Believarexic

by J. J. Johnson

  I nodded.

  “You look great,” she said. “Now get ready for breakfast.”

  I ate breakfast in a daze, alone at the abandoned EDU tables. Thinking about my weight.

  How could I have forgotten what those numbers could do?

  I spread peanut butter on my toast. Chewed with dry mouth. Got through the cereal, juice, milk, everything.

  Dr. Prakash found me in my room. She gathered me into a big, cigarette-smelling hug. “Jennifer! It is good to see you!”

  “How was your vacation?” I asked.

  “Oh, wonderful. Greece is lovely. You really must go sometime.”

  She led me to her office. We sat.

  My jeans felt five times tighter than yesterday, which meant they felt twenty-five times too tight.

  “So, Jennifer. How have you been?”

  “Okay.”

  She lit a cigarette. “I see you weighed yourself this morning. How was that? Are you comfortable in your body?”

  Comfortable! In my body? At this weight? “Uh, no.”

  “Jennifer, I need you to listen to me,” she said. “Whether or not you are comfortable with your weight, there is to be absolutely no going below the lowest number of your weight range. Do you know what that is? The exact number?”

  “Yes,” I said.

  “Tell me.”

  I told her.

  “Now promise.”

  “I promise.”

  “Good. And have you gone over your discharge plan with your primary? Remind me, who is your primary again?”

  “Ratch—Sheryl.” I did not try to hide my disdain.

  She squinted as she took a drag of her cigarette. “And, Jennifer, your secondary is—”

  “Chuck,” I said. “Oh! Can I do my discharge planning with him instead? Please please please?”

  “I think in this case, and at this time…yes. I will make a note of that.”

  “Please write it big, all over the front of my folder, so everyone will see it, and no one can accuse me of lying.”

  She chuckled, then opened my folder and wrote. “You will review this with Chuck when you fill out your discharge planner. But I trust you have already discussed follow-up care in family therapy?”

  “Yup. I’m going to Dr. Wexler’s outpatient group. Plus, we’ll have family therapy once a month with him. And, let’s see. There’s an OA group in Norwich, so I’ll go to that. And…” I hesitated. I always felt embarrassed, talking directly about my therapeutic relationship with Dr. Prakash or Dr. Wexler. I wasn’t sure why. But, onward. “And I’ll have individual with you. I’ll see you on Thursdays before group?”

  “Yes,” she said. “In the out-patient building. Weekly at first, and then every other week, if things are going well.”

  “Sounds good,” I said.

  “And what about weigh-ins?”

  “Once a week.”

  “With your family doctor?”

  “No, a nurse practitioner. Mom heard she’s nice.”

  “Jennifer, I want you to weigh yourself once every ten days. No more and no less. Can you do that for me?”

  “In addition to the weigh-ins?”

  She nodded. “It is a good habit to get into, since we will taper the clinical weigh-ins if you continue to do well. This way, you can be responsible to yourself and to me. You can be sure you are staying within your healthy weight range.”

  “Okay.”

  “But you must not weigh yourself obsessively or frequently. Can you do that?”

  I nodded.

  “I need a yes,” she said.

  “Yes,” I said.

  “Very well.” She sat back. “Tell me, Jennifer, how are you feeling about your chances of recovery?”

  I let out a deep, apprehensive breath. “I’m really nervous.”

  “Good.”

  “Good?”

  “Nervous means you will be on your toes. You will have a better chance of recovery,” she said.

  “Do you ever fully recover from an eating disorder?”

  “What do you think?”

  What do you think? The classic therapy turnaround.

  “I think…I don’t know. That’s why I asked. Because staff says an eating disorder is a disease that we’ll always have. We can be in recovery, but it never goes away.”

  “And what do you think?”

  “I’d like to think you can recover. I mean fully recover. Not just manage it and work around it, but leave it in the dust. But staff says that’s denial, because I’ll always have my disease.” I choked on the last word, started crying.

  Dr. Prakash waited.

  I breathed, trying to rein in my tears. “I guess I thought I’d have to wait until the skies were clear, all my issues were resolved, and then I’d be in recovery. But now I’m realizing that there will always be issues. Life is never smooth sailing. So the trick is to figure out how to be in recovery while stuff happens. And that’s what’s scary.”

  “Yes. Well put. Jennifer, do you remember a long time ago, when you talked about your depression as a bouquet of balloons?”

  “I’m surprised you remember that.”

  “It was a memorable analogy. I was wondering, how would you characterize your balloons now?”

  “Do you mean, is the Norpramin helping?”

  She shrugged, “The Norpramin, but also, everything else. Your balloons. The entire picture.”

  “I’m not sure.”

  “Take your time.”

  I picked at a thread on my sweatshirt and thought. “I don’t feel a whole lot different on the Norpramin. So I don’t know if that’s really helping or not. But I guess I feel like I know how to get helium now. And balloons and string. So if my balloons are deflated, or float away, or my strings are cut, I know it’s not forever. That’s the difference. Now I know it can be fixed. I can get more.”

  “And where would you get more helium, or strings, or balloons, as you put it?”

  “Hallmark.”

  “Very funny.” She raised her eyebrows, waiting.

  “Reaching out for support.”

  “Yes. From whom?”

  “My family. My friends. Outpatient group. Therapy. OA.”

  “You have a big safety net, Jennifer. It bodes well for your recovery. You must be sure to utilize it.”

  “Okay.”

  “Can you do it? Reach out? Utilize your safety net?”

  “I can do it.”

  “You do not want to stay in the hospital longer?”

  “Good God no! I can’t wait to get out of here,” I said. “Oh, sorry. No offense.”

  She chuckled. “No offense taken, Jennifer. I am very, very proud of you. I am proud of the work you have done here.”

  It felt good to hear.

  But what felt even better is that I didn’t need to hear it.

  I didn’t need her to be proud, because I was already proud of myself.

  Tuesday, January 24, 1989

  Sophia came back! Her Medicaid or Medicare or whatever kicked in.

  That was the good news.

  The bad news: she was back on stage one.

  It was incredibly unfair. But Baldy said it was policy that all admissions had to start on stage one.

  My room felt complete again. And it was so good to sit with her at dinner.

  Dinner was fried clams. Or possibly it was rubber bands dipped in breading and thrown in hot oil. There couldn’t have been much of a difference.

  I was on 2100 calories for maintenance. It wasn’t too much food, but it was too many fried rubber bands/clams. There was also an orange, which made me think of Monica—the old, pretreachery Monica—and scalloped potatoes, and, as always, a carton of milk and a small, sad salad.

  I looked at Sophia’s t
ray. Since she was on stage one, and technically a new admission, they had her back on 1200s. A handful of fried rubber bands, a salad, skim milk.

  “No,” she said.

  “It’s okay,” I said. “You can do it. One bite at a time.” I was scared, though; how bad had her time on the outside been, if she was refusing to eat this piddly amount of food?

  “I don’t mean no, I don’t want it.” She turned to Baldy. “I mean, can I go up to 1800s? I practically starved last time on 1200s.”

  Baldy looked taken aback. “Yeah,” he said. “I imagine that would be fine. I’ll have to double-check. But…yeah, I think that’s okay.”

  No patient had ever asked to increase her calories before.

  I might have been hungry on 1200s, too. Yet I never would have asked to go up to 1800s. For one thing, I hadn’t known a patient could ask for something like that, advocate for herself like that. But most importantly, I would have been afraid it was a sign of weakness, of a not-bad-enough eating disorder.

  Good for Sophia. Good ol’ Sophia.

  Wednesday, January 25, 1989

  It was snowing so hard that all travel was cancelled, but Chuck still took me for snack out. Instead of driving up to the frozen yogurt place by SU like we’d planned, we put on coats and boots and tromped around the fence to the Mobil station convenience store.

  I got Peanut M&M’s and a can of noncaffeinated root beer. The root beer I stuck in my coat pocket. But the M&Ms I opened right away. I didn’t want to wait. My first candy in ten weeks. Chocolate and peanuts. At last. I popped a green one into my mouth. “Want some?” I offered Chuck the packet. “Oh wait, sorry. I’m probably not supposed to share.”

  He smiled. “How are they? Are they triggering you?”

  “Nope.”

  “Are they as good as you remember?”

  “Yup. The milk chocolate melts in your mouth, not in your hands.”

  “Catchy. You should write advertising jingles.”

  “I know.” I ate a tan one. “Mmmm. So good. Here, have some.” I tapped a few out of the package onto my hand. “I’ll never get used to the red ones.”

  “I remember before they took red away.” He took a red one. “And now they’re back. Thanks.”

  “Because you’re older than dirt,” I said.

  “Yup, I’m a dinosaur. A friendly brontosaurus.” He helped himself to another M&M. “You have the rest. I know you’ve missed them.”

  “I’ve missed these, and Ben & Jerry’s ice cream, and gum. I miss blowing bubbles.”

  He looked around the store. It was tiny, dirty, rundown. The man behind the counter was reading a magazine. We were the only customers.

  “What’s your favorite kind?” Chuck asked.

  “Of gum?” I asked. “Bazooka. Grape. Because of the comic.”

  “Would you swear never to tell anyone if I bought you a piece?”

  My eyes went wide. Gum wasn’t allowed on the EDU because of its common, diseased use as a meal replacement. “I would double pinkie swear!”

  “You have to wait until you’re discharged to chew it. I could get fired.”

  “Yes! I swear I won’t tell.”

  He selected a piece of Bazooka and set it on the counter. “My gift to you,” he said. “You can blow bubbles on your car ride home.”

  Samuel Tuke Center

  Eating Disorders Unit

  EDU Discharge Plan for: Jennifer Johnson

  The following is my plan for discharge:

  1. Residence: My house—with my parents and brother (Norwich, New York)

  2. Income from: Mom and Dad. Spending money from after-school job at the Gathering Place

  3. Employment/School: Norwich High School

  4. Follow-Up Care:

  Name of Physician or Treatment Center: Dr. Wexler—family sessions and group; Dr. Prakash—individual sessions

  Date and Time of First Appointment: February 2 (Thursday) Dr. Prakash at 5:00 p.m., group at 7:00 p.m. (Group and outpatient therapy meets in the Samuel Tuke outpatient building.)

  Method of Transportation: Mom (or possibly Dad) will drive me

  Medications: Norpramin 75 mg per day

  Dietary: 2100 calories per day Lunch on day of discharge (if applicable): Restaurant with family

  Dinner: 2 oz. protein (hamburger)

  2 breads (hamburger bun)

  2 veggies (green beans, salad)

  1 fruit (apple)

  2 fats (butter, salad dressing)

  2% milk

  Snack: frozen yogurt or yogurt

  Next day breakfast: 2 thin slices French toast; an orange; 2% milk; Raisin Bran

  5. Additional Follow-Up Care:

  Spiritual: OA meetings—Mondays in Norwich (can walk or ride bike there), AA meetings if necessary, church, meditation

  Physical (weight and safety): Once a week with nurse practitioner—for weigh-in and vital signs

  Physical (well-being and exercise): Aerobics classes at the YMCA three times a week (probably Tues., Wed., and Sat.), walks, bike rides, Friday night dances!

  Date: 1/26/89

  Patient Signature: Jennifer Johnson

  Staff Member Signature: Charles Gordon, III

  Thursday, January 26, 1989

  The snowplows had cleared the roads enough for us to drive up the hill to Chuck’s favorite pizza place for my first meal out. It was fantastic. But scary. But fantastic.

  I was scared in the same way I’d been scared about meals downstairs: there was no nutritionist determining your exchanges, measuring your portions. You had to figure everything out for yourself.

  But I was ecstatic because this would be my first nonhospital meal in more than two months, Peanut M&M’s

  notwithstanding.

  Chuck found a parking space close to the restaurant. Snow was piled high, blocking the curb. We picked our way over the snowbank, treading carefully in the footsteps already punched in and hardened from the afternoon sun. Chuck fed the meter, which was almost buried by snow. Only the top of its little meter head could be seen.

  The pizza place blasted us with warm air when we went in. It smelled of freshly baked bread and tomato sauce. I closed my eyes, breathed deeply. It felt so good. The place served thick rectangular slices. It was packed with SU students—noisy, but not rowdy. They probably all knew someone who died in the Lockerbie crash.

  We got in line. When it was our turn, we ordered at the counter; Chuck paid for both of our meals with petty cash from the nurses’ station.

  We filled our waxed paper cups at the soda machine. I got club soda. Chuck got Coke.

  We found a booth and waited for our slices to warm in the huge oven.

  Chuck chewed ice from his Coke.

  “That’s bad for your teeth,” I told him.

  “I like to live dangerously.” He set his cup down. “You nervous, kid? You seem nervous.”

  “I’m nervous.”

  “Just eat. Mangia, mangia,” he said in a broad Italian accent. “Food is one of the essential pleasures in life. Try not to stress. ‘Don’t worry—’”

  “‘Be happy’?” I cocked an eyebrow. “You’re quoting Bobby McFerrin? At a time like this?”

  “Wrong Bob. I was quoting Bob Marley. Or trying to, before I was so rudely interrupted.”

  “Sorry.” My knee was bouncing under the table. Nerves. “Continue.”

  “You know the song. Sing it with me. ‘Don’t worry…’bout a thing…’cause every little thing…’”

  I shook my head.

  “Hell’s bells, kid. You don’t know ‘Three Little Birds’? Bob Marley?”

  I kept shaking my head.

  “Greatest reggae singer of all time?” His eyes were wide, his mouth o
pen. His face showed disbelief mixed with horror. He tried again, like I would recognize it if he just sang more: “‘Rise up this morning…smiled with the rising sun…three little birds…’”

  “Nope. Sorry.”

  “Unacceptable. I’ve been your secondary all this time, and this hasn’t come up? I’m not doing my job.”

  “You’re a great secondary. The best secondary.”

  “I’m failing in your music education, though.”

  “Music education? That’s not a real part of being a PNA.”

  “It is to me.” He was looking around the restaurant. “Shoot. I wish this place had a jukebox.”

  “Okay, Fonzie,” I laughed. “You think a jukebox would have reggae?”

  “Not just any reggae. Bob Marley!”

  “Because white college kids listen to reggae,” I said.

  “Yes. They do.” He put his head in his hands and groaned. “It’s like talking to a wall. I can’t believe this.”

  The guy at the counter called our order numbers; we went to get our food. The trays were smallish, light, flat red plastic; they weren’t the huge, heavy, sectioned, orangey beige trays of Samuel Tuke.

  I had ordered a slice of pepperoni pizza and a side salad of shredded lettuce with chopped apples and Italian dressing. Chuck had ordered two slices of pepperoni.

  We set down our trays and slid back into our seats.

  I scooped some napkins out of the dispenser on the table. “I forgot a fork.”

  “A fork for pizza? Blasphemy.”

  “A fork for salad,” I said.

  “Oh. Right. I’ll get it,” Chuck said. “They’re over by the drinks. You want a refill?”

  “No, thanks.”

  I stared at the food, hoping the numbers for my food plan exchanges would magically appear in the air above my tray. No luck.

  Was a slice of pizza one fat exchange, or two? Or three—grease was pooling on the cheese.

  Was it one bread exchange, or two, because the crust was so thick?

  One protein, or two, all this cheese?

  Another protein for the pepperoni. Another fat, too?

  Did the cheese count as one dairy or two?