‘Shall I get you a cup of tea?’
‘Yes, please.’ I sat down and waited, looking at his empty coffee cup while he paid for more at the counter, then brought our drinks back to the table one balanced in each hand, folding himself over slightly because he was concentrating on not spilling anything. He stooped over the drinks as if he wanted to protect them. He sat down and reached out with his right hand and placed it on top of my left, and was still for a moment, looking at me.
‘How are you?’ he asked.
‘I’m OK.’ All I could think was that there was milk in the tea, and that I didn’t think I was brave enough to drink it. By then I could only drink tea if it was black. Allowing myself milk would have left me disgusted at myself, my greediness, my need.
He nodded, slowly. ‘Good. I’ve been thinking about something, and I wanted to bring it up with you. Is that OK? I don’t want you to get upset.’
It wasn’t so different from the time he sat me down to talk about hiding my sandwiches. I don’t think I felt hostile towards him. I was upset and angry – distraught even – at what might happen now someone knew, but there was also a sense of relief. I had been waiting for someone to come along and take all that secrecy out of my hands, because I still didn’t know how to talk to people about what was going on.
‘What’s the matter?’ I asked, and he smiled, and his eyes filled for a moment with tears. I felt dizzy, as if the room had moved. I had never seen Dad cry. He was always so calm, so grown up about everything. I had never seen him share his vulnerability with anyone before, and I didn’t think he wanted to share it with me now; it seemed like he was simply breaking down. He was afraid for me, and that shook him out of the calm that had always defined him.
‘Kate, I think … you’ve got very thin. I think you’ve got quite a lot too thin, and I wondered whether you were aware of it.’
I started to reply, then felt a catch in my throat, and looked down at Dad’s hand where it was cradling mine. My hands were already thinner. Even my feet had got thinner; my shoes were all getting too big. Dad’s hands were old, but the veins on mine stood out bluer and clearer. I didn’t say anything then, just thought about how different our hands seemed now from when they used to hold each other.
‘I think you are aware of it. I think you’re not eating. And I’ve come to ask whether we could make an appointment for you to go and see a doctor about what’s going on?’
I told him then that I’d already been seeing doctors for a little while, that I had a name for what was happening to me, that people were aware of the downslope I was on, the black run. As I talked I started to cry, my hands shaking, and couldn’t get the words out. He gave me a hug and I tried to get calm again.
‘Can I come with you to an appointment, Kate, would that be OK?’
‘Why do you want to?’
‘I just want to make sure you’re getting all the help you can. I want to talk to your doctor. Would that be all right?’
We booked an appointment on the phone there and then, and he travelled back to Bristol a few days later, and we went to the surgery together and sat in the plastic chairs, and listened to the GP warning me that I needed to change, as if I didn’t know that already.
After we’d come out of that appointment, Dad tried to take the problem off my hands, but I wouldn’t let him.
‘I think you should move home, while you’re ill,’ he said. ‘This is a very serious problem, Kate, more serious than work, or paying your rent or anything like that. It’s your life. Why don’t you take a bit of pressure off yourself, and come home for a while, and we can look after you?’
‘The trouble is I think moving home would do the opposite.’
‘How do you mean?’ Dad tried to act puzzled, but I guessed that he knew what I meant.
‘I don’t want to upset you, but I feel like Mum’s part of this, that’s all.’
‘I see.’ He couldn’t look at me for a moment then, and I felt guilty and ashamed. I wished I could explain it to him. But he had never seen it, all the years we had lived under the same roof, he just hadn’t got it. The way she made me feel like I wasn’t really worth anything. The way she made me feel as though there must be something wrong with me, some secret I didn’t know about yet. All my life, that unspeakable shame, and he had never noticed, he didn’t understand.
I had convinced myself that this had always been in me, ever since childhood. There had been some trouble planted deep within me, right back at the start, in the years when I didn’t know how to love my mum. All I had ever been waiting for was a wound deep enough to bring this out.
Dad paid for private therapy, but it didn’t really help. I suppose I had started giving up. I had decided I would never eat again. My energy levels dropped, and my speech was slurred, and I often became dizzy and faint. I took laxatives to try and purge my body of all the fat I could feel, even though it wasn’t there, even though I wasn’t eating any more. I cried myself to sleep night after night, alone and terrified and exhausted.
‘If we’re going to be able to work together, I need you to commit to eating three times a day, Kate.’
I couldn’t even tell you the name of the therapist I saw in the last few weeks before my admission. A kind woman, she hugged me at the end of our first session. She knew it was too late for her to have any effect. Dad told me later that she tried to help by writing urgent letters to the GP, telling him to do more, to step in, take action. I barely had the energy to speak back to her when she spoke to me.
‘Right.’
‘Can you do that?’
‘I don’t think so.’
‘Can you commit to trying, at least?’
‘I don’t know.’
‘We’re not going to be able to do anything together if we’re not committed to a common goal.’
‘Yeah.’
On it went, for an hour. Dad could tell when he talked to me afterwards that it hadn’t done any good. He used to plead with me, hold my hand and demand that I eat. But I had decided I just couldn’t do it any more.
Then a night came when I was woken at half past one by the ring of my phone and someone leaning on the buzzer to the flat. At first I ignored all the noise, but whoever was downstairs kept buzzing and buzzing, and after a minute or so, one of my flatmates got up and answered it. I lay in bed. A premonition crossed my mind that something terrible was coming, but I didn’t know what. I just knew the person at the door had come for me, because my phone had been ringing as well. Then there was a knock on my bedroom door, and Dad looked into the room where I lay in the soft dark waiting for death or the ease of my suffering, and I saw two paramedics dressed in green and unfolding a wheelchair behind him. And I felt like the world had ended. I hated Dad in that moment with a burning certainty I’d never known before. I knew what was going to happen: I saw all of it. The degradations and humiliations of the hospital, no privacy at any hour of the day, the shame, the fear, over and over again.
‘Darling?’
‘Oh, no no no.’
‘I’m so sorry, my love. But it’s time.’
‘I hate you.’
‘I’m so sorry.’
‘Why now?’
‘I’ve begged them every day for weeks, Kate. I’ve been asking for weeks. Tonight is just the first night I’ve got through to someone who agreed with me. It’s going to be all right, my love. They’ll save you now. It’s going to be all right.
‘I hate you.’
‘I’m so sorry. But I can’t let you die, my darling.’
Dad got me sectioned by calling 111 again and again, behind my back, despite my insistence that he mustn’t try and take that step, calling day after day until he got through to a doctor who backed up his instinct that I was in grave danger. That doctor called an ambulance, and came to the flat to talk to me before I was taken into hospital. Dad told me afterwards that for a long time no one had listened to his opinion at all, whoever he tried to speak to. Half the time, when he called, they w
ouldn’t put him through to anyone because he wasn’t with me, so they couldn’t speak to me to make their diagnosis. When he did get through to a dietician, they would tell him there was nothing they could do; that it was the choice of the patient whether they started treatment or not. And then they would tell him that people could become very upset and angry with their loved ones if they took these decisions for them, that the blame and the hatred could be very difficult. As if they were asking Dad to give up. I always wonder what happens to the people whose families give up trying when they’re told that. I can’t help but think they all die.
When I saw the wheelchair I sobbed and hid deep in the burrow of the bed as the paramedics came into the room. Till then I’d found ways to keep walking despite how weak I felt, but the strength went out of me when I knew I was going into hospital. I thought my life was ending. I thought I was going to die, now there were going to be machines all around me, now there would be drips falling endlessly, nurses staring into my eyes. They put me in the wheelchair and took me down to the ambulance. Dad followed after me, but I wouldn’t speak to him. All I could say to him again and again was ‘I hate you, I hate you, I hate you.’
He watched me, helpless. ‘I know,’ he said. ‘I’m so sorry. I’m so sorry this happened to you.’
I had lost the strength to think clearly, and believed that because I hadn’t died yet, what was happening to me wasn’t going to kill me after all, despite what the doctors had been saying. In the heat of my malnourishment, my mind had stopped working. I had started to believe I was going to be able to go on for ever without eating a thing. When that faith was taken away from me, it was the biggest shock, a terrible crumbling of the world beneath my feet. But in the middle of the horror and defeat of that discovery, I saw something I hadn’t been able to make out before, and that clarity probably saved me in the end. I realised that what I’d been trying to do was to be more like Joe. I had been trying to find my way into a hospital bed because Joe was gone from me and I couldn’t bear it, because I wanted to show him that I still cared. So when I was laid out on the trolley in the ambulance, and the paramedics were studying the way my heart had started failing, a secret, silent part of me felt this was victory, this was mastering something. I hadn’t been good enough for him, but I could be good enough at this. I had thought at first that I wanted to live, but that had only been fuzzy thinking. Now I was seeing things clearly, right at the end, by the river that had beckoned, the place of forgetting. Now I was learning the role and the act of dying.
‘Hello, Kate, you’re looking well.’ I turn, heartsick because I don’t want to look well, I don’t want anyone to tell me that, and see my uncle Owen. Owen’s actually a cousin, Grandma’s brother’s son, but those kinds of people always prefer to be called aunt and uncle, I find. When I was younger I thought Uncle Owen was cool, because he was an opera singer, and had done Don Giovanni for the Welsh National Opera, and there was a poster from the production in the hallway of our house.
‘Hi, Uncle Owen. How are you?’
‘Not so bad, thanks. Intimidating seeing all these people, isn’t it?’
‘Do you think so too?’
Owen laughs. ‘Of course. Everyone does on days like this. You’re always terrified you won’t remember someone’s name. That was why I was excited to see you, you’re someone I can definitely say hello to.’
I think it’s just possible that Uncle Owen is sufficiently distant from the rest of my family that he isn’t aware of my illness. He lives in Lincoln, after all, which is miles from anywhere, and like many of Mum’s relatives, he doesn’t get on with her at all. Perhaps no one told him what had happened. I feel a momentary lifting of the darkness that has been assailing me as the thought crosses my mind. It would be good to pretend to be someone else for the duration of a conversation. I thought everyone I saw today would be staring at me, checking for signs.
‘How are you then? What are you up to these days?’ I ask.
‘I’m actually looking to do a bit of directing.’ Owen bites down on a vol-au-vent, spitting puff pastry in a gentle cloud as he speaks.
‘Oh, right?’
‘Yes.’ Having finished his mouthful, Owen pauses to wash it down with the dregs of a glass of Prosecco. ‘The lungs go as you get older, you see, and the work dries up, so it’s important to diversify. I’m doing a Rigoletto in Ludlow in the summer with a view to making my name and my fortune.’ He chuckles as if this is very funny, and it strikes me how much more exciting everyone seems when you’re a child, and you haven’t learned yet how to spot the flaws in people. Even the most glamorous lives end up looking ordinary, if you watch them for long enough.
‘That sounds brilliant.’
‘You must come, if you’re free. It’s on for a week.’
‘I’ll definitely see if I’m around. That would be great.’
‘All right. I’ll find you a flyer before I go. Speak later,’ Owen says, and walks away, and for all that I think he seems ridiculous and sad wandering round a family gathering trying to advertise his show, I love him in that moment for having no idea what happened to me, for talking to me as if I am purely and simply myself. It’s rare, these days, to be addressed like that. As if there’s no thin ice anywhere that someone might tread on, no past to fall into and drown.
Once I was in hospital I refused fluids for the first twelve hours. I wanted to show Dad how much he had betrayed me. The only thing I still knew how to do was try and die, so I threw myself into it, desperate, aching. The medical team couldn’t compel me to take anything until I was formally sectioned, and the relevant forms had been signed. I was angry that I had been brought there, and the only way of showing that was hurting myself a little further. Dad sat with me, bowed over with his elbows resting on his knees, all the strength gone out of him while he begged me to live, and I refused to speak to him. The doctor told me if I kept trying to go without a drip, I’d most likely die later that night.
‘I’ve already lost three patients tonight in the same condition as you. You have to take on fluids or you will die.’
‘But how much longer could I go without dying? Couldn’t I stay out until I absolutely can’t any more, and then come into hospital? How many more days could I have gone? A week?’
A look passed between the doctor and Dad, tired and defeated, heavy eyes snagging each other. The doctor looked back to me, dragging the same heavy look like a body through undergrowth.
‘I’m afraid we’ve already reached that point where you’ll die if we don’t help you. Tonight is that point. We have to get fluids in now.’
I found it was easier to accept things when it felt like there wasn’t a decision to be made, or someone else was making the decision. So I let them put in a drip, sobbing so hard that I couldn’t breathe properly, because I thought they would find a way to get food into me through it. And then I decided I had to get away from the place. I tried to get dressed and leave, but Dad wouldn’t let me. He held me in the bay and I fought him, battering at his chest, his arms. I barely had the strength to stand but I found the strength to fight him. He told me later that I seemed like a bird held between cupped palms, it was so easy to keep me still. He could feel my wings beating but they had no real strength. I screamed and cried at being so trapped. I had to lie down again because my heart wasn’t strong enough to pump the blood through me, and I started to faint. Dad cried, and I offered him no sympathy. I told him it was his fault. I told him I hated him for what he was doing to me. For the whole of that first night I sobbed, and felt as if I was filled with so many different people, all these voices screaming, wanting so many different things. They came like waves in and out of my consciousness. The determination that I didn’t need this help being forced on me, that I was being kidnapped, that I needed to escape. The determination that I had always wanted to end up here, and be like Joe, and feel closer to Joe because I was almost as damaged now as he was. The terror that I was going to have to die, because I didn’t want to l
ive. The terror that I was going to have to live, because I didn’t know how I could bear dying either.
The next morning, the first of my minder nurses turned up, the noise of their arrival waking me from an unconsciousness that couldn’t really be called sleep. Dad, who had sat awake next to me through the night, tried to hold my hand and make me feel safer while I stared in fear at this strange new face sitting beside me, not understanding what he was going to do, whether he was here to hurt me or force me to eat.
Registered Mental Health Nurses, as the minders were properly called, were detailed to sit with patients under section every hour of the day and night, dividing the day into two twelve-hour shifts, to ensure the terms of the section were enforced. My first RMN was a thin black man with an accent from somewhere in Africa. I couldn’t narrow it down any further, being delirious and barely listening to him anyway. He worked, it transpired when Dad tried to talk to him, as a lecturer in postcolonial history at the University of the West of England, and topped up his income with nursing. He said very little to me, but talked to Dad all morning about mindfulness. He wouldn’t listen to Dad when he explained the severity of my anorexia, and believed it was good practice to keep offering me food in case I felt able to accept some.
‘Whenever they come round to take orders for meals, I’ll just order some food, OK? Then if the patient wants to have some of what I’ve ordered, they can, or if it doesn’t feel possible still, they can leave it.’ He beamed reassuringly at Dad.
‘Dad. Tell him.’ I had wanted to never speak to him again, wanted to never forgive him. But now he had put me in this place, there were new horrors I couldn’t face on my own. So I bit down on my pride and accepted I needed him, clung to him for help like I was a child again, and saw he understood what had happened, the modicum of forgiveness he had been given, and the chance he had to protect me from this place.
Dad tried to explain as gently as possible that this tactic was unlikely to succeed. ‘I don’t know how much experience you’ve had with anorexic patients. I admit I haven’t had much experience myself. But my daughter hasn’t eaten anything at all for several weeks. The likelihood of her feeling able to eat an ordinary plate of hospital food right now seems quite low to me, so I wonder whether what you’re proposing is going to just cause more distress?’
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