Monday, February 13, 2012

Half In/Half Out or All In?

February 13, 2012

I’ve never really struggled with where or how to begin writing one of my posts.  Then again, I’ve never had to visit a friend in the hospital who is days away from dying from an Eating Disorder.  After a thirteen year struggle with Anorexia and Bulimia, her heart has finally given out, can no longer circulate oxygen.  Her potassium levels have bottomed out.  Her organs are shutting down.  I don’t know how to write about this with my usual panache; don’t know how to package this in elegant prose. 

I walked into the cardiac intensive care unit and Laurie (not her real name) was lying on the bed, wired to machines and monitors, hooked up to oxygen, pale and wan.

“Kerry,” she gasped, struggling to sit up and gave me a hug, holding on to me as tight as she could.  I hugged her back, gently, not wanting to squeeze any breath out of her.  Another friend stood by her bed.  Blond, tanned, and skinny.  Laurie waved her over.  “This is Melanie (another alias).  She’s Ana (aka anorexic), too.  Kerry’s Ana, too.  Let’s just get that out there so none of us feel awkward.”

Okay.  I felt awkward.  I mean, maybe I am struggling with an Eating Disorder, but I am not my Eating Disorder, and I’m trying to be in recovery.  But okay.  Laurie is dying, so just go with the flow, right?

“Does it smell like smoke in here?” Laurie asked, then fitted the oxygen line back into her nose.

I raised my eyebrows.

Melanie laughed.  “Laurie just smoked in the bathroom.  I had to sit on the bed so the alarms wouldn’t go off while she was in there.”

“They have the bed rigged so alarms go off if I get out of bed,” Laurie explained, laughing again. 

“Hold on guys, I need to stop talking.  Just give me a minute.  I can’t breathe.”  She collapsed back into pillow and closed her eyes, taking shallow breaths, then slowly opened her eyes again and reached for her cup of water.  She took a quick sip, sloshed the water around her mouth, then spit it out in an empty cup.

Melanie was thumbing through a Cosmo magazine, the front cover displaying some airbrushed, hyper-thin celebrity surrounded by headlines promising super-fast weight loss and power-burn exercise tips and 10-ways-to-cock-tease-your-mate-and-make-him-yours-forever articles inside.

Laurie sheepishly shrugged.  “I’m restricting water now.  That’s so fucked up, right?  I’m dying and I know it, but that’s how deep in this disease I am.”  She started to cry, struggling for breath again, and monitors started beeping.

I took her hand in mine.  “It’s okay,” I said.  “I’m not judging you.  I know how fucked up this disease can be.  It takes everything from you.  It lies to you.”

Melanie sat on the other side of the bed, and took her other hand.

Laurie looked at both of us.  “This wasn’t supposed to happen.  I wasn’t supposed to be one of those girls who die from Anorexia.  I’m twenty-seven.  I’m not supposed to die.  And now I am.  My husband is going to have to bury me.  And my mom.  How could I have done this to them?  How could I have been so selfish?  How could I have let this disease do this?  I’ve ruined everything, everyone.”  She collapsed, burying her head in her hands, sobbing, damning herself.

“Look at me,” I said, “You’re forgiven.  You’re loved.  You’re already forgiven.  It’s okay.”

I’ve been there.  The waterfall of guilt, the guilt that buries you, the guilt that makes you hold a knife to your wrist, the guilt that makes you swallow fistfuls of pills, the guilt that makes you believe that aiming your car into a tree will save your husband and kids from the burden of having to save you once again from yourself.  But I am here now, holding her hand, offering support, not the woman dying in a hospital bed.

That’s what Laurie pointed out to Melanie, too.  “Look how good she’s doing!  Kerry was just in the hospital in September!  And it’s been how many months?”

“Five months.”

Melanie looked at me in astonishment.  “How did you do it?”

“I have a therapist who won’t let me get away with anything.  The threat of a state hospital.  Wanting to be around for my kids and husband.  And eating three meals a day.”
Melanie stared at me in astonishment.  “You eat three meals a day?  I could never do that.  I eat maybe one meal, and I still take laxatives and water pills.”

Then Lauriejumped out of bed, ignoring the alarms for a moment, and pulled up her shirt.  “What do you think?”

What was I supposed to be thinking?  Ahh, I was supposed to be complimenting weight loss, the smaller body beneath all the taped wires.

“How much do you think I weigh now?  Don’t worry.  I won’t be mad if you guess more.  And all this is just extra skin from losing it all so fast these past few weeks.”
I wanted to throw up.  But she was insisting.  Fuck me.  Fuck this disease.  “I don’t know.  120?”

She looked triumphant.  “No way, girl.  109. 10 pounds just in the last 2 weeks!”
“But you’re fucking dying,” I said.

She climbed back into bed.  “I know,” she said, and started crying again.  “That’s what so fucked up.  I know I’m dying and yet I feel like it still isn’t enough.  But I don’t want to die.  I can’t die.  I want to live.  I am not ready to let this disease take me.  I still have the fight in me.  I’ll go down fighting.  I won’t give in easily.”

Of course, recovery from an Eating Disorder requires making a choice—there are those moments when you have to choose Life over Death.  Today I will eat a piece of bread, an apple, a cup of yogurt.  Today I will follow my meal plan.  Today I will not purge.  Today I will not exercise.  Today I will follow what my Recovery Team has decided is in my best interest even if I rail against it.  Today I will not follow the voice of ED (or IT).  Today I will yield, cede control, follow the way of recovery rather than MY way which will surely lead to death.  Today.  And Today might lead to Tomorrow which might give me a future.  Which might lead to hope.  Grounded, promising hope.

But, for all that buoyant, sanguine, can-do recovery cheerleading, there is also the underlying bio-chemical brain pathology associated with Eating Disorders--the consequential structural changes in the brain associated with starvation, as well as the other neurological pathways that have to be rewired after years of obsessional thought patterns and behaviors.  So it shouldn’t have shocked me that when the nurse brought Laurie her Potassium pill--the very thing keeping her heart beating—Laurie popped the pill in her mouth, the nurse left, and Laurie spit the pill back into her cup and asked me to flush it down the toilet.

“I can’t” she said, “It will make me gain water weight.”

This is the surreal, insane end game of an Eating Disorder.  I have been here, too.  My heart has never been here, but almost.  Just a few months ago I was wearing a twenty-four hour monitor because doctors were concerned about some abnormal rhythms.  But all was well.  There have been some electrolyte problems.  Some close-to-blackout dizzy spells.  And my brain has certainly been a losing pawn in that surreal, insane end game.  How many inpatient programs and hospitalizations?  How many manic-psychotic breaks due, in part, to starvation? 
Take the Potassium and you might live.  Flush the Potassium and you will likely die.  The starved brain is insane, cannot think or see clearly or make any rational decisions. 

I still get tripped up by this.  For instance, when I look at myself, all I see it someone who is “normally” sized, despite the fact that my husband tells me my ribs stick out, my hipbones jut out, and my collarbones are visible beneath sweaters.  You see, I’m eating; I’m following my mealplan; I’m not even exercising; I haven’t purged in months.  So what I see, by evidence of the fact that my eating has been “normalized,” is a normal body, albeit a “slim” body.  But that has been my genetic destiny all across my lifespan, so why all the fuss?  But every now and then, in those 3-way mirrors in dressing rooms, I catch a brief glimpse of myself, and for a whisper of a second, I allow myself to see what he (and likely Dr. B.) see—the ribs, the hipbones, the still-underweight, still-too-thin woman.  I look away quickly, unable to…  No.  Stop there.  Unwilling to see that body.  I don’t believe in that reflection.  The Eating Disorder tells me that I am just fine as I am.  What everyone else sees is a lie, a distortion.  All they want is for me to get fat, and fatter.  To join the McDonald’s crowd.  I know.  I make them feel guilty.  I remind them that they have lost control because I have maintained control.

See?  Just like alcoholism, an Eating Disorder is cunning, baffling, and powerful.  It will find a way to worm its way in, to manipulate the genuine care and concern of others and transform it into a spiteful power struggle wherein ED must emerge the victor—and victory can only be Death.

For years now, Dr. B. has been asking me, “Do you want to be thin or sane?  Do you want to be thin or sane?”

I’ve played dumb.  “Why can’t I have both?  Be both?”

I think I’m done testing out that “And.”  It truly is an “Either/Or” for me.  Just like it is for my friend Laurie.  She wants to live and yet, she spits out the Potassium pills. 

Another push from Dr. B.: “You can’t be half in and half out.  You can’t be pursuing living at the same time that you’re also trying to die.”

Miraculously, Laurie made it home and is on a twenty-four hour breathing machine.  Her heart can still stop at any second.  She is trying to gather enough seconds, enough minutes and hours and days to stabilize so that she can be admitted to an Eating Disorders Critical Care unit.  It will be her third time in that program if she lives long enough to make it there.  If.  Half In-Half Out is all about testing the if-then-maybe hypothesis.  If I don’t take the Potassium pill, then I won’t gain water weight, and maybe I’ll die, but maybe I won’t, and if I don’t die, then I’ve won another round, and I don’t have to look in that mirror and see the truth.

All in.  Dr. B.  keeps asking me if I can yield.  All in.  Do I have the courage to look in the mirror and see myself as I am and see the truth without the lies?