Since the flakes—when was that? yesterday? the day before?—I haven’t been able to eat anything. I drink everything they give me (except the milk), but nothing else seems possible; everything sits on the tray, self-sufficient, unbreachable, as if sealed in an invisible skin. I did eat two packets of mustard off the lunch tray yesterday, very slowly, dipping the point of my tongue, like a paintbrush, into the bright, burning paste. It helped counteract the sweetish taste in my mouth, but a few seconds later my gut convulsed, as if to heave. I can’t stomach anything at all now, it seems.
I realize that the chair has stopped—has been stopped for some time, perhaps?—and she seems to be waiting for me to step out. But I’m very relaxed, very dreamy, my hands floating in my lap; I can’t quite see the point of standing up, getting on the scale. All I want is to go back to my bed and flop down again, fade out.
She reaches for my hand, to help me up, I suppose, but, confused, I think for a moment that she wants to crush it in her strong, sausagey grasp; she must be annoyed with me, and she’s going to snap my dry hand into shreds. But then her grasp feels surprisingly warm and gentle. “I can stand up by myself,” I say, pulling away, pushing myself, wobbly-kneed, to my feet.
It’s with a distant, fatalistic satisfaction that I watch her slide the scale’s cold claw down from seventy, where she’d optimistically begun, past sixty-eight, to stop on sixty-seven. She gives a slight shake of her head and records it on the chart. I’m expecting a lecture, but it seems she’s not going to oblige today. Perhaps she’s given up on me, won’t even pretend to care? Or perhaps she’s not going to say anything but wheel me straight to the tubes, like a car to the gas pump?
Instead, she takes me back to my room and, when I’m flat on the bed again, settles herself in the molded plastic chair and says, “Josie, please listen carefully, because I need to explain to you about hyperal.”
Hyper Al? Who is Hyper Al? A manic patient who has escaped from the psycho ward, perhaps, and is roaming the corridors with rape on his mind?
“What happens is this,” she says. “We have to put a catheter into the subclavian vein—that’s a big vein right under the collarbone, above the heart.” She taps her own chest briskly; it doesn’t make the hollow sound mine would, I note. “Then there’s this bottle that drips the total parenteral nutrition solution through the tube right into the vein.”
Parental nutrition, right into the heart? Perhaps I could have used that, once—but not now, not like this. It’s too late.
“To get the catheter in, Josie, we’ll numb the area with an anesthetic, so you won’t feel anything while it’s being inserted. We sort of tunnel the catheter under the skin for a few inches to keep it in place and then put a sterile dressing on it. You’ll need a chest X ray to make sure it’s in place properly.”
This is worse than I had imagined: an incision directly into the heart.
“Then of course we’ll need to keep track of your blood sugar with ear pricks and urine tests . . .” but I’m not listening anymore, imagining myself lying helpless, incised, with sugar dripping into my heart. The idea is terrifying—I can see it all building up, bagging out into fat—but at the same time strangely alluring: no choice at all but to take it all in, become a sweet-heart.
Realizing, finally, that she’s lost me, she gets up to go, promising me a visit soon from Dr. Frog and leaving me a couple of booklets—“Care of Your Central Venous Catheter,” “Nutrition Support Service Patient Information.” Fascinated, I page through them, pausing at crude line drawings of a stoic-looking man (neatly coiffed but naked, cut off at the waist) with a tangle of roots and bulbs in his chest and a jar of colorless fluid levitating above his right shoulder.
One end of the administration tubing has a white plastic spike. Am I a vampire, then, who must have a spike driven into my heart? But no: This sterile pointed end is used to enter into the bag of solution.
The solution consists of dextrose, amino acids, lipids, electrolytes, vitamins, and minerals (as if that could solve anything). Plus something called “fat emulsion,” which provides calories and—they say—essential fatty acids. Fat, they lie, is “necessary for normal growth and functioning.”
So they’re going to mainline fat right into me, right into my veins.
You may notice that the pump normally makes a soft humming noise. It beeps when something goes wrong. Things that can go wrong: air embolism, clotted catheter, blood backup. Blockages of various kinds.
When the lunch tray arrives, I decide I have to eat something. But I feel guilty just having so much food in my possession. From the load of thick, oily substances—soup, slice of quiche, salad swimming in slime—I choose a green apple and a cube of nondescript yellow cheese. I put these together on a separate plate, which I remove from the tray, pushing it as far away from me as possible on the other bed. Then I climb back on my bed with the plate and the knife, and draw the curtains tightly around me. Within this pale greenish space—the air tinged and watery like a sea cave’s—I confront the food, my heart knocking against the bones of my chest as if to be let out. First I slice the apple into quarters, then eighths, then sixteenths. With delicate precision, I slice the one-inch cube into sixteenths, too, each slice as transparent as skin. I arrange the apple pieces in a perfect ring around the plate and then place a slice of cheese on top of each piece. Then, very carefully, I consume each piece, first nibbling around the edges of the apple segment so it is the same shape as the cheese slice, and then biting delicately away at the resulting square, one side at a time. It takes about four minutes to eat each piece this way, and I wait three minutes between pieces. To discipline myself, I leave one piece on the plate, one perfect white wedge of apple, edged with a nail paring of green and topped with its skin of cheese.
When it’s over, I lie back in fear, feeling stuffed and bloated, anxiously palming my belly to gauge the swelling there. I’m pregnant already, pregnant with matter that will soon be me.
As she’s wheeling me for another blood workup later that afternoon, a hurried, self-important doctor stops her in the hall and engages her in an abrupt discussion of some missing test results. Because they’re talking about another patient, I know I’m supposed to act as if I’m not there: I’m deaf, I’m invisible. Blind too, if you like, except that while they talk—argue really, politely but insistently—I’m looking across into an open door.
It appears to be a dayroom of some kind—TV, armchairs, magazines, card table—and two women are sitting there on a sagging couch. A frenetic game show is blaring from the TV, but neither is paying it any attention. One, strikingly beautiful, with an artfully painted face, is paging through a Cosmopolitan. The other, a skeletal-looking Asian, who could be anywhere from fifteen to thirty, is staring at herself in a mirrored compact, applying ice-cream-pink blusher along her cheekbones. When she’s done, she continues staring at herself, fixedly. Neither looks toward the open door nor acknowledges in any way my captive presence.
She’s very thin, the Asian one, certainly thinner than me; I see I have a way to go. She is a mere skeleton (which they falsely say of me), as frail and lanky as a Halloween toy loose-jointed in the breeze. She’s frightening, too: there’s something otherworldly about her as she stares hypnotized into the mirror, her gaze fixed already on some far distance.
The other one, perfectly slim, doesn’t strike me as sickly: I wonder what she’s doing here, among the skeletons. She weighs about 105, I’d say, at five feet four inches, and is gorgeous by any standards, with her honey-colored hair, her almond eyes, her long legs, and—it hurts to see it— a tiny, chaste waist.
There’s a jolt, and I realize Miss Squeak has concluded her debate with the doctor—he seems disgruntled, she defiant—and is resuming our interrupted journey down the hallway’s perfect one-point perspective. As she pushes me along, more energetically than before, adrenaline no doubt rioting through that stolid flesh, I try to catch a glimpse of myself in the doors’ glass panels. Which one do I most
resemble? I’m thinner than the gorgeous one—therefore more gorgeous, surely?—yet the Halloween toy has put me to shame, so much more perfect a skeleton than I.
I should never have come here, never have allowed myself to be swayed from my path. I was completely in control and now I control nothing, not even my limbs. Soon they are going to flood me with sugar, cut into my heart and feed it until it’s plump and cushiony, like a satin valentine. Perhaps then I could offer it for them to feast on—so red, so sweet, so meaty—and make my escape, eviscerated.
“What if I just say no?” I ask.
“The medical team has made the assessment that your life is in danger,” he tells me solemnly. “At this point, we have the right to take the necessary steps, with or without your consent.”
“But what if I just refuse?”
“I’m afraid, Josie, you’re really in no position to refuse anymore. We’ve tried to reason with you since you’ve been here, we’ve tried to explain your options, but you won’t eat, your weight has continued to drop.”
“I have been eating. I ate an apple and some cheese.”
“Good, but that’s only a couple of hundred calories in over twenty-four hours. Your electrolytes are out of balance, and, as we explained, we’re seriously concerned about tachycardia. You don’t seem to realize, Josephine, that you could die.”
So could you, buddy: the odds in fact favor it.
“No, I don’t, you’re right. I feel fine. And anyway, why isn’t she on Hyper Al, that girl I saw today?”
He’s confused. “Which girl is that?”
“The Asian one.”
He scans his memory bank, his eyes swiveling upward and rightward. “Oh, her. Well, the other patients are really no concern of yours at this point, Josie. What matters is your life, your health.”
They always say they’re concerned about me, about my health, when all they want is to control me. They want to pin me down and force-feed me: with lies, with what they call love. Like prisoners everywhere—like the suffragists, even—all I have left is the power to refuse.
He goes on talking, his mottled little hands working the air, but I’m somewhere else—an empty cage, a pile of straw—and I crawl back out only when I realize that the inflection of a question is hanging between us.
“I’m sorry?”
“I asked, Josephine,” professionally patient, yet with a more emphatic croak than usual, “when you would say was the last time that you just ate normally, without thinking about it?”
“I do eat normally. I can’t help it if everyone else is constantly stuffing themselves.” Without thinking about it? Never—though there must have been a time when hunger announced itself, was satisfied, went away, came back, was satisfied again. Unimaginable now—but there must have been such a time.
If I had my things here, I could show him the photo graph album: Exhibit A. (It’s been edited, of course, purged, but there are a few token images of the terrible years—lest I ever forget.) Naturally it begins with a wedding, a formal portrait on thick cardboard, warped now and faded, like memory’s own pigment. The two children in fancy dress, smiling proudly, are my parents, Virginia and Michael, Ginny and Mike; I like to think I’m there too, a tadpole curled beneath the layers of tulle—though the official story is that I was born two months prematurely: a four-pound fetus, to be incubated, like an egg, in a box.
A few baby pictures follow, generic, of no particular interest (though I notice, in passing, that I was never chubby, never dimpled and fat-braceleted as so many babies are). It’s the images of the growing child—sturdy, short-haired, rarely smiling—that I search carefully for clues. The wrists, I note, were always thick and strong, even on a skinny child of nine; the face has always been broad, the calves well-muscled (ballet classes since the age of four: here I am, a leotard-clad tot, with an outstretched leg and upturned nose; here I am ten years later, attired as a nymph, my toe shoes very shiny, my mouth blood-dark).
Somewhere in these images must lie a pure form, an essence of self; somewhere there has to be a shape I can recover, that’s mine, that’s me. Because at eleven or twelve, something happens. The mutation begins; everything turns lewd, coarse, lumpy. No more sleek, clean lines—only a self immured, sluglike, in flesh. From somewhere deep within, I—she, somebody—stares out in disbelief.
A few pages of these strangers (I shied away from cameras then, except when my disguise was exceptional) and then the ballooning begins to reverse itself. Here I am, thin-armed again in an evening gown, someone’s champagne glass in the corner of the frame as if to toast my decline. And here I am baring a svelte midriff beneath the mimosa. In a dark, narrow-waisted jacket, braving a strong wind, I look as if I might snap in two. And, then, finally—before people stopped taking pictures, before they started looking away—the series I have lingered lovingly over: a body in a red bikini, each rib sharply etched (I have counted them), hips jutting hollowly, clavicles as clear as cartoon-strip dog bones. I must have been nineteen, and I stared at the lens in utter triumph.
Leave me alone, Dr. Frog, I want to replay that series, run those images again in my mind. Because somewhere in the gap between two of them is the reason I’m here now, perfecting my emptiness.
One more time: we have a sturdy-looking but basically skinny kid, hair cut pudding bowl-style, posing seriously and awkwardly with little brother, who’s distracted by something outside the frame, a half smile sweetly dawning. We must have been on our way somewhere special, a birthday party, perhaps, because I’m wearing my best dress, blue and green stripes with a broad white collar (I still remember its starchy feel, its peachy smell). Small sibling, hair plastered back, looks like Little Lord Fauntleroy, except one knee sock has decided to descend.
The next one, at nine or ten, is a study in grays: eyes wary, hand touching my bare neck, my lips almost black.
He appeared one day in my bedroom with his new camera, a bulky affair with a protruding zoom, and, concentrating on clicking a dial’s serrated edge into place, said, “Come, Jo, let’s try this thing out.”
“Ah, Dad, I’m doing my homework.” Actually, I was reading an adventure novel, my favorite—four friends who were allowed to ride their bicycles in the street, who set off for whole afternoons at a time, who made sandwiches and climbed trees and solved crimes without anyone asking just what they thought they were doing.
“Come on,” he said, “it’s pretty fancy.”
Sighing and rolling my eyes in exaggerated, movie-brat fashion, I put the book down and followed him into the garden, where, face scrunched, he realigned the same cog. To signal my boredom, I exhaled loudly and shifted from foot to foot.
“OK,” he said, looking up at last, “where shall we put you?”
“Right here,” I replied, grimacing grotesquely, a starlet at Cannes; when he didn’t respond, I stretched the corners of my mouth with my hands, pushed my nose into a snout, and peeled my lower lids down, exposing the eyeballs in their veiny red bed.
“Josephine, please,” he rebuked, “that’s not very nice.”
Seeking an artistic locale—the birdbath? no, empty and new—he found an unpruned patch behind the gardener’s shed (the gardener had recently quit, spitting over his shoulder while my mother, in a frenzy, dialed 911; I watched thrilled from an upstairs window, hoping he’d come back and axe her). “How about here?” he proposed, steering me by both shoulders to the shed’s grainy side.
“Dad,” I said, striking a pose, then dropping it, “this is boring.”
“Look up a little,” he said, “and now to the left. The left, not the right.”
He snapped a few times, then, ducking his head clear of the strap, set the camera down in the shade and, frowning, flipped through the manual until he reached P.
A portrait should reveal something about the subject.
“Look right at me.”
When shooting a portrait, try to include some other part of the subject’s body: the hand, for instance, or part of the arm.
This helps to convey information and create a mood.
“Let’s have your hand on your neck.”
“Now a close-up (wait while I find the right—ah, here it is).”
When working in black and white, contrast’s the key.
“You’re so pale, Josephine. A little color, perhaps?”
Mother wore “Coral Reef.” Before her mirror, like a thief, I stood on tiptoe and crayoned an amateur moue.
Next page, please: a class picture, seventh grade, St. Theresa’s School. Now I would consider the uniform rather chic—white shirt, blazer, tie—but at the time we all hated it and tried to imprint it with individual flair: collar turned up, socks rolled down, skirt surely a little too short (though that tactic never survived the quarterly inspections, when we had to kneel, penitent, for a teacher to tape the inches between patella and hem).
Look closely, because something has gone awry.
All the same parts are there, but different somehow, coarsened. I’m in the second row, behind Amanda Jane (slouching, insouciant), where much of me is hidden, but what does show suggests the whole: the calves quite chunky now, fingers thick, the face a sullen moon. In an ill-advised attempt at glamour, I’m trying to grow my hair, so it’s over my eyes and scraggly on the neck, with a few pieces coaxed forward in front of the ears. (I remember taping it at night to make it stay like that: why?) It looks oily, as does my skin. What the body can’t stomach, it starts storing on the outside, as ugliness.
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