Believarexic
Page 7
because Bronwyn looks
on the thin side of the dreaded healthy,
instead of the puffy, bloated side of healthy,
like Monica and some of the others.
“Nope,” Bronwyn says, eyeballing Jennifer.
“And they’re going to need to fatten you up, too.”
“Like lambs to slaughter,” Jennifer says.
Bronwyn throws her head back and laughs.
“Ha, exactly! I like this one,” she tells Monica.
Monica smiles. “I know.
Our little Jennifer here is a keeper.”
It is such a relief that these two are being nice to her.
“How long did it take you to reach maintenance?”
Jennifer asks them both.
Monica says, “It took me thirteen weeks.
I’ve been here four months.”
Bronwyn rolls her eyes. “Yes, Miss Anorexia.
We know you had a lot more to gain than us lowly bulimics.
I’m four weeks and counting,” she adds.
“It’s going to take you a while, Jennifer.”
Jennifer’s heart sinks,
even though she’s proud they think she’s underweight.
Four months. Monica’s been here four months.
That is one third of an entire year.
“How long do you think it will take?” Jennifer asks.
“How much weight will I have to gain?”
Bronwyn narrows her eyes at Jennifer.
“Let me see your neck?”
Jennifer pulls her turtleneck away from her throat.
“I’d say a good fifteen or twenty pounds,”
Bronwyn announces.
“You think, Monica?”
“Seems about right,” Monica agrees.
“That much!” Jennifer says.
It comes out in a terrified squeak.
“I’ll look like the Kool-Aid Man.”
This makes Monica and Bronwyn laugh,
but Jennifer isn’t trying to be funny.
Fifteen pounds? Twenty pounds?
She’ll be barrel shaped.
“So…spill it,” Bronwyn whispers.
“Did you tank?”
Jennifer shakes her head.
Fifteen pounds.
Twenty pounds?
Bronwyn gives a small shrug,
like, Okay, I believe you.
“You get any sleep?” Bronwyn asks,
stretching her arms over her head.
“A little,” Jennifer says.
“First night’s always rough,” Monica says.
“And last night was a doozy.
Jesus Lady really went to town, didn’t she? Poor thing.”
“What did they do to her?” Jennifer asks.
“Took her to the ‘I see you,’ probably,” Bronwyn says.
She picks up her pack of cigarettes and walks away.
Did Jennifer say something wrong?
Why did Bronwyn leave?
Bronwyn stands in front of Nurse Trendy,
pulls a cigarette out of her pack,
and brings it to her lips.
Trendy flicks the lighter
and holds the flame to Bronwyn’s cigarette.
Bronwyn puffs, then returns to the couch.
“What’s the ‘I see you’?” Jennifer asks.
“An observation room?”
Monica chuckles.
“She thinks it’s I see you,” she tells Bronwyn.
Bronwyn smiles. “Good one.
But no. It’s not I see you, like Peek-a-boo! I see you.
It’s the letters, ICU.
Intensive Care Unit.”
Jennifer feels stupid.
She should have figured that out.
“What’s the ICU like?” she asks.
Monica shrugs. “Not sure. It’s not a medical ICU.
They use University Hospital for medical emergencies.
Thriller came from there—”
“And had to go back her first week,” Bronwyn interrupts.
“We thought she was a goner.”
“Oh,” Jennifer says.
For Thriller, it probably was like in the movies:
rushing gurneys, emergency rooms.
“Sorry I’m asking so many questions,” she adds.
She doesn’t want to annoy these girls.
She needs friends.
“Don’t worry about it, newbie,” Bronwyn says.
They are quiet a moment.
Monica goes to Trendy for a light, comes back.
Jennifer watches them smoke.
Smoking seems to pass the time.
Maybe it’s a way to punctuate hours.
If only Mom and Dad had signed the permission form
to let her smoke.
Then again, it’s probably good that they didn’t.
She’d end up with a two-pack-a-day habit.
“Is she—are the people like her—dangerous?” Jennifer asks.
“The lady from last night.”
She doesn’t want to disturb the quiet companionship,
but she needs to know.
Bronwyn shrugs. “She’s never bothered us here on the EDU,
if that’s what you mean.”
Monica says, “She’s more of a danger to herself
than anyone else.”
“The nurse came in my room all night?”
Jennifer finds herself saying,
before she realizes she’s asking a question.
“Yeah.” Bronwyn taps her cigarette ash.
“They make rounds every hour when we sleep.
Every thirty minutes for newbies like you.”
“Thirty minutes?” Jennifer asks.
“It felt like longer.”
“Time flies when you’re having fun,” Bronwyn said.
“This place is the opposite of that.”
“It seemed like she was feeling around for something,”
Jennifer says.
“Checking your lightbulbs,” Monica says.
“To make sure you haven’t broken one.”
Puzzled, Jennifer asks, “Why would I—”
“To use the glass to cut yourself,” Bronwyn says.
“Oh.” Wow.
So much she doesn’t know here.
It is uncharted territory.
She is grateful for these two guides.
Samuel Tuke Center
Eating Disorders Unit
Rules and Therapeutic Expectations
Meals and Food
Newly admitted patients shall begin meal plan of 1200 calories per day for first week (seven days) following admission.
•If weight gain is required, caloric intake shall increase weekly: 1200, 1800, 2500, 3000 until patient reaches maintenance weight.
•If necessary, additional calories and supplements will be given to patients on 3000-calorie meal plan.
•If weight gain is not required, patient will continue at 1800-calorie plan, or other necessary for weight stabilization, as determined by treatment team.
•If weight loss is necessary, patient will continue at 1200-calorie meal plan.
•All meal plans are subject to change without notice as deemed necessary by treatment team.
Patients are REQUIRED TO EAT ALL FOOD EXCHANGES AS SERVED, with the exception of three dislikes.
Patients shall not be late for meals.
•Breakfast is served at 8:00 a.m.
•Lunch is served at 12:00 p.m.
•Dinner is served at 5:00 p.m.
•Snack is served at
approximately 8:30 p.m.
Breakfast, lunch, and dinner shall be eaten while seated at dining tables in the lounge (except for stage three patients with breakfast and/or lunch dining-room privileges).
Patients must finish eating all food on tray within one hour from time meal is served.
Patients must remain seated at table for thirty minutes after finishing meal.
Patients must remain in the EDU lounge for an additional thirty minutes, totaling one hour of after-meal supervision.
Patients may not use bathroom for one full hour after meal is finished.
Patients may select up to two condiments per meal from the condiment tray.
Patients who are served salad dressing may make a 1:1 trade for a different flavor salad dressing from the condiment tray.
Garnishes and gristle do not have to be eaten. In the event of disagreement as to what constitutes “garnish” or “gristle,” staff retains sole determination. Staff directives must be followed.
•Garnish examples: parsley sprig served with chicken, lemon wedge served with fish
•Garnishes are NOT: skin on chicken or turkey. This is not a garnish and must be eaten.
•Gristle examples: a distinct section of fat on the edge of meat
•Gristle is NOT: small lines of fat within meat. This is part of the meat and must be eaten.
Snack may be eaten anywhere in the lounge.
Snack must be finished within thirty minutes of serving, and patient must remain in lounge for thirty minutes after finishing snack.
DISLIKES: Each patient is allowed three “dislikes,” for which they may make a 1:1 trade. Staff will provide patient with appropriate substitution.
•Dislikes must be specific (i.e., “red meat” cannot be a dislike; patient must choose “veal” or “roast beef” or “hamburger patty”).
•Dislikes must be eaten once (or more) before they can be declared.
•Once a dislike is declared, it cannot be changed for any reason.
OPTIONALS: Patients are allowed, but are not required, to consume up to two “optional” liquids per day between meals. Optionals are subject to staff discretion.
•Choices include: 8 oz. apple, cranberry, or orange juice; one cup herbal tea; one packet decaffeinated instant coffee (“Sanka”); one packet instant hot chocolate; or one 12 oz. noncaffeinated, regular soda from the soda machine.
•Patients are responsible for paying for soda from the vending machine.
•No caffeinated drinks, artificial sweeteners, or diet beverages are allowed at any time.
•Patients may drink water, but should avoid tanking or binge behavior.
All rules are subject to change without notice by staff.
Breakfast arrives, trays slotted into the wheeled cart,
pushed into the lounge by Nurse Ratched.
She scowls when her gaze collides with Jennifer’s.
Patients groan, complain,
crush out their cigarettes,
and assemble slowly around the tables.
Jennifer sits next to Monica.
Bronwyn sits across from them.
The four-seater table is rounded out
by the young, frizzy-haired Amanda.
The trays smell of food,
but they don’t smell good.
It smells like cafeteria food: overcooked, indistinct.
Each tray has a yellow Post-it Note
indicating the last name of the patient it is for.
Heather enters the lounge.
“Nice of you to join us,” Nurse Ratched says.
Heather grunts in response.
Nurse Ratched sets Jennifer’s uncovered tray in front of her.
Jennifer looks at it.
A Red Delicious apple that is red, but doesn’t look delicious.
A carton of skim milk.
In the middle of her tray is a yellow washcloth:
a scrambled egg.
She’s never eaten plain, cooked eggs before.
Nurses Trendy, Ratched, and Bosom
continue placing trays in front of patients.
“No rituals, girls,” Trendy announces.
“No tiny pieces, no eating things in a certain order.
Mix it up! Eat like normal people.”
Normal people.
Normal people means everyone except
the patients on this unit.
Normal people means the three nurses on breakfast duty.
Three normal people watching abnormal people eat.
“You’re so lucky, Jennifer,” Amanda says in a quiet voice
as she opens her carton of chocolate milk.
“I’d give anything to be on twelve hundreds again.
Three thousands are impossible.”
She says this with a hint of pride.
“Is three thousand the highest?” Jennifer asks.
She can’t remember from the rule book,
and she wants to talk instead of eat.
Bronwyn shakes her head.
“Thirty-five hundred is the most.”
“Thirty-five hundred is a three-thousand tray,” Monica says,
“plus two cans of Ensure between meals.
I had to do it. It was awful.”
“What are you on now?” Jennifer asks.
Monica’s tray has eggs and fruit, like Jennifer’s,
but two percent milk instead of skim, plus a sausage link,
and one of those individual serving-size boxes
of Shredded Wheat.
“Eighteen hundreds,” Monica says.
“That’s what most of us get, for maintenance.”
She skewers her sausage with a fork.
The white plastic tines sink into the meat.
She slices it with her plastic knife.
“Heather’s on twelve hundreds. They’re trying to reduce her.”
“Shut up!” snaps Heather from the other table.
“Sorry,” Monica calls in Heather’s direction.
“Just giving Jennifer some factual information.”
“None of her business,” grumbles Heather.
Monica raises her eyebrows at Jennifer,
like maybe she sympathizes with anyone
who has to share a room with Heather.
It gets quiet. Everyone is concentrating
on their food.
Jennifer looks at her tray.
The yellow washcloth.
Her throat is thick.
She can’t eat this.
Not because she wants to break the rules,
but because it’s disgusting.
What if it makes her gag,
and she accidentally throws up?
That has happened to her before
when she’s had to eat something gross.
Like the time Kelly’s mom served
Cream of Wheat for breakfast.
Jennifer barfed it up all over their table.
Doing that here wouldn’t just be mortifying,
like it was at Kelly’s.
Here, it would open a huge can of worms.
Ugh, worms. Don’t think about that.
She pokes at the egg with her fork,
not ready to tackle it yet.
What does she know about the other patients so far?
Bronwyn is nineteen. Bulimarexic, gaining weight.
Monica is twenty-one. Anorexic, maintenance weight.
She’s been here more than four months. Four months.
Amanda looks very young, maybe thirteen or fourteen.
Anorexic, obviously still gaining.
Thriller looks old,
but that might just be
because she’s a skeleton.
She’s anorexic, and not medically cleared.
Heather looks like she might be Jennifer’s age,
or slightly older.
She’s an overweight bulimic or compulsive overeater.
Not sure which. But they have her on a diet.
The other patients, Jennifer doesn’t know a thing about,
except whether they were in line to be weighed this morning.
Okay. If she doesn’t get started eating,
Nurse Ratched will probably write it down in her file.
If she hasn’t already.
Jennifer puts a bite of egg in her mouth.
She gags.
It’s revolting.
She opens her milk carton quickly,
takes a swig of milk to wash the egg down.
With trepidation she takes another bite of egg,
gags,
drinks some milk,
starts to cry.
“You have to get it down, sweets,” Monica says.
“Otherwise it follows you to your room,
and staff will give you grief,
and you have to sit there until you eat it.”
“I know, I’m trying,” Jennifer sniffs.
“Eggs are better with ketchup,” Bronwyn suggests.
“Can’t I put eggs on my dislike list?” Jennifer asks.
Tears drip onto her tray.
Amanda looks like she feels sorry for Jennifer.
“You can, but it’s not a good idea.”
“Definitely don’t put eggs as a dislike,” Bronwyn says.
“It’s not specific enough. You’d have to say ‘scrambled eggs,’
and then they’d give you powdered eggs every day,
which are even worse.”
Tears. Tight throat.
“What if I say ‘scrambled and powdered eggs’?”
Jennifer asks.
Monica shakes her head.
“Then they’ll give you hard-boiled or fried.
You know, the kind with runny yolks.”
The words “runny yolks” make Jennifer gag again.
She takes a packet of ketchup from the condiment basket.
Her hands are shaking; it’s hard to rip the foil.
She squirts ketchup onto her tray.
The tines of her plastic fork bend
as she cuts a triangle of washcloth.
She stabs it with her fork, slides it through ketchup,
puts it in her mouth.
Oh, God.
It’s worse with ketchup.
“Is it the texture?” Bronwyn asks.
Jennifer nods, wiping her nose with her napkin.