by Yara Zgheib
I am not anorexic. I am out of control. I know it but I cannot stop. I am a child in a body that grew up too soon, found adulthood and real life a scam, and now is trying to lose enough weight to lift off the ground, fly away.
As for my body, I think it is fine. It and the world just disagree. If only my ovaries …
I notice a little human crawling on the floor by the pew. Little fingers, little feet in their little blue shoes. He looks up at me.
His mother clearly dressed him in his Sunday best this morning: a pale blue and white checkered shirt with a little clip-on tie. His pants are kept from slipping off by brown suspenders on which graze little giraffes. He seems content enough to waddle around, floor-level, examining shoes and handbags curiously, searching for things to put in his mouth.
I crouch down to his level. He interprets my move as an invitation to play. He reaches out to me with the open hands and smile only toddlers in this world seem to have. How can I refuse such hands? I sit down, cross my legs, and we play peekaboo while the faithful congregation prays on.
38
Let’s make a baby,
Matthias said.
Sure,
she said.
Let’s.
It was raining in Paris in June. They were looking out the window, sipping their coffee. Anna laughed at the surprise on his face.
Really?
Really.
It was an easy yes. Of course she would make a baby with him.
After Camil she had decided she would not have children of her own. She had seen what his death had done to Maman. So no. No children, bedtime stories, lullabies, treasure hunts. No nightmare banishing, birthday cakes, no Sunday morning cartoons. It was too messy, it hurt too much.
Until she had met Matthias.
Let’s make a baby.
Yes.
How many babies would you like?
Two. Two boys. Or two girls. Or one of each. I don’t care.
Whatever the sex, we will teach them to ski. Oh! And play tennis! And the piano!
Ballet classes for the girls, like their mother,
Matthias added.
Of course, and tiny trainers that match yours.
They will speak many languages and be very intelligent.
And be good at math!
She was counting on their father’s genes for that.
Let’s make a baby then,
she told Matthias.
We’ll start in Saint Louis,
he smiled.
Neither Anna nor Matthias had heard of amenorrhea then. They soon did: the absence of menstruation for at least three months.
Or more.
They both pretended not to see the reason right in front of their noses, on her plate; a body that can barely sustain itself is not qualified to hold another.
Severe calorie restriction and low weight cause hormone levels to drop. No more cortisol, leptin, LH, FSH. Without those, no estrogen. Without estrogen, no egg, and with that no need for a uterine lining. What for?
No period for more than three months. Or twelve. Or twenty-four.
They kept trying anyway, but the more weight she lost, the less Matthias mentioned a baby. In fact, the less keen he seemed on wanting one, or her in general.
She was angry. She could have blamed her disappearing curves, breasts, lips, thighs. The insufficient food, the absence of fats and protein in popcorn and apples. She could have blamed all the running or, more simply, anorexia. But that would have meant acknowledging anorexia. Instead, she blamed Matthias.
Deep down, honestly, she blamed herself. For not being enough. Beautiful, sensual, or just good enough to be a mother. But she fought the sickening thought with denial and the anecdotal evidence that some women with anorexia could and did conceive,
and clung to that fantasy so desperately that she took a pregnancy test every month.
39
We step outside to find the van already waiting for us. Sarah and I enter and do not speak. Neither does Direct Care, thankfully. I had once been more outgoing. I used to laugh, ask questions, flirt. These days I find myself shy around people, out of body and place.
I glance at Sarah, next to me in the backseat. She looks like a movie star, and not at all like she suffers from an eating disorder. Or like she suffers from anything. Then again, I have been at 17 Swann Street a week, long enough to know that every one of us has demons, whatever the lipstick we wear.
We park and I stop to soak in some sun before going back into the house. Sarah turns to Direct Care:
Since we got some time before lunch, may we sit outside for a while?
Her vowels trickle like honey, I marvel. I have never heard anyone speak like that. Her hair and lips in the sun are ruby red. I fuss with my own hair.
Direct Care’s shrug is taken as a yes. We sit on a bench along the back wall. I am uncomfortable and self-conscious by this sensual woman, but the sun on my skin is worth it.
I close my eyes.
Sarah speaks:
You like children, then. Want any?
I open my eyes. Sun gone.
I cannot have them just now.
Too blunt. She was just being nice. Damage control:
Do you like children?
I have a two-year-old boy.
I am stunned. A second look at her. I reevaluate her movie lipstick, her age. She looks so young. I try to respond normally:
You must miss him.
Darlin’, horribly.
I do not know what to say, so I say nothing. Then she starts speaking, like a stream:
He was a mistake, you know, my Charlie. I named him after Bukowski. I had no interest in motherhood, or in marrying his idiot of a father. I fancied myself an actress. I knew I had talent. But I was born in the wrong place and the wrong body for a star.
The wrong body. I look at her again and wonder what she sees in the mirror.
Where was that?
Oh, girl, in a farmhouse as deep South as you can picture. I had three brothers and two sisters and one very discontented mother who made jam and pies with lots of cream. She had gorgeous red hair that I did not inherit, but I fixed that when I was seventeen.
She gives her hair a coy shake, for emphasis.
Just about the only thing about her I ever envied.
I could easily see her, red hair and lush curves, dominating any stage. But she is not onstage. She is here, at 17 Swann Street.
My boyfriend’s name was Sam. Sam. Short and sweet and nondescript, exactly like him. One night, we were chugging stolen beer in his car. I told him I was running away. I wanted to become a star. I became pregnant instead.
So I married him and moved from Ma’s house to his.
She laughs bitterly.
I wanted to be anything but her. Instead I turned into her. Thank God I took the jam and pies with me. They kept me company.
Her farmhouse, I note, is my cube on 45 Furstenberg Street. I can relate to her solitude, except that instead of food, I filled that void with air.
But then you had Charlie.
Then I had Charlie.
I did not have a Charlie. I do not have a Charlie. She turns her long-lashed eyes to me:
Why do you want a baby?
Out of body and place again. The best answer is the simplest, I decide.
Because I love Matthias. I want a family with him.
You’re lucky.
She is right. I am.
Don’t let your Matthias go. Whatever you’re here for—anorexia, I’m guessing?—think about what it’s costing you.
I do not appreciate her assumption that I chose this disease, or her unsolicited advice. The air cools between us. She must sense it, because she quickly, candidly adds:
I promise I’m not preaching, darlin’. Believe me, I’m in no place to judge. Look at me: I should be spending Sunday with my son. Instead, I’m sitting here.
Why are you sitting here then?
Because in the hours I spent alone with Charlie,
I drank, ate pie, whole loaves of bread with butter and jam.
She tells it like a story, dispassionately. Someone else’s life.
I tried painting, reading, going on walks, but I always wound up in the kitchen. I rode two damn years on sugar and alcohol, and when I could get my hands on it, Xanax.
She stops awhile in the space of those two years. I do not interrupt. Then she resumes:
Our birthdays are a few days apart, little Charlie’s and mine. On my nineteenth birthday I had whiskey and Benadryl while he slept. When I woke up, Charlie was crying in his crib. Sam was bent over me, pathetically terrified.
I turned twenty last week and he turned two and I had whiskey and Benadryl again. Sam threatened to take him and leave me. Then he up and did it, the fucker.
Sarah is twenty. Sarah is twenty. Just a child in a woman’s body. All the makeup in the world will not change that. Still, she pushes her sunglasses up further.
So now I’m here. Not for Sam, but for Charlie. I want to fix myself up before his next birthday. I can’t live without my baby.
It echoes between us. I can’t live without my baby. And I cannot live without Matthias. Matthias who, unlike Sam, did not leave.
Yet. Did not leave yet.
Don’t let your Matthias go. The back door opens and Direct Care’s head pops out:
Come on, ladies! Time for lunch.
40
Do you really remember?
Every detail. The way you smiled, your earrings and that giant scarf you like. My heart was beating like an orchestra.
I feel my cheeks turning pink, embarrassed. I remember that night too.
It was so cold but the lights were so beautiful! Remember? I hid in your coat.
I remember,
Matthias says, his hand in my hair. Then:
When all this is over, we’ll go back to Paris and see the lights.
Silence,
but he does not notice, painting his picture in the air between us, on a Sunday night in an upstairs bedroom at an eating-disorder treatment center.
We’ll stroll through the Christmas markets, freezing, but I’ll keep you in my coat like last time. We’ll have mulled wine and buy chestnuts in newspaper cones. And I know you love the displays at Printemps, so we’ll go there, and to … what was the name of that shop? Repetto? For your ballet shoes?… and that pâtisserie by the Place des Vosges, with all the art galleries—
Pouchkine,
I interrupt flatly.
Pouchkine! Yes!
He carries on, along the streets of Paris in his head. But I am still at 17 Swann Street. I cannot leave the Van Gogh room. He eventually stops and looks at me, probably waiting for an answer. I have not been listening.
Anna? Are you listening?
Yes.
Well, what was the name of that song?
I do not know, because I have no idea what he had been saying.
Can we talk about something else?
He is disconcerted, but responds:
Of course. What do you want to talk about?
Anything but the future. Or the past. I had not thought the mention of either would cause such sharp pains in my chest. That Matthias remembers me on that first night, when we met on the Grands Boulevards, when I do not remember or recognize myself, those earrings, that scarf.
When all this is over. The sentence angered me. How does he know it will be? How can he see Christmas lights in May when I cannot see beyond evening snack? I cannot see tomorrow, or myself in the mirror. I cannot see myself at all. Matthias is still waiting for an answer. I still do not know what to say.
He pulls me closer:
Hey, I’m here. Talk to me. Tell me what’s wrong. Did I make you sad?
Not sad, no. Just weary.
Sorry, I am just tired.
Do you want me to leave?
I do not know what I want, or rather, do not know how to want anymore.
Anorexia nervosa makes the brain shrink; it cannibalizes itself. It must; it is starved but it must keep working. Gray matter must be sacrificed. My brain must have eaten up the sections where my hope, ambition, dreams were. Thoughts like when, soon, tomorrow are fantasies I can no longer imagine.
We used to make plans. I used to make plans.
No, I do not want you to leave.
I want to want something. I need to want something. A baby, a job, a future, a reason to get out of here.
Matthias, I cannot remember. My brain is so foggy.
I try to conjure an image of Matthias and me in Paris, Matthias and me without anorexia. Matthias and me happy. But I only see the photograph on the whiteboard, and I am not even in it; Matthias is disheveled and sleepy, squinting at me, behind the lens.
I keep my voice steady when I speak again, but my chin gives me away:
What if this is not over by Christmas?
Then we’ll go to Paris the Christmas after that.
His voice is as shaky as my chin, but his face is adamant. I realize he is telling himself this just as much as he is telling me.
You will remember and get better, and after that, we’ll go to Paris.
What if I do not? What if this is it?
This is not it. It can’t be it!
We both want to believe him. He lowers his voice:
You don’t understand, Anna. That girl from the Grands Boulevards, she’s everything to me. You cannot forget her. I need her to exist.
I need her to exist too. I lean into Matthias, both of us still, in the present and in the Van Gogh room.
He smells of musk, my head in the nook of his neck. A freckle. He speaks very softly now:
I know you’re fighting hard and are exhausted. I know you can’t see the future. But I need to, Anna, or I’ll go insane. I’ll picture it for both of us, okay?
Okay, Matthias.
I need something to hold on to, and I think you do too. It doesn’t even have to be Christmas. How about just next month? Next week? Tomorrow?
After a while, I nod my head into his neck. He breathes out in relief.
Good.
We can hear Direct Care’s heavy footsteps on the stairs. Matthias glances at his watch. He turns me toward him and kisses me forcefully on the lips before she comes.
All right, Anna, we have a plan: Focus on your meals, and we’ll have a date tomorrow. How about a game of chess? I’ll bring the board.
I nod.
Chess sounds wonderful.
We both already know that tomorrow night, he will win and I will stink. There is comfort in that certainty.
I walk him down the stairs. He does not kiss me in front of the girls, but at the front door he turns to me:
I know you don’t want to hear it, but I need to say this for me: when all this is over and you leave this place, I will take you on a real date. We’ll go wherever you want: a movie, a concert, an art exhibit, dinner. Then we’ll come home and I’ll make love to you. Who knows, maybe we’ll make a baby. Then we’ll go to Paris for Christmas.
I nod.
I’d like that.
I miss you. I miss us.
Me too.
He goes home and I miss going home with him. I miss sleeping with him, wanting to.
My brain must have eaten my libido too, when it shut down my ovaries. A result of malnutrition, the doctor had said. But also that with weight gain, according to some studies, some gray matter might be restored.
41
Treatment Plan—May 30, 2016
Weight: 89 lbs.
BMI: 15.3
Physiological Observations:
No noticeable weight gain in spite of patient compliance with meal plan. Treatment team estimates this to be normal consequence of the body’s exposure to normal nutrition after prolonged starvation. Patient’s metabolism likely in hyperactive mode as organ repair commences. Risk of refeeding syndrome is high.
Psychological/Psychiatric Observations:
Patient appears compliant with her meal plan but continues to str
uggle with eating-disorder rituals: avoidance of certain food groups, particularly proteins and fats, cutting food into inappropriately small bites, eating too slowly. She has significant fears around weight gain, as well as negative body image, but is working to modify certain habits.
Patient appears motivated to make progress toward recovery. Interactions with her husband on daily visits and with other patients appear healthy. Residential treatment remains necessary.
Treatment Objectives:
Increase normal nutrition to restore weight. Monitor for refeeding syndrome.
Monitor vitals. Monitor labs. Follow hormone levels.
Meal Plan Update:
Target caloric value: 2,400 calories daily
42
How was your weekend, Anna?
I am not sure how to answer that. The therapist knows I spent my weekend here, and how that must have been.
It was fine.
I test the waters. Receive silence. I conclude she expects more.
All I did was eat and sleep, and the bed is cold when I am alone.
Do you dislike being alone?
I dislike this question and this couch, and I do not need this session. And I do not have to answer the therapist, I realize, so I do not.
She tries again:
Has Matthias been visiting every evening?
Yes.
You two seem very close.
We are.
