Little Girl Blue

by Randy L. Schmidt

  Agnes was what Levenkron termed an “oppressive-dependent” mother. At first she appeared to be overbearing, but that same domineering presence is oftentimes a cover for her fear of losing her daughter—or at least control over her daughter. Levenkron suggested to the family that Karen was in need of a more tactile, demonstrative kind of love. Karen bawled uncontrollably during the meeting. She told them how terribly sorry she was for having put them in a situation where they felt a need to defend her upbringing, and she went so far as to apologize for ruining their lives.

  “I think Karen really needs to hear that you love her,” Levenkron told the family.

  “Well, of course I love you,” Richard told her unreservedly.

  “Agnes?” The therapist tapped the mother’s shoe with his own.

  Rather than address her daughter, Agnes explained how she preferred to be called Mrs. Carpenter. “Well, I’m from the north,” she continued. “And we just don’t do things that way.”

  “Agnes couldn’t do it,” says Itchie Ramone, who discussed the meeting with Karen and Levenkron after the family left. “She couldn’t do it! . . . In therapy you’re basically stark naked. Then your own mother can’t reach out to you? And the way she doted on Richard! Most children would try to dance as fast as they could to make their parents love them, but it was at that point that I think Karen decided it was time to take a step back.”

  When Levenkron lightheartedly suggested to the family that Karen might come out of treatment and realize she no longer enjoyed singing, that was it for Richard. His distrust of the therapist was forever solidified. In his mind, there was no question of Karen’s deep-seated love for singing. She loved performing and recording more than anything in the world. As she explained to Ray Coleman in 1976, “I gotta sing. I love that crowd.” Karen had always considered herself fortunate to be able to make a living doing something she loved. “A lot of people don’t get the chance to do that,” she explained in a 1981 interview. “They spend their whole life doing a job they hate. . . . We walk in and sing and have a good time and make albums, go all over the world.”

  After the meeting with Levenkron, Richard became angry with the treatment plan, which he thought to be worthless. “At that point, he didn’t have a lot of respect left for Levenkron,” Itchie says. “At first everybody was grabbing for any information Levenkron might have that could help Karen. Then all of a sudden in a few months it turned around to where everyone was asking, ‘Is this guy for real?’”

  Richard was upset that Karen had not checked herself into an inpatient facility as one would do to conquer substance abuse, like a Betty Ford Clinic but for eating disorders. According to Levenkron, he also wanted to put Karen in an inpatient facility immediately after she arrived in New York, but she refused to even consider it. The therapist proceeded to work with her in what he called a “less-than-perfect treatment modality,” according to his interviews with Ray Coleman. He went on to say the modality ended up being a nonissue, however, because the damage that would eventually kill Karen had already been done. “In the end,” he explained, “what killed her was all her behavior previous to coming to New York.”

  The Carpenter family returned to Downey and, although greatly alarmed, chose to keep their distance after this painful encounter with Levenkron. Wishing to consult exclusively with Karen during this time, they made no further attempts to contact her therapist. “What I find interesting,” Levenkron stated in 1993, “is that in the entire time Karen was in New York, I got zero calls from the entire family. I have never treated anyone with anorexia nervosa that their family didn’t call somewhat regularly because they were concerned.” Likewise, Richard claimed to have never received a call from Levenkron.

  Karen and Itchie were surprised to learn that Levenkron was not an actual doctor. “We used to call him ‘Dr. Levenkron’ all the time,” Itchie explains. “Then we found out that he wasn’t even a real doctor. Any medical issues she had, we had to go see this other doctor who was a medical doctor at Lenox Hill Hospital.”

  According to Evelyn Wallace, “She picked the wrong guy to go to. He wasn’t even a doctor! It seemed like Levenkron was simply trying to talk Karen out of having anorexia, but she’d talk to him and she’d go back to the same routine. He was some kind of a counselor. I don’t know what you’d call him. Call him a liar! That’s what he was.”

  Wallace could only do so much from afar. She wanted to see Karen with her own eyes and be able to hug her and show her love and support. Although she refused to travel by plane, Evelyn called an area train station to inquire about a round-trip ticket from Los Angeles to New York. “I think I’ll go visit Karen,” she told Agnes one afternoon.

  “Oh no, you can’t do that,” she responded.

  “Oh? Well, I wouldn’t stay long or bother her or anything,” she explained. “Just visit.”

  But Agnes was adamant that she not try to see Karen. “The doctor said she can’t have any more visitors!”

  This puzzled and even angered Evelyn. She knew Karen was not in any sort of confinement. “She was alone in a hotel room,” Wallace says. “I was so mad! I thought, ‘What in the heck has she got, something catching?’”

  BY THE fall of 1982, Karen showed no real signs of progress. In fact, her walks to and from sessions with Levenkron kept her body weight dangling beneath the eighty-pound mark. Itchie Ramone called Levenkron and voiced her concerns. “Look, Karen’s getting thinner and thinner and thinner,” she exclaimed. “Plus, it’s obvious she doesn’t have her usual energy anymore. When do you expect this turnaround? She’s just skin and bone!”

  The therapist agreed that Karen seemed extra tired and was not responding as quickly as he had hoped and vowed to try another approach. Leaving her next session with Levenkron, Karen asked Itchie if she could borrow a swimsuit. “What?” Itchie asked. “There’s no pool in the hotel. Besides, it’s cold out!”

  “No, I have to wear it tomorrow for Levenkron,” Karen answered.

  The two stopped by the Ramones’ apartment to pick up a size 2 light green bikini belonging to Itchie. Karen changed into the bikini and emerged smiling. Itchie was mortified and unable to hide her reaction. “What’s the matter?” Karen asked. “It fits.”

  “Uh, yeah, it fits,” she said hesitantly. “You can use it tomorrow, I guess.”

  Returning to Levenkron the following day, Karen was asked to change into the bikini and stand in front of the office mirror. He urged her to survey and evaluate her body. “She didn’t really see any problem with how she looked,” Itchie recalls. “In fact, she thought she was gaining a little weight. But she was seventy-nine pounds. That was one of the times where I would go home and lock myself in my bathroom and cry.”

  Karen, too, was growing impatient and discouraged that she was not progressing as quickly as she had hoped. Her impending self-imposed deadline was on the horizon, and she had nothing to show for almost a year of therapy. “My mother is going to kill me if I haven’t gained weight,” she told Evelyn Wallace and reportedly expressed the same to her therapist.

  In mid-September Karen phoned Levenkron and told him her heart was “beating funny.” She was quite upset, anxious, and confused. She complained of dizziness to an extent that she was unable to walk. He recognized her symptoms as those of someone suffering extreme dehydration. He knew she needed immediate medical attention but was unable to refer Karen to a hospital based on his own credentials. Instead he asked Dr. Gerald Bernstein to meet him and Karen for an evaluation.

  At what might very well have been her lowest point ever, both physically and emotionally, Karen was admitted to New York’s Lenox Hill Hospital on September 20, 1982, to begin hyperalimentation, or intravenous feeding. “When they do that they’re really seriously worried that you’re going to die,” Frenda explains. “That’s why they do it. It’s a last resort.”

  Two blocks east of Central Park, Lenox Hill Hospital is an intensive care hospital on Manhattan’s Upper East Side. “In the beginning sh
e was definitely a Jane Doe,” Itchie recalls. Attempting to check in as Karen Burris, she was recognized by the receptionist as the singer from the Carpenters. She was “terrified but determined,” according to Dr. Bernstein, who conducted a series of tests that revealed a critically low blood potassium level of 1.8. The normal range is 3.5 to 5.5. Upon admission to the hospital Karen was, in Levenkron’s words, “seventy-seven pounds of dehydrated skeleton.”

  The next morning Karen went into surgery to have a small-bore catheter implanted within the superior vena cava (right atrium of the heart). An unexpected complication was discovered later that day when she complained to the nurse of excruciating chest pain and X-rays revealed the doctors had accidentally punctured one of her lungs in their attempts to insert the tube. She phoned Frenda at the first opportunity. “I could hardly understand her,” she recalls. “I went running on the red-eye to New York. It was just a nightmare!”

  As Karen recovered, Itchie took on the arduous task of re-creating the suite from the Regency in her hospital room. “Lenox Hill was an absolute nightmare for me,” she says. “I turned her hospital room into a multimedia room. I thought the nurses were going to kill me! I had to set up the TV equipment, a refrigerator, and bring in tons of videos, a cassette player, you name it.” Listening to piles of cassette tapes and song demos helped Karen pass the time when she was alone and surrounded by four orange walls. “She was always drumming everywhere,” Itchie recalls.

  Between various needlepoint projects she watched reruns of I Love Lucy and even took time to finally read the manuscript for Cherry O’Neill’s forthcoming book, in which O’Neill referred to anorexia as a “sophisticated form of suicide that afflicts millions of young women.” The parallels between these two women’s stories were apparent. Like Karen, Cherry grew up in a musical family with singing siblings and shared similar desires to please everyone around them. Both women grew up in Christian households with what O’Neill refers to as “authoritarian-type parents.”

  Near the book’s conclusion Karen read how Cherry’s newfound freedom spurred a long-overdue confrontation with her mother: “When are you going to stop treating me like a child? Why can’t you relate to me as an adult? I’m twenty-four years old and even though I’ll always be your daughter, I’m not a baby anymore!” The words mirrored Karen’s own cries for autonomy. She deeply feared the idea of ever having to face up to her mother, and her attempt at confronting Agnes several months earlier in Levenkron’s office had ended up being more of a pleading for forgiveness. But now she knew that she would have to confront Agnes in the future to get her attention.

  “I did it!” Cherry wrote in triumph. “I actually said what I felt for years but could never reveal. I declared my independence, embraced my adulthood, and confronted my mother with a truth to which both of us had been blind. The little bird who fought so furiously—and belatedly—to learn to fly refused to have her wings clipped.” Starving for Attention was in many ways Karen’s personal story but with an added “happily ever after” ending. It seemed more like a fairy tale than nonfiction.

  As her lung began to heal, Karen’s body quickly responded to the artificial means of feeding. The hyperalimentation process completely replaced all of her nutritional needs, and a precise daily calorie intake was dispensed through the catheter. This loss of control was known to oftentimes spark fear in patients, but Karen was assured the goal was to help her gain weight, not force her to gain weight. Doctors who oppose hyperalimentation argue that it does not teach the patient to eat properly and therefore does not personalize their experience. Karen gained twelve pounds in only a few days. This rapid increase alarmed Itchie, who called Frenda, Jerry Weintraub, and Karen’s doctors back home in Los Angeles. “Please help me,” she told them. “Karen’s gained twelve pounds in less than a week! Where does it go from here? She’s gaining much too much weight too soon. It’s just going to be too hard on her heart!”

  Debbie Cuticello and her mother, Teresa Vaiuso, visited Karen at Lenox Hill. “They say I have anorexia,” she told them. “But look, I have all my teeth, and I have all my hair,” she joked, as if suggesting the diagnosis was in need of revision. Both mother and daughter were distraught to see the once vibrant and youthful Karen in such a debilitated state. She looked too old and frail for someone just thirty-two years old.

  Mike Curb was disheartened to see the beautiful young girl he had dated in this predicament. Although Karen walked around the room during his visit, she wheeled intravenous drip bags and an infusion pump beside her. “She was so thin that it almost brought tears to my eyes,” he says. “I didn’t know what to say then. I was more than shocked; I was heartbroken and devastated.”

  Solid foods were slowly reintroduced as the level of assistance from Karen’s IV lessened, and she continued to gain weight steadily. Unlike many other patients she seemed pleased and excited to show visitors her progress. Richard flew in to visit on October 25 and was expecting to see evidence of the improvement she spoke of in her calls. The sounds of the dripping IV and beeping monitors provided the soundtrack for this family reunion. Cards, gifts, Mickey Mouse toys, and various stuffed animals decorated the room but did little to warm the cold and sterile surroundings. Like most who saw her there, Richard was more shocked and saddened. She was still horribly emaciated and barely identifiable by this stage. “You see how much better I look?” she asked.

  Richard nodded in agreement but only to appease his sister. In an attempt to divert the attention away from her situation, Karen told him of other patients who were much worse off. But he was not sidetracked, finally breaking his silence. “Karen, this is crap,” he said. “Don’t you understand? This is crap! You’re going about this all the wrong way. This guy isn’t getting anything accomplished because you’re in a hospital now!”

  Three days later, on October 28, 1982, from her room at Lenox Hill, Karen scrawled her name across a petition for divorce.

  BY NOVEMBER Karen was eating three meals a day at Lenox Hill and trying to stay positive about the weight gain, by then approaching the thirty-pound mark. The return of her menstrual cycle, which had ceased during the previous year, seemed to signify an improvement in emotional and physical well-being. “The extent of her bravery has to be stressed,” recalled Dr. Bernstein. “These patients have enormous fear as they look at the pounds coming on.” Looking at her developing arms she told her therapist, “I’ll just have to keep remembering that they’re supposed to look like this.”

  On the phone with Frenda, Karen bragged about her weight gain. “I’ve gained!” she said. “I’m going to come home for Thanksgiving, and I’m just going to knock everybody’s socks off!”

  Yeah, but by hyperalimentation, Frenda thought to herself. That’s not eating it on, that’s a tube. Just because you gain, that means nothing!

  Karen was upbeat when discharged from the hospital on November 8, 1982, but as Cherry O’Neill recalls, “It was during a time when Levenkron was out of town that Karen chose to check herself out of the hospital. She terminated her therapy before she should have. She knew that people were depending on her for another album, and she was giving herself an imaginary deadline of Thanksgiving being the time she had to be ‘well’ so she could meet everyone else’s expectations of her.” As Dr. Irving George Newman, a Hollywood internist and father of musician Randy Newman, once told Cherry, “There are no contracts when health is concerned.” She shared this advice with Karen but was sure it fell on deaf ears. “That is hard medicine to take, in and of itself, especially for those of us who never want to let other people down. Therapy and recovery don’t work that way. It takes several years to develop the behaviors and thought patterns involved in eating disorders. It takes a while to untangle them and turn around to start moving in another direction.”

  Dr. Bernstein signed the paperwork allowing for Karen’s release from Lenox Hill in time to return home for Thanksgiving in Downey. He sensed that she was very positive and optimistic as she left the hospital
that day. “She was a little anxious about the future,” he recalled, “but also very eager to get back to L.A. and sing.”

  Karen remained in New York for two weeks after checking out of the hospital. She returned to the Regency Hotel, this time with the aid of a personal nurse and explicit instructions against walking to and from Levenkron’s office. It was during this time that Richard phoned Phil Ramone, concerned his sister might overdo things following the release from the hospital. “Promise me that you won’t go into the studio,” he said. “I am telling her I won’t either. You’ve got to stand alongside me, and she’s got to eat. She looks like a skeleton.”

  Ramone agreed he and Itchie would watch over Karen and was puzzled that Richard would think they would even consider recording together at this juncture. “He asked me not to record, but why would that happen? We’d shelved the album!”

  Karen’s return to hotel life left her homesick again, and she called Werner Wolfen to arrange her return trip to Los Angeles. He strongly advised her against abruptly ending the treatment, but she would not be swayed. She had checked out both mentally and physically. “I don’t care,” she told him. “I’m going home. I’m cured. That’s it.”

  On November 16 Karen visited Steven Levenkron for the last time and presented him with a farewell gift, a framed personal message in needlepoint. The large green-threaded words YOU WIN—I GAIN served as tangible proof of the long hours Karen had spent alone in the hospital. Learning of her plan to leave, Levenkron reminded Karen she was abandoning the program much too soon and that treatment takes at least three years. He even suggested a therapist in Los Angeles so that she might continue a routine of some sort upon her return home, but she declined. She promised to call him and swore she would not take any more laxatives or diuretics. Agnes and Harold met up with Karen at Levenkron’s office that day. The couple had flown to New York City to bring their daughter and her twenty-two pieces of luggage home.