Pieces of My Heart

by Sinéad Moriarty

  While Paul went down to pour the wine I marched into Ali’s room. She was sitting at her desk.

  ‘For God’s sake, it’s like a bloody revolving door,’ she grumbled. ‘Can I please get some peace? I have work to do.’

  I stood beside her desk. ‘You may think you’re fooling your father, but you’re not fooling me, Ali. You have a serious problem and we’re going to see Dr Garner first thing in the morning. I’m not letting this go on for one more day. I’ve already let it go too far.’

  ‘I’m not going to see any doctor. I’m fine.’

  ‘This is not up for negotiation. I’m going to make you better and nothing is going to stand in my way. I’ve been negligent and blind and I’m sorry for that. I should have seen the signs earlier. Now, I want you to put those books away and get into bed. You’re exhausted.’

  ‘I have an essay to do.’

  ‘Not tonight. I’ll talk to your teacher. Tonight you’re to sleep. I want you fresh in the morning so we can work out the best way to get you well again.’

  ‘Stop fussing.’

  ‘Ali,’ I said, putting my hands on her shoulders and forcing her to look at me, ‘I love you and all I want is for you to be happy and healthy and I’m going to do everything I can to make that happen. We’ll have you back to yourself in no time. Trust me, pet, I’m going to help you get better. Now, get some rest.’

  She reluctantly turned off her desk lamp and put her books into her bag. ‘Can you go now? I have to get changed and I could do without an audience.’

  ‘Fine, but I’ll be back up to check on you in ten minutes and you’d better be in bed resting or sleeping.’

  She turned her back on me. ‘Just close the door, will you?’

  When I got downstairs Paul was on his way out to work. ‘Where are you going? I need to talk to you about Ali.’

  He looked at me, surprised. ‘But I just spoke to her and she promised to stop all this mad dieting and eat.’

  ‘Jesus, Paul, how can you be so naïve?’

  He sighed. ‘Don’t you think you’re overreacting a little? I know she’s been hiding some of her food, but she told me she’s going to stop all that and start eating now.’

  ‘Will you get your bloody head out of the sand? She has an eating disorder, all the symptoms are there. Come in here and look at the websites she’s been on.’ I dragged him into the lounge and logged on to the pro-anorexia websites I had found on Ali’s computer. ‘Does this seem normal to you?’

  He flinched when he saw some of the pictures of the girls being promoted as beautiful – they were emaciated skeletons.

  ‘You see, this is really serious. She’s not going to wake up tomorrow and be cured.’

  ‘All I’m saying is, let’s not jump to any conclusions. Let’s see how the next few days go,’ he said.

  ‘Fine. Well, then, why don’t you have breakfast with her tomorrow and see how much she eats?’

  ‘OK, I will. I have to go now.’ With that, he walked out of the door and went to work.

  I spent most of the night on the computer looking up those evil pro-anorexia sites and then the best ways to cure the eating disorder. I learnt that anorexia is curable in 80 per cent of cases that are detected early and treated effectively. I tried to remember when I had first noticed Ali cutting down on her food. It was a couple of weeks after David had broken up with her, so two and a half months ago at the most. They all said that professional help was essential because it was a complex illness that affected a person’s physical and emotional sides.

  I read that people with anorexia were often perfectionists and overachievers, the ‘good’ child in the family who tries to please everyone. It was as if they were describing Ali.

  A lot of the websites gave different advice, but they agreed that it was vital to get proper medical help and to get to the bottom of the psychological issues underlying the illness. They advised a patient and gentle approach and said it was important never to make negative comments about your own body.

  As I lay in bed, I went over the last few months in my head. How had I missed the signs? They seemed obvious now. But how had things spiralled out of control so quickly? I kept seeing the vision of Ali in her underwear. It was heartbreaking. What mother would let her daughter get so thin without noticing? Was I so wrapped up in my own life? Was I selfish or just plain stupid? I tossed and turned, berating myself, until daylight finally broke.

  21

  When I walked into the kitchen the next morning, I found Paul and Ali sitting in silence. Ali had an untouched bowl of cereal in front of her.

  Paul shook his head. Maybe now he’d realize how serious things were.

  ‘Can you drive Sarah to school? I’m taking Ali to see Dr Garner,’ I said.

  ‘Sure. Is she up?’

  ‘Yes, she’s nearly ready.’

  He looked relieved to be leaving the kitchen and Ali.

  ‘Ali,’ I said, ‘I’ve rung the school and they know you’re not coming in.’

  ‘I don’t want to go to the doctor. I’m not sick.’

  I looked her in the eye. ‘Ali, get your coat.’

  Half an hour later we were in Dr Garner’s surgery. She’d been our family doctor since the girls were toddlers. She was about fifty, tall, slim, and wore her hair up in a chignon. She was always impeccably dressed in a black, navy or grey suit. She had a kind but efficient bedside manner and, most importantly, I trusted her.

  ‘Hello, Ava, hi, Alison. I haven’t seen you in a while,’ she said, shaking our hands.

  ‘Hello, Judith, nice to see you again,’ I said, sitting down.

  ‘What can I do for you?’

  ‘It’s Alison. She’s lost a lot of weight lately and she’s refusing to eat. I’ve just found out that she’s been hiding food under her bed, throwing out her school lunch every day and exercising obsessively. I’m really worried about her.’ I tried to control the tremor in my voice.

  Dr Garner gave my arm a reassuring pat. Then she looked at Ali. ‘You do look very thin, Alison. Have you been trying to lose weight?’

  ‘I’m just trying to be healthy. Everyone’s making a fuss about nothing.’

  ‘Do you think you’ve lost any weight recently?’

  ‘Maybe a tiny bit, but not much. Nothing to make a big deal about.’

  ‘How’s everything at school? Is anything happening that’s upsetting you? Are any of your classmates making you feel uncomfortable about the way you look?’

  ‘Nothing’s going on in school. Everything is fine.’

  ‘Well, there was an incident in school,’ I said. ‘Alison broke up with her boyfriend a few months ago and he’s now going out with another girl in her class who’s very thin. It’s been very difficult for her.’

  ‘For God’s sake, Mum, would you stop going on about David? It happened months ago, and I’m totally over it.’

  ‘It must have been hard for you, though,’ Dr Garner said gently.

  Ali shrugged her thin shoulders. ‘At the time it was, but it was ages ago.’

  ‘Do you think his new girlfriend has a nice figure?’ Dr Garner asked.

  ‘Yeah, she does – she’s a part-time model so she has to be thin.’

  ‘Is that why you’re throwing out your school lunches? Because you want to look like this model?’

  ‘No, that’s not it at all. I just threw a few of the lunches out because I didn’t like what Mum put in on those days. I’m seventeen, for God’s sake. I don’t need my mother to make my lunch. It’s embarrassing.’

  ‘She was exhausted all the time and losing weight, so I was trying to get her to eat something more substantial,’ I explained.

  ‘That seems reasonable to me,’ said the doctor. ‘Alison, are you worried about your exams? You’re in final year, aren’t you?’

  ‘I suppose I am a bit stressed about doing well, but nothing major.’ She shivered and huddled even further under her coat.

  ‘Are you cold all the time?’

  �
�Yes – she’s constantly freezing and wears layers of clothes even when the house is like a furnace.’ I was determined that Dr Garner was going to have all the facts so she could make a proper diagnosis.

  ‘Have your periods stopped?’

  Ali’s head snapped up. ‘How did you know?’

  ‘It tends to happen when girls lose a lot of weight.’

  ‘Well, they only stopped this month. In fact, it’s probably just a bit late because I’m tired.’

  ‘Alison, are you happy with the way you look?’ Dr Garner asked.

  ‘Not really.’

  ‘Would you like to put on weight?’

  ‘God, no!’ Ali’s hands flew up to her mouth.

  ‘Right. Let’s weigh you and take it from there,’ Dr Garner suggested. She pulled out a big set of scales, told Ali to take off her coat and step up on it. ‘Six stone twelve pounds.’

  Jesus Christ!

  ‘You’re very underweight for your height, Alison. A healthy weight for a girl of five foot eight would be ten stone or nine and a half at the least. You can sit down now. I’m going to take your blood pressure.’

  Ali was three stone underweight. This was worse than I’d thought.

  ‘Your blood pressure is low. Alison, for the next while I’d like you to cut out all exercise and have lots of rest. Maybe even take a break from the books for a few days and just build up your strength. Put your feet up and watch movies. I’d also like you to try to eat lots of little meals instead of three big ones. How does that sound?’

  ‘It sounds fine, but I can’t take a break from studying. I have Christmas exams coming up.’

  ‘Well, don’t overdo it. You need to rest. Now if you wouldn’t mind stepping out for a minute I’d like to have a quick chat with your mum.’ Dr Garner showed Ali out to the waiting room and closed the door.

  ‘How bad is it?’ I asked.

  Dr Garner sat down beside me. ‘Alison is very underweight and her blood pressure is low. Her symptoms would suggest that she has an eating disorder.’

  ‘Anorexia?’

  She nodded. ‘How long has she been dieting?’

  ‘About two and a half months, but it only got really bad in the last few weeks.’

  ‘Well, that’s very positive. Early detection is key to curing anorexia.’

  ‘It still took me two months to find out. How did I not see what was going on?’

  ‘Don’t beat yourself up, Ava. It’s extremely hard to tell when a child is just dieting or when it becomes more than that. Anorexics are very clever at hiding their illness, which is why so many aren’t diagnosed for years. You did the right thing by bringing her to see me immediately.’

  ‘Is she going to be OK? Don’t some people die of this?’

  ‘Yes, they do, but the majority get better, especially teenage sufferers. However, you’ll need to watch her like a hawk and encourage her to eat little and often. She mustn’t exercise at all. I’d also like her to see Mary Boland. She’s a psychologist who specializes in treating teenage girls with eating disorders.’

  ‘Do you think this is all because of that boy breaking up with her?’

  ‘That certainly could have been the catalyst. Mary will help us get to the bottom of the problem, which will be a key factor in Alison’s recovery.’

  ‘Does she have a good success rate?’

  ‘She’s the best around. I think you’ll really like her. In the meantime, someone will need to supervise Alison’s meals and sit down with her while she eats. Gently encourage her to eat five or six small meals a day.’

  ‘Is there anything else I can do to help her get better?’

  ‘Just be there for her. Try to get her to talk to you and maybe do some fun things as a family. Make her feel as secure as possible.’

  ‘I’ve booked a holiday to the sun at Christmas.’

  Dr Garner smiled. ‘That sounds perfect. A change of scenery will do her the world of good and the sun will help build up her immune system.’

  ‘What if she refuses to eat?’

  ‘If that happens, we’ll have to look at more in-depth treatments. But remember, Ava, Alison’s chances of full recovery are very high. You’ve sought professional help and are committed to helping her get better. These are all vital ingredients to her getting well quickly.’

  ‘Thank you, Judith. Thanks so much,’ I said, trying not to get emotional.

  ‘If you’re worried at all in the next ten days, call me and bring Alison back for a check-up before Christmas. In the meantime, book her in with Mary Boland and enjoy a nice family break.’

  Ali and I walked to the car in silence. I was trying to figure out the best thing to say to her. But I was in shock. It had been confirmed: Ali had anorexia. She was sick. She could die. A mother’s job is to fix things. I had to make this better. I had to save her. I concentrated on driving and took deep breaths. I was no good to anyone if I was hysterical. I needed a calm head.

  ‘Ali, you heard the doctor. You’re very thin and you need to rest and eat, so that’s what we’re going to do. I’ll keep you at home for a few days.’

  ‘No, Mum, you can’t. I don’t want to stay at home. I need to go to school and keep up with work. I’ll just get bored at home. I’ll eat.’

  ‘Yesterday you promised Dad you’d eat but you had nothing for breakfast.’

  ‘I was just stressed about going to the doctor. I’ll have some cereal now. Don’t keep me at home, Mum. Let me go to school.’

  ‘Why are you doing this?’

  ‘What?’

  ‘Starving yourself. Why do you want to be so thin?’

  ‘I just decided to be healthier, that’s all. I don’t have anorexia. I was just a bit too strict on my diet, but I’ll stop now. It’s all fine, Mum.’

  ‘It’s not all fine, Ali. Dr Garner told me to take you to see a psychologist.’

  ‘What? I don’t need to see a psychologist, I’m not mad. Jesus, Mum, why do you have to overreact to everything? I’ve lost weight, not my mind.’

  ‘She thinks this woman will help you figure out why you’re not eating.’

  ‘Are you deaf? I’m not going to see a shrink.’

  I parked the car in front of the house. ‘Yes, Ali, you are.’

  She followed me into the kitchen. ‘Why are you trying to make me out to be crazy? OK, maybe my diet was too extreme, so I’ll stop now. Just leave it alone, Mum. Don’t start freaking out and sending me to see psychologists.’

  ‘You’ve been lying to us for months, Ali. I don’t know how to make you better, so I’m going to get help from people who can. I am not letting this go any further or get any worse. Don’t you get it? I’m trying to help you.’

  ‘I’m going to call Dad. He won’t let you send me to a shrink, I know he won’t.’

  ‘Go ahead.’ I handed her the phone. She knew she’d lost this battle.

  ‘I’ll talk to him when he gets home. I’m going to tell him what a psycho you’re being. I need to go to school now.’

  Ali went to change into her uniform and I made her lunch. When she came back in, I handed her the food. She rolled her eyes and threw it into her rucksack.

  ‘Please eat it. Please don’t throw it away. You need to work with me, not against me, Ali.’

  ‘Whatever. Can we go now?’ She avoided eye contact.

  We drove in silence to the school. Ali refused to talk to me, so I gave up. She sat with her arms crossed, looking furious. I had no idea how to get through to her. I dropped her at the front gate and watched her walk across the lawn into the school. Who was this stranger who had taken over my Ali?

  22

  I drove to work in a daze and sat in the car park, leaning back into the headrest. I tried to breathe in and out slowly to calm down. I felt as if my head was going to explode.

  Sally came out of the office and knocked on my car window. ‘Are you OK? I’ve called you a million times. How’s Ali?’

  I got out and she hugged me. ‘Let’s go inside. I need
a drink and a cigarette.’ I hadn’t smoked since I found out I was pregnant with Ali seventeen years ago, but I needed one now.

  Sally lit me a cigarette and opened a bottle of wine that we kept in a little fridge in the office. In between gulps, puffs and sobs, I filled her in on the last twenty-four hours.

  ‘Oh, Ava, I’m so sorry. Poor you. Poor Ali.’

  ‘When you started talking about your flatmate it was like a light bulb went on in my head. All of Ali’s weird behaviour suddenly made sense. How could I have been so stupid, Sally? I just thought she was a bit depressed because of David, but she was actually starving herself.’

  ‘Don’t blame yourself,’ Sally said. ‘Teenagers are always losing weight and being moody and Ali had a reason to be depressed – her first love broke up with her. How were you to know she was throwing out her lunch and running for miles every day at school? You can’t watch her all the time.’

  ‘She must have been hiding food in her napkin every time I turned my head, because I thought she was eating two slices of toast every morning as well as cereal. She’s been deceiving us for weeks … It’s so unlike her to be sneaky and manipulative.’

  ‘The important thing is that you’ve found out what’s wrong and you’re doing something about it. How’s Paul taking it?’

  ‘Last night he told me I was overreacting, but when Ali refused to eat this morning, he finally realized we have a problem. I’m raging with him for being so unsupportive.’

  ‘It’s harder for men to understand. They don’t obsess about weight the way we do.’

  ‘Do I talk about weight a lot?’

  ‘No, you don’t.’

  ‘Sometimes I squeeze my stomach and say I need to cut down on bread or start walking again. Do you think I could have given Ali a bad body image? She’s so bright and smart and beautiful I never worried about her, only ever about Sarah.’