“Alexis? Alexis? Are you all right? Did you say your daughter ate her own fingers?”
“Yes! She ate them down to the bone! Three of them! She’s raiding the refrigerator right now! What’s wrong with her?”
“I-I don’t know. Maybe it’s some extreme type of binge-eating disorder coupled with dermatophagia. Has she ever eaten her own skin before to your knowledge?”
“No. I’d never allow such a horrible thing. What’s dermatophagia?”
“The eating of one’s own skin. It can be symptoms of a number of different things, but rarely is it caused by hunger. Stress is a major cause. Many victims feel stress and picking and eating their own skin is a form of self-soothing. Self-image issues are another of the main causes. They may pick their skin in the hopes of correcting some perceived irregularity in their complexion, though they invariably end up making themselves look worse. Skin-picking may also provide needed stimulation for the nervous system when someone is bored or under-stimulated.”
“You didn’t hear me. She didn’t just chew on her skin. She ate her own damn fingers and she did it because she was hungry! What the hell is wrong with her?”
There was a pause. She heard the doctor clear his throat.
“Self-cannibalism, autosarcophagy, is pretty rare. I’ve never encountered a true case of it myself, though I have read about it. A Chilean artist named Marco Evaristti held a dinner party for a few of his close friends back in 1996 and served a pasta dish with meatballs made from beef and his own belly fat extracted during a liposuction treatment. He claimed he did it as an artistic statement. That may or may not have been the symptom of a mental disorder. That same year, a deathrow inmate in Texas pulled out his eye and ate it. There was a pretty famous case of vorarephilia when a German man, Bernd Jürgen Brande, cut off and ate his own cooked penis before being killed and eaten by Armin Meiwes, the ‘Rotenburg Cannibal’, who also ate some of Brande’s cooked penis.”
Alexis gasped.
“That’s disgusting! Why the hell are you telling me all this? I need you to come over and take care of my little girl.”
“If she’s hurting herself, the best place for her is probably a hospital or a mental facility. Now, I can suggest a few places-“
“A nuthouse! You want me to put my little girl in an insane asylum?” Alexis asked with an exaggerated, theatrical tone of outrage.
“Not an asylum. A place where she can rest and be looked after where she won’t be able to hurt herself.”
“I-I don’t know. Do you really think that’s the right thing to do?”
“I think it’s what’s best for her.”
11
Wednesday, 9:35 a.m.
Brian was hungry. He was already on his way to the restaurant, and there was plenty of food there, but he almost felt like he wouldn’t make it. In addition to his growling stomach and his rapidly shrinking waistline, he felt a deep existential dread. He literally felt like he would be dead within minutes if he didn’t eat something right now.
Brian had never wanted the treatment in the first place. It had been a birthday present from his wife. Going to the gym, taking up kickboxing, and running had all been working, but she had wanted to surprise him with something guaranteed to get the job done faster. He’d been ambiguous about the idea from the start.
“The doctors at the clinic say it’s a permanent weight-loss solution. One treatment and you’re guaranteed to drop as much as fifty pounds a day! That’s amazing, isn’t it?”
“Sounds dangerous. Has it been tested? Are you sure it’s approved?”
She shook her head.
“It isn’t approved in America yet. It’s a brand-new treatment, but this is one of the most famous and exclusive cosmetic surgery and weight-loss clinics in the world. They have all the best doctors, and they use the latest medical procedures. Their clients are billionaires, movie stars, and rock stars.”
“Sounds expensive. How much does it cost?” he asked, and then braced himself for the answer. His worst fears of financial extravagance fell short of the reality.
“It was fifty thousand dollars.”
“Fifty thousand! You spent fifty thousand of my money on this?”
“Our money. We’re married, remember? What’s yours is mine. And I did it for you. This way, you won’t have to spend so much time at the gym, and you can spend more time with me!”
She’d been ecstatic. Brian sucked down his anger as much as he could. He made a pretty good living, well into the six figures, but he was not exactly wealthy. Fifty thousand was more than half their savings and it had taken him six years to save up that much. Now that he was married, it would probably take twice that long to build it back up.
He closed his eyes and took several deep breaths before speaking. He knew he had to phrase his words carefully. “But I like going to the gym, and I was saving that money for a house.”
“We still have enough for a house. You only need to put down 20 percent. Houses aren’t that expensive, unless you were planning on buying a mansion. I bought it for you. You’re going. That’s it. I already paid for the plane tickets and everything anyway. We can turn it into a mini-vacation. You’ll be happy we did this. You’ll see.”
She’d been right. He was happy. They had a blast in Cancun, lounging on the beach and drinking the most powerful margaritas on the planet, deep-sea fishing, visiting Mayan ruins, swimming with the dolphins. Even the treatment hadn’t been bad. It was just one little intramuscular injection.
“That’s it?” Brian asked the doctor, still holding the cotton swab to the injection site on his thigh.
The young doctor, who looked like he’d just graduated from college, smiled and nodded. “Yup. That’s it. You need to spend the night here just to make sure it took. If not, we’ll try again in the morning.”
“How will you know if it took?” Brian asked.
“We’ll weigh you in the morning. On average, someone your size can fluctuate between five and seven pounds between the evening after eating all day and after sleeping for eight hours. We’ll be looking for something more dramatic than that. At least a twenty pound loss.”
“Twenty pounds? In one night?” Brian scoffed.
“At least.”
Dr. Trevor Adams held Brian’s gaze without the slightest hint of humor. He affected an air of supreme self-assurance.
Brian instantly disliked the man. Cocky little prick.
The next morning, Brian woke thirty pounds lighter and ravenously hungry.
“The hunger is normal. Your metabolism is on hyper-drive. Take advantage of it. Eat whatever you like. We have the best chefs on the island here at the clinic. You don’t have to worry about watching what you eat ever again.”
By the time Brian left the island, he was a hundred pounds lighter. He had to admit, he looked great, but the hunger just seemed to get worse the more weight he lost. He wondered what would happen when there was no more fat left for his body to consume. There was no way someone could continue to burn a hundred thousand calories a day. You would have to eat nonstop to feed such a metabolism. As a chef, he knew the highest-calorie foods. They were some of his favorites. But even if he ate every fried, sugary, buttery food he could think of, dripping in gravy with a creamy dessert to follow, he’d never be able to eat that many calories.
The restaurant was only five miles away on Third Street. In normal traffic, he would have been there in ten minutes. But rush-hour traffic had slowed to a crawl.
“Fuck! Come on! Move!”
The fire in his belly had increased. Brian felt like he could feel his body eating itself, turning fat and muscle into adenosine triphosphate and incinerating it. The pants he was wearing had just been purchased yesterday when he realized his entire wardrobe no longer fit. In fewer than twenty-four hours, he’d gone down two more sizes, and his new pants were now sagging off him. He was wasting away.
He was almost to the Oltorf exit, just two exits away from Third Street, but he didn’t think
he could make it. There was an Indian/Texas fusion restaurant on Oltorf he’d always wanted to try. He jerked the wheel to the right onto the shoulder and headed toward the nearest exit. He never saw the police cruiser racing down the shoulder, never even felt the impact.
Brian’s neck snapped cleanly when his head smacked the dashboard, and he was simply gone.
12
Wednesday, 9:37 a.m.
Officer Angel Velasquez blinked several times, trying to clear the fog from his head. He wiped what he thought was sweat from his eyes and his hand came away red. He was bleeding, a head wound. Blood poured down his face from a gash that looked like his forehead had grown a vagina and it was that time of the month. Instead of fear, he felt anger. “That sonovabitch pulled out right in front of me!”
He opened the car door and staggered out of his vehicle, almost stepping out into traffic. It wouldn’t have mattered; traffic was at a standstill. The police cruiser was smashed. The bumper was completely crushed, and the hood had folded up like an accordion. The big, black Yukon that had crashed into him didn’t look too bad except for the bumper, which was hanging off, and the huge dent in the hatch. The guy behind the wheel, however, wasn’t moving.
Angel rolled his eyes. Oh, great. He’s probably going to try to sue me. And because I rear-ended him, he’ll probably win. Fuck my life.
But as he got closer and noticed the man’s bleeding head tilted at an odd angle, he was pretty sure the guy was dead.
Damn.
He flagged down the ambulance that was racing up behind him. It was en route to the same accident Angel had been en route toward before he’d struck the Kamikaze commuter, but Officer Velasquez suspected this was more urgent than some obese housewife faking whiplash for insurance money.
The ambulance stopped in back of his cruiser, and two EMTs jumped out. One was a huge black guy who looked like he should have been chasing a quarterback across a football field, and the other was a mousy little white woman with brown hair who had all the markings of a meth addict, right down to the rotting teeth and acne scars.
“The driver looks like he needs help. He don’t look so good. I think he might be dead. His head might have hit the steering wheel or something.”
“Are you okay? Your head’s bleeding. Why don’t you go back to the ambulance and sit down, okay?” the mousy little meth addict said. Her breath was rancid, like she’d been on a strict diet of Twinkies and road kill.
“No, I’m okay. You just take care of that guy up there.” Angel leaned against the cruiser while the EMTs jogged over to the vehicle and went to work. It was hot as hell out, at least one hundred degrees with 60 percent humidity. Too fucking hot to be screwing around in traffic.
The EMTs were fast and efficient. They already had the guy out of the Yukon and onto the gurney and were frantically administering CPR as they raced him back to the ambulance.
“Is he gonna make it?” Angel asked as they passed him.
The big linebacker of an ambulance driver looked at him and shook his head. “At least he was an organ donor,” he said, handing Angel the guy’s wallet.
Angel flipped it open.
Brian Wubbenna, Austin, Texas, age thirty-seven. In the bottom corner was a little red heart designating him as an organ donor. Damn. Thirty-seven was too damn young to die. What the fuck was this guy thinking pulling out in front of me like that? At least his organs will do some good. Maybe save some other poor bastard’s life.
13
Wednesday, 9:52 a.m.
“We’ve got a donor! There was an accident on I-35 this morning. The guy died instantly. His heart is in excellent condition. They’re rushing it over to us now. We need to get you prepped for immediate surgery.”
Anthony Berkley had been born with a congenital heart valve defect. He had his first heart attack in the middle of a college basketball game while charging up the court for a lay-up. Since then, he’d had two more and was informed he’d be dead in a year unless he received a transplant. He was only twenty-two, six foot eight, 265 pounds, good-looking, clean-cut, had his entire life ahead of him, but his failing heart made him doubt if that life would account for more than twenty-four years. He was on the top of the donors’ list, but that didn’t mean a damn thing if they couldn’t find him a heart, and it had begun to look like that would never happen. Anthony had already given up hope when the doctor came in with the good news.
“Who was he? The donor, I mean?”
“He HeHHe was thirty-seven years old and in good physical condition. Not an ounce of excess body fat on this guy from what they tell me. You lucked out.”
***
Wednesday, 10:31 a.m.
Nurses surrounded Anthony, shaving his chest and washing it with a special antiseptic cleaning solution. The anesthesiologist attached heart and blood pressure monitors to his arms, head, and ribs and then began an IV fentanyl drip.
“Okay, I need you to count backwards from fifty,” the doctor said.
“Fifty, forty-nine, forty-eight, forty-seven…”
He was unconscious before he could get to forty-six.
***
Wednesday, 5:40 p.m.
Anthony woke from surgery in recovery, and for the first time in months he didn’t feel out of breath. He was woozy from the drugs and his throat felt dry and scratchy from the air tube they’d shoved down his throat during the procedure, but other than that, he felt pretty damn good.
“How are you feeling?”
“Pretty good. My throat hurts. Did everything go okay?”
The doctor nodded. “It went perfectly. The sore throat is normal. The nurse will bring you something to drink.”
“No ice cream? I thought you were supposed to get ice cream after surgery.”
“If you like,” the doctor answered, still studying Anthony’s chart, checking the EKG.
“I think I do. I’m hungry as hell for some reason.”
“That’s normal after surgery. You’ve essentially been fasting for twenty-four hours.”
Anthony put his hand over the sutures in his chest. “It feels funny. Like it’s about to beat right out of my chest.”
The doctor nodded. “That’s normal too. Because the nerves leading to the heart are cut during the operation, your new heart beats faster than a normal heart, about a hundred to a hundred and ten beats per minute compared to about seventy beats per minute for a normal healthy heart.”
Anthony rubbed the bandages around his chest and took a deep breath. There was a hint of panic in his eyes. “It feels like thunder.”
“You’ll get used to it.”
***
Saturday, 6:06 a.m.
The hunger woke Anthony from a sound sleep. His belly was on fire. His appetite had steadily increased since the surgery. The room was dark and deathly quiet except for the blinking lights and the whir and hum of the monitoring equipment. He groped for the nurse’s call button and rang it.
The night nurse hadn’t left for the day yet. She walked into the room followed by the day nurse. She did a reasonably good job of masking her annoyance.
“Yes?”
“I’m starving! I need something to eat.”
“We’ll be serving breakfast in a few hours. You just hold tight.”
“No! I need to eat now!”
Over the past three days, he’d had countless X-rays and blood tests and been pumped full of anti-rejection medications. Through it all, he could think of nothing but the next meal. Last night, his mother brought him a grilled chicken sandwich from some healthy restaurant downtown and some baked fries. He’d scarfed it down and then begged her for a couple of cheeseburgers.
“The doctor said you have to keep your weight down or you might put too much strain on your new heart,” his mother said.
“Do I look like I’m gaining weight?” Anthony asked.
His mother, a young thirty-eight-year-old who’d given birth to Anthony at the tender age of sixteen, shook her head. Anthony appeared withered and shru
nken, even more sickly than he had before receiving the new heart. It was understandable after such an arduous surgery, but he seemed to be getting worse, not better. He was concerned that his body may be rejecting the new heart.
The bones in Anthony’s face were prominent. It looked like a skull with skin pulled tight around it. Like the face of a mummy. His ribcage protruded through his skin. Before he’d been admitted to the hospital, before the life-saving surgery, he’d been muscular and robust. He had looked very much like the NBA player he’d once dreamt of becoming. Now he was an emaciated shadow of his former self.
His mother smiled, trying hard to keep up the appearance of optimism, but Anthony could see the concern on her face. He knew he looked like shit.
“You’re right. I’m sorry. Whatever you like.”
She’d brought him three cheeseburgers, fries, and a milkshake. He scarfed down the food without tasting it and then fell asleep. The fire in his belly had been temporarily assuaged.
Now he was awake again, and his mother was nowhere to be found. His appetite had increased exponentially since his last meal. It felt like he hadn’t eaten for weeks.
Anthony pulled the IV tube from his wrist and pulled off the EKG lead wires. He swung his legs over the side of the bed and began to stand. “Something’s wrong. I’m starving! I need food!”
The nurse was young and pretty, though several pounds overweight. Not obese, but pleasantly plump. She had a wide flat ass, huge hips, and large breasts supported by a belly that was only slightly smaller. She wasn’t the type of girl a guy like him would ever call girlfriend, at least not publicly. She was the type of girl you banged on the side because she was more sexually adventurous than your real girlfriend, your showpiece. She was what his friends called a “Moped”-fun to ride, but you wouldn’t want anyone to see you with it.
She panicked as Anthony pushed his way past her. His elbow brushed against her chest, and Anthony was surprised to find his appetite respond to the contact. He began salivating. He looked at her, drooling.
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