It is stuffed with every book and notebook
from her locker at school.
She pulls her heavy suitcase out of the trunk,
and it slams against her legs.
“I’ll take that,” Dad says.
“I’ve got it,” Jennifer snaps.
She is unable to speak to Dad with any kindness,
even if she wanted to.
Everything he says is infuriating.
Inside the glass vestibule,
Dad tugs at the locked door.
People in the waiting area turn to look.
He pulls again, aggravated.
He wasn’t here Friday.
He doesn’t know.
“You have to be let in,” Mom says.
She presses the red intercom button.
“Can I help you?”
“Jennifer Johnson,” Mom says.
“Patient admission?”
Mom waits a heartbeat.
“Yes.”
The buzzer sounds.
Jennifer’s stomach plummets.
This is a psychiatric hospital.
What was she thinking?
How is she here?
How is this her life?
They sit. They wait.
Time slows until it’s a slug,
creeping,
leaving a slime trail.
“Jennifer?”
She had been waiting,
but her bones startle when she
hears her name.
A short woman with a file folder
stands before her.
Sweater dress, padded shoulders,
heels Flashdance high,
the sort of shoes Jennifer had thought,
when she was nine or ten,
that she’d wear when she was in high school,
but of course she doesn’t.
The woman has huge poufy hair,
like an immense wad of cotton candy,
except it’s dull black instead of bubblegum pink.
She has medium-brown skin,
the color Seventeen and YM obliquely call “olive.”
Mom and Dad stand.
Jennifer stands.
“Hello,” the woman says.
“I am Dr. Prakash, and I am a psychiatrist.
All patient intakes must be conducted
by a physician, such as myself,
in addition to the unit director.
I’ll see Jennifer alone first, please.”
She has a thick Indian accent:
Ah’ll see Jenny-fah fahst, please.
Dr. Prakash leads her into a small room
with a sign on the door that says Admissions.
She plops down in the chair behind the desk,
and motions for Jennifer to sit.
She opens the folder
and asks Jennifer questions:
“How long have you had an eating disorder?
When was your last period?”
A lot of the same things Dr. Wexler asked.
Her th’s sound like t’s,
and her accent is so thick that
Jennifer’s ears struggle
to decipher the words.
“Was yoah gar-ham-muttah tin?”
Was…what?
Jennifer doesn’t want to be rude.
This lady may become her psychiatrist;
Jennifer wants, maybe even needs,
Dr. Prakash to like her.
But she can’t make sense of the last word.
“My grandmother?” Jennifer asks. “Was…
was she what?”
Looking at the paperwork,
Dr. Prakash repeats, “Tin.”
Jennifer still doesn’t get it.
“I’m sorry. Was my grandmother…”
Dr. Prakash looks up,
presses her tongue to her teeth,
stares at Jennifer, and makes a very,
very exaggerated th sound.
“THHHHHHHHHHH-in.”
Jennifer’s cheeks blaze.
The psychiatrist thinks she’s racist.
What a terrific start this is.
“Oh. Um, not really,” Jennifer says,
trying to sound casual, and
casually nonracist.
“Um, she was just regular.”
“Bote gar-ham-muttahs?” Dr. Prakash asks.
Jennifer nods. “Um, yeah. About the same.”
“And yoah gar-ham-fatttahs?”
“I’m not sure. They both died before I was born.”
The process of asking seems like more trouble
than this information can be worth.
The door opens
and Dr. Wexler appears
with Jennifer’s parents in tow.
Dr. Prakash’s part is apparently over;
she signs some of the papers,
gives Jennifer a small smile,
and totters out,
high heels stabbing the carpet.
More questions.
Excruciating
with Mom and Dad here.
One or both of them borrowed
Dying to Be Thin from the library this weekend.
(She saw the bright yellow cover
on the kitchen counter,
the library’s only copy, its pages worn from
her own previous, secret readings.)
And yet they are still utterly clueless
about their daughter’s eating disorder.
Talking about it in front of them
makes Jennifer squirm.
It is so embarrassing.
She is ashamed.
And angry.
“Okay, folks. Voluntary or involuntary
admission?” Dr. Wexler asks.
Jennifer’s feet are freezing.
Her thin red socks are bunched up
where her jeans taper at the ankles.
They certainly aren’t doing a good job
of keeping her feet warm.
She studies her shoes,
her favorites:
black patent-leather loafers
with multicolored buttons decorating the top.
Mom calls these her “Jenny shoes,”
because she thinks they personify her daughter:
colorful, creative, unique.
Maybe those words described Jennifer
when she was little.
But now? Who is she?
She is the girl with the eating disorder.
What should that girl’s shoes look like?
She can feel her parents looking at each other.
“What’s the difference?” Dad asks.
“Well, since Jennifer is fifteen,
voluntary admission
means much the same thing
as involuntary.
Both of you must sign her in,
along with Dr. Prakash and myself.
In order for Jennifer to be released,
both of you must sign her out.
Legal minors under the age of eighteen
cannot sign themselves in or out.
And if you want her to be released
before we feel she is ready for discharge,
both of you must request it in writing.
Even then, there is a mandated
three-day waiting period.”
Dr. Wexler taps a pen against the papers.
“Written requests to leave against
treatment recommendations
are referred to as a ‘72-hour letter.’
They are, needless to say, highly discouraged.”
Jennifer starts crying.
She wipes her cheeks with her sweater.
“Involuntary,” Jennifer says,
voice choked,
because
she didn’t choose to have an eating disorder
or feel so hopeless
and also right now
involuntary
is how
this
hospitalization
feels.
“It’s your decision,” Dr. Wexler tells her parents,
not even looking at Jennifer.
“But I suggest voluntary,
since again, it’s much the same thing.”
Dad nods.
“Voluntary will look better.”
Yes.
Voluntary will look better.
Because what if she wants
to be the president some day?
Or an astronaut?
You can’t be the president or an astronaut
if you’ve been involuntarily committed
to a psychiatric hospital.
But…can you be the president or an astronaut
if you’re admitted voluntarily?
Will this moment,
this exact moment,
annihilate Jennifer’s chance at a future?
Which future?
The presidency? Walking on the moon?
Or going a full day without
vomiting dry toast?
Dr. Wexler picks a different pen
out of the plastic desk organizer.
He hands it to Dad
and slides the papers toward him.
No.
“Wait. I don’t want to do this,” Jennifer sobs.
“I changed my mind.”
Their attention focuses into intense beams.
Dr. Wexler clears his throat.
“Do you really have an eating disorder, Jennifer?”
“YES!”
It comes out before she can think.
Why?
Because screw them, that’s why.
How dare they question her pain?
And so
it is admitted.
The fact of the eating disorder.
And then,
so is Jennifer:
admitted.
Samuel Tuke Center
Eating Disorders Unit
Rules and Therapeutic Expectations
Treatment Stages
Stage One: The dual focuses of stage one are (1) medical safety of patient, and (2) patient acceptance that he/she has an eating disorder requiring treatment. Stage one includes:
•Regular monitoring of vital signs and medical concerns
•No unsupervised showers or tub baths until medically cleared by physician
•No off-campus trips, passes, or excursions unless approved by physician
•One-to-one staff-to-patient ratio, with ten-minute checks. At staff discretion, a stage one patient may be allowed in bedroom without staff; staff will check on patient at a minimum of once every ten minutes during waking hours.
Stage Two: Patient may request and start earning privileges as approved by treatment-planning team. Stage two privileges can include:
•off-campus meetings and activities supervised by staff
•up to three off-campus passes per week, totaling ten hours per week, with approved chaperone or accompaniment. (Chaperone MUST be patient’s legal guardian if patient is under 18.) Destination must be preapproved.
•morning walks (7:00 a.m.) at indoor track, Syracuse University (outdoor if weather permitting). Patients with morning walk privileges must drink one 8 oz. juice in addition to meal-plan exchanges before leaving for walks and must remain in staff view at all times.
•supervised “shop walk” to stores downtown when offered by staff
•art room access with supervision
•outdoor smoking courtyard access
Stage Three: Patients underweight at time of admission must reach maintenance weight to be considered for most stage three privileges. Stage three privileges include:
•7:00 a.m. walks, jog-walks, or jogs as approved by treatment team (8 oz. juice and eyes-on supervision as in stage two)
•breakfast in downstairs dining room
•lunch in downstairs dining room
•regular trays
•unsupervised bathrooms
•meal planning
•one weekend day pass with lunch out, with approved accompaniment or chaperone
•snack out with staff
•meal out with staff
•knowledge of weight
•discharge date
•discharge plan
All rules are subject to change without notice by staff.
— Stage One —
Monday, November 21, 1988
Paperwork signed,
fate sealed,
they follow Dr. Wexler
up the blue carpeted stairs.
He leads them down the hall of the second floor,
the EDU hall.
Past his office,
past a larger room with couches and tables.
A couple of doors further,
to a room on the right.
Inside the room is a closed door,
which Jennifer hopes is a private bathroom.
Two twin beds,
two nightstands and bedside lamps,
two chairs, like the ones in the waiting room.
Two dressers, one closet with sliding doors.
Thin beige carpet.
Windows with ugly curtains of multicolored matchsticks
prancing on a putrid orange background.
This is where she will live.
This is not a bright, sunny hospital room,
with white sheets and flower bouquets.
This is an old motel room,
mildewed and airless, with sour
odors from other people’s bodies.
The first bed is messy,
pillow bunched in a corner, sheets jumbled.
A digital clock sits on the nightstand,
next to a book that looks like a diary.
Dr. Wexler motions to the bed near the window.
It is a bare mattress and box springs on a metal frame,
with a stack of folded sheets and blanket, waiting.
“This will be your room, Jennifer,” he says.
“Your roommate’s name is Heather.”
Numbly Jennifer lets her backpack slump to the floor.
She places her pillow at the head of the bed.
Mom hefts her suitcase onto the mattress.
The bed jiggles under the weight of her belongings.
Belonging.
This is her bed now,
and for how long?
“Your parents need to go,” Dr. Wexler says.
“Don’t draw out your good-bye.
It will be harder if you wait.
I’ll see you at group tomorrow morning.
Don’t unpack yet.
A nurse will be right in.”
Tears glisten on Mom’s cheeks, and in Dad’s eyes.
Jennifer is crying, too.
Attention-seeking behavior?
She got their attention,
but now they are leaving her.
She hugs Dad,
and then Mom,
holding on for dear life.
They go.
Mom looks back,
taking Jennifer’s
heart away with her.
This is
a mistake.
This is by far the biggest mistake
of Jennifer’s life.
Her heart is galloping.
She can’t think.
It’s too much—
there is too much
cortisol,
or adrenaline,
or whatever it is that circulates fear,
throbbing through her body,
flooding her brain.
This is a mistake.
She lurches toward the door.
A woman walks in,
stopping her.
Middle-aged, stout, with pale skin and short, curly hair.
She isn’t wearing a nurse’s uniform.
She’s wearing regular clothes:
pastel floral mock turtleneck,
navy blue stirrup pants,
white low-top Reeboks.
Her bosom is enormous, like
a big shelf has been installed on the front of her body.
Nurse Bosom (not her real name—
does she even say her name?
Jennifer can’t remember)
is holding a round wicker basket the size of a hubcap.
She sets the basket on the dresser and says,
“We need to check for contraband.
We’ll start with this.”
The nurse lifts Jennifer’s backpack onto the bed
and opens it without asking.
Nurse Bosom pulls everything from the backpack
and sets the stuff on the mattress,
books and notebooks sliding into an array,
like a deck of cards fanned out for a magic trick.
Blue-spined French for Mastery: Salut, les amis!
with happy teenagers on the cover.
Heavy biology textbook, covered in the thick brown paper
of a folded grocery bag, as required by her teacher,
who is also her next-door neighbor,
and the father of the first boy she kissed,
because Norwich is a small town.
A dense trigonometry book,
the boring The World: Past and Present for social studies,
her English textbook, and some small books,
all stamped “Property of Norwich High School.”
The Old Man and the Sea, The Elements of Style,
Romeo and Juliet, The Great Gatsby,
The Poems of Edgar Allen Poe.
Next are Jennifer’s own books, her nonschool books,
their pages bent from multiple readings.
Big, floppy paperback collections of
Bloom County and Calvin and Hobbes.
Her mother’s copies of Richard Bach’s books,
Illusions and The Bridge Across Forever.
Also A Wrinkle in Time,
and The Prophet, old, with a rip in the cover.
Nurse Bosom fans through pages
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