is jealous. You and Carla never really speak again.

  Carla’s letters were the only things that got you through some days and now, suddenly, they are gone.

  It grows bitterly cold in Minneapolis. At negative thirty-five degree windchill, the tears on your eyelashes freeze. You feel even fatter because you have to wear long underwear and so many layers.

  One of your roommates has friends coming in from Wisconsin for Thanksgiving. You think it will be a lonely holiday for you, but you fall in love the day before.

  Her name is Diana and she’s a tall, redheaded Minnesotan. She persuades you to go dancing at Lucy’s Bar, but you don’t so much dance as make out. She is five-foot-nine, and at five-foot-five, you have to stand on tiptoe to reach her lips.

  Her scent is lavender. You are enamored. Your friends drive both of you back to your house at 2:00 AM; it’s you and Diana in the back seat, kissing, while your friend drives through the deserted streets of St. Paul, where the hard, granular snow glistens in the light of the streetlamps.

  The sun rises before the two of you fall asleep, a mess of tangled limbs in your tangled sheets.

  At first, Diana is a weekend event. Then she calls you every night and you grow overwhelmed; she is too close. You talk about this and she backs off.

  You always have a bottle of wine waiting for Diana, as well as fresh sheets. It’s all very romantic. Your Minnesota friends like Diana. You meet her parents. But you don’t tell her your secrets.

  Diana’s skin is a winter white, paler than your own skin. The two of you lie on navy blue sheets; her head rests on your chest while you twist strands of her auburn hair around your index finger. It’s snowing again, and you listen to the wind scour the plains.

  “Your heart is beating out of rhythm,” she says.

  “I know.”

  “Why does it do that?”

  Shift her off your chest and kiss her.

  Then, on a frigid January morning, she breaks up with you. Now she’s the one who feels stifled. You binge and purge the day away at McDonald ’s. Then you start drinking. You are hungover and depressed from purging and drinking.

  People start noticing that you aren’t all right. You keep losing weight and you look like hell. One of your friends in the English department is the first to confront you in the grocery store Rainbow Foods on East Lake Street. She stares you down in the canned-goods aisle and asks whether you are bulimic, anorexic, or a little bit of both. You think for a moment and say a little bit of both. She glances in your cart and shakes her head. Your cart contains a tub of fat-free plain yogurt, a bag of salad, cans of vegetables, a bunch of bananas, and a half-gallon of skim milk.

  You don’t realize how out of control you are, even after you fall down a flight of stairs in the English department. Much to your relief, no one sees you fall.

  Spring semester, you take Memory and Memoir and Poetry of Social Change classes. You love both of these classes and actually start talking in them. You have found your voice again. You enjoy the cha
llenge of reading Proust and Nabokov, and you love working at St. Stephen’s Men’s Shelter through Poetry of Social Change. It makes you feel like you have some self-worth. Sometimes it makes you feel incredibly guilty as you walk through the ghetto, dressed in a warm coat and waterproof shoes, in subzero weather. The inhabitants of the ghetto have none of this.

  One impenetrable Midwestern night, you are desperate because you are trapped in your life. There is no way out, so you binge on and purge an entire tube of Pillsbury rolls (half-cooked—you are too impatient to wait for them to bake), an entire box of chocolate Malt-O-Meal, a pint of Godiva ice cream, and a mug of chai tea. Though you know that constant purging and starving leads to dehydration, you don’t rehydrate when you’re done.

  In bed, you can’t sleep. Your heart is skittering erratically. You wonder if you’re dying. Maybe you won’t wake up in the morning. Maybe that wouldn’t be so bad.

  You do wake up the next morning, and you have a bulimic hangover because you are so dehydrated and malnourished. The world spins, your head aches, your heart throbs hard in your chest, and you almost pass out in the shower. You think about canceling the class you teach, but don’t.

  After your shower, you dress, then reach to get your cell phone off the table in your room. You lose your balance and fall to the floor, smacking your head on the corner of the table. Instantly, you vomit. You remember this is a sign of a concussion, so you call a cab to take you to the health center.

  By the time the cab arrives, you’ve grabbed your insurance card, jacket, cell phone, and keys. You sit on the curb, head in your hands, sobbing.

  At the student health center they take one look at you and start an IV. They think you have the flu and you let them believe this. They are concerned—you’re dehydrated, your electrolytes are a mess, and your already low blood pressure plummets when you stand up. They think you have a concussion and they send you to the ER.

  You are admitted to the cardiology unit because you are having premature atrial contractions, premature ventricular contractions, and bradycardia. All of these heart irregularities are direct results of your eating disorder. You call home to Pennsylvania because you think it’s the right thing to do. You are scared. The cardiologist tells you this is all a result of purging, starving, and diet pills. You tell your parents it’s just stress; there is no need to worry them with the truth.

  The doctors release you from the hospital the next day, and it is apparent that you have a concussion. Typing is an ordeal, as are most cognitive functions. All you want to do is sleep.

  You realize you are going through the motions of life. You are running literally on black coffee and diet pills. Everyone is concerned about your hospitalization. Later, you find out no one bought your story about having the flu.

  Your poetry professor drives you home every Tuesday night after seminar. She pulls up in front of your house and peers at you. She wants to know what is really going on. You hop out of the car and thank her for her concern, but you are just fine.

  At this point, you wonder if you’ve lost your mind. All you think about is food and school. You think things can’t get any worse, but they do.

  It’s seven o’clock on a Sunday morning, the last day in February. You answer your cell phone and your father tells you your uncle has been killed in a car wreck. His ancient Blazer slid on the winter-slick gravel roads of home, flipped, and rolled into a dark ravine. You fly home. You are numb; you don’t believe this is really happening. You go to his gravesite in an icy March rain and say goodbye. You finally cry there.

  You stay home for a week after your uncle dies. You don’t want to fly back to Minnesota, but the hills of Pennsylvania are suffocating, so you go back.

  You start attending eating disorder group therapy at the student health center the next week, but quit shortly after you start. Someone always cried during group therapy, which made you grip the arms of your chair, not sure how to react. Group was a strange place where the unofficial motto was “I’m okay, you’re okay, and we’re all just okay.” This was supposed to help, to show that you were not alone. Group was part of your mental-health maintenance. Going every week, setting goals, and acknowledging setbacks were supposed to help you get better.

  In group, you talked about food and feelings; you lay stretched out on the floor and tried to imagine a time when you were happy with your body. Your mind drifted to the green hills of home and the drought-dry tall grass that lines the back field by the edge of the cliff. You remember searching for sun-ripened raspberries in the abandoned chicken coop, the searing midday sun on your bare shoulders. You were eight and sturdy. Your body was yours, no one had trespassed upon it, and you valued the steady beat of your heart.

  You drifted back into the reality of the urban landscape outside the group therapy room, to the sound of rush-hour traffic hurtling down the street. The women talked about their memories of a time before the vigilance of eating disorders, but your mind fixated on the memory of your eight-year-old self.

  Your therapist urges you to enter a treatment program. You tell yourself you are just fine.

  Meanwhile, because you are so miserable, you are praying for a gastric rupture or the chance to die in your sleep. Your therapist claims you are passively suicidal, and you tell her an eating disorder is a slow, painful suicide. An eating disorder is an abusive lover you keep crawling back to. You wonder if you can break the cycle. You call your insurance provider, BlueCross BlueShield of Minnesota, and ask if they cover residential eating disorder treatment (a woman from group therapy has recommended residential treatment over treatment in the local hospital). They do. You qualify. You don’t even have to pay a copayment, because the powers that be have deemed treatment medically necessary. And so you order your train ticket, $76 from Minneapolis to Milwaukee, and on May 24 you decide to give life a try, again.

  The End Is the Beginning ·

  I spend my last night of freedom in the 400 Bar in Minneapolis, swaying to an unknown band, a plastic cup of lukewarm Sam Adams in one hand, a cigarette I bummed off someone in the other. In three months, the jeans I’m wearing, my favorite pair of size 9 jeans that fit just right, won’t fit me. This is the last beer I will drink for over three months. I haven’t left for treatment yet, but somehow I sense this is the end of something; this last night at the bar has a sense of finality to it.

  Someone spills beer on my shirt and I want to ask the bartender on a date, but he’s got a girlfriend and I’m leaving for treatment in Wisconsin tomorrow. Back at my house, I pack halfheartedly. My roommates are out celebrating the end of the semester, so I am alone. I swallow some Dexatrims that I wash down with a Diet Coke chaser because I know at this time tomorrow, I won’t be allowed to have either. Dexatrims and Diet Coke are considered contraband at the Eating Disorders Center. I imagine friendly nurses with squeaky white shoes catching me with the Dexatrims I’m planning on sneaking in. In my imagination, the nurses let me keep the pills because they see that I need them. They see that I am fat.

  Around 2:00 AM, I make an entire box of chocolate Malt-O-Meal with skim milk and a gluttonous amount of white sugar. I eat all of this viscous, syrupy-sweet concoction and then frantically search the cupboards for something to binge on, but there is nothing to eat. I sprint to my room in search of my scale, forgetting that a friend confiscated it this morning. I am paranoid that I have gained weight from the beer and the Malt-O-Meal and the brunch I had with friends earlier in the day. I chug Diet Coke and head to the bathroom and retch until there is nothing left in my stomach.

  I lie awake in bed, jittery with caffeine and insomnia. My heart races and thumps in an unsteady beat. I should care, but I don’t. Part of me wishes for cardiac arrest because I don’t know how I’m going to let go of this.

  My alarm goes off at 5:30 AM, and I wait for the cab to pick me up and take me to the Amtrak station. As the train lurches out of St. Paul, I mutter, “Goodbye, Minnesota” because I don’t think I’m coming back. I don’t eat all day
, and wash diet pills down with Diet Coke at regular intervals as the train speeds south and east. I’m lulled by the soothing rocking motion and fall into a stupor, staring at the lush greenness of late spring in the Midwest. I can’t read or write; all I can do is watch Minnesota fade into Wisconsin.

  Day One—Admission

  I step off the train at the Milwaukee depot, clutching my two battered suitcases and trying not to shake from anxiety and the diet pills I took during the ride. An older man with a grizzly gray beard is standing inside the dilapidated station with a sign that simply reads: NICOLE. I attempt to smile as I walk over to him.

  “You Nicole?”

  “Yes.”

  “Let’s go, then.”

  I want to jump on one of the trains headed west, or east, or anywhere other than here.

  The driver loads my suitcases into the white hospital van, and I call my mother from my cell phone to let her know someone picked me up at the train station. She wishes she could be here with me, but I am glad she is at home in Pennsylvania. I am embarrassed and don’t want her to see me like this. I want to protect her from what I have become. The surly driver attempts to make conversation with me by identifying all the wildflowers along I-94 and telling me about his grandchildren. I only half listen to his ramblings and wonder if he thinks I’m thin enough to have an eating disorder. Finally, we pull up to the Eating Disorders Center (EDC). From the van, the EDC appears to be a rustic wooden structure surrounded by a carefully manicured and landscaped lawn. It does not look like a mental institution.