Just then Direct Care walks in with a patient we have not seen before. She seems cold and exhausted, leaning almost entirely on Direct Care for support.
We make room for her on the couch. She lies down, wrapped in a thick woolen blanket I immediately associate with the inside of an ambulance. Curled into a ball, she closes her eyes. Without a word, Direct Care walks out.
The other girls, unfazed, return to their knitting, writing, napping, jumbles. I make to leave my armchair to welcome the new patient, but Julia touches my arm:
Not this one.
Not this one. Why not?
We call patients like that weekenders.
What patients like that?
What are weekenders?
Wry, sad smile. Jumbles aside. Julia leans in toward me. I do the same. She whispers:
Weekenders are patients who usually leave before you even realize they’re here. Involuntary admissions, most of them, and they tend to make that very clear. They’re either sad, angry, or sleeping on the couch. Behold Exhibit A.
Her dispassionate description suits the unnamed, shivering girl.
I try to stay away from them. Not a very lively bunch. Very, very sick girls.
Why do they leave so quickly then?
Because they are too sick to be here. They need to be hospitalized. Too thin, too sad, too many medical complications. Too far away in their heads.
How horrible.
You’ll see what I mean when this one wakes up. She’ll stare out the window for hours.
I do not like the term “this one.” I wish I knew the girl’s name.
Why are such patients brought here at all then?
Julia shrugs.
Wishful thinking mostly. I guess their families don’t realize how serious the situation is. Or want to.
She reflects further:
Sometimes they come here because insurance has not approved higher care. Sometimes it has, but there are no beds available in hospital psych wards. But if that’s the case, one should free up by tomorrow and the new girl will be transferred.
How do you know a bed will free up?
Someone is bound to die or be discharged,
comes the simple, callous reply.
How smoothly she had said it! I withdraw, appalled. Julia notices but does not take offense. She smiles sadly at my indignation and speaks again, this time softer:
Look, Anna, and look around you. Every patient is a tragedy here. It sucks, I know, but there are too many of us for me to cry over every one.
I understand. Julia is not jaded, just trying to protect herself. Choosing wisely where to invest her heart. She forces a smile and jokes:
Heck, if I should cry over someone, I would probably start with myself!
I do not laugh, but I lean back toward her. We are both quiet for a moment. When she speaks again she is not joking:
Actually, I would start with Emm.
Emm?
How come?
Because Emm is at the other end of the spectrum.
Across from us, we watch her knit.
Emm and 17 Swann Street go way back,
Julia says in a lower voice.
Yes, I remember: four years back. Julia continues:
She’s a regular. Knows this place by heart: the schedule, the rules, the rooms with the best view, the weekly menus, all the staff—they’re her friends.
Is that bad?
You tell me, hon. Is it bad that she knows that the smoothies are actually made from a powdered mix? Or which nurse will slip you antacids or, if you ask really nicely, sleeping pills?
I see where Julia is going with this.
Emm has been at 17 Swann so long it’s become part of her. Patients like her, the regulars, they … They get comfortable here.
That makes terrifying sense.
Four years at 17 Swann Street, in any place, and that place becomes home. Staff becomes family. Treatment becomes familiar. The schedule, even the menus become safe.
Most regulars never get discharged, and those who do know they will be back.
I nod. The real world is fraught with unrewarding jobs and hurtful relationships. Bills to be paid every month, food to be consumed every day. At least here in treatment the cook makes the meals and staff takes care of the dishes. Insurance pays rent and somebody else changes the lightbulbs and mows the lawn. The real world is lonely but here doctors have pills and therapists always have time to listen. I cannot believe I do, but in a way, I understand Emm.
Emm is still knitting. The movement is predictable, the pattern repeats itself. This is not real life, but perhaps she has no interest in pursuing one. Perhaps all-inclusive survival on this side of the walls is enough.
As for you,
Julia interrupts my thoughts,
you’re a different kind of patient. I think you’re one of the lucky ones.
Which ones?
The ones here for someone else.
Someone else, outside here, waiting for me at 45 Furstenberg Street.
You have a reason to survive,
Julia says casually as she reaches for her pouch and begins rummaging through it for gum.
See, Emm’s life is here, not outside these walls. And the girl on the couch doesn’t want one. You, with a little help and a little food in your belly … Dammit, I’m out of gum.
A reason to survive.
Never mind! False alarm!
She pops two pieces in her mouth at the same time and offers me one.
I shake my head slowly.
No, but thank you, Julia.
Silence for a moment, then I dare:
What about you?
What about me?
Pop.
What kind of patient are you?
She does not answer. I do not ask again.
31
The day is over, as is dinner, whatever dinner was. It is 7:20. I rush to my room, brush my teeth and my hair, dab a little bit of blush on my cheeks, one, two spritzes of perfume, then scramble down the stairs just as Matthias’s blue car pulls into the driveway.
He steps out of the car at 7:28, rings the doorbell at 7:30. It marks the beginning of the countdown: we have ninety precious minutes left.
He is well dressed and smells nice. I know that scent: tobacco musk. He knows mine: apple and jasmine. He kisses me at the door. Toothpaste.
I ask Direct Care for permission to sit outside with my husband. Permission laughingly granted,
So long as he has you back inside by evening snack!
I ask about his day. He says work was fine, and that our little orchid back home is as well. He declares being quite concerned, however, that it has not bloomed since last year. I try not to smile, but
I can see your mouth twitching, Anna, but you cannot imagine how worried I’ve been! I blame you for this, you know, buying us an orchid and then running off to treatment. Do you know what kind of matinenance orchids need?
Would you have preferred a cactus?
A cactus! Yes, a cactus! You have to be purposeful about letting a cactus die. When all this is over, I’ll buy you a cactus.
Haha! You have a deal.
He asks me about my day. I keep my account just as light. I tell him about a book I have been reading. I found it in community space.
Rilke. His poetry is magical. It transports me away from here.
Do you have time to read?
I do in the morning, after vitals and weights and before breakfast at eight. I love it. It is quiet and the sun rises and the Van Gogh room just lights up.
You always did like mornings best.
I did. I do.
Oh! Did I tell you? I went on the walk this morning.
How was it?
Too short, but freeing.
Are you making friends?
I laugh.
I am trying. Most keep to themselves, and we are all quite busy anyway.
Busy? What, with all the meals?
Once again, it strikes me how little Matthias, or any normal person, can understand. How little of an eating disorder the naked eye can actually see. Busy?
Yes busy,
to the point of exhaustion. Every bite and every thought is. But to anyone else, perhaps we just look like girls with bad eating habits.
Six times a day, Matthias.
And you’re doing it! I am proud of you, Anna. Don’t stop.
He beams, and I am suddenly gripped by fear: What if I do stop?
What if I let you down, Matthias?
I do not voice that thought. Instead:
This afternoon, I chose my cereal for tomorrow’s breakfast.