Hope and Other Luxuries: A Mother's Life With a Daughter's Anorexia

by Clare B. Dunkle

  “She’s pretty crazy,” Valerie agreed. “I think she’s going to be okay, though. I don’t have a reason for that, except that I’m okay now. I got through it—and yeah, I know it wasn’t as bad as what she had to deal with. But still, I got through it, and I think she will, too.”

  As Valerie talked, I idly watched her hands, busy with the green salad leaves. The light played off those hands unevenly, in small flashes of pink and silver.

  Valerie coming downstairs, humming. And her hands . . . the dark purple circles on her hands . . .

  She was right. If those could heal up, anything was possible.

  CHAPTER THIRTY-ONE

  My phone rang. That meant something was wrong. Whenever something went wrong, my phone rang. I used to perk up when I heard the phone ring. Now, I simply hated it.

  “Mrs. Dunkle, we have to talk to you.” It was Emily again.

  I waited with a sinking heart. This couldn’t mean anything good.

  It was the beginning of April, over two months since Elena had left to go to Clove House. She had recently stepped down from residential treatment to day treatment, which ran seven days a week for ten hours a day. During the off hours, Elena was staying in a halfway house that the Clove House management ran. A staff member stayed there with the patients and gave them their medicine, but they had breakfast on their own and less structure in the evenings. It was an extra charge, not covered by insurance, but it was the ideal solution for us.

  So far, Elena’s day treatment had been going well. And when I’d heard from Elena, she had sounded better—more like her old self. She’d even started to tell me entertaining little stories again about her days and about the other patients in treatment. But now, Emily was on the phone, and that meant only one thing:

  Something had gone wrong.

  “Elena cut herself,” Emily said. “When she did that, she violated the contract we made with her. We can’t keep her in our overnight house any longer.”

  Cut herself! I felt a shiver of disgust. Isn’t the not eating bad enough? Thrown out of the overnight program—now what are we supposed to do?

  But I fought down my feelings of frustration. My daughter was sick. She wasn’t hurting herself just to complicate my days.

  This wasn’t about me.

  “Well . . . Are there hotels nearby?” I asked. “Can we book her a hotel room and a rental car?”

  “We can’t allow that,” Emily said. “We’ve discussed it, and it isn’t safe. Elena can’t stay overnight by herself. She needs someone there to monitor her. If no one can do that, we’ll have to remove her from our program.”

  My frustration returned, tinged with pure out-and-out panic.

  Where would Elena go if she couldn’t stay there? What was this going to mean for her recovery? Because if there was one thing I did know about Elena at this point, it was that she was a very long way from recovery.

  When Elena had first gone into full-time treatment, I’m not sure what I was expecting. The only thing I could really compare it to was classes I’d taken. I had expected a steady progress of some kind, a climb up the learning curve. By two weeks she would learn this; by a month she would know that.

  What I hadn’t expected was the kind of erratic, explosive non-progress we had observed from a distance. Elena zigzagged every few days from being fully compliant and gaining weight to calling me up in the middle of a medication-fueled fury, yelling over some real or imagined conflict at the treatment center. “Buy me a ticket!” she would angrily demand. “I’m done! We’re done here!”

  Just because I didn’t understand what was going on didn’t mean that the Clove House team was doing no good. On the contrary, Elena had made significant strides in their care. They had persuaded her to bring her trauma out into the open. This meant she could finally start to work through it.

  But, for Elena, letting the rape come to the surface after all those years was like being raped all over again. Once more, she was living through enormous emotional storms of rage, hatred, and shame. This time, Elena didn’t have the comfort of her eating disorder behaviors to calm those storms back down. She couldn’t starve the feelings away. And the medications she was on didn’t help her suppress those feelings, either. They were there to help keep her from slamming on the brakes and covering those feelings back up again.

  I didn’t understand much about the process, though, and it left me feeling anxious and mystified. When exactly was Elena going to get better?

  Now, Emily suggested a course of action I hadn’t expected at all. “Can you come out to stay with her, Mrs. Dunkle? You could bring her into treatment in the mornings.”

  This wasn’t a welcome suggestion. I loved my daughter very much, but I absolutely hated minding her business. The times we had been happiest were the times when Elena had been well; she could share with me the parts of her life she wanted to share, and I could cheer her on. But the times when I had had to “manage” Elena—to wake her up in the morning and nag her through her days—those had not been happy times.

  I had no desire to step back into that role. I didn’t want to run my daughter’s life.

  “Oh! I—I don’t know,” I stammered. “I mean, you know I don’t live there. I’m several states away. I can’t just move into a hotel, I’ve got my family here to take care of.” And in my head, I’m afraid I added, It’s your job to manage her. Not mine!

  “I’m not sure how long you would need to be here,” Emily said, “but maybe only for a week or so. If Elena does well and stops self-harming—if she shows us that she’s trying—then she can go back into our halfway house program. And it would give you two a chance to go through some family therapy sessions.”

  “Me? Why?” I said blankly. “Elena’s an adult now.”

  Three years before, during the Summer from Hell, I would have jumped at the chance to do family therapy. But back then, one psychiatrist after another had blocked us from Elena’s care. Now, Elena was an adult, and that was exactly how I saw her. She had lived on her own for a year, and even in our house, she had had her own independent existence. She had made it clear, in a thousand arguments, that that was how she wanted things to stay.

  I was ready to let things stay that way, too.

  “Elena’s family has no say over her treatment,” I pointed out. And, again, in my mind, I added, This isn’t my job! I’m not welcome in this part of Elena’s life. This isn’t my problem anymore, and that’s fine with me. She tells me all the time to let her handle it.

  “We think family therapy would be helpful,” Emily said.

  “Well, sure, then,” I said, and I let it drop. But I still didn’t see the point.

  Together, Emily and I worked out the details. Elena’s care team would ask the insurance company for approval to put Elena back into twenty-four-hour care for a few more days. In the meantime, I would drive out, spend one night in a hotel alone while they assessed how well Elena and I did in some sample sessions together, and then, if all went well, Elena would spend the next week in the hotel with me. If she handled that week successfully, they would let her back into their halfway house program. Then I could go back home.

  Waking up Elena, doling out medications, pushing her to get ready in the mornings and to eat dinner in the evenings—it all sounded very distressing. And then there was the purging. She had thrown up for years. What if she was vomiting, right there in the hotel room? Was I supposed to lock the bathroom door and do some sort of sick inspection routine?

  And the cutting. What about the cutting?

  Oh, this was going to be ghastly!

  “You know I don’t have any special training,” I said. “Elena purged for years right here in the same house with me. So, if she decides to purge or hurt herself, I’m not exactly sure . . . I mean, what do you think I can do?”

  “We’re not looking for you to give her nursing care,” Emily said. “It’s just to keep her company, and to call nine-one-one if things go wrong. We’ll see you soon, Mrs. Dunkle.
Good-bye.”

  I replied automatically and hung up the phone.

  Nine-one-one?

  I got a shivery feeling in the pit of my stomach. I would have cried if I believed in doing that sort of thing.

  Nine-one-one!

  Some of my worst memories crawled out of the back of my brain, and my imagination served them up in my own private documentary movie. The crude slash of a razor cut healing on the inside of a forearm. “I wasn’t trying to kill myself, Momma!” Valerie walking downstairs, humming, and her hands . . . What was wrong with her hands? . . .

  I crept away from the memories like a kicked dog. I wanted to put my head under the blankets and howl. Of all the places I’d had to go with my daughters, this was the one place I had never wanted to come back to.

  But I didn’t howl. I reached for paper, and I wrote out a packing list. And then I walked out and had a matter-of-fact conversation with Valerie about it. “I just hope it goes okay” was all I would reveal of my anxiety.

  “She’s pretty crazy,” Valerie agreed.

  Joe and I talked it over that night as I packed. He was supportive and a little worried for Elena and me both.

  “Tell her I love her,” he said. “Give her a hug for me.”

  I remembered Elena’s latest angry phone call. I wanted to give that hug, but would Elena accept it?

  Would she even talk to me?

  A long cross-country trip later, I arrived at the city that was home to Clove House and joined the traffic on its outer loop. The city was sprawling and impressive from the highway, full of modern glass office buildings and big hospitals. I drove further in, through gorgeous historic neighborhoods with wide lawns and quaint mansions. What a beautiful place!

  And Clove House didn’t look clinical, I was happy to see. It didn’t look like Drew Center had, like a massive imposing University of the Mentally Ill. It looked comfortable. A busy Starbucks occupied a corner across the street from the office building that housed it.

  With butterflies in my stomach, I introduced myself to the receptionist behind the glass. At least this place has a receptionist, I thought to myself, and I remembered getting trapped in the empty waiting room at Drew Center.

  I’m so afraid, I thought while I waited. I’m so afraid this is going to be ghastly! And my imagination replayed for me snippets of that furious voice on the phone, of that stranger who seemed so full of rage.

  After a couple of minutes, Elena came out to greet me, and all my worries melted away.

  Elena didn’t look like a stranger. She looked like my beautiful daughter. Her face wasn’t gaunt and pale anymore. She looked better than she had in years. Even the color in her cheeks was different: a bright, healthy pink. I’d gotten used to the gray skin tone of anorexia.

  A little shyly, Elena hugged me. So she felt shy, too! Maybe she, too, had been afraid.

  “Do you want to eat lunch with me?” she asked.

  “I’d love to!” I said.

  Elena’s meal arrived in courses: salad, soup, chicken tenders, and fruit for dessert. It was a lot of food, but she handled it like a pro. I hadn’t seen my daughter eat with such matter-of-fact ease in years. While we had our meal, she told me stories about the girls she lived with. But she wasn’t using the stories to keep the food away this time. That was an exciting change.

  This new Elena was a little more subdued than I was used to, but hints of the old Elena surfaced from time to time: a wry smile, or a sudden sparkle in her eyes. It was obvious that she had made some important friendships. But what I couldn’t get over was how much better she looked. Her whole body had filled out in a way I had never even known it could. She didn’t look like a thin little old lady anymore or a child from a famine zone. Now she looked like a real young woman in her twenties.

  “You look so healthy,” I said. “You look fantastic!”

  “Mom,” Elena said a little apologetically, “it’s better if we don’t talk about appearances. That kind of talk can be triggering for eating disorder patients.”

  “Triggering?”

  “It can make us obsess about negative thoughts.” She sounded like she was reciting a rehearsed speech. “It can bring out our interior critic and increase the urge to engage in negative behaviors.”

  “Oh, I get it. Sorry.”

  “No, that’s okay. Don’t worry about it.”

  I watched Elena work her way through the plate of fruit salad in silence. I had said that I got it, but I didn’t really. Why would a compliment release negative thoughts? I thought I understood insecurity pretty well, but compliments made me feel better.

  “So, how’s Valerie?” Elena wanted to know. “Is Clint nice? What’s Gemma doing now?”

  “She’s smiling,” I said. “And she’s just started making a noise that’s maybe a laugh—this robotic giggle that makes everybody in the room laugh. She’s found her feet, too, so as soon as you put a pair of socks on her, she pulls them off. Valerie can’t bear to put her down.”

  Elena smiled. “I wish I could see her.”

  “I watched her get her two-month shots,” I said. “Clint wanted to come, too. Valerie was just like she always is, joking with the nurse, but you should have seen Clint’s face! When the nurse gave Gemma her shot, he turned green. Really green! There he is, this big strong guy with biceps like tree trunks, but he couldn’t bear to see them hurt his baby. He has more names for her than I can even remember: Angel, Itty Bitty, Precious, Princess . . . He just adores that child.”

  “I wish I could see her,” Elena said again.

  After lunch, I met Emily. Elena’s therapist was very young. She hardly looked older than Elena herself.

  “I’m going to arrange for you two to have a pass for the afternoon,” she said. “Why don’t you go take a walk together and get some fresh air? Just be back before the van leaves to take Elena to the overnight house.”

  Elena and I went downstairs in silence, and I waited while she smoked a cigarette. “I’m down to four a day,” she told me, but her voice didn’t hold much enthusiasm. I knew that the Clove House staff strongly discouraged her smoking.

  “Do you know any good walks nearby?” I asked.

  “I don’t want to walk,” she said. “I want to go to the hotel and rest.”

  “But Emily said we ought to walk,” I said, feeling a little worried, as if I’d just been invited to cut class.

  “This is the first break I’ve had in over two months,” Elena pointed out. “They run their program seven days a week. I don’t want to walk. I walk all the time. I just want to sit around and see what’s on television.”

  This sounded so reasonable that I drove us both to the hotel.

  I liked my hotel room. When the desk clerk heard I was in town to visit my daughter in the hospital, he booked me into a corner suite instead of a regular room. It was on the third floor, and it had wide clear windows on two sides, so I could see over the nearby buildings to distant gray clouds. The furniture and room colors, taupe and soft green, looked peaceful.

  Elena turned on the television, curled up on the bed, and instantly fell asleep. I muted the television and unpacked my things into the dresser. It felt good to be moving in, even if it was just for a week. I lined up the books I’d brought with me on the kitchenette counter, and I set out my laptop on the writing desk.

  After a couple of hours, I woke Elena up. She didn’t yell at me in that exhausted monotone as she had a few months ago. She just blinked and stretched. Then we drove back to Clove House.

  “Come back tomorrow afternoon,” the receptionist told me. “After lunch.”

  The next afternoon, Elena had another free day, and this time, we did go for a walk. We wandered through the little shops nearby. Then we found a bookstore and vanished inside, vanished from ourselves and from each other like water drops soaked into a sponge.

  When we returned to awareness forty-five minutes later, Elena had two books of short stories to read that night, and my imagination had the memory o
f dozens of old black-and-white photographs to play with: handsome young men standing by their covered wagons; earnest, unsmiling girls; grandmothers who had been born in the old country; and babies lying in their coffins. Bouquets of flowers had been tucked in next to those babies’ little fists—flowers that had lived longer than they had.

  I thought of Gemma and felt a pang. She was growing up every minute that I wasn’t there. But at least I had the comfort of knowing I’d see her in a week or so. No wonder Elena felt so bad about missing out.

  Emily came out of her office when we returned. “How did things go?” she asked. The question sounded artificially cheerful, like the greeting of a tour guide or a first-grade teacher.

  “I had a lot of fun,” I said.

  Elena stayed quiet.

  “That’s great,” Emily said. “Tomorrow morning, why don’t we have a family therapy session. Say, nine o’clock?”

  On my way out, Elena walked with me through the main room, where the other patients were resting. But this place wasn’t what Drew Center had been, a sort of reform school dominated by locked doors. The whole place felt friendly and informal, like a small private school run by a principal with advanced views. The Clove House staff members weren’t in white uniforms, either, and their greetings sounded warm and genuine.

  But the patients—they were something else again.

  The patients assembled in that warm, welcoming room looked very creepy. They were so abnormally, painfully thin—so ridiculously tall for their features—that they looked like grade school children who had been stretched on Willy Wonka’s taffy puller. And even when they laughed, their eyes stayed tired and shadowed. They looked ready to give up on life.

  Elena didn’t look like that. She looked like Elena, a healthier and better-looking Elena than ever before. I couldn’t see Elena as one of those skinny, towering little girls with abnormally long legs and knobby knees.

  “I don’t get it,” I said to her. “What do they do about their schooling? Like that girl—is she working on homework over there?”

  “Mom!” Elena said, and her tone carried an amused warning. “She’s getting her master’s degree.”