by Yara Zgheib
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Table of Contents
About the Author
Copyright Page
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To you, who, in these pages, found your reading glasses, sweatshirt, earrings, favorite book or flavor of ice cream, freckles, perfume, signature crêpe recipe, nose twitch, stutter, or missing sock
1
I call it the Van Gogh room. Just a different color scheme. Hazy peach blanket, hazy peach walls. Pastel-green carpet on a cherrywood floor. White blinds and shutters, the window and closet creak. Everything looks pale and tired, a little like me.
I look around and think, This is where it starts. In Bedroom 5, on the east side of a pink house at 17 Swann Street. As good, as bad a setting as any, I suppose, for a story like this. Plain and mildly inviting, dubiously clean. At least there is a window; I can see the driveway, the edge of the street, bits of garden and sky.
Four hangers, four towels, four shelves. I have not packed much, I do not need more. I have, however, packed my makeup kit, a red one my mother used to own. Not that I need it; I will not be going anywhere for a long time. No work shift to check into on Monday morning, no plans for the weekend. But I will look nice, I have to. I set the kit on the white shelf and dab blush on my cheeks.
Deodorant, coconut lotion. My apple and jasmine perfume. A spritz behind each ear, two more. I will not smell like a hospital bed.
Four magnets on a whiteboard. Oh, I will need much more. For the time being, I spread my thick stack of photographs in a rainbow on the floor. I contemplate all the faces I have loved in my life and put up my favorite four.
My mother and father. Maman et Papa, on the faded day they eloped. She in her borrowed white dress and white shoes, he in his father’s suit.
A picture of Sophie, Camil, and me on a picnic by a stream. It must have been autumn; the sky above us was cloudy. Camil must have been five or six; Leopold in his lap was still a puppy.
Matthias, gorgeous Matthias squinting at the sun and my lens. The first picture I took of him, that first morning in Paris. A quietly happy day.
Last, Matthias and me, mouths covered in chocolate, hands holding messy half-eaten crêpes. Our official wedding photo, posed for proudly outside the Métro three years ago.
The kaleidoscope goes by the bed, the slippers and a box underneath. Blinds up, night-light on.
I have moved into Bedroom 5, 17 Swann Street.
My name is Anna. I am a dancer, a constant daydreamer. I like sparkling wine in the late afternoon, ripe and juicy strawberries in June. Quiet mornings make me happy, dusk makes me blue. Like Whistler, I like gray and foggy cities. I see purple in gray and foggy days. I believe in the rich taste of real vanilla ice cream, melting stickily from a cone. I believe in love. I am madly in love, I am madly loved.
I have books to read, places to see, babies to make, birthday cakes to taste. I even have unused birthday wishes to spare.
So what am I doing here?
I am twenty-six years old. My body feels sixty-two. So does my brain. Both are tired, irritable, in pain. My hair was once wild-lion thick, morning blond. It is now a nondescript, mousy beige that falls in wisps around my face and out in my hands. My eyes, green like my mother’s, are sunk so deep in their sockets that no makeup will fill the craters. I do have lovely eyelashes. I always liked those. They curl up at the edges like those of a doll I used to own.
My collarbones, ribs, kneecaps, and streamer-like thin blue veins peek through paper-thin skin. My skin, largest organ of my body and its first line of defense, has been more decorative than functional lately. In fact, not even that; it is cracked and taut, constantly bruised and cold. Today it smells of baby oil. For the occasion, I used lavender.
I have a flat stomach. I once had lips and breasts, but those shrank months ago. Along with my thighs, my liver, my behind. I lost my sense of humor too.
I do not laugh very often anymore. Very little is funny. When I do, it sounds different. So does my voice on the telephone. Apparently. Not that I can tell the difference: I do not have many people to call.
I realize that my phone is not with me, then remember; they took it away. I am allowed to have it until 10:00 A.M. and after dinner in the evenings. One of the many house rules I will have to learn while I am living here, however long that will be. How long will that be? I turn away from the thought …
… and hit a tidal wave of panic. I do not recognize the girl, or the reality I just described.
2
Clinical Intake and Assessment Form
Friday—May 20, 2016
Patient Identification Information
Name:
Anna M. Roux, maiden name Aubry
Date of birth:
November 13, 1989
Place of birth:
Paris, France
Sex:
Female
Age:
26
Emergency Contact Information
Name:
Matthias Roux
Relationship:
Spouse
General Background
Occupation:
I tell people I am a dancer. I have not danced in years, though. I work as a cashier in a supermarket, but my real occupation is anorexia.
Marital Status:
Married.
Children:
None.
Yet. Hopefully, maybe, after this is all over?
I skip Ethnic Background, Family and Social History, Education, and Hobbies.
Physical Health
I feel fine, thank you.
Allergies:
None.
Last menstrual cycle:
Unknown.
I cannot remember.
Birth control? Contraceptive medication?
What for? And what for?
Weight and height:
None of your business.
Patient’s weight:
88 lbs.
Patient’s height:
5' 4''
BMI:
15.1
So I am a little underweight. So what?
Daily Habits
Tobacco:
No. I do not like the smell.
Alcohol:
A glass of wine, once a week on a Friday night.
Recreational drugs:
No.
Caffeine:
How else do you think I function on only three hours of sleep?
Number of meals eaten on a normal weekday:
Define the words “normal” and “meal.” I keep a few apples in my bag in case I get too hungry.
Number of meals eaten on a normal weekend day:
Why would that be different? Well, I do sometimes make popcorn in the microwave. Single serving. Nonfat.
Regular exercise routine: Yes.
Naturally.
Frequency: Every day.
Please describe:
I run, build strength, and stretch for two hours, every morning before 7:00 A.M.
What do you do to manage stress?
&nb
sp; I run, build strength, and stretch for two hours every morning before 7:00 A.M.
Mental Health
Basic problem or concern: Difficulty eating certain foods.
Difficulty eating, period. Loss of interest in food, loss of interest in general.
Significant changes or stressors in recent history: None
that I have any interest in disclosing here.
Previous mental health diagnoses: None.
I said I feel fine.
Feelings of sadness?
Check.
Hopelessness?
Check.
Anxiety?
Check check.
Please check any symptoms experienced in the past month:
Restricted food intake.
Check.
Compulsion to exercise.
Check.
Avoidance of certain foods.
Check.
Laxative abuse.
Check.
Binge.
Check. A whole box of blackberries last week.
Self-induced vomiting.
Only with guilt. See above on blackberries.
Concerns about weight, body image, feeling fat.
Check. Check. Check.
Total weight lost over the past year:
Pass.
Lowest weight ever reached:
Pass again.
These questions are inappropriate.
Diagnosis
Anorexia nervosa. Restricting type.
3
The bedroom, the whole flat in fact, was an industrial cube. The sort of unit prized by cost-cutting developers and lower-income tenants. High ceiling and concrete walls left provocatively naked, lined with steel pipes. More loft than apartment unit, more studio really.
Light flowed in buckets through the one window that covered the only external wall. She walked up to it and looked down onto a little patch of green, across onto the next building, up onto the third floor and window parallel to theirs. The blinds were drawn. Did neighbours know their neighbours here? There was no “u” in the word “neighbors” here. She would have to remember that.
“Flat” was not the right word either, she reminded herself. Flats here were called apartments. She was in America now.
Apartment. America. She tried both words on for size, feeling them on her tongue as she rolled them around in her mouth. This apartment was bare but it was theirs, small but luxurious by Parisian standards.
In Paris they had been living in a cupboard of a room, sharing a wall, bathroom, little stove and fridge with a philosophy major, a psychologist, their lovers, and a computer technician who was never there but made outstanding pesto when he was. Bohemian life did not scare her; she had always loved and led it happily. But this was not bohemian, or Paris. This was the American Midwest.
She had landed last night. Matthias had been waiting at the airport with a red rose. He had driven her here. Dinner, wine, sex, and this morning he had left for work …
… and had not said when he would return, Anna realized. She finished unpacking—apple and jasmine perfume, lotion, hairbrush, toothbrush next to his. Books by the bed. She had forgotten her slippers. Done. Eleven o’clock.
One more look around. The walls were not too bare. She would cover them with photographs of home. She would also buy groceries, candles, and some more wine. Would Matthias be home for lunch?
Surely not. But she would make sure dinner was ready when he did. They would have a feast, then go out to explore this new city. Till then …
She hummed notes at random and walked toward the fridge. A quarter of the pizza Matthias had ordered the night before remained. He had left the crusts on the side; he knew Anna liked them. There was also a piece of cheese, some yogurt, a few fruits. She took the yogurt and some strawberries.
Where would she eat them, though? They had no furniture yet beyond the coffee table and the bed. Coffee table then. She would just sit on the floor.
She boiled water and stirred in instant coffee. One sip. Disaster. Enough. That was not coffee. She poured it into the sink and decided she would have tea.
They did not have tea. Eleven oh five. The yogurt was the fruity kind, with syrup. She put it back in the fridge and ate the strawberries. Eleven oh six. It would soon be time for lunch anyway. She reached for the phone, then put it down; it was late afternoon in Paris and everyone was surely busy now.
Perhaps she would go for a run before lunch. Matthias just might be back then.
He was not. She showered and slowly went through her lotion routine, dried her hair, put on a blue dress, reached for a red makeup kit: face cream, mascara, peach blush. Pink lipstick applied. Twelve twenty-eight.
Fridge. Pizza, crust, cheese, yogurt, and fruit. She should buy groceries for the evening. She could make crêpes and a salad. Cheese and mushrooms. They would have the fruit for dessert.
Twelve twenty-nine. She would go before lunch.
One thirty in the afternoon and she finally had everything she needed. The store she had spotted on her run had not been as close as she had thought. Her voice had croaked mildly at the cash register; she was using it for the first time that day. A while later, the eggs, milk, flour, ricotta, and lettuce, mushrooms, tomatoes were in the fridge. Done.
Concrete walls. She took the phone and put it down. Opened and closed the fridge. She took two of Matthias’s leftover crusts, ripped them into little bits, and slowly chewed the first, looking out the large window, exhaling the anxiety away.
Nine full minutes later it was done. She hated eating alone. At 1:41 she took the blue dress off and hung it neatly with the rest of her clothes. All she owned had moved from one suitcase to twenty hangers and a shelf in cube 315 of many more in the building on 45 Furstenberg Street. She climbed back into bed.
Matthias would be back soon anyway and then she would make the crêpes.
4
I do not suffer from anorexia, I have anorexia. The two states are not the same. I know my anorexia, I understand it better than the world around me.
The world around me is obese, half of it. The other half is emaciated. Values are hollow, but meals are dense with high fructose corn syrup. Standards come in doubles, so do portions. The world is overcrowded but lonely. My anorexia keeps me company, comforts me. I can control it, so I choose it.
The Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) defines anorexia nervosa as a brain disease, a mental disorder with severe metabolic effects on the entire body. Characteristics:
1. Restriction of food, self-induced starvation with the purpose of losing weight.
2. An intense fear of gaining weight or becoming fat.
3. A distorted perception of body weight or shape with a strong influence on mental well-being,
as well as
a lack of awareness of the severity of the condition.
I run for eighty minutes each day, build strength for another twenty, keep my caloric intake below eight hundred calories, a thousand when I binge. I weigh myself every morning and cry at the number on the scale. I cry in front of mirrors too: I see fat everywhere.
Everyone around me thinks I have a problem. Everyone around me is scared. I do not have a problem. I just have to lose a little bit of weight. I am scared too, but not of gaining weight. I am terrified of life. Of a sad and unfair world. I do not suffer from a sick brain. I suffer from a sick heart.
Cardiac arrhythmia. Irregular heartbeat. Like falling in love, or a heart attack.
Cardiomyopathy. Loss of heart muscle mass. Yes, but only the excess.
I do not need dispensable tissue, dispensable fat or organs. But my body is greedy; it wants more potassium, sodium, magnesium. Energy.
My body does not know what it needs. I make that decision for it. In protest, my heart pumps less blood. Bradycardia. Slow heartbeat. My blood pressure drops.
The rest of my body follows suit, falling quietly, like rain, like snow. My ovaries, my liver, my kidneys g
o next. Then my brain goes to sleep.
5
Anna? Should I pause the movie? You are missing the good parts.
Anna?
Anna, are you all right in there? Open the door please.
Anna, open the door! Anna!
6
Matthias found me on the floor, legs like cotton, mouth numb. I could feel the bathroom tiles, freezing, painful against my back, but I was also falling through them. I could not grasp the wisps of words I needed to tell him that I was fine. I could not grasp his shirt; my hands were clumsy. My thoughts were clumsy too.
I could not move my hands, I could not move. Matthias carried me from the bathroom into the bedroom.
For a few minutes neither of us said anything. The movie was on pause too. I wanted to press Play, end the ugly intermission. Matthias had other plans.
We need to talk, Anna.
What about?
What happened in there?
I fell in the bathroom, Matthias,
I sliced.
I am fine now. I just stood up too fast.
Muscles tense, defenses up, circling the ring. He could feel the edge in my voice. He circled too, carefully.
What about yesterday, during your shift? And last week, when you hurt your shoulder?
I was tired! I slipped!
We need to talk, Anna.
We are talking!
We need to stop lying then.
Matthias was a few years older than I was, thirty-one in a couple of months. He looked older just then. Our voices had been rising, but he said that last sentence very quietly.
Another lull while he chose his words. I did not, would not, help him.
I think you need treatment. I’ve been a coward. I should have spoken a long time ago. I just kept convincing myself you were fine—
I told you: I am fine!
