Thin

by Alicia Michaels

  Nodding in acknowledgement of that unsolicited info, I went back to my lettuce. It didn’t escape my notice that Derek slid a napkin filled with fresh-baked cookies into his pocket before leaving the dining room. However, I kept my mouth shut. It wasn’t my place to snitch or to judge.

  After dinner, I said good night to everyone and retreated to my room. After a quick shower, I fell into bed at eight o’clock with a paperback I’d borrowed from the rec-room library. Electronics that can communicate with the outside world were banned, so I’d had to leave my e-reader behind. Still, I found the aroma of old pages and their feel at my fingertips comforting. I fell asleep mid-sentence.

  The morning brought a cheerful, bouncy nurse aide named Sheila to my room. While I got dressed in the bathroom, she made my bed and chattered. Through the closed door, I gathered that she was a single mom with three teenage kids, and had been working as a certified nurse’s aide for sixteen years. When I emerged, she was waiting for me, a clipboard containing a list resting in one hand. The woman stood short and a bit round, with adorable, plump cheeks and twinkling eyes. She reminded me of everyone’s favorite neighborhood mom—the one who bakes cookies, lets her kids’ friends hang out at her house, and keeps the best snacks in her fridge.

  “So, you and me will be joined at the hip today,” she said. “I’ll escort you to your various appointments. We’ll get as much done as we can before taking a lunch break, then we’ll get back at it. The goal is to finish all your testing by the end of the day, so your team can meet and formulate your action plan. It’s going to be a rough day, but I’m here for whatever you need. Even snacks!”

  Reaching into the front pocket of her scrub top, she produced two granola bars and smiled before handing me one.

  “Here’s your breakfast. Okay, honey, let’s get this show on the road.”

  Following her to the elevator, I engaged in idle small talk with Sheila, who seemed very interested in my life. After filling her in about school and my post-graduation plans—I found myself dropped off with the first of many doctors that would poke and prod me.

  My first exam turned out to be a regular checkup. After being measured, weighed, suffering through a round of questions, and submitting to having my eyes, nose, ears, and throat checked, I was sent down the hall for a cardiac assessment. I lay on my side for over half an hour while this doctor performed an echocardiogram—causing my protruding hip bone to ache by the time I could stand again. I was then ushered to a small chamber next door, where I was hooked up to monitors for a stress test.

  Seeing as how I hadn’t exercised in months, I found myself struggling to even pedal the stationary bike. The mask agitated my face, but I couldn’t take it off. Hooked up to it, along with electrodes on my back and chest hooked up to various wires, a blood pressure cuff and a little band around my index finger keeping track of my pulse, I felt like some sort of lab rat. By the time the bicycle ride ended, I was drenched in sweat, my hair beginning to frizz at my forehead and temples. Sheila met me with a bottle of water and a sunny smile, letting me know there was one more stop to make before lunch.

  This doctor was a gastroenterologist, who ran tests to see how badly I’d damaged my stomach, esophagus, and throat with my constant purging.

  Our time in the cafeteria was short, with Sheila taking advantage of the offered taco bar, while I filled a small bowl with fruit and drank my water.

  The remaining afternoon passed much faster, with my remaining appointments being less stressful than the first. A phlebotomist took several vials of my blood, while an OBGYN asked me intrusive questions about my period and did an ultrasound to check on all my girlie parts. My last three stops were with an orthopedist who subjected me to a bone density scan, a nutritionist who questioned me about my daily eating habits, and a psychologist who asked me a round of questions about my mental state.

  Sheila and I parted ways, as it was the end of her shift, and I skipped dinner in favor of my bed. I didn’t even bother trying to read my book this time, simply curling up and hugging my pillow tight while exhaustion claimed me. The stressful day had taken a lot out of me, and I just wanted to sleep—possibly never waking up again.

  I didn’t know if my fatigue was due to depression, my ridiculously low-calorie diet, or my long day. All I knew was that I missed having the energy to do things, yet had no notion of how to become that girl again.

  Chapter Five

  My first meeting with the treatment team assigned to me was scheduled for the morning after my round of appointments. Seated at the foot of a long conference table with various doctors, I couldn’t help but feel intimidated. Dr. Swanson sat at the head, with the nutritionist, phycologist, and cardiac specialist flanking her on either side. Seated to my left was a man I had yet to meet. Based on the sweats he wore and the jock-guy vibes he put off, I guessed he was a personal trainer of some sort.

  A clipboard sat in front of me holding a stack of papers. The one on top read ‘Nutrition Plan: Kinsley Simmons’.

  Dr. Swanson smiled at me from across the table. “Kinsley, after your assessments, your team met with me to put together a holistic plan for your recovery. Each member of your team will oversee a different aspect of your treatment, and we will reconvene after thirty days, then again at sixty to reevaluate your plan and make adjustments as necessary. We’ll meet one last time at the end of your ninety days to put together an outpatient plan. If you’re ready, we’ll go over the plan now.”

  I shrugged. “I’m all ears.”

  The slender blonde nutritionist—who had introduced herself to me as Dr. Edwards—spoke up first. “On top of the stack you’ll notice the meal plan. I’m not going to ask you to count calories, or follow a strict eating regimen. What I will do, is ask you to try to follow those guidelines as closely as possible when you fix your plates at mealtime. The goal is to have you eating three square meals and two to three healthy snacks a day.”

  I quickly did the math in my head and estimated this new plan required me to eat something every four hours. Glancing down at her meal plan I cringed. For breakfast I was supposed to have one serving of dairy, a serving of fruit, and one carbohydrate rich food. Dairy and carbs … my two Achilles heels. And that was only breakfast; lunch and dinner required things like fats and oils.

  I must have looked as sick as I was feeling on the inside, because she reached out to place one hand over mine.

  “It’s intimidating, I know. But we just want you to take this one meal at a time, one day at a time. If you put these items on your plate and can’t eat them all … well, that’s okay. All I ask is that you try. Can you do that, Kinsley?”

  I nodded, though I wasn’t entirely certain I was telling the truth. I might eat the food, but there were no guarantees it would stay down.

  “This is your food journal,” she said, sliding a small, pocket-size notebook across the table toward me. “There’s a smaller copy of your meal plan taped to the inside. The journal isn’t for anyone to look at but you. As the days and weeks go by, I hope you’ll start to notice a change in your habits.”

  I accepted the notebook and placed it next to my stack of papers. I flipped to the next packet and found a sheet for logging physical activity.

  The guy in the sweats cleared his throat and spoke up. “I’m Randy, and I’ll be overseeing your fitness regimen while you’re here. We keep things pretty low key. There’s no pressure to do one thing or another. All I ask for, right now, is twenty minutes of some kind of activity in the morning after breakfast. Anything you want, as long as you do it for twenty minutes. We usually head outside together after everyone’s done eating as a group and everyone breaks up and does what they like. If you don’t want to do tennis, basketball, or walk on the track, there’s a gym on the therapy floor, the pool in the basement … there are options. The log will help us both keep track of what you’re doing. Just fill it out once a day with the activity and how long you did it for. It’s not about losing weight … I’m not going to measur
e you or anything like that. The key is to get you active. Okay?”

  Just thinking about walking any farther than the elevator made me tired. It seemed I couldn’t find enough energy to do much of anything these days. Still, I nodded along in agreement, not ready to voice my doubts over any of this yet.

  Dr. Iverson, who had assessed my mental health, was next up to bat. “Kinsley, I’d like to try a combination of oral medication, as well as individual and group therapy. I agree with your previous doctor’s assessment … you suffer from Obsessive Compulsive Disorder, and it’s manifested itself in your behavior as an eating disorder. I believe oral medication will lessen your urge to binge and purge. It’ll also work wonders for your depression, and I hope, give you more energy. I see here in your records that you’ve tried amitriptyline without success. Tell me about that.”

  Uncomfortable having so many eyes on me while my personal issues were being discussed in a room full of people, I lowered my gaze to the table.

  “Dr. Brown prescribed it, and I eventually stopped taking it. I didn’t like the way it made me feel.”

  Adjusting his glasses, Dr. Iverson nodded in understanding. “Drowsiness? Mood swings?”

  I nodded. “Yes. I could hardly function from being so tired, and my mood would flip at the drop of a hat.”

  “Those side effects are normal with anti-depressants. However, I’d like to try a different drug for you. Would you be willing to try fluoxetine? Different people respond to different meds in their own ways. Your body might handle fluoxetine better.”

  I shrugged. “It’s worth a shot.”

  “Give it thirty days,” he instructed, “starting today. If you don’t like it, we’ll try something else. You’ll take it at night, and that should help with the daytime drowsiness. Aside from the medication, I’d like you to attend group therapy twice a week, as well as individual sessions, also twice a week. Your group therapy sessions will be Mondays and Wednesdays at one p.m., and your individual sessions will be at the same times on Tuesdays and Thursdays. I’d also like you to explore some adjunct therapy options in your free time. That packet in your file has a schedule of all the different classes we offer here as a form of therapy. There’s art, cooking, sculpture, music … I’d like to see you select one or two, and attend those classes. We’ll discuss how they may or may not be helping you during our sessions.”

  Art and cooking I could handle … but group therapy? The only thing I wanted less than one-on-one therapy, was to sit in a circle with a bunch of other people and talk about my problems. It didn’t matter that everyone here suffered from some form of the same illness. They might as well have asked me to get naked in front of everybody.

  “Sounds good,” I said, just to be able to move on. I could digest the rest of this later.

  “I’ll continue to monitor your overall health during this process,” chimed in Doctor Adams, who was going to be my general doctor while I was here. “Your bone density scan had good results, which means you haven’t done enough damage to your body that it’s affected your bones. However, your heart is seeing some wear and tear due to abuse of diet pills. I think regular cardio and a healthy diet will be enough to save you from any lasting problems.” He gestured toward the cardiac specialist, who sat beside him at the long table. “Dr. James and I will work to continue monitoring your heart health while you’re here.”

  Glancing back down at my chart, he continued. “You reported that you haven’t had a menstrual cycle in three months … is that correct?”

  My face went hot, but I nodded. There had been a time I would have been grateful to be done with PMS and cramps, but not having a period just reminded me how badly I’d been treating my body.

  “Your ultrasound had promising results. I’m confident that if you stick to your nutrition, exercise, and therapy plans, your body will rebound and you’ll see regular menstrual cycles every month. You aren’t so far gone that we need to worry about infertility, however, I must caution you that it is a possibility if you don’t change your habits. To help things along, I’d like to prescribe you birth control pills. The additional hormones will be a nice boost and get you on your way. How do you feel about that?”

  “I’ve never tried the pill before, so it’s worth a shot,” I replied. “Let’s do it.”

  “I know this seems a bit daunting,” Doctor Swanson spoke up from the head of the table. “But we are going to take this one day at a time, without worrying about any specific goals or milestones. Do you have any questions, Kinsley?”

  Only like one hundred. Foremost in my mind was: How the hell do you expect me to do all this when I can’t even think past getting out of bed in the morning?

  However, I wouldn’t voice any of that aloud right now. I supposed therapy would be as good a chance as any to voice my worries that I would fail at this. The plan was solid. I could find no fault with it. I was the X-factor here.

  Chapter Six

  My first full day on the program was a Wednesday—which meant I had group therapy to look forward to. As I rose to shower and dress for my day, I tried not to think about it too much. I still had breakfast, exercise, and lunch to get through before I needed to worry about it.

  “One step at a time,” I told myself.

  I was going to have to do this if I wanted to get home to my friends, college, and Aaron. I would take this challenge on as I had every other I’d faced—with determination to come out on top. I was not going to let this thing continue to beat me.

  As I chose a fresh set of sweats to wear for the day, I wondered when the new meds would start working their magic. I sure could have used some of that extra energy Dr. Iverson claimed this new pill would give me. Even after a full eight hours of sleep, I was exhausted, wanting nothing more than to climb back into bed and snooze for the rest of the day. The hunger gnawing on my insides urged me to keep it moving, quickly showering, dressing, and pulling my hair into a ponytail. Slipping the little journal my nutritionist had given me into the pocket of my sweats, I left my room and found the hall filled with others headed in the same direction as me.

  Dawn exited her room at almost the same time as me. Smiling, she reached out and took my arm, linking hers around it and slowing to match my pace.

  “Anyone ever tell you that you look prettier when you smile?” she said. “Frowning gives you lines and wrinkles.”

  Before I could reply, we came to the intersection between the boys’ wing and the girls’, finding Derek waiting for us. Draping an arm around my shoulder, he fell in step with us.

  “She could always get Botox, like your mom,” he said.

  “No one is getting Botox,” I replied, unable to help my grin at Derek’s snide remark. I was fast coming to love the guy. “And I didn’t realize I was frowning. I’m just … nervous about this group therapy thing. What’s that like?”

  “Well, I’m in the overeaters group,” Derek declared as we came to a stop before the bay of elevators, waiting for one of the four of them to come up. Others clustered near the metal doors, waiting for one to open.

  “That means they all sit in a circle and compare who can fit the most Oreos in their mouth,” Dawn muttered, wrinkling her nose at Derek.

  “Bet you my food tastes better going down than yours does coming up, Slim Jim.”

  “Yeah, well no one’s going to have to dig me out of my apartment with a crane someday, Pillsbury Hoe-Boy.”

  Derek put one hand on his hip. “This Hoe-Boy is getting more action than you, miss thing.”

  The elevator opened, and they stepped on, leaving me behind. They’d stunned me, and I had needed a second to recover. Realizing my shock, Dawn reached out to grab my arm, pulling me through the open doors.

  “Honey, relax. Me and Derek have been busting each other’s balls for months. This is his second attempt at the ninety-day program, and you already know how long I’ve been here. When you’ve dealt with this problem for as long as we have, you either learn to laugh about it, or let it break
you.”

  “What Twiggy Smalls here is trying to say,” Derek added, “is that ragging on each other gets us through the day. You’re welcome to join the club if you’d like. I’m fat and gay, which leaves me open for all kinds of jokes.”

  My stomach experienced the dropping sensation of downward movement as the elevator carried us to the recreation and dining hall floor. Derek and Dawn were no Jenn and Chloe, but they would do. It was nice to have something to make me laugh in a place like this. I tried to relax a bit as we stepped off the elevator. I still felt like a stranger here, but I was going to have to adjust. This would be my home for the next ninety days.

  “I’ll be sure to come up with a few one-liners in my downtime,” I assured them as we headed toward the dining hall.

  The scent of different foods slapped me in the face when we walked through the doors, making my stomach turn for a moment. I paused, biting back nausea and giving myself a chance to adjust. It wasn’t that the food didn’t smell good … the problem was that it smelled fantastic. My first instinct was to run for my life. The guilt of eating the waffles and pancakes I smelled would surely drive me over the toilet. Closing my eyes, I took a few slow breaths and clenched my fists to stop the itching and twitching of my fingers.

  “One dairy item, one complex carb, one fruit,” I recited out loud to myself. “I can do this.”

  Opening my eyes, I found Derek and Dawn had gone ahead of me, getting in line and grabbing their trays. Someone jumped in between us, but I fell in behind them, taking up the large red tray and sliding it along the metal railing built along the side of the buffet. As I skimmed the offerings in front of me, I took my time with my decisions. I took so long, a few people actually grabbed their trays and moved around me to get to whatever they wanted. By the time I joined my newfound friends at the table, Derek had already eaten two pancakes, and Dawn had peeled open a container of yogurt and sat mixing it about with her spoon. I never actually saw her take a bite, though.