The Girls at 17 Swann Street Page 21

  She pauses.

  I guess she just got tired of anorexia and waiting for me to fix it.

  But you cannot “fix” anorexia.

  I know,

  she answers tiredly.

  Four years in and I’m still trying to.

  We sit together in silence.

  I break it this time:

  What is your sister’s name?

  Amy,

  she replies. Then repeats it, lower:

  Amy.

  Her cruise director voice returns:

  Perhaps it is better this way.

  What is?

  That she and I don’t talk. At least I know she won’t develop anorexia one day because of me.

  Even I know it does not work that way.

  You cannot pass anorexia to your sister.

  No, but she could copy me.

  Emm, it’s a disease.

  But Emm is not listening:

  I couldn’t bear it if she ended up here.

  I could not bear it either, the thought of Sophie at 17 Swann Street.

  Your sister is a grown-up,

  I tell Emm.

  You are not responsible for her.

  She disagrees:

  You are responsible for those you choose to love.

  86

  We hear a loud crack, a plate crash, an injured scream in the kitchen. Both Emm and I freeze. Running footsteps, a struggle, one, two voices screaming. The first we recognize as Julia’s:

  I was just getting a snack! I was hungry! What kind of sick place locks food away?

  More footsteps. The night nurse has come in and is trying to pin her down.

  Fucking let go of me! I want to leave! You can’t tell me what to eat and do! I’m sick of these rules! Let me go!

  Her screams are shrill and desperate, ricocheting off the house’s walls. Julia is suffocating. I put my face in my hands and whisper, Please, just let Julia go.

  I can leave when I want! Let go of me, dammit! I want to go home!

  The screams turn to sobs, to pleas. I am crying too. I do not want to picture Julia, happy carefree Julia, pinned down.

  For a snack. Just a snack! What a duplicitous disease. We all know it was a binge. Even Julia, though she keeps screaming:

  I just wanted a snack! Let go of me, bitch!

  Julia’s parents had not come to Family Day. They had not even called. And none of us had noticed, I realize now. She had not brought it up. In fact, she had feigned studied indifference, breezing through the afternoon, dinner, evening. She had made it all the way to her room, I suppose, before falling apart.

  Julia’s voice is muffled. She gradually calms down, probably as the shot of Haldol begins to take effect. Emm and I stay in our spots, frozen quiet, while we hear some feet shuffle away. The nurse carries her up to bed while Direct Care cleans the mess.

  Julia had been alone in her room while I had been out with Papa. She had been fighting her demons while I had been having ice cream with sprinkles.

  I could have been there when she needed me, but I had been downstairs with Emm. Perhaps she had knocked on my door. We could have talked, and perhaps it would have helped.

  Emm and I sit in the living room, she on the leather armchair, I on the couch. The house is quiet again. Eventually Direct Care finds us.

  What are you doing here?! Go to your rooms and to sleep, you two! You barely have half an hour left before vitals and weights.

  I go upstairs. Julia’s door is closed. It still is half an hour later. She does not emerge for vitals, weights, coffee, or the jumbles at breakfast. The latter begins promptly at 8:00 A.M. and ends at 8:30 sharp. We go on our walk. When we return we are informed that Julia has been discharged.

  I run upstairs. Yes, her room is empty. Painfully, whitewashed empty. Not a vinyl, piece of chewing gum, or empty wrapper. No sock forgotten under the bed. Like Valerie, not a trace of Julia left. Another disappearing act, like a punch in the gut. The vanishing girls of Swann Street.

  You know the rules, Anna,

  Direct Care’s voice says. She is standing behind me.

  You should not be up here after breakfast.

  Where did you send Julia?

  My voice is far too high-pitched.

  She touches my shoulder lightly. I pull back, scalded.

  How could you send her away?

  Direct Care wants to calm me down, but knows better than to touch me again.

  She assaulted a staff member.

  She did not mean to!

  I know, Anna, but those are the rules. She posed a serious threat to the patients and staff—

  Julia would never hurt anyone!

  Anna!

  Direct Care is no longer patient. Her next sentence bites:

  She knew the rules. She broke them.

  She is sick!

  So is every patient here.

  Her cynicism slaps at my face. For once I really look at Direct Care: she is tired, and old, much older than I realized. Direct Care is her job, not her name. And Julia in her notes today will be: Discharged Patient from Bedroom 4.

  But I am not jaded yet. Julia is still Julia to me: my friend, and

  Julia cannot leave!

  She cannot give up! is what I mean.

  You will bring her back,

  you will help her,

  won’t you?

  Now my voice is low, begging.

  She does not reply. I know she cannot. I try again nonetheless:

  Will Julia be okay?

  Direct Care sighs.

  I really hope so.

  87

  On Mondays the day and night staff switch shifts, new admissions are brought in. The schedule starts over, and so do the meals. I know this by now; this is my fifth.

  Monday morning also means a debrief of my weekend successively with the therapist, the nutritionist, the psychiatrist. Their own weekends they spend away from eating disorders and 17 Swann Street. They probably have brunch, cocktails, go to yoga classes or on runs. Not that they speak of those with us.

  My session with Katherine is scheduled, as usual, post–midmorning snack, at ten thirty. That meal is particularly rushed today; I was delayed by the Julia affair. At least it is incident-free; I am used to the yogurt at this point. I sprinkle granola and swirl it into the vanilla. Both no longer scare me. Too much.

  Ready, Anna?

  Last bite, then yes. Direct Care checks my empty bowls and nods. Then walks me to the now-familiar office. I take my usual place on the couch.

  Katherine comes in.

  How was your weekend, Anna?

  This time I am ready for her.

  It was actually wonderful.

  I tell her, in detail, about the evening I spent with my father.

  She hears me talk about dinner and dessert. Asks:

  How did the ice cream taste?

  Painful, but worth it. You should have seen the look on my father’s face when I ate it.

  So you would have it again?

  A loaded question. I contemplate it and the window.

  Yes, if it means that I get another evening like this with him.

  She looks up from her intensive note taking to smile genuinely at me. For a second, Katherine the therapist disappears and Katherine, just Katherine, says:

  You may get more than an evening, Anna. You may just get your life back.

  But she seals that crack swiftly and her next question is professional again:

  Would you say you want recovery now?

  Another loaded question. I balk. Rather, part of me does, clinging to the safety of the anorexia I know. The other part answers:

  I would say I want to try.

  At what cost?

  She pushes,

  Dairy? Protein, fats, and sugar? Eating those every day?

  She leans forward and asks:

  Anna, do you think you are ready for Stage Three?

  Silence. In my head too. I have no idea what Stage Three entails. I tread cautiously:


  What exactly does that mean?

  Katherine reaches for the patient manual, flips it open, and reads:

  “Stage Three: Patients at this stage still require daily medical monitoring and treatment for their eating disorder, but have demonstrated their commitment to their recovery and collaborating with their treatment team. They have experimented with instances of limited autonomy and exposure to eating-disorder triggers, and have performed satisfactorily.”

  I suppose both meal outings were experiments, and my performance was satisfactory.

  “The focus is now on a protracted and gradual increase of patient autonomy and exposure to normal life circumstances—”

  How so?

  I interrupt.

  “By downgrading treatment and supervision to ten hours daily.”

  Meaning?

  She looks up at me and translates:

  Meaning you would still have to come in for full treatment programming every day, eight to six, but would no longer be required to have dinner or sleep here.

  The air and thoughts race through my brain as it registers that last sentence. I am surprised at my first reaction: No, I am not ready for Stage Three.

  I have only been on two meal outings. I had one ice cream cone, once! Forcing myself to eat dinner, every day, unsupervised, on my own?

  No.

  Her professional face does not stand up to this. Katherine is genuinely shocked:

  What do you mean no, Anna?

  No I am not ready.

  But I thought you said—

  What I said is irrelevant! Now I am panicking.

  I do not know how I managed it! It was just an outing with Papa! I cannot do this every day—

  But don’t you want to?

  The softness of her tone nips the anxiety in the bud. She lets the question float. I contemplate it, and the image of me having a meal on my own. She looks back at the manual:

  “Patients at Stage Three must begin taking action independently…”

  She pauses to look meaningfully at me.

  “… despite the discomfort this elicits.”

  She closes the manual.

  What are you afraid of, Anna?

  I am afraid of myself. Of spiraling out of control and falling into anorexia again. Of throwing away all the hard work I did this month because old habits die hard. Of leaving the treatment center at 6:00 P.M. and never coming back. I am afraid of dinner on my own.

  I do not trust myself not to relapse.

  She does not brush away my concern. I am grateful for that.

  Instead, she says:

  That may be the most honest sentence you have said to me since you came here.

  I think of that. She may be right. To her and to myself. I decide to keep going, wobbly, down that line of thought.

  This weekend was a one-time act I performed for my father. I cannot do this every day.

  What other choice do you have?

  Silence. None.

  Do you want to stay here forever?

  No!

  Why not, Anna?

  Because … Emm. Because I do not want to be Emm.

  Or Julia. Or Valerie, but I do not tell the therapist that. Instead I say:

  I am scared.

  She nods. She is human again:

  I know you are, Anna.

  She changes tactics:

  Let’s say you weren’t, why would you want to leave?

  Because,

  Because I want to buy my own cereal. Maybe even Lucky Charms. I want to go to the bathroom without asking for permission from anyone. I want to take a shower in the middle of the day. A long hot bath, actually. I want to go for a walk. Alone. I want to turn right instead of left.

  Because I want to keep walking aimlessly till I discover a sidewalk café. I want to sit at a table outside and order sparkling wine at 4:00 P.M. I want to listen to someone play the guitar as I read and sip, soak sun and air, looking at the people passing by.

  Because,

  Because I also want to want something more than a walk and my choice of cereal. I want a goal. I want to make a list of goals. I want to have purpose again.

  I was ambitious once. I was a dancer, a dreamer. I was loved, I was in love, I loved life. I once had books to read and places to see, babies I wanted to make. I want to want those again.

  Because I think I want to live,

  that life Katherine mentioned I may get. Hazy outlines of family Christmases; children; basil, mint, and thyme in clay pots.

  I want more weekends like the one I just had,

  more time with the people I love.

  And what are those weekends worth?

  Everything, I realize. Everything.

  Worth eating?

  Yes, worth eating.

  Worth the weight and calories?

  Yes.

  And the pain and the anxiety at every meal?

  Coffee and croissants, a conversation with Sophie. My father’s famous omelettes. Crêpes on Sunday mornings with Matthias, stealing bites from his fork.

  Yes,

  because a birthday cake means a birthday celebration and ice cream means a good date. I can swallow the pain and anxiety if I can see that.

  She looks at the clock; our time is almost up.

  Let me summarize Stage Three: Patients continue treatment every day from eight to six. That will be at another facility. You will be assigned a new treatment team. You will take part in programming with another group of girls, and be responsible for your own dinner and evening snack.

  Suddenly, I notice something. My head begins to spin.

  I get to sleep at home.…

  You get to sleep at home,

  she says with a smile.

  I get to sleep next to Matthias again.

  88

  Treatment Plan Update—June 24, 2016

  Weight: 99 lbs.

  BMI: 17

  Summary:

  Treatment team has approved patient transition to Stage Three of treatment, effective Monday, June 27, 2016. Patient will be transferred to the day treatment facility at 45 Forest Park Road.

  Physiological Observations:

  Patient weight has been increasing steadily and consistently with increases in meal plan. She remains significantly underweight but has been open to increasing food variety and reassessing body image distortions. No signs of refeeding syndrome. No other physical complications.

  Psychological/Psychiatric Observations:

  Patient has been completing meals and working on replacing negative eating-disorder behaviors with positive coping skills. She continues to struggle with poor body image but is working on challenging cognitive distortions.

  Treatment Objectives:

  Contingent upon medical stability and continued commitment to recovery, treatment team recommends a gradual and protracted increase in autonomy and exposure to normal life circumstances.

  Patient will be required to present herself for treatment daily from 8:00 A.M. to 6:00 P.M. Patient will be allowed to complete dinner and evening snack alone and sleep at home.

  Target caloric value: 3,500 calories daily, to be maintained upon discharge until adequate weight is reached.

  89

  My fifth and last Friday evening at 17 Swann Street. My last Friday-night date here with Matthias. It must be different.

  I have an idea. I share it with Direct Care, who, to my surprise, says yes. She finds what I need easily enough: a box of colored chalk. Then, after lunch, she escorts me to the sunroom, where I spend twenty minutes on my knees, sketching and scribbling on the floor. I use up all the chalk.

  At 7:26, I am long finished with dinner and peeking out the window. I am wearing my white dress for the occasion, pink lipstick, a little blush, my mother’s pearl earrings, some perfume.

  Matthias’s blue car pulls into the driveway at 7:28. He does not know. I cannot wait to tell him, cannot wait for him to reach the front porch.

  I open the door before he rings, too excited to wait.<
br />
  Why, hello,

  says a confused Matthias, taking in the dress.

  You are being kidnapped,

  he is informed before I put the blindfold on him.

  In the dark, literally, Matthias is led through the house and into the sunroom.

  And where am I going?

  Away, with me.

  He smiles.

  I would love nothing more.

  I guide Matthias to the perfect spot in the center of the room. Then I uncover his eyes and say:

  You can look around now.

  We are standing on a giant chalk drawing of a big jet plane, mostly white; it is purple in the spots where I ran out of chalk. Also more flying fish than plane. But he understands the idea and smiles: We are flying away.

  My treatment team thinks that I am ready for Stage Three level of treatment.

  Matthias makes no reaction at first. I emphasize:

  Nonresidential treatment.

  Slowly, very slowly, he asks:

  Anna, what exactly does that mean?

  That, if you don’t mind, I would like to sleep at home on Monday night!

  I cannot keep calm in any longer:

  I still have to go to treatment every day, but I can leave after six! They say I am stable enough not to need night supervision!