‘We are going to move her to the critical care unit and start treatment.’ He tapped the clipboard with the end of his pen and gave a forced smile, indicating the end of their discussion.
‘What is the treatment, exactly?’ Lockie spoke for them both.
‘We will give her – Lexi,’ he corrected, ‘nutrition via a feeding tube.’ He nodded matter-of-factly.
‘What do you mean by a feeding tube?’ Freya found her voice, wanting to understand. ‘Is it the same as drinking through a straw?’ She knew this had helped Lexi get her shakes down before.
The doctor gave a slight, almost imperceptible snort. ‘Not quite. It’s where we insert a tube through the nasal passage, down the oesophagus, and into the stomach. We then deliver nutrition directly to the stomach over a specified period of time via a pump.’
Lexi lifted her heavy head from the pillow. ‘No!’ she shouted with as much energy as she could muster, her body arching from the mattress, her distress causing her to writhe.
Freya placed her hand on her chest. ‘Calm down, Lex! You need to keep calm!’
‘Don’t . . . don’t let them, Mum! Please! Please! No!’ She fought for breath.
‘What are the alternatives?’ Freya looked from her child to the young doctor, silently pleading.
‘She has to take on nutrition, there’s no discussion to be had.’ He stood firm.
‘I can make her eat! I can! Just give me a bit of time, and if it doesn’t work then we can try your way, but please just give me a bit of time. Please.’ She looked at her daughter, who loosened her grip on the bedsheet, and saw her shoulders relax against the mattress.
‘What’s going to make her better the quickest?’ Lockie asked. ‘That’s what we need to understand.’
Freya shot him a look.
The doctor sighed. ‘I have to weigh the distress and reluctance factor against the benefits of a feeding tube. The goal is to get her to eat, and if her mother feels she can achieve that, then I’m happy to let her try, but if your daughter hasn’t taken on food within the next hour we’ll do it my way.’ He swept from the room.
Freya leant close to her daughter’s head. ‘Did you hear that, Lexi? You have one chance! You have to eat or they are going to make you, with a tube down your throat.’ Her own throat seemed to close at the thought.
Lexi nodded.
‘I can’t believe you almost pushed him to do that, Lockie. I can feed her!’ She raised her voice.
‘I wasn’t pushing for anything. I just want the best and quickest way to make her better. Can’t you see that? You are so desperate to avoid discomfort for her, upsetting her, that you are in danger of not seeing what will help her!’
She ignored him, unable to explain that every time she looked at her little girl, she saw her as a toddler who needed her protection. Two nurses arrived to wheel the bed to the critical care unit.
Freya’s telephone rang.
‘Mum?’
‘Yes, darling?
‘I’ve just finished school. You said you’d pick me up. Where are you?’
Her tears fell as she realised that yet again she had quite forgotten about Charlotte.
‘Charlotte, I am so sorry! Jump in a cab; there’s money in the jar on the sideboard in the kitchen. We will be home as soon as we can. Lexi isn’t well. I’m—’
‘Yeah, I know, Mum. You’re sorry. So you’ve said.’ She hung up the call.
‘Is she okay?’ Lockie looked angry.
She could only nod, unwilling to discuss another of her failures.
The smiling nurse delivered a banana-flavoured protein shake, a different make to the ones Lexi had been taking at home. Freya watched, amazed and horrified that even here, even now, Lexi propped herself up on her elbows and tried to read the nutrition label.
Freya turned it round, wary not only of her daughter’s reaction, but also of Lockie’s. She knew him well enough to see that his patience was being stretched.
‘Here we go, Lex. Let’s sit you up, darling.’ She reached behind and repositioned the pillows, before holding her daughter under the arm and lifting her light frame upwards. Placing the straw at Lexi’s mouth, she nodded and smiled, as if this might be enough to get her to drink.
‘I can’t, Mum!’ Lexi cried, fat tears rolling down her emaciated cheeks.
‘Yes, you can.’ She kept her tone level. ‘You can and you must. Let’s try again.’ She held the straw to her bottom lip, willing her to suck.
Please, Lexi! Please do this! Do it! I need you to; I don’t know how much longer I can keep things at bay. Please . . .
Lexi’s flow of tears made it almost impossible to draw breath, let alone take on food.
‘I don’t want that inside me. I don’t,’ Lexi mumbled, as if she were alone, caring little who heard or what the consequences might be.
Lockie stepped forward and sat by the side of the bed. ‘Enough, Lexi. Enough! You drink this shake and you keep it down. Because if you don’t they will put a tube down your throat and force you. What bit of that don’t you understand? They will put a tube down your throat!’ The hardened edge to his voice sprang from frustration, but did little to encourage his daughter.
‘Don’t get angry with her, Lockie!’ she barked. ‘It’s not helping!’
‘Angry?’ He bowed his head. It was only when he lifted his face that she saw it was streaked with tears, as he too cried.
‘Look at her!’ He let his eyes rove over her ravaged form, as he shook his head in desperation. ‘Look at my little girl! I just . . . I just want her to drink this. She has to. She has to, Freya, or they’ll hurt her! I can’t stand it.’
With his elbows resting on the mattress, he placed his face in his hands and sobbed.
Five hours . . .
Freya stared out of the window. She heard Lockie tread the stairs to the kitchen as she carefully chose her next piece to write.
I’ve been thinking about that day, Lex, that terrible day when you were taken to hospital. I shan’t ever forget it. I think that was the day I realised two things.
First, just how dangerous your illness was, that it could kill you, a thought I had managed to bury until that point.
Second, I understood that it didn’t matter how much Daddy, Charlotte and I loved you, how hard we tried to be a supportive family and make everything better: at best we could only offer a sticking plaster, and it was going to take a lot more outside intervention to make you better.
That was a tough one for me.
Up until that point, I believed that by giving you the odd protein shake and sneaking other food to you when we could, and the comforting chats with Hilary, it would all be okay. I knew it would take time, but I believed we could get there. This was the first time I questioned our approach.
I wasn’t banking on your determination. Crazy, really. You have always been very tenacious in your approach to just about everything.
When you were about four, you asked me if you could cut your hair; you were desperate to get hold of scissors. I told you that your hair was pretty and didn’t need cutting and I said it was dangerous, which only seemed to intrigue you more.
I should have suspected you were up to something when you went quiet on the topic, only to emerge from my bedroom with the front of your hair hacked off and big chunks missing from the back where your scalp was visible. I asked you if you’d cut your hair, and you shook your head and said, ‘No, Mummy,’ staring at me, as if this couldn’t have been further from your mind; and I would have fallen for the sweet, sincere denial had I not been staring at the evidence.
TEN
Freya had sat in the ward and listened to Dr Roberts, the psychiatrist who had been assigned to Lexi. He was an older man, kindly and unflustered, with little round metal-rimmed glasses that were too small for his large bearded face. No matter how well delivered, his words made her feel hopeless, picturing their life on this merry-go-round of destruction.
She spent hours lying awake at night, trying t
o fathom the dilemma. They had been told that anorexia was not about food, and the advice was not to make an issue out of Lexi’s eating and purging. But then the medical team hourly reminded her of the importance of getting her child to take on calories, reinforcing the message that, above all, Lexi had to consume food. Freya felt pulled in every direction, overwhelmed by doubt, and could only imagine what it felt like for Lexi, who was also battling her fear of eating.
Dr Roberts explained that, in his experience, people with eating disorders were usually experiencing underlying emotional distress, and were dealing with difficult life changes or past trauma. This sent Freya into a spin, analysing every month of Lexi’s fifteen years on the planet, trying desperately to spot the point when things had started to fall apart. What had they missed? She had even gripped Lexi’s hand: ‘Is there anything you want to tell me, darling? Any reason you can think of as to why you might have these feelings?’
Bracing herself for the answer, Freya hoped there was a reason, something she might be able to understand, while praying that there wasn’t, that nothing had hurt or damaged her little girl and that she hadn’t inadvertently committed a dreadful error. She wanted, above all else, to be a good mum.
Lexi had looked her in the eyes. ‘There’s nothing, Mum,’ came her heartbreaking reply. ‘I wish there was, in a way. I don’t know what it’s like for other people, I only know what it’s like for me, and I can’t help it.’
Freya couldn’t wait to see Dr Roberts again, telling him that she was unaware of any past trauma or difficult life changes, as if this might exonerate her parenting, absolve her of at least one layer of guilt.
Freya closed the curtains in Lexi’s bedroom and smiled at her daughter, who lay in her bed. Finally she was back home; this in itself was a huge achievement. In the nine weeks she had been in hospital, her weight had plateaued, and her resistance during hospital mealtimes had lessened, as if she’d accepted, begrudgingly, that this was the only way she would ever get home. It had been a stressful time. Freya had felt pulled: whether at home with Charlotte or sitting with Lexi, she always felt guilty that she was not with the other. It was a horrible no-win situation. She crawled into bed each night, weary from the travel, the lack of routine, and the gut-twisting worry about her children.
Much to Marcia’s annoyance, Freya had hardly worked, and left the daily running of the house and the ferrying of Charlotte back and forth from school to Lockie. She had eventually confided in Marcia, without giving too much detail, simply giving her enough information to let her know that they had hit a bump, crying as she outlined Lexi’s struggle, and crying some more with every word of sympathy her friend muttered.
Lockie and Charlotte took their meals on the fly or sourced them from the fish and chip shop; this was yet another avenue of food for her to feel guilty about.
‘Happy to be back?’
It was the first day out of hospital.
Lexi nodded as she shivered, her teeth rattling as she sank down lower on the bed.
‘Are you still cold?’
She nodded. This too was now familiar: Lexi’s lack of body fat meant she was invariably freezing.
Freya unfurled the patchwork quilt that had graced her parents’ bed and laid it over the two duvets that already held Lexi fast. Still she shivered.
She and Lockie had, after consultation with the specialist team, decided against referring Lexi to an in-patient facility, and the look of total relief on her daughter’s face told her this was the right choice. Instead, they were adopting an approach that meant she could stay in the family home.
The specialist explained it was a way of treating anorexia in a familiar environment, with treatment by the family, whilst still under the out-patient care of the hospital. A specially trained therapist would visit them, fully explain the plan to them and, most importantly, maintain the stance to Lexi that starvation was not an option. To them it made immediate sense to keep Lexi in her home environment, where phase one was for her to gain more weight. Freya felt anything was better than sending her to an in-patient facility. Lockie, however, had taken a little persuading; his resistance only provided more fuel to Freya’s fire. She was determined to make it work.
Their therapist was of Chinese heritage. She was a sober, efficient graduate called Iris, who had a strange sense of fashion but a wide smile and a calm manner that gave them confidence. She arrived one evening bringing bright-green tights, yellow shoes, a pink shirt and buckets of hope into their family home.
‘I shall merely observe tonight.’ She smiled. ‘Please go about your family meal as if I weren’t here and then we can chat afterwards. How does that sound?’ she asked as she took a seat at the countertop, pulled out her laptop and popped on her square-framed glasses.
Freya swallowed as she reached into the crisper for the veg. Her hand shook. ‘I feel like I’m taking a test that I don’t want to fail.’
Iris laughed. ‘I know, everyone says that. It takes a bit of getting used to. It’s not like I’ll be here for every meal, just a couple, to observe and help if I can, and more if you need me. But try not to think of it negatively. Just ignore me; we are on the same side and there is no right or wrong. You can’t fail: we can only learn what Lexi needs right now to thrive, and help put it in place.’
Her words were gratefully received, but in truth did little to calm Freya’s nerves.
Lockie looked sheepish as he came up from his studio and headed towards the fridge. ‘Hello, I’m Lockie. And you must be Iris?’
‘I am. Hello, Lockie, how are you?’
‘Nervous.’ He exhaled. ‘I want a beer with my supper, but fear that might earn me minus points.’
‘Not at all, you have to relax. Have your beer.’ She smiled.
‘Ah, “relax” . . . Yep, well, that’s certainly a lot easier to do when we are not being observed. There’s a knot in my gut when I think about what Lexi might do next. I’m also afraid of her slipping up again and ending up in hospital.’
Iris and Freya stared at him. It was rare for him to be so forthcoming with his emotions.
Iris pushed her glasses up on to her nose. ‘I know this is a difficult time, but as I was just saying to Freya, we are on the same side, presenting a unified front. This isn’t about scrutiny or blame; it’s about helping Lexi gain. That’s it, right now. That’s the goal.’
‘Okay.’ He nodded and pulled the dark-green bottle from the fridge door, flipping the lid with the bottle-opener end of the corkscrew.
‘How you doing, Lexi?’ Iris smiled and crossed her legs on the stool as Lexi skulked in. Her flared pyjama bottoms dragged on the floor and the hood on her grey Jack Wills sweatshirt was pulled up, hiding her hair and half her face.
Lexi stared at her with a look of naked aggression that Freya hadn’t seen before, and her heart sank. She swallowed the desire to tell her to be nice, to make Iris welcome; this was, after all, a therapist, here to observe, and not simply an extra guest for dinner.
‘Ooh, lovely,’ Charlotte sang as she sat down. ‘What are we having? I’m starving.’ She had been briefed on Iris’s visit.
‘I hate you, Charlotte!’ Lexi yelled. Her anger, volume and choice of words were so entirely out of character that the whole room went quiet, as each looked from one to the other, trying to figure out what might come next.
It was Lockie who found his voice. ‘Ignore her, Charlotte. That is a horrible thing to say, and I feel sad, Lexi, that this is how you choose to talk to your sister.’
Freya kept her eyes downcast as she served the chicken breast, steamed vegetables and spicy rice on to the plates and set them down with a trembling hand. Charlotte began eating straight away, carefully avoiding eye contact with her little sister, a stranger to them all.
Freya didn’t know whether to comment on the fact that Lexi placed her hands in the front pocket of her hoodie, determined not to eat. She sat next to Lockie, knowing the only way to get through this family therapy session was with their thig
hs touching under the table, providing not only comforting contact, but also a steady anchor when it felt as if everything was in free fall.
It took all her strength to smile and make small talk, bracing herself, waiting for the next heavy, blunted act of aggression to hit her on the side of the head.
‘Eat up, Lexi,’ Lockie commanded.
‘I don’t want it,’ she snapped petulantly, pushing her plate a little further on to the table.
‘I understand, but it’s not about what you want anymore, it’s about what you need. Do you want me to feed you?’ His offer was sincere, as if the issue might lie in the actual cutting and lifting of the food.
Lexi snorted her reply. ‘No!’ She looked and sounded like a frightened toddler.
‘Okay, then cut the food into pieces and make a start. You are not leaving the table until that plate is clear, and it will be more palatable when it’s warm.’ He remained articulate and cool, whilst cutting into his own food.
Lexi’s anger then turned to distress; her tears seemed to make further protest hard. Freya noted the way her eyes strayed to Iris, confirming not only her embarrassment at the display in front of their visitor, but also that she was still a little girl, just a confused one.
It was heartbreaking.
Freya caught Iris’s eye. The therapist gave her a small nod of approval. They were all doing fine.
It was a little after ten that evening. Iris had been waved off an hour or so before, and Freya finally finished up the dishes and was clearing the kitchen. Lockie completed the picture edit he was working on. The two slumped wearily on the sofa in the den. Lockie ran his hand over his face and hooked his hands behind his head with his eyes closed and his glasses on the table.
‘An hour and a half we sat at that table,’ he lamented. ‘I wanted so badly to say, “Okay, just leave it!” but I knew that if we gave in this time, we’d give in every time.’
The Food of Love Page 17
