Brave Girl Eating_A Family's Struggle with Anorexia

chapter one

Down the Rabbit Hole

Starvation affects the whole organism and its results may be described in the anatomical, biochemical, physiological, and psychological frames of reference.
—ANCEL KEYS, from The Biology of Starvation
My daughter Kitty stands by my bed. It’s Saturday night, close to midnight, and I’m trying—and failing—to fall asleep. Even in the dark, even before she speaks, I can tell Kitty’s worried. I sit up, turn on the light, fumble for my glasses. Kitty’s hand is on her chest. “Mommy?” she says, her voice rising in a way that instantly lifts the hairs on the back of my neck. “My heart feels funny.” There’s fear in her deep brown eyes, different from the anxiety I’ve been seeing since this nightmare started. A month ago? Two months ago? I can’t remember a beginning, a discrete dividing line separating before from after. There’s only now. And now is suddenly not good at all.
“Funny how?” I ask, wrapping my arm around her narrow back. I could lift her easily. I could run with her in my arms.
Kitty shakes her head. Closing her eyes, so huge in her gaunt face, she digs the point of her chin into my shoulder as I reach for the phone to call the pediatrician. I know, the way you know these things, that this is serious, that we will need more than soothing words tonight.
Dr. Beth, as I’ll call her, phones back right away and tells me to get Kitty to the emergency room. She’ll let them know we’re coming, she says; she’ll tell them about Kitty. About Kitty’s anorexia, she means. I grab Kitty’s sweatshirt, because she’s freezing despite the 90-degree heat. I slip on shoes (a sandal and a sneaker, as I later discover), shake my husband, Jamie, awake. He wants to come to the hospital, but someone has to stay home with Emma, our sleeping ten-year-old. “Call me when you know something,” he says, and I’m out the door, the car screeching through the rain-slicked streets of our small midwestern city.
Six months ago I barely knew what anorexia was. Six months ago my daughter Kitty seemed to have it all going for her: she was a straight-A student and a competitive gymnast; she loved friends, books, horses, and any kind of adventure, more or less in that order. One of her most noticeable traits, since toddlerhood, has been her reasonableness. I’ve seen this quality emerge in her again and again, even at times when I would have expected her to be unreasonable—at age two, being told we weren’t going to buy a particular doll; at age five, tired from a long train ride. I’ve watched thought battle feelings in her for a long time, and reason has nearly always won out, a fact that has, over the years, concerned me at times: Aren’t toddlers supposed to be unreasonable? Don’t kids have to go through the terrible twos, the unruly threes, the rebellious twelves?
Which is why Kitty’s recent lack of reason when it comes to food and eating has been all the more puzzling. We’ve talked about it again and again: How her body needs fuel to keep going, especially since she’s an athlete. How food is good for her, not something to be afraid of. How human beings are meant to eat everything in moderation. Including dessert.
Even now, I don’t truly understand why Kitty can’t pick up a fork and eat the way she used to, why she is suddenly obsessed with calories and getting fat. She’s never been fat; no one’s ever made fun of her because of her weight. She has always loved to eat. In one of our favorite family stories, Kitty, age four, ordered a huge bowl of mussels in a restaurant one night and devoured them, licking the insides of the shiny dark shells. The chef came out of the kitchen to see the child with the adult palate and sent out a bowl of chocolate ice cream in appreciation. Which Kitty finished.
I still don’t understand, but I’m beginning to know. To recognize the sick feeling in my stomach each time we sit down at the table and Kitty does not eat. I’m beginning to be able to predict how each meal will go: Jamie and I will take turns cajoling, pleading, ordering our daughter to eat, and she will turn aside everything we say with the skill of a fencer parrying a lunge. She will eat a few bites of lettuce, a handful of dry ramen noodles. She will count out six grapes and consume them with infinite slowness, peeling each one into strips and sucking it dry. She will pour her milk down the sink when she thinks we’re not looking, allow herself only five sips of water.
And at the end of the meal, she will climb the stairs to her room and do a hundred extra sit-ups, penance for the sin of feeding herself even these scraps. Which would not keep a dog alive.
Which will not keep her alive, either.
Kitty sits next to me in the front seat, her lank blond hair scraped back in a ponytail, looking small and lost in the oversized sweatshirt that fit her six months ago. “I’m dizzy, Mommy,” she murmurs. I keep one hand on the wheel, the other on her, as if I can keep her from floating away. My brain seems to divide as I drive, so that while part of me is watching the road, hitting the gas and brake, another part is thinking Don’t die. Please don’t die.
The triage nurse is waiting when we hustle into the emergency room. She has my daughter on a gurney, sweatshirt off, hooked up to the EKG machine, within minutes. Kitty trembles in the hospital air-conditioning, goose bumps rising along arms so thin they look like Popsicle sticks. She clutches my hand, the sharp bones of her fingers leaving bruises, as the nurse applies goo and deftly arranges the sensors across her chest.
“Don’t leave me,” she says, and I promise. They’ll have to handcuff me to get me out of the room this time.


I’d left the room a few months earlier, at Kitty’s fourteen-year-old checkup, trying to be a good mother, a wise mother, a nonhelicoptering mother. The truth is, I was worried about Kitty’s weight. She’d always been on the small side, built lean. When she turned eleven, she’d gained a little weight as her body got ready to grow. It wasn’t much, maybe five or six pounds, but Kitty was unhappy about it. That was the first time she talked about not liking how she looked, at least to us. Of course Jamie and I reassured her, reminding her that this was her body’s way of getting ready to develop, that she’d be healthy and strong no matter what shape or size she was meant to be.
She was in sixth grade at the time, the first year of middle school, and the emphasis in health class, then as now, was on obesity. The sixth graders were weighed, their BMIs calculated, their fat measured with calipers. They learned about calories and nutrition, all from the cautionary perspective of too much rather than not enough. So it didn’t surprise us when Kitty came home one day and announced that she was cutting out desserts because they weren’t “healthy.”
I thought it might be a good idea. I applauded her discipline and willpower. Like most women in America, I’ve had a conflicted relationship with food and eating. Like most women in my family, I’m short and plump and have a sweet tooth. And like most mothers of my generation, I was determined that my kids would be healthier than me. My children would breathe in no secondhand smoke; they would always wear seat belts and bike helmets and eat organic food as much as possible. I baked Kitty’s first birthday cake myself, a homemade concoction of carrots and raisins, using applesauce instead of oil and a quarter of the sugar the recipe called for because I didn’t want my baby getting a taste for the hard stuff. Our photos from the big day show a sagging Leaning-Tower-of-Pisa construction with barely enough icing to cover the 100 percent whole wheat dough. Very kindly, none of Kitty’s grandparents criticized the cake. But nobody ate it, either. Not even the birthday girl. Not even me.
My views had evolved since then. All things in moderation, as Aristotle advised. Still, we probably ate too much sugar; less, in this case, might be more.
If I’d understood what was to come, I would have served dessert at every meal. I’d have bought an ice cream maker, taken up cake decorating. I’d have whipped up brownies and cookies every week. Every day. Hell—I might have opened my own bakery.
Kitty’s worries about being fat seemed to dissipate by the end of sixth grade. She grew an inch and put on some muscle after joining a gymnastics team. But at her checkup that December, she weighed half a pound less than she had the year before, despite the fact that she was taller.
“Isn’t she too thin?” I asked the pediatrician.
Dr. Beth is a small woman, short, with streaked blond hair and laugh lines at the corners of her eyes. She looked over my daughter’s vitals and her chart. She soon had Kitty laughing and chatting about school and gymnastics and friends. While they talked, Dr. Beth plotted her growth on a chart and showed me that Kitty had gone from the 50th percentile in weight to about the 42nd—not a big drop, and probably, she explained, just a blip, a temporary dip in the curve. She’d dropped in percentile that way between ages nine and ten, though she hadn’t actually lost any weight that time. Still, said Dr. Beth, this was probably within the range of normal adolescent growth.
“She’s just naturally thin,” she said. Then she asked me to leave the room so she and Kitty could talk privately. That, too, was a first, a sign of Kitty’s growing autonomy. A sign that she had her own life now, and that as her mother, there were things I was no longer privy to.
But sitting in the waiting room, I felt more worried, not less, and I didn’t know why. Was I being overprotective? I told myself the doctor knew best. I reminded myself to be proud of Kitty’s maturity and good sense. Proud of myself and Jamie, for the hard work of raising her so far. If I felt a pang at the thought that our work was nearly done, that Kitty was growing up, well, that was my problem and my issue, wasn’t it?
So why did I feel so uneasy?
Fast-forward four months, to April. Kitty was fourteen years old, with shiny blond hair that fell below her shoulders and dark eyes flecked with gold. She was, as she had been since birth, a compulsively curious person, physically and intellectually adventurous. Her goal was to be a lawyer, and she already knew where she wanted to go to law school: Columbia, because more than anything, she wanted to live in New York City. Which is why it was so much fun to take her to New York that spring, just the two of us. We stayed with friends, shopped, saw a play. And we ate: Indian dinners and sushi, bowls of pasta in alfredo sauce, creamy gelato—far better food than anything we could get back in the Midwest.
When I got the photos back the week after our trip, I thought Kitty looked taller. Or, possibly, a little thinner. In every picture, though, she was smiling broadly, one arm looped through mine. The image of happy confidence.


The triage nurse raises the strip of the paper and studies the zigzagging lines that hold the answer of what will happen next to Kitty. Then she busies herself tidying up the gurney. “Wait outside,” she says briskly to both of us. “The doctor will come get you.”
I pull Kitty’s shirt over her bony chest and button it, slide her arms into her sweatshirt the way I did when she was a little girl, zip it all the way up again. It’s not enough to keep her warm. I wrap my arm around her and she leans on me as we make our way back out to the waiting room. The TV’s on, mounted high in one corner of the room, the sound off, and we turn our faces toward it, toward the light and normalcy it represents. The images on the screen might as well be scenes from a foreign film, like the filmstrips shown in grade-school social studies classes, the kind of movies that establish firmly the otherness of the lives on-screen even as the script tries to make them seem just like us. Now we’re the others, our lives unimaginably far from the brightly colored lives on-screen. Now we’re the ones to be studied. Dissected. Pitied.


On Mother’s Day—only two months ago, now—we planned a family bike ride. Emma had recently gotten good enough on a two-wheeler to keep up with the rest of us. And so we set out after lunch on a warm Sunday afternoon. Our route was an easy eight-mile ride; even with lots of water breaks, it shouldn’t have taken more than two hours. But almost as soon as we hit the bike trail, half a mile from our house, Kitty began to cry. Not a few sniffles, either, but full-out hysterical sobbing.
We stopped right away. “What happened?” I asked. She’d been fine at home, ten minutes earlier. “What’s wrong?”
“I don’t know!” she wailed. She wouldn’t, or couldn’t, tell Jamie or me what was wrong.
After twenty minutes of sitting by the side of the trail, Jamie asked, “Should we go home?”
“I don’t want to ruin Mother’s Day!” sobbed Kitty, getting back on her bike. Off we pedaled. Five minutes later, the same thing happened again. On and on Kitty wept, and we watched helplessly.
After an hour, we’d made it to a small concrete gazebo in the middle of a playground in a subdivision of McMansions. The gazebo offered the only shade in sight, and we huddled under its small roof, rubbing Kitty’s back, trying to get her to drink (she insisted she wasn’t thirsty), trying to figure out what had gone so suddenly and bewilderingly wrong. “I don’t know,” she said, over and over, as tears literally squirted from her eyes and down her cheeks. “I don’t know! I’m sorry!”
She didn’t want to go home, but she couldn’t ride. And so we sat in the gazebo. And sat. The rest of us ate our snacks and drained our water bottles and still Kitty cried. Ten-year-old Emma lay on her back on the picnic table, shredding the season’s first dandelion, kicking the top of the table in frustration. I could feel my empathy begin to wane. By now all I wanted for Mother’s Day was to be sitting in air-conditioning with a book and a glass of ice water. Preferably alone.
Eventually we persuaded Kitty onto her bike and began to pedal home slowly. As soon as we got there Emma disappeared into the house, slamming her bedroom door behind her. I would have loved to do the same thing. Instead, I wheeled my bike into the garage. “Tell me what’s wrong,” I said to Kitty, propping the kickstand. “What’s going on?”
We sat down on the garage floor, surrounded by stacks of skis and bikes, garden tools, piles of the boards Jamie used to make furniture. Kitty laid her head in my lap the way she used to when she was a toddler. Lately she’d been both insecure and clingy. She reached for my hand constantly, wanting to link arms, walk in step. She hovered when I cooked dinner. Was this normal, I wondered? Weren’t fourteen-year-olds supposed to be pulling away? She did spend a lot of time alone in her room, where she’d created a rigorous gymnastics training regimen that involved doing hundreds of push-ups, V-ups, and chin-ups a day. And she was out of the house four or five nights a week at the gym, practicing with her team from six to nine, eating dinner by herself every night around five. When she got home at 9:30, she did homework or fell into bed.
Kitty had always been wired for action. She hadn’t slept through the night until she was four. Maybe this was just more of who she was—wide awake, sensitive, tuned in. Sitting on the cool cement floor of the garage, I stroked her hair, noticing that her skin was chilled and dry, even in the heat.
“What is it?” I asked. “What’s wrong? You can tell me, you know. No matter what it is.”
Her eyes were squeezed tight, as if in pain. Tears streamed down her cheeks. “I’m afraid, Mommy,” she whispered.
“Afraid of what?” I asked.
She raised one arm and laid it across her eyes. “Remember I told you that my Spanish teacher has OCD?” she asked. I nodded; the Spanish teacher was Kitty’s favorite this year, and we’d been hearing a lot about her idiosyncrasies.
“And remember I told you she has to rearrange the chairs and desks so they’re lined up exactly?” Kitty continued. “She says if things aren’t lined up, she gets really worried and she can’t stop thinking about it until she fixes it.”
“Yes,” I said, wondering where this was going.
“I think I have OCD, too,” she whispered.
This was…unexpected. “Why?” I asked.
“Because I can’t stop worrying!”
“Worrying about what?”
She shook her head, her eyes still hidden from me, and said no more.
I told her I’d noticed she seemed a little worried lately. And I had noticed, because Kitty had never seemed fearful or anxious before. Cautious, yes; she was the kind of toddler who watched and waited rather than throwing herself into a new activity, who studied the stairs for weeks and then one day walked down them carefully, perfectly, one step at a time. But she loved travel, meeting new people, going places. She wasn’t shy or nervous; she’d never been afraid of the dark, or burglars, or dogs. I would never have described Kitty as anxious, and anxiety is something I know a lot about, because I’ve had panic disorder my whole life. But Kitty was nothing like I’d been as a child. At age eight, she insisted on going to overnight camp for two weeks and wasn’t homesick at all.
“How about if we go talk to someone?” I asked her now. “About the OCD thing.”
Kitty was shaking her head before I finished. “I’m not crazy!” she insisted.
“Of course you’re not crazy,” I said. “It’s not about crazy. Everyone needs a little help at some point.”
She said she wouldn’t talk to anyone and she didn’t need any help. She just needed more Mommy time, that was all. I didn’t point out that we’d just spent four hours together and she’d done nothing but cry. Instead I handed her a tissue and said, “If you change your mind—”
She blinked. “I just want to talk to you about it,” she said. “Only you. Promise me.”
“Of course,” I said. I hardly knew what I was saying.
She scrambled out of my lap and ran into the house.
That night Jamie and I went over the conversation again and again. What was really going on with Kitty? He hadn’t noticed her counting or arranging things, or showing other symptoms of OCD, and neither had I. But something was making her worry.
Maybe we’d never know. After all, we told each other, she was fourteen, an age one friend described as “the lost year.” Her daughter spent most of her fifteenth year in her room, coming out only to snap at the rest of the family. Then one day she simply reappeared, her earlier personality restored, and resumed the civilities of family life.
I remembered fourteen. You couldn’t pay me enough to be that age again.
Was Kitty going through the kind of adolescent angst that’s triggered by hormones? Maybe. She barely had breasts; she hadn’t gotten her period yet. Late bloomers are the norm in both our families. Then, too, the kind of intense gymnastics training Kitty was involved in could delay development. But that could be a good thing, couldn’t it? I’d written an article years earlier for Health magazine on research showing that teenage girl athletes who delay menstruation have a lower than normal lifetime risk of breast cancer, which runs in our family.
In the end, Jamie and I decided, we weren’t that worried. Kitty was smart, savvy in ways I certainly hadn’t been at her age. She was growing up, that was all. We agreed we’d keep an eye on her, though we had no idea what we were looking for.
And yet. Most parents of an anorexic child can look back on a day when they should have done something but didn’t. A day when they first realized something was very wrong but still had no words for it, just a feeling—a prickle at the base of the neck, the hairs on their arms standing up, something in them recognizing danger. For me it was the next day, the Monday after Mother’s Day, when Kitty called me at work to ask what we were having for dinner on Friday night, five days later. She’d never done anything like that before, and I was, frankly, flabbergasted.
“I don’t even know what we’re having tonight,” I said, laughing. Maybe she was joking.
“I have to know,” she said. “Why can’t you just tell me?”
I wish, now, that I’d paid attention to the frantic tone in her voice, to the anxiety driving this odd and insistent questioning. What if I’d made an appointment that day to see “someone”? Would that “someone” have seen what we couldn’t, yet?
I’ll never know, because instead of making a call, I got annoyed. I’ve never been good at meal planning; I’m the kind of parent who rummages in the fridge and throws something together on the spot. When Kitty wouldn’t stop pressing me, when she didn’t back down, I said in exasperation, “Spaghetti, OK? We’ll have spaghetti on Friday night.” And when that calmed her down enough to get off the phone, I forgot about it.
Only I didn’t. A few days later I stopped at the library on my way home from work and checked out a video called Dying to Be Thin. I didn’t go looking for it, and I couldn’t have told you why I checked it out. I brought it home and put it on my desk in the living room, where it was quickly covered by a pile of papers. It sat there for weeks, long past its due date, but I never watched it.
Much later, Emma told me that when she saw that video on my desk, she knew Kitty had anorexia. “Why else would you have taken it out of the library?” she asked, with incontrovertible ten-year-old logic.
If only I’d paid attention to my own signals.
As May wore on, Kitty’s mood continued to deteriorate. She cried more; she was testy one moment, clingy the next. She kept up with her homework, as usual; she’d always been disciplined about school. Too disciplined; anything less than an A on the smallest assignment could send her into a spiral of anxiety about college and law school. In her chipper moments she couldn’t stop talking about her new passion for cooking. “I want to make a dinner party for your birthday, Mom!” she announced one day. My birthday is in October, but that didn’t stop her from making elaborate plans—dinner for thirty, place cards, fancy dress. She spent hours reading cookbooks, marking pages with yellow Post-its, making lists of ingredients—lobster, Cornish game hens, heavy cream, tarragon, butter. She called me at the office where I was editor in chief of a magazine to read me menus for the kind of four-course meals you could cook only with a kitchen full of Williams-Sonoma equipment. She flopped down on my bed at night to debate the relative merits of scallops versus shrimp, sweet butter versus French butter. She begged for a subscription to Gourmet magazine.
I’d been trying to get Kitty to cook with me since she was three years old, to no avail. Was it possible for a child who had never shown the slightest interest in baking chocolate chip cookies to suddenly care about making a roux? Maybe I’d simply been boring her all these years with my pedestrian suggestions for brownies or spaghetti, and now her gourmet abilities were making themselves known. That didn’t exactly feel like the right explanation. But then what was going on?
I grew suspicious—of what, exactly, I couldn’t say—and then questioned my own suspicions. I’d always been a practical cook, more apt to produce a one-pot casserole than an elaborate menu. Was I threatened by Kitty’s new expertise in the kitchen? What kind of mother was I, to be wary of my daughter’s new interest? Why couldn’t I just support it? Talking about food was the only thing that made her eyes light up. Even gymnastics, which she’d loved for years, seemed more of a chore than a pleasure these days.
The thing was, she didn’t actually eat what she cooked. A bite here, a nibble there, that’s all. She always had a reason: this dish upset her stomach, she wasn’t in the mood for that one. Jamie and Emma and I ate what she cooked, and it was delicious. But still Kitty’s behavior left a bitter aftertaste.
I started watching her. Watching what she ate, and didn’t eat. Watching the way goose bumps ran up her arms on a sunny afternoon. How her head suddenly looked too big for her body.
At her eighth-grade graduation in early June, Kitty wore a blaze-orange halter dress she’d borrowed from a neighbor. From across the crowded gymnasium, I saw my daughter with different eyes, away from the usual context of our lives, and what I saw made my heart begin to pound. In an auditorium crowded with eighth graders, she was by far the thinnest girl in the room.
As the other parents in the bleachers clapped and cheered, Jamie and I sat alone. It was as if someone had turned off the sound. When I dared look at my husband, I saw my own terror mirrored in his eyes. We didn’t say a word; we didn’t have to. The next morning I called Dr. Beth’s office and took the first appointment offered—for the end of June, three weeks away.
If I’d said it was an emergency, we could have gotten in earlier. But I felt oddly fatalistic about the appointment. We would take the time they gave us, and until then, I told myself, I would stop worrying about it. Stop thinking about it. I knew, then, on some level; but I still didn’t want to know. I was engaged in the magical thinking of denial. If I don’t get upset about this, it won’t be a big deal. I’m a writer; putting things into words is not only what I do, it’s how I think and feel and process the world. But I didn’t think in words about what was wrong with Kitty, and I certainly didn’t say them out loud.
Over the next three weeks, Jamie and I behaved like travelers stranded on a small and isolated island. We knew the big ship would come, and that once it did, everything would be different. We were scared of the change that was approaching and also anxious for it, and so for those three weeks we lived in limbo, in the time between before and after.
Usually, I talk to Jamie about everything. In our relationship, I’m the garrulous one; talking to him helps me figure out what I think and how I feel. And over the twentysome years we’ve been together, my naturally taciturn husband has come to appreciate and participate in the process of hashing things out aloud. But I didn’t talk to him about Kitty now. I could see some of my feelings mirrored in his face—fear and distress and hope—but he did not bring them up, and I didn’t ask. I longed for the day of the appointment, when Kitty’s doctor would put a name on what was happening to our child. When she would tell us what to do. And I feared it, the moment when I would have to say the word I’d been avoiding in my head all these weeks.
But I knew what was going on now. I couldn’t help it. I saw that Kitty was starving herself. I just didn’t know what to do about it. I cooked her favorite foods and watched in frustration as she pushed them away, or took two bites and insisted she was full. I got mad. I yelled. I wanted to both shake her and wrap my arms around her. I wanted to scream, “I don’t understand!” And I didn’t.
In mid-June we took a family vacation to Door County, a peninsula that extends into Lake Michigan like the thumb on a glove. The bed-and-breakfast we stayed in was freezing and rustic. Kitty spent the week wearing every piece of clothing she’d brought, her teeth literally chattering. Because we were eating in restaurants, for the most part, we didn’t feel like we could make a scene about what or how much she was eating, and so she ate even less than before. We were all relieved when it was time to go home.
I kept waiting for her to fall apart, for her hunger and malnutrition to catch up with her. But Kitty kept up her demanding schedule: gymnastics practice four nights a week and days spent working at the gymnastics day camp. Her functioning confused me; how bad could things be, really, if she was able to manage all that? Maybe, I thought, Kitty just didn’t need as much food as other people.
Looking back, I recognize that it wasn’t just Kitty who was under the sway of an eating disorder; Jamie and I were too. Our thinking was also distorted, by fear and anxiety, confusion and hope. That’s one of the strangest things about eating disorders: they affect not just the person who has them but everyone around that person too. They’re so insidious, so counterintuitive, that the brain just can’t make sense of them. It’s like the visual phenomenon called edge induction, where the brain fills in visual gaps in a scene or landscape that’s poorly lit or hard to interpret. On some level, we see what we expect to see, or what we want to see.
I knew even then what I wanted to see: that Kitty was all right. That she didn’t have a problem.
I just couldn’t make myself believe it.


By the end of June the summer had turned hot and humid, the kind of weather that constricts your lungs and slows everything down to a dreamy, underwater pace. Our house had no air-conditioning, but Kitty wore a jacket and long pants, even to bed. We were all fractious and tense. More than once Emma ran from the dinner table, hands over her ears to block out the sound of us arguing over what Kitty was and (mostly) wasn’t eating. These were battles, now, and we lost every one. We never got Kitty to eat even a bite more than she’d allotted herself.
Once upon a time, family dinners had been a ritual I looked forward to, a time when we came together to talk and laugh. Now I dreaded them. I developed a Pavlovian response to the approach of the dinner hour—headache, churning stomach, sweating palms—and by the time we actually sat down at the table, I couldn’t eat either.
I was glad when Kitty was at the gym, even as I worried about her. I went to sleep worrying and woke up worrying, and by the day of our appointment with Dr. Beth, my anxiety was nearly as high as Kitty’s. Hers was now undeniable. She fretted for an hour over what to wear to the office, what would happen there. “Dr. Beth is going to help us help you,” I told her, over and over, and hoped to God it was true.
As we waited in an examining room, Kitty clutched my hand and I held on, feeling as though we were on a raft heading out to sea and Dr. Beth had the life preserver. She came in with her usual smile, took Kitty’s pulse, looked at her chart, and sat down across the room from us. “Now tell me why you’re here today,” she said with her characteristic directness.
“I think Kitty has anorexia,” I said.
There it was, the terrible word, out in the world. Pandora’s box, opened now, never to be closed again.
I ticked off the symptoms. Kitty was way too thin. She avoided eating. She cried a lot. And now there was something else, a sour smell I’d noticed in the last week or two. A smell that reminded me of our elderly cat shortly before she died of kidney failure. Ketosis—the smell of the body digesting itself.
Dr. Beth turned to Kitty. “What do you think?” she asked. Eyes closed, my daughter moved her head a fraction. It was the first time she’d acknowledged that she had anorexia. And it was the last time, for more than a year.
There was no leaving the room this time. Dr. Beth examined Kitty, talking soothingly as she listened to Kitty’s heart, took her temperature, felt her glands and belly. Kitty’s heart was beating only forty-two times a minute (normal is sixty to eighty). She weighed six pounds less than she’d weighed the previous December, and she’d grown half an inch. Suddenly she was at least twenty pounds underweight.
After Kitty pulled her sweatshirt back on, Dr. Beth took one of her ice-cold hands. “I know this is hard,” she said. She looked at Kitty, but she was speaking to both of us. “I know you don’t feel well, and you’re scared. I won’t lie to you. Anorexia is a very serious disease, and there’s no quick fix for it. But I promise you, Kitty, that a year from now, you’ll feel better.”
Of all the gifts Dr. Beth gave us over the next year, this was the greatest: she gave us hope. Her words kept us going through the nightmare that was still to come.
She spent a long time talking to Kitty that day, reiterating why and what she had to eat. She encouraged her, talked to her about what was happening in her body, how much better she would feel if she ate. She held Kitty’s hand, stroked her shoulder, smiled into her eyes.
Afterward, while Kitty waited in the exam room, Dr. Beth talked to me in the corridor. She had two pieces of advice: try to get Kitty to eat, and find a therapist, fast. What she didn’t tell me, what I read for myself later, was that the average length of time for recovery from anorexia is five to seven years. That most people with anorexia bounce in and out of hospitals, recovering and relapsing. That anorexia is the deadliest psychiatric illness; close to 20 percent of anorexics die, about half from starvation and the other half from suicide. Nearly one-fifth of all anorexics try suicide; many succeed.
There was relief in having Kitty’s illness out in the open—on the table, so to speak. But I still couldn’t see the path to recovery. I was numb and terrified; I felt like a block of stone with a tiny crack in one corner. The crack would widen, with stress and time, and the stone would come apart. The only questions were when and how.
Dr. Beth sent us downstairs to the lab for blood work and to check Kitty’s vitals, including her heart. She said she wasn’t too worried because Kitty was a gymnast, and athletes have slow heart rates. I was reassured by her words, though later I learned that anorexia can cause cardiac arrhythmias and heart attacks.* I wondered, later, if Dr. Beth, too, was in denial about how serious Kitty’s illness was. Or maybe she was simply trying not to overload us with terrifying news.
The lab technician lifted Kitty’s sweatshirt, and for the first time in weeks I saw my daughter’s naked chest. The sight made me want to howl. Her skin stretched tightly over her sternum. I could see the arching curve of each rib, each nick and indentation of her collarbone. Her elbows were bowling balls set into the middle of her matchstick arms. She looked like a concentration camp victim, right down to the hollow, hopeless look on her face. My bright, beautiful daughter lay broken on the table, her eyes dull, her hair lank. I could not bear it.
And then the tech smiled at Kitty and exclaimed, “You’re so nice and slim! How do you keep your figure?”
If I’d had a gun in my hand, I swear I would have pulled the trigger.
My daughter closed her eyes and turned her face to the wall. This wasn’t the first compliment she’d gotten on her slenderness, just the most inappropriate. That spring, strangers stopped us on the street all the time, wanting to tell Kitty how attractive or darling or stylish she was. In a shop one afternoon where I was trying on clothes, the saleswoman turned to Kitty and said, “Aren’t you lucky—you got the thin genes!”
Every one of these comments made my skin crawl. Yet how could I protest, when people were just, as the tech insisted later, trying to be friendly, offering a compliment? What could I say, when I, too, liked to be told that I looked thinner, prettier, sexier?
That night, after Kitty’s diagnosis, I spent hours online and came away bleary-eyed and confused. The next day I called a therapist I knew, retired now, but who’d treated eating disorders for many years, and asked for her advice.
“Anorexia and bulimia and cutting, problems like that, are always about the great crisis in a teenager’s life, the onslaught of sexual feelings,” she told me. “Anorexia is a way to stay small, to not grow. It reflects a teenager’s conflict about growing up. It’s not about the food.”
Just about every parent of an anorexic hears this somewhere along the line: It’s not about the food. And the next comment is usually something like So don’t make an issue out of her not eating/binging/purging/fill in the blank. It’s a hell of a mixed message. Kitty’s illness wasn’t about the food, but we had to try to get her to eat. It wasn’t about the food—but she was starving to death.
Though I respected my friend the therapist and her years of experience, her words made no sense to me. With each day that passed Kitty was disappearing, mentally as well as physically. She was hysterical, emotional, fragile. She couldn’t think straight, couldn’t sustain simple conversations, let alone express or “work through” feelings. If it wasn’t about the food, then why was she so irrational about eating? Why, then, would a relatively innocuous comment from one of us—“Kitty, have another bite of pasta”—send her rushing from the kitchen, screaming and crying?
If it wasn’t about the food, what was it about? I didn’t care. What I really wanted to know was, How was Kitty going to get better? She needed to eat. That was clear to all of us. What wasn’t at all obvious was how to make her do it. I felt both helpless and utterly responsible. If only I could find exactly the right words, the right tone of voice, surely she would see the truth. Surely, then, she would eat.
I started reading everything I could find about eating disorders, beginning with The Golden Cage by Hilde Bruch, long considered one of the classics on anorexia. Bruch portrayed anorexics as attention-seeking and manipulative, purposefully self-destructive. And she painted a devastating portrait of the “anorexic family,” one where parents (especially the mother) were critical—expecting outward perfection, quick to pick apart a child’s looks and weight, highly controlling—and also emotionally negligent, shutting down any expression of a child’s true feelings, forcing the appearance of conformity and pleasantness and refusing to acknowledge difficult emotions.
I felt sick, reading this. Was it true? Was Kitty seeking attention? That didn’t feel right. On the contrary—Kitty avoided being the center of attention. She was a classic “good girl” whose fear of screwing up led her to be too pliant, if anything.
Were Jamie and I critical of our daughter’s appearance? Did we shut down her feelings, give her the message that she had to conform to our ideas of who she should be? I would have copped to any family dynamics, no matter how bad, if it meant finding a way to fix Kitty, but I didn’t recognize our family in Bruch’s book. We had our issues, certainly, but overly controlling and hostile? Again, it didn’t feel right.
I grew up in a house where how people looked was the major topic of conversation. Where my mother weighed herself daily, recording the number on a chart that hung on the bathroom wall. Where the highest compliment you could pay anyone, anytime, was “You look so thin! Have you lost weight?”
I’d worked hard not to perpetuate this obsession with appearance. I was careful to praise Kitty for her intelligence, her empathy for others, her sly wit, her love for books. One of our often-told family stories was about an encounter we had in an airport when Kitty was just learning to walk. She was dressed in blue pajamas, handed down from a male cousin, and a woman sitting beside us said, “Ooh, what a big strong boy you’ve got there!” When I told her that Kitty was a girl, she immediately cooed in a high-pitched voice, “What a pretty little girl!” Jamie and I rolled our eyes. For years we’ve used that story as an example of obnoxious gender stereotyping.
So no, I didn’t recognize myself in Bruch’s characterization; nor did I recognize our family. But I was coming to mistrust my perceptions. Maybe, I thought, I was in denial about this, too. Each time Jamie or I urged Kitty to eat a little more, to take another bite, I felt not only the anguish of watching Kitty shake her head, push away the plate, disappear bit by bit; I also felt the shame of trying to get her to eat, of needing to try, of not being able, as the books said, to just ignore Kitty’s eating, talk about other things, steer clear of the subject.
Dr. Beth said we needed a therapist as soon as possible. I called our health insurance company’s referral line and, after much wrangling, got the names of three therapists. One didn’t see adolescents. One wasn’t taking new patients. The last couldn’t see us for five weeks. I made the appointment and put our name on her cancellation list. In the meantime, we were back in all-too-familiar terrain, trying to get Kitty to eat. Mealtimes were intensely unpleasant and unproductive. “Dr. Beth says you need to eat,” Jamie would say as she pushed away her nearly untouched plate.
Kitty’s responses were always the same: “I’m full!” “I had a big lunch!” Or, more and more, “Just leave me alone!”
But we were more stubborn now than we’d been a month ago. “Come on, Kitty,” I would say. “Are you trying to kill yourself?” Anorexic behavior is the very essence of self-destructiveness. Humans have to eat; I couldn’t understand how Kitty didn’t see that. Fear and frustration made me desperate, and the more distressed I got, the more Kitty dug in her heels. “Why don’t you just eat?” I shouted one night. “I don’t understand! You’re a smart girl! You know you have to eat!”
The look that passed across her face was nothing I recognized. It was the look of a cornered animal, something with fangs and claws and wild medusan hair. The next second we were back to what passed for normal these days—me wheedling, pleading, and ultimately shouting, and Kitty refusing. Refusing food. Refusing, now, even milk and water. She would take only a few sips of vitaminwater, then insist she wasn’t thirsty, she was fine, she was tired, she was going to bed. As we went around and around in the awful circle that had become our lives, that other look haunted me. Had I imagined it? I was exhausted, not sleeping, anxious and antsy and haunted by what Kitty did and didn’t eat. Had I hallucinated? Was I now projecting my anger and fear onto my daughter?
That must be it, I told myself. I was losing it. I should try to chill. Still, the vision of my daughter’s face, distorted and alien, rose up at odd moments. I dreamed about it one night—a mask of fury superimposed over her familiar and now terribly sad eyes. I could not forget it.
Every day was fraught now, strewn with minefields and tears. The most ordinary activities were emotional mountains we could not scale. Every trip to the grocery store with Kitty had become an agonizing series of negotiations. And she always wanted to come along. Each time I reached for a gallon of milk, a box of cereal, a piece of fruit, Kitty would argue: we should buy skim milk instead of 1 percent, packets of ramen noodles instead of soups, fish instead of chicken, pretzels instead of corn chips, Special K instead of Cheerios, frozen yogurt instead of ice cream.
I didn’t want to buy those things. I wanted to buy food full of calories to heal my starving daughter. But if Kitty promised to eat the frozen yogurt, maybe I should buy that instead of the ice cream, which I knew she wouldn’t eat. Because, after all, it wasn’t about the food.
I became obsessed with getting calories into her. Kitty said it was easier to eat in front of the TV, so we ate in front of the TV, something we’d never done before. Kitty said it was harder for her to eat in front of other people, so we stopped our casual potlucks with neighbors, didn’t go out to restaurants, and told Emma she couldn’t invite friends over.
I bought the ramen noodles, the Special K, the pretzels and air-popped popcorn, the light bread, thinking Something’s better than nothing. None of it made a difference. Kitty still didn’t eat, and her excuses for not eating grew less and less persuasive. She knew that we knew, now, that none of it was true: the food was neither too hot nor too cold, neither too spicy nor too bland. Her stomach was upset, but it was always upset now. She refused Tums and wouldn’t tell me why, but I thought I knew: each Tums contained ten calories. She knew that we knew that she wasn’t full, she hadn’t eaten at a friend’s; in fact she had stopped talking to her friends weeks earlier. “I’m too upset to eat,” she said one night. We were sitting at the kitchen table, where it seemed we now spent the worst hours of our lives. Two fans blew hot air across the table, which was piled with sweet corn, chicken sausages, and tomatoes from the garden, none of which Kitty had tasted.
“We’re all upset,” I pointed out, my voice rising. She said I didn’t understand. I was pressuring her, which made it worse; my anxiety was making her anxious, too anxious to eat. Tomorrow would be different, she promised. She begged me to understand, to be compassionate. “I’ll try harder!” she swore, and I wanted to believe her. But when tomorrow came, she ate three grapes, half a fat-free yogurt, a single slice of low-calorie bread.
Worse, I could see what it cost her to do even that. The fa?ade of hostility slipped sometimes, revealing a deep, relentless anxiety that made my heart ache. “Mommy, is it OK?” she would ask, racked with guilt over a forkful of broiled chicken, and I would reassure her: Of course it’s OK, your body needs food and milk and nutrition. Food is good for you, I would say. Everyone needs to eat, including you. If you don’t eat, you’ll die. These conversations took on a ritual feeling, a kind of stylized call-and-response that reminded me of the way a toddler will run two or three steps away and look back at her mother, seeking reassurance. Only nothing I said or did made eating easier for my daughter. In fact, my words seemed to have the opposite effect: the more reassurance I gave Kitty, the more fearful we all became.
One night in early July she lay down beside me in bed, sobbing, and it was as if her tears unlocked the words she’d been holding back. “I don’t want to die, Mommy, but I feel so guilty,” she cried. “I ate a whole Popsicle and I wasn’t even hungry. I ate a piece of fish. I’m a greedy pig, Mommy. I ate and I wasn’t even hungry. I know it’s wrong to feel these things, but I can’t help it, it’s how I feel.”
I gathered her in my arms and rocked her, my teeth chattering with fear. “I’m not going to let you die,” I promised. “You’re going to be OK. I’m going to keep you safe.”
But how could I keep her safe when I couldn’t get her to eat a single french fry?
Kitty often cried herself to sleep now, with one of us sitting beside her, holding her icy hands, rubbing her back the way we had when she was a toddler. In bed later, Jamie and I looked at each other in despair. The therapist we’d finally found, Dr. V., would help. We had an appointment in three weeks, and then we would know what to do. Dr. V. would have the answers.
I tried to forget that I’d felt that way about seeing Dr. Beth, too.
That night and every night after for a long time, I went to sleep thinking of the sharp angle of Kitty’s elbows, the shape of her bones under skin. I saw against my closed eyelids her hollow face, her enormous eyes, the unnatural point of her chin. I could not bear to see these things. I could not stop seeing them.
In the meantime, our health insurance refused to accept a diagnosis of anorexia from Dr. Beth because, as the “consultant” told us, only a psychiatrist can diagnose a mental illness, and anorexia nervosa is listed in the DSM-IV, the bible of mental illnesses. Once more I started on a seemingly endless round of phone calls. The only psychiatrist who could see us within six months—six months—was a psychiatric fellow in her last year of training whom I’ll call Dr. Newbie, who had an opening the following week.
Our first visit was not auspicious. Kitty stayed curled in a fetal position, her head in my lap, while Dr. Newbie asked question after question. Her diagnosis, after forty-five minutes, was depression and eating disorder not specified, commonly known as ED-NOS. She prescribed fluoxetine (the generic form of Prozac) and weekly visits, both of which we dutifully began, neither of which seemed to help. Dr. Newbie was kind but more or less clueless; she spent most of our sessions telling Kitty she had to eat, which we were already doing at home. The fluoxetine gave Kitty headaches and upset her stomach, making it even harder, she said, to eat.
Worse, what I didn’t understand then was that our mental health coverage was limited to $1,800 a year. Seeing Dr. Newbie, it turned out, cost us $200 a pop, using up our precious benefits on an exercise in futility.
Nothing seemed to help Kitty’s anxiety and guilt around eating. Though we rarely cook red meat, one night I made lamb; Kitty’s lab reports showed that she was anemic, and lamb is rich in iron. After an hour of cajoling, arguing, and yelling, she choked down two bites of meat. Afterward she ran into the backyard and curled up in the grass, where Jamie and I could see and hear her through the kitchen window. “Oh my God,” she cried, arms wrapped around herself, rocking in the grass. “That must have had three hundred calories in it! Oh God!” We sat at the table and listened to our daughter’s agony, and did not know what to do.
I hoped the therapist would help. On the day of our first appointment in mid-July, she came out to the waiting room and said hello in a high-pitched, syrupy chirp that immediately set my teeth on edge. The old Kitty, a precocious observer of human nature, would have rolled her eyes at me. The new, withdrawn Kitty didn’t even blink.
Dr. V. tried to get Kitty to come in alone, but I was done with staying in the waiting room. So in we went, to Dr. V.’s blandly beige office, where she commenced interrogating Kitty in the same gooey tones. I didn’t care how idiotic or patronizing she sounded, as long as she could tell us what to do and how to do it. If she’d come up with a workable plan, I would gladly have given her all our disposable income for the next ten years. If I’d trusted her, even a little, we would have been in her office twice a week. Alas, no plan was forthcoming, and trust was not an option after Dr. V. informed me that anorexia “isn’t about the food” and was typically caused by “the mother’s unresolved conflicts.”
“Now, Mom, don’t be the food police!” she admonished me as she ushered us out of the office. I wanted to bite her head off. How in the world could Dr. V. be considered an expert on adolescents when she talked to Kitty as if she were two years old? She hadn’t a clue how to relate to a teenager.
“What did you think?” I asked Kitty in the car. She shrugged apathetically, but I thought I caught the tiniest hint of something—amusement? sarcasm?—in her dulled gaze. It cheered me immensely, which I needed when I imagined coming back to Dr. V.’s office week after week, offering up our family’s dysfunctional moments as Kitty grew thinner and weaker and paler. Dr. V., it was clear, was not going to save Kitty. But if she couldn’t do it, who could?
That night, Emma ran away from home. She didn’t go far—only to the end of the block—and she was easy to find, because she stood on the street corner and screamed, “I have the stupidest, most lousy parents in the world!”
Man, was I jealous. I wanted to stand on the corner and cuss someone out too. I just didn’t know who.


In the second week of July, the weather turned even steamier, with three-digit temperatures nearly every day. One of those days was our city’s annual opera in the park concert, which we went to every year, eating a picnic dinner on a blanket in the grass.
Kitty spent that entire afternoon in our sweltering kitchen, frying chicken and making carrot cake, the oven and range going full blast. The room was like a sauna, but she wore a long-sleeved gray sweatshirt over a T-shirt, heavy jeans, fuzzy socks—and still she did not sweat. Nor would she drink, even when I followed her around with a glass of ice water, begging her to take a sip. “For God’s sake, it’s a hundred degrees in here,” I said.
“I’m not thirsty.”
“Promise me you’ll at least eat some of what you’re cooking,” I said, my voice raised in frustration.
Kitty looked at me calmly. “Of course I will,” she said.
Of course she didn’t, not really. She peeled every speck of fried coating from a drumstick and picked at the meat. She produced a small bag of red grapes and ate three, turning down the carrot cake, the potato salad, the apple juice. “My stomach hurts,” she said. “I’m not hungry.”
I got angry. Furious, actually. Furious enough to turn my back on Kitty in her sweatshirt, zipped up to the neck. I sat at the opposite end of the blanket, denying her contact, avoiding her icy hands, her now nearly constant need for physical reassurance. Fine, I’d thought. OK. You want to starve yourself to death? Go right ahead.
The chicken and carrot cake were, no doubt, delicious. I don’t know, because none of us ate a bite. I went to bed angry, feeling like things were about as bad as they could get.
And that’s when Kitty came to me in the dark, her hand on her chest, her voice full of fear.


I can see from the look on the nurse’s face that the news is not good. She ushers us back to the emergency room cubicle, where an earnest young doctor shakes my hand and opens Kitty’s chart. He seems to be a long way off, his voice tinny and low as he explains there’s a problem with Kitty’s EKG. The electrical impulses that initiate each heartbeat are coming from the wrong part of her heart, a sign that her body is stressed. She’s also dehydrated, and her heart rate is too low, only thirty-five beats per minute. The number penetrates the gray fog that’s descending over my whole body. Kitty’s heart rate has dropped since our visit with Dr. Beth two weeks earlier. This isn’t good.
“I’m going to admit her,” says the doctor. He rubs his eyes as he speaks, as if the very sight of us makes him weary. I suppress the urge to apologize, barely, but it persists as I fill out the paperwork, as we wait for a bed to open upstairs, Kitty shivering in my arms now, fear shining from her huge brown eyes.
By the time we’re ushered upstairs to the pediatrics ward, the sun is rising, lightening the pale green walls, the hospital bed, the chair beside it. A nurse opens the door, taking us in with a professional flick of her eyes—Kitty, curled in a ball on the bed, her eyes closed; me pacing, my hair uncombed, my eyes red, literally wringing my hands. She sets to work, helping Kitty into a hospital gown and into bed, talking to her in a soothing voice as she inserts the IV line that will help rehydrate my daughter. Normally Kitty would put up a fuss; needles are the one thing she’s scared of. But this morning she lies listlessly in bed, eyes closed. She’s asleep by the time the line is in.
The nurse tidies up and leaves, the hospital door closing soundlessly behind her. I sit in the chair beside Kitty’s bed and watch clear liquid drip into her arm. Her face is chalk-white; her jaw is clenched in sleep. I take one of her freezing hands between mine and hold it, trying to warm her with my own heat.
There’s relief in being in the hospital, after the weeks of going it on our own. It’s cool and clean, and, best of all, someone else is in charge. My job is to sit at Kitty’s bedside and talk to the endless parade of residents and interns, who want to hear her history over and over: How tall is she, how much does she weigh, when did you notice a change in her eating, when did she lose weight? I tell them she lost only a couple of pounds. I tell them she was fine until two months ago. I tell them our family is not dysfunctional, that we are reasonably happy, that Kitty has never been abused.
Actually I don’t tell them that. I want them to believe it, but I see that they don’t. I watch their young, transparent faces as they make notes in Kitty’s chart, notes I am not allowed to read but that no doubt say things like Mother in denial. I don’t care. I’ll accept any judgment they want to offer, if they will make my daughter well.
I don’t get it yet. I still think someone can make my daughter well. That this is a process that will take days, that there’s some incantation that will reverse the damage, turn back the clock, remove the curse, and that, like Sleeping Beauty, Kitty will open her eyes and be magically healed.
If only.
After twenty-four hours with the IV, Kitty is rehydrated, but her heart rate is still too low. She’s too dizzy to sit up by herself; it takes two of us to help her to the bathroom. She hates the hospital meals, and I don’t blame her. The kitchen sends up mountains of steamed broccoli, little cups of Jell-O, bowls of consommé, all of it unappetizing, none of it with enough calories to sustain a caterpillar.
Although she’s not on call, Dr. Beth turns up at the hospital that first day, a Sunday, and spends hours talking to the doctors on the ward and sitting with Jamie and me. She is our lifeline, our reminder of the world of sanity and light. And so, late the next afternoon, when the resident tells me that Kitty’s heart rate isn’t coming up and he wants to transfer her to the ICU, it’s Dr. Beth I call in a panic. As the nurses wheel Kitty’s bed to the ICU, I trot along beside them, arguing. Isn’t this a bit extreme? Aren’t we overreacting just a little? Can’t we give her more time? She’s a reasonable girl. She’s going to come around, I know it. The ICU is for people who are really, really sick, isn’t it? My daughter’s not that sick.
But of course, she is.
Jamie arrives in time to hear the doctor in charge of the ICU tell the nurse, “Get an NG tube.”
“A what?” I say.
The doc looks up, his eyes impatient. “A feeding tube,” he says, drawing the word out as if he thinks I can’t hear him. And maybe I can’t. “It goes up her nose and into her stomach,” he adds briskly. “We’ll feed her that way if she won’t eat.”
“No, Mommy!” cries Kitty from the bed. “Not the tube! I want to be able to taste my food!”
It is a moment of the highest imaginable absurdity. I want to say, “But you’re not eating anything now!” Later, I understand her reaction. The need to eat is hardwired into our brains and bodies. Anorexia can keep a person from eating, but it can’t turn aside that primal force. Hunger denied expresses itself in other ways—in Kitty’s case, in the compulsion to taste and savor every shred of food she consumed.
I bargain with the doctor. “Give her an hour,” I beg. “If she eats something in an hour she doesn’t need the tube.”
The doctor raises an eyebrow. Clearly, he thinks I’m a deluded and interfering mother. Clearly, he doesn’t believe Kitty will eat. But reluctantly he agrees that if she downs a whole protein milk shake in the next thirty minutes, and then eats a plate of spaghetti an hour later, he will hold off on the tube. For tonight.
The ICU nurse, who is the kindest person I have ever met, brings a chocolate protein milk shake and a straw. She helps Kitty sit up, arranges the pillows behind her, pulls a tray over, and puts the milk shake on it. Kitty reaches for the milk shake, holds it in one hand, lifts the straw to her lips. She’s crying silently now, tears slipping over the sharp cliffs of her cheekbones. Her hands tremble. Her whole body trembles. For five minutes, ten minutes, fifteen minutes she sits, holding the milk shake and crying, while Jamie and I murmur encouragingly.
I have fed this child from the moment she was born. I have fed her not just with food but with love. The thought of a nurse, even this one, pushing a bolus into her stomach through a tube makes me want to vomit. I try to arrange my face into a neutral expression. I try to be ready for the sight of the rubber tube threaded up my daughter’s nose and down her throat.
But Kitty eats. One shaky, terrified bite at a time, crying steadily, she consumes the shake. Between bites she talks out loud to herself. She seems beyond caring that we can hear, or maybe she’s so deep in her own nightmare that she doesn’t know we’re here. “Come on, Kitty, you can do it,” she says. “You don’t want to go back to that scary place.” Jamie and I are crying now too, as we understand for the first time exactly how courageous our daughter is. Each time she lifts the spoon to her lips, her whole body shaking, she is jumping out of a plane at thirty thousand feet. Without a parachute.
Thirty minutes later exactly, Kitty finishes the milk shake. And an hour later she eats the plate of spaghetti, one agonized bite at a time. The nurses praise her extravagantly, rubbing her hands, her back. It’s more than Kitty’s eaten in days. Afterward she falls asleep. Jamie goes home to collect Emma from the friends who have been taking care of her. I sit in a chair beside Kitty’s bed, exhausted but unable to sleep. Every time I start to nod off, Kitty’s sunken, terrified eyes rise up before me. Seeing the shape of her ulna revealed against the white hospital sheet feels strangely pornographic, like seeing part of someone’s brain pulsing and exposed. It’s a reminder of my daughter’s vulnerability, and it feels unbearable, because there is nothing I can do to protect her from the thing that is eating away at her. And how ironic—she’s being eaten alive, literally, by the fear of eating.
There is no privacy in the ICU; a glass wall separates us from the rest of the unit. I see the nurses filling out charts at the station, doctors hurrying back and forth. I see other parents with bloodshot eyes and ravaged faces. As night falls I sit, and I watch, and I wait for whatever will come next.