Purge

by Nicole Johns

  On the way to Caribou Coffee, Holly leans in behind RC Julia and sticks her lit lighter in her face while Julia is trying to make a left turn. I know this is dangerous, but I can’t help but laugh. At the coffee shop, we pile out of the van and fight each other to be the first person in line for coffee. All of us order medium Caramel Coolers, and when RC Julia isn’t looking, we ask for extra shots of espresso.

  We sit on the patio, watching the sun melt below the horizon. RC Julia says we all look so happy, and she takes a picture of all of us with my camera. Then Laura and Holly lean in and kiss each of my cheeks, and even though Julia thinks the gesture is inappropriate, she takes a picture anyway. When I get this roll of film developed, I don’t recognize myself, with my hair hovering above my chin and my eyes looking off to the side in uncharacteristic shyness. And, I wonder, when did I grow so unsure of myself?

  Holly gives me a piggyback ride to Big Red, and Sarah takes a picture of our butts. We are all caffeinated and giddy on the way back to the EDC. Then, halfway through the ride, we crash, and everyone falls asleep except RC Julia and me. I stare out the window, watching the grass and trees roll by in a smear of green.

  “What are you thinking about, Miss Nicole?” asks RC Julia.

  “My other birthdays. For the past two years I’ve had ridiculously large parties with lots of alcohol, and now I’m happy with caffeinated coffee.”

  “Well, just think about how much more fun your birthday will be next year, when you’re healthy,” says RC Julia.

  I look over at her and smile.

  “I know you’re going to beat this, Nicole,” says RC Julia.

  I think this is the best part of my birthday. RC Julia believes in me.

  Desperation

  We are desperate. Our eating disorders are an addiction, and we want to succumb to them. We try to engage in eating disorder behavior whenever we think no one is looking, or we do it blatantly until we are told to stop. Danielle tends to hide in her closet. Rather than admitting that she is exercising in there, she claims she is masturbating. Courtney sneaks out the front door and goes running in the woods. She comes back sweaty and claims that it’s just hot outside. Laura stashes her nuts down her pants at dinner, then dumps them in the toilet. I habitually sneak down the hall when no one is looking (or when I think no one is looking) and ram my fingers down my throat and purge my meals. When I hear the clomp of RC Julia’s boots against the floor, the sound coming closer to the bathroom, I panic and attempt to finish my purge before she swings open the bathroom door and finds me slumped over the toilet, hand coated in mucus and food chunks, tears streaming down my face.

  Not until years later will I realize just how desperate most of us were, shaking our legs to burn calories, going on secret missions to purge, and telling never-ending lies to cover up our eating disorder behavior. At the time, all of those actions were part of everyday life; to us they had become normal.

  Repeat Offenders

  Holly has been to the EDC twice before; Danielle has been three times. Repeat offenders are common. It’s easy to end up back at the EDC: It’s safe and predictable, you are taken care of, and you have someone to talk to at all hours of the day and night. It’s easy to run scared from health and life, and to slip back into sickness. Most residents don’t achieve health and recovery on the first try, and repeat offenders are more common than you would think. Throughout the summer, I try to decide if I want to be a repeat offender, but I can’t come to a conclusion.

  Heart Trouble

  I’ve just turned twenty-three, and I’ve been at the EDC for a month. Holly is curled up beside me on the blue leather sofa in the dayroom, right before Art Therapy. My arms hug my knees to my chest, and I am trying to stay calm and breathe. Is this a panic attack or a heart attack? My heart is pounding so hard, I think it’s liable to thump its way out of my chest. I picture my damaged heart lying bloody at my feet. The beat is so erratic that Holly can’t take my pulse.

  In the RC office, my heart rate is 105 (my baseline is 40) and my blood pressure is registering at 130/110, compared with my baseline of 86/58. Now there is a throbbing pain in my chest and it hurts to inhale. Shannon and Brett, the two RCs on duty, page the health supervisor, who sends me to the emergency room. This is my sixth emergency room visit in two years for heart trouble.

  At the hospital, I’m hooked up to an EKG that registers premature atrial contractions, premature ventricular contractions, and abnormal sinus pauses. My potassium levels are low again, which affects the rhythm of my heart. I am given IV fluids and potassium, then released.

  If I continue to engage in eating disorder behavior, I will be in danger of further heart damage and a heart attack. But two days after my emergency room visit, my head is back over the toilet. I slip down the hall after dinner, when the RCs are busy giving everyone their after-dinner Maalox and Tums. I take off my shoes so no one will hear me glide down the hall, and I shut the bathroom door cautiously, taking care not to make noise. Then I quietly heave up the contents of my stomach until nothing but acid comes up. I lay my head against the toilet seat, relieved that I am empty again.

  Nutrition Group

  NORMAL EATING IS

  eating when you’re hungry

  and stopping when you’re full.

  It’s eating healthy foods,

  but treating yourself occasionally.

  johannsonator Sessions

  Dr. August Johannson is my psychiatrist while I am at the EDC. When we are not in his presence, we call him the Johannsonator, or Augie. He is a quiet and thoughtful man, an ex-lacrosse player for the University of Wisconsin, who walks with a swagger and has a shy Midwestern smile. Several residents have intense crushes on him. Whenever his back is turned, Courtney does hip thrusts and makes an orgasm face behind his back, which sends us into gales of giggles. The consensus on the floor is that most everyone would fuck the Johannsonator if given the chance (I, however, would not). I tend to think this sexual fascination with him comes from the power he holds over us. He decides if we get solo walks (the privilege of walking around the hospital grounds unsupervised) and what medications we are given, and, most important, he is the one who decides when we are well enough to discharge.

  During my time at the EDC, I am not on any psychiatric meds, although I spend many of my Johannsonator sessions begging for Ativan or Xanax because I’m having massive anxiety attacks that leave me curled in a ball on the sofa, feeling like I’m dying of that heart attack I used to wish for. The Johannsonator thinks I need to experience my feelings instead of numbing them out with eating disorder behavior or medication; therefore, he will not prescribe me anything but Prozac, which I refuse to take because of a horrible experience I had with Paxil when I was seventeen. (I had withdrawal when I stopped taking it, even though I tapered the dosage as my doctor directed me to.)

  Because we don’t have much to talk about in the way of medication, the Johannsonator and I talk about my body image (it’s usually atrocious). He asks me about my body image and I start crying, and he says, “I’m guessing this means it’s not too good.” Then we argue about whether my weight is stable (I say no, he says yes), and then we are done until the next week, when we have the same conversation again.

  However, sometimes we also talk about my parents, and how they think everything I do is meant to get their attention or to rebel against them. For example, I pierced my nose and they thought it was a direct attack on their values. I pierced my nose because I find nose rings aesthetically pleasing. My parents sometimes forget that I am no longer an angry adolescent determined to get a rise out of them. I respect the Johannsonator because, unlike other medical professionals I have dealt with, he does not talk to me in a condescending manner. He sees me as an individual, not as a disorder, which is refreshing, as some of the staff members at the EDC are prone to lumping all of the residents into a homogenous eating-disordered group.

  The Johannsonator and I discuss what my main issues are, and we agree that I strug
gle with perfectionism academically and in relation to my body. I internalize my emotions and put up a strong front until I explode in a ball of rage or eating disorder behavior. (My symptoms tend to follow a cycle: It worsens during the school year and it starts as restricting myself.) When Rachel, the psychodrama counselor, questions the degree to which I drank during college, the Johannsonator understands when I tell him I am not an alcoholic, although I admit to having abused alcohol in college, like so many other college students.

  In an atmosphere that can be best described as chaotic, my weekly Johannsonator sessions keep me grounded. They are part of how I learn to trust people again, and to open up.

  Art Therapy

  Art Therapy stresses me out. I am expected to express emotions I cannot verbalize; I am supposed to leave the realm of words. These prospects terrify me, and in protest, all my paintings (I refuse to do anything other than paint) have words on them. There is a series of projects to work on in Art Therapy, including the History Behind Your Eating Disorder project, the Body Perception project, Half Trace/Half Perception, Full Body Trace, and the Discharge Anxiety project.

  Art Therapist Tracy picks what she thinks is an appropriate project for me.

  The Half Trace/Half Perception project makes me hate my body with an unprecedented level of intensity. For this project, I cut a sheet of paper taller than I am and paint it orange with swirls of white and red. Next, I draw a line down the center of the paper. On one half of the paper I draw how I perceive my body (just the left side). Tracy has me lay the paper flat on the ground, and she traces my right side, so that half of the paper is my perceived body image, and the other half is my actual body outline.

  My perception is completely out of proportion with my actual body. In my distorted vision my arms are thicker, my waist less defined, my hips broader, and my legs completely shapeless. Yet the actual traced side angers me more than my perception, because it confirms that I am not a shapeless entity. My waist curves in and my hip curves out. Tracy claims that a woman is proportional if her shoulder aligns with her hip. Mine align perfectly, but I still hate my body.

  The Full Body Trace project will go much better. I will do it the week I discharge, whereas the Half Perception/Half Trace occurs halfway through my eighty-eight-day stay. Something clicks for me when I look at my body outline on the paper. I realize with a sense of shock that I have been completely ridiculous. The body on the paper is not so bad; it has curves, but proportional ones. It is not the thinnest body, but it is not overly large. For the first time in years, I see through the veil of my eating-disordered perception, if only for a few minutes. And I start to cry when I think about all the time I’ve wasted trying to reduce and diminish the perfectly good body on the paper before me.

  Thin Clothes Bonfire

  Tracy tells us to bring our thin clothes to Art Therapy because we are going to burn them. Everyone tells me to bring my favorite size 9 jeans, the ones I have hopes of fitting into again someday. Soon after the day I writhed around on the floor, bemoaning their growing tightness, I had to stop wearing them. But I can’t bear to watch them burn, so they sit in the back of my closet, a reminder of my thinner days. The RCs tell me they are my eating disorder jeans, but I don’t care. In the end, they will fit me again.

  They are Mossimo brand, low-rise, flare-leg jeans. I bought them at SuperTarget on Nicollet Mall in Minneapolis on a golden autumn day, the same day I bought my scale.

  The indigo dye has faded with time and washings, and the fabric feels soft and worn-in. The bottoms of the cuffs and the inseam have grown ragged with almost constant wear. At some point the inseam will tear and I will mourn the loss of these perfect jeans.

  These jeans are a testament to my personal history. I wore them when I taught class, when I sat in shady bars drinking gin and tonics. Diana, my first girlfriend, often placed her hands in the back pockets of these jeans when we made out.

  These jeans have known Minnesota winters, Wisconsin and Pennsylvania summers.

  They are the jeans I wore at the height of my eating disorder. At first they were almost too snug, and then they grew so baggy that I couldn’t wear them without a belt.

  The pockets of these jeans have held dollars, miscellaneous change, phone numbers, lip gloss, condoms, tampons, my cell phone, shopping lists, and ticket stubs.

  These jeans, a vestige of my eating disorder, have been through so much with me that I just can’t let go.

  Laura burns her black polyester thong; it emits a foul, synthetic odor as it smokes and smolders. Danielle burns letters that she wrote to her anorexia. Holly burns a shirt and pair of pants that are now too small. Sarah and Courtney aren’t ready to let go yet, so they just sit and watch everything burn.

  I take a pastel purple tank top to the Thin Clothes Bonfire. I don’t usually wear pastels, but I went through a phase when I was determined to wear lighter colors. But I felt out of place in the pastel tank top, as if it belonged to some sorority sister with a swinging blond ponytail and a butterfly tattoo. As I toss the tank top into the bonfire, Tracy asks what it symbolizes. I say: the girl who was never good enough, the girl everyone else wanted me to be, the girl I will never be. I stare into the fire and watch as my symbolic ideal of myself vanishes into smoke and embers.

  Black Market and Contraband

  Sharps (razor, tweezers, nail clippers), products containing alcohol (hairspray, perfume), mirrors, and my cell phone—all of these items are kept in my personal bin in the office. They must be signed out by an RC. I have signed away my right to shave my legs whenever I want, as well as to use my cell phone before 4:00 PM.

  Upon my arrival, my economy-size bottle of Metabolife diet pills is confiscated. I never see it again.

  I discover that there is a thriving black market at the EDC. Gum is the most popular item, as it is small and easy to conceal in a padded bra (just remove the padding) or in the sole of a shoe. Diet Coke is also popular, but rarer, as it is hard to sneak in unless the smuggler is wearing a hooded sweatshirt with a big pocket in the front. It is summer when I am at the EDC, so wearing sweatshirts arouses suspicion. Diet Coke smuggling is on a decline until fall.

  Laura is a candy fiend. Her side of the room contains bag upon bag of candy, Lorna Doones, and Diet Coke hidden between her mattress and bed frame. After her off-campus Alcoholics Anonymous meetings three evenings a week, she tosses the contraband up to the deck, where she retrieves it after checking in for the night. I later learn her AA sponsor is buying bagloads of candy for Laura to sneak into the EDC.

  One night when Laura is out, I decide to steal a piece of chocolate from her secret stash. Just one piece, because it’s there and I don’t know when I will have the opportunity to eat chocolate again. I savor the texture of rich, dark chocolate, letting it dissolve into nothingness in my mouth. I take another piece and repeat the process until I have eaten the entire bar. I read the nutritional information on the wrapper and contemplate purging. I decide not to, to see what it feels like to eat something rich and not purge.

  Danielle sneaks into my room while Laura is out on pass and I am sitting in the office, talking to RC Caroline. Danielle binges on Butterfingers and Jolly Ranchers, then purges. Later that night, she confesses and I raid Laura’s side of the room, gathering up bags of contraband that I give to RC Caroline, who has grown disgusted with Laura.

  I have partaken in the gum chewing and diet soda guzzling and binged on candy because the opportunity to have these forbidden things doesn’t arise every day. These actions lead to my chugging a liter of Diet Code Red Mountain Dew while I am on pass. I come back to the floor a jittery, wild-eyed mess.

  Moderation was never a concept that I practiced. The eating-disordered are infamous for all-or-nothing thinking and impulsivity.

  During a trip to the Milwaukee Art Museum, Sandra and I slip into the café and order coffee and Diet Coke that we must drink within a few minutes, before the RCs and Art Therapist Tracy realize we are gone. The van ride back to the
EDC is miserable. The air-conditioning is broken and the temperature is in the upper eighties. Traffic has slowed to a rush-hour crawl on I-94. The coffee and Diet Coke are roiling in my stomach, which has forgotten how to deal with large quantities of caffeine. I spend my evening retching over the toilet, so miserable that I use my skills at purging to make myself vomit and feel better (plus, it’s an excuse to purge).

  Weekly trips to Target and the local movie theater present a tempting opportunity to consume contraband. At Target, a resident “takes one for the team” and distracts the RC who is with us on the belongings run (our biweekly trip to buy necessities at Target or Wal-Mart that often turns into a giddy, contraband-filled shopping spree). Then someone else buys diet soda in the express aisle and carries it around the store in her purse. We chug soda in the automotive section, hidden among car batteries and windshield fluid. We eat candy in the lingerie section, ducking beneath boy-cut briefs.

  At the movie theater, we are permitted one small popcorn as a snack challenge and one small soda that is neither caffeinated nor diet. After the lights dim, we exchange our Sprite for Diet Coke and buy Sno-Caps and Reese’s Pieces. We munch away happily and slurp our soda slowly during the movie, making it last as long as possible.

  Knowing My Weight