It’s the summer before I head down to Boston University, and I’m stuck in the New England Eating Disorder treatment program. From my sprawled-out spot on the floor, I can view everyone in the room and most of the nurses’ station. The bolted hospital window behind me mocks my position. I sit up and peer outside. I hear the glass and frame creak with laughter at my situation: trapped inside a building, relatively immobile, with a view of Portland and everything I am missing.
I lie back down and glance around at my fellow patients. Everyone in the eating disorders program seems to be competing—all having conversations over one another—and the sound is deafening. I can hear each individual over the music emanating from the small plastic headphones in my ears. As the volume on my Discman is already at its maximum, I abandon the hope of drowning myself in melody and turn my focus to eavesdropping.
“So how’d your meeting with your mom go?” Jen's question, directed toward Ashley, catches my attention.
I am curious about the way other people’s families function, as mine is so inadequate at doing so.
“Well, you know. My mom cares and all, but she just doesn’t get it. She just doesn’t understand that I am not the textbook anorectic. Reading a book won’t help if she won’t listen to me.” Ashley has a tendency to suck people into her stories; with her overemphasis of words, she engulfs you in the great urgency of her plight. “My psychiatrist tries to explain that to my mother, but you know how it is with parents. I am lucky, though, to have such a wonderful therapist. She just understands me. I don't even have to say what I’m thinking, she just gets it. Of course, I have to see her every week. If you were as sick as I am, they would make you do the same.”
I just roll my eyes and shake my head. Ignoring Jen’s reply, which will consist of a lot of oh, I knows and you are so braves, I search for a less melodramatic dialogue.
“Did you get 36-down?” The crossword puzzle is a daily routine. Started each morning with our first snacks, it provides relief from boredom during free-time and distraction during meals.
“No, sorry Stacey, I was thinking ‘aspires,’ but it’s too short. Oh! Did you get the jumble yet? I’m stuck on the third word.”
“You know I’m no good at those, Karla. Go ask Joan, she just looks at them for about two seconds and solves it.”
I do it faster than she! I’ll help! I want to shout, always needing to prove my intelligence as some sort of defense. But I remain quiet, too shy to assert myself, too self-conscious to brag.
I watch Karla get up slowly, all the while chewing on her pen cap, and make her way across the room to the nurses’ station. As she walks, her pants hang loosely on her hipbone, and she tugs absent-mindedly at their waist to prevent losing them. Her shoulder blades are visible through her child-sized sweater, resembling oversized chicken wings.
How disciplined she must be. Why am I so weak?
The hierarchy in the program is divided along the diagnosis line. Anorexia is its own caste, up on top, delineated within only by how close to a feeding tube you are. Bulimarexics, or so we call them, are second tier; fasting most of the time, they only purge when they slip up or after a scheduled once-a-week binge. Straight-up bulimia trumps only the not-otherwise-specifieds and overeaters. We’re not supposed to compare ourselves, but we all do.
I glance around the room, surveying my fellow program attendees. Karla is by far the thinnest, but Ashley and Stacey are approaching her status. Jen is probably a bit thinner than I...but she’s four inches shorter, right? Some excuse.
Sean, the only male in the program this round, looks an awful lot like a deflated Brad Pitt.
At least Jessie is heavier than I am. But she’s being discharged soon.
I glance over at the clock, our dictator. Snack, breakfast, snack, lunch, snack, dinner! he proclaims every hour or two. I find it humorous that the symbol of stability and routine sits perched on a window sill, slightly tilted to the left and partially covered by vines.
As though he is trying to blend into the crowd over which he rules.
As though he is trying to hide himself in symbols of life and an outdoor view to seem less like the cold, sterile hospital.
Mocking us with his off-kilter stance.
“Well, I’m not really here for me, I’m here for my alter.”
All of the simultaneous conversations that fascinate and irritate me so cease in an instant.
If I said that, would they quiet for me?
Until this comment, no one had paid much attention to Elaine, except for Stacey, who had met her during a previous hospitalization. We, of course, gave Elaine the obligatory hellos and I’m-so-and-sos, but she seemed so nondescript, why bother pushing the introductions? Almost everyone, even the repeat offenders, came in demure and subdued. Whether out of self-hatred, depression, an acute sense of failure, or some other emotional affliction, people shrink into the room, become smaller than their already fragile frames, and attempt to disappear with the great fervor reserved for acting out eating disorders.
Elaine was no different. At lunch, after the introductions, she sat silently, poking at her food, occasionally letting out a half-sigh, and resting her forehead on her left palm. No different from anyone else.
But now, what intrigue! What a comment! Although Elaine made the remark to the recreational therapist, Tracy, it now belongs to everyone in the community room.
She probably wanted everyone to overhear.
“I don’t have an eating disorder,” Elaine is explaining, “but I have DID.”
“What is DID? And why are you here if you don’t have an eating disorder?” Ashley’s voice conveys her irritation; she is obviously threatened by this creature with a possible case of condition-worse-than-mine.
“Dissociative Identity Disorder,” I whisper. After years of being pushed through various doctors and being heavily medicated by my parents, I’ve read a lot of psychiatry books. The DSM is a rabbit hole of could this be me?
Ashley glares at me. I have chosen my side: I either have to make an ally of Elaine or petition for my immediate discharge. Elaine seems the more attainable choice.
“Yeah. Anyway, basically I have several different identities in my body. Elaine, who is talking to you right now, is me. One of my alters, Kris, is a seventeen-year-old anorectic. And her eating disorder is interfering with our—I have three known alters—recovery. So I’m here for Kris.”
Most of the other patients just murmur and return to their crosswords or journaling. Ashley won’t allow Elaine to steal her self-designation of worst-off, and I am fascinated by anything dark enough to make you split yourself apart, so neither of us will allow the matter to drop.
“Now when you say you have more than one personality, do you really mean you can identify them, or do you just mean you feel like there are many different people inside you?”
“I just spent four months at McLean Hospital to learn to identify some of my alters and to help me gain control over them. Ask them.”
Elaine won’t play games. I smile.
Ashley leaves to pout over her discovery of something more complex than she. So competitive: a character trait of personality type A, a character trait running rampant in our group.
“At least she’ll have a valid reason to sulk for a while. You get what I said.” With her statement, Elaine turns from me and continues the conversation she began with Tracy earlier.
I do understand. Elaine is one mind, shattered into several pieces. Her fragments are other identities, embodiments of different parts of her, results of some horrific events or emotions or memories. She dissociates to deal with life.
I, too, am shattered into several pieces, though still stuck together enough to present as a single girl. Memories missing, gaps and nightmares. Fragments of ambitions and plans and goals and projects all started and abandoned. My life is a series of dichotomies—even if false—of failure or success, empty or bored, good or bad, restless or exhausted. The entire shading spectrum out-shadowed by its two extremes, black and white.
I am obsessive-compulsive, bulimic, suicidal, paranoid, hallucinating, and college-bound with a National Merit scholarship.
I can dissociate myself from my symptoms enough to separate my mind from my life. I itemize myself: my projected identity outside, filled with strength and displaying promise, composure; my crumbling reality inside, a file cabinet of wires, my brain being rearranged and I with no recourse. Destroying myself slowly and secretly. I am caught between two worlds.
With her revelation of her DID, Elaine became a new person to me, elevated in my mind to tragic heroine—beautiful, intelligent, dryly humorous, and possessing a character flaw. With the start of her crusade against the injustices she perceived in the program, she became a new person to everyone.
“Get me a stool.”
“Pardon me, Elaine?” Joan doesn’t even look up from the newspaper to reply.
“Get me a goddamn stool.” A few of the girls turn around, curious, as Elaine comes storming through the room.
“Calm down. Why do you need one?” Joan puts down her paper now.
I sit still, wishing I had the guts to swear at the nurses.
“My feet won’t touch the frickin’ floor in the bathroom, that damn toilet is too high. I have to be grounded to pee!”
A few girls nod. Joan smiles.
“I know! It’s impossible to urinate when...”
“Oh, shut the fuck up, Ashley!”
“Hey, I’m short too. I know what you mean.” She pouts and turns away.
“Seriously, Joan,” continues Elaine, “that toilet is like three feet off the ground, I have to climb up onto it, and then my feet don’t even touch, so then of course they swing back and forth like when you’re a little kid sitting on a chair at an adult’s dinner table, and so they swing and swing and this last time, my pants came right off my legs and landed on the floor. And the whole time I kept thinking, what if Dr. Jansen or George walks in and sees me sitting here like a five-year-old with just a shirt on swinging my legs? I may as well have been singing Itsy Bitsy Spider.”
I burst out laughing and Elaine grins at me. A few of the other girls vouch for her complaint. All the while I just keep picturing Thumbelina sitting on a huge toilet, rocking back and forth on a giant porcelain swing. Knowing her complaints are garnering an audience, Elaine continues the performance.
“And then! On top of that, the toilet paper holder is so low to the ground that I have to perform the greatest balancing act in all of history as I attempt to lower my right side to grab some paper while I use my left arm to cling desperately to the side of the bowl. Not only does this put me in danger of throwing out my back and needing physical therapy for years, but I am also exposed to a multitude of dangerous germs. It’s a compromising position and a disgrace to this program!”
Those of us listening cheer and clap. Joan shrugs at the other nurses now looking out from their station.
So that’s what it’s like to be short—you are never grounded. But I’m not stable, and I’m five inches taller than Elaine.
“So get me a goddamn stool, I’m sick of this shit.”
“I’ll see what I can do.”
“What are you guys trying to do to people?” Elaine accosts Thursday’s nurse, Margaret.
“What do you mean, Elaine?”
“I mean, we are already sick enough. We don’t need you putting up signs to make it worse.”
“I, I don’t believe I know what you mean. We are here to help you...”
“That waiting room sign.”
“Yes, what’s wrong with it? It’s there so people know where to sit and wait while...”
“Exactly. They told me to go to the goddamn waiting room and I would see the sign on my right down the hall and it would show me where to go. And I got off the elevator and looked to my right, and there was the sign, on the edge of the double-door frame, with an arrow pointing to the left. So I walked over there and went to my left and where the hell was the room? On the RIGHT! In front of me was a fucking wall.”
“It’s so people who aren’t crazy already will have something to lose it over,” I say rather loudly.
Elaine focuses intently on Margaret. “You have to change that goddamn sign, I’m sick of this bullshit.”
I feel a bit bad for Margaret, she’s just a sweet old lady devoting her time to helping people, and here she is, subject to the rage of some aspect of Elaine.
Maybe this is Kris now. Elaine says Kris curses more.
“I’ll see what I can do.”
“See what they can do, see what they can do, that doesn’t mean shit.” Elaine is pacing and mumbling. “What the hell do you want, George?” She turns to face the counselor.
“I heard you were getting agitated earlier. Dr. Jansen and I want to talk with you. Can we go to my office and talk?”
Elaine rolls her eyes, gets up, mouths me the words just wait, and walks out of the NEED room.
Twenty minutes later, as I am curled up in my usual spot near the bolted-down window, listening to Tidal, lying atop two pillows and covered in a blanket, Elaine marches triumphantly into the room like a prophet proclaiming the return of a god.
“THEY CHANGED IT!” she screams and flashes me a huge grin.
The nurses dash from their station to find the source of the yelling, the girls bolt up from their naps or crosswords or homework, and I cheer over the music in my ears.
“What is going on here?” Betty, one of the clinicians, halts Elaine.
“They changed the sign. Your superior changed the goddamned waiting room sign.” She switches to the past tense of the curse to describe the sign. Its day of judgment has finally come.
“What waiting room sign?”
“The one that pointed to the wrong side of the room.” Elaine is cheerful now, calming down. I bet she will stop swearing. “The arrow pointed the wrong way, and when Dr. Jansen and George were taking me to discuss my earlier behavior, some guy in a suit came up to talk with them about how this program was going. And seeing me, a fine specimen of said program, he asked me. And I told him about the sign, and he said it was, indeed, wrong, and he went over and ripped off the arrow from it. So then I told him all about the bathroom and demanded a stool. And he promised to make sure we got one. He even told George to get us a nice one out of oak." She’s beaming.
We need these small victories. The chance to feel we accomplished something in the face of giving up our eating disorders, which have been the only constant in most of our lives. There are few battles we can win in the program. We can’t lie our way out of eating or fake our weight to reduce the amount of food on our meal plan. At the end of the day, all we have is the fear of dealing with the roots of our neuroses.
“I think it’s been a productive day,” says Elaine. “Get me a goddamn crossword.”
“I’ll see what I can do.”