Nano: Finally daring to look back

National Novel Writing Month–November, 2010.  I was so happy then.  From November 1st until November 17th, I wrote an entire novel.  It’s hard to believe.  During this busy time, I still ran at the gym nearly every day, and maintained my usual social contacts.  I even had time to take care of myself and prepare meals and eat. I realized that I needed to keep my body in shape in order to write well, and eating was part of taking care of my body.   Writing a tragic book about a 50-year-old woman with anorexia was perhaps one of the most difficult writing projects I have ever undertaken, and to do the entire thing in 17 days made the experience extremely intense for me.  I remember all this with amazement.  I did it. There was Nano, and there was the 5k I ran, almost exactly a month later, both incredible accomplishments, and sandwiched between the two was saying goodbye to a therapist I’d worked with for two difficult years, and starting up with a new one.  Wow.  And running, running, running.  Maybe getting sick was a way to run away from it all.

Last night, I glanced back.  I went to Staples yesterday afternoon and bought a new ink cartridge, in case I needed it, and some printing paper.  I printed out the entire manuscript to I am So Cold, and Hungry in My Soul, my Nano book.  This is the very, very first time I’ve even looked at my Nano book since I finished writing the final words, “And another,” on November 17th.  Last night I read the book cover to cover, and loved what I saw.

I know this now: I wrote a book about a woman with anorexia with the understanding that only a sufferer knows.  I saw a character, a middle-aged woman who grieves the loss the life she once knew many years ago.  I watched a woman with anorexia lose a beloved pet.  I saw her grieve as her sisters abandoned her.  I saw her cling to a man to whom she is forced to turn when she believes he is the only ally she has left: the man who raped her.  I felt her intense sorrow over the suicide of her best friend, also anorexic, and the rage at the ones who ultimately drove her friend to choose that path.

Yeah, the book needs a lot, lot, lot of work.  But I am saying that because it needs work.  That is, it can be worked on, and will be worked on.  What I am saying is that I don’t need to chuck the book.  What I am saying is that it is a decent book that is worth salvaging.  It’s more than a decent book.  It has a lot of potential.  There was some really nice, poignant stuff in there.  Much of the book made me cry.  Maybe someday a lot of the book would make a lot of people cry.  See, I’m going to revise it, right here right now.

So right away I signed up for an online novel revising class recommended by a Goddard grad I know.  The course works well for Nano novels, it turns out.  It is a five-month, intensive course.  I know I can do this.  My “confidence level,” as my T puts it, is 100 percent.

This is the time, and this is the place.  I can write.  I can concentrate.  I can read.  I found these things out last night.  As for It, well, I can work around It.  I have motivation, I have will, I have desire, I have motivation, I have skill and talent.  And I have a damned good first draft.

All I have to do now is to stay out of the slammer.  That means eating.  Hear that?

And maybe, over the next few months, I’ll be glancing back more and more at those happy few months I spent eating and taking care of myself and doing things I loved, and asking myself what I did right, and what I could have done better, and why it all fell apart.  Maybe I need to carefully examine December and January, and see what I could have done differently, so that what happened–the falling apart, the months following, the heartbreak, the loneliness, the tragedy of it all–won’t repeat itself.   There are misunderstandings, sheer ignorance of what could and may happen to us–what could happen to anyone, in fact–and we do learn from our mistakes so that we don’t repeat them.  Or at least if we are good, patient learners who have truly lost ourselves and don’t want to lose again, we don’t repeat our mistakes.  I may be stupid, but when it comes to another, I am cautious and caring enough to know better.  And in the end, when all is healed, there will be no need to apologize, as no wrong has been committed, and love and forgiveness is a given.

A Letter to My Friend, Never Sent

Open your hand and catch the joy I am sending to you now
It is attached to this e-mail
Catch the joy and hold it to your heart

Hold it in your heart and feel the rush in your body
Hold it in your heart and feel what I feel for you
Hold it, and know I am here for you

I am here for you and I told you so in an e-mail
You did not write back
So I held that thought in my head and my fingertips

I walked to Watertown Square and back three times
Just a skinny girl running errands
It is my nature–our nature–to be foolish

And while walking, very fast
Some rude guy said to me
“Watch where you’re going, Lady!”

Yes, I’m watching where I’m going
I’m watching myself become strong again
I’m feeling it in my body and mind and heart

You see, the snow is starting to melt
The sidewalks are clearing
I listened to music and broke into a run

Because we are so cold and hungry
I am sending you a seat by the fire
I am seated beside you

You have told me that to nurture you
I must nurture myself first
But what I cannot do for myself I do for you

Because it is our nature not to save ourselves
For our own sake, but perhaps we will do it
For another, at first, and then for ourselves

For you, I will climb a tall fir, and harvest the sap
And spread the sticky stuff upon my hands
So that I can stick to you more firmly

For you, I will tie great snakes in knots
So that they will not harm you
And pull all hundred legs from every centipede

For you, I will run, too
I will run all the way to the airport
And then, on the plane, watch Boston disappear

Yes, I’m crazy, you’re crazy, too
Everyone will think I’m nuts–or maybe they’ll know
They’ll know…why….

I will crash though your door
Wood splinters flying everywhere
Run up the stairs to your room if that’s what it takes

If that’s what it takes to heal
I love your shirt, your strong hands, your hair
Everything about you

If it comes to this
Then it is real, and necessary, and right
Because we are real, and necessary, and right

If it comes to this
I will do anything
If that’s what it takes to heal.

 

 

 

 

 

The McLean Papers January 10, 2011

I was hospitalized January 2-24 2011 at McLean Hospital in Belmont, Massachusetts.   While there, I kept a brief log of my feelings and experiences to show to the doctors and staff.  I also kept a record of what medications I was put on and other relevant experiences.  Here is my paper for 1/10 (I believe I posted the other 1/10 paper the other day).

List for 1/10

Good:
I have more physical energy
running helps me
I know a couple of people’s names [I learned the patients’ names while there but most of the staff’s names I did not learn]
I talk to my roommate
I negotiate with people

Bad:
I talk to staff less
I hide my feelings
I am terrified of my roommate
I am terrified of everyone
I don’t trust anyone

I fear that I will not get better
I fear that I will not survive
The binge-urge is getting worse
Only Frank understands the seriousness of this
Only Frank understands that something must be done
Right here right now
Immediately–today–not tomorrow–
Not after I get out
For some reason, I am managing to get to the point here
About my terror
About how I feel like a scared, trapped, cornered animal
I feel smothered
I feel like I am figuratively in restraints
And I don’t know who or what will release me
Or if the cuffs are loose enough for me to slip out
Only medication helps with bingeing
After 30-plus years with this eating disorder
I know my history–better than anyone
I know my body
I know my terror
The patients comment–all the time–on my thinness
They watch me eat and comment
Any comment is a rude comment
It is a given
Sometimes the depression is so intense
That I fear I will drop dead from t–spontaneously
Some days I have felt this
It lasts for a number of hours and yesterday I told no one
Yesterday I managed to tell the day shift nurse about 10% of it
The weekend psychiatrist spent less than 45 seconds with me
Sometimes I am way too terrified to ask for help

My Eating Disorder and It

Many people choose to call their eating disorders “Ed.”  Well, I choose not to.  That is not very original.  If everyone calls their ED’s “Ed,” why should I, too?  I have never called my ED “Ed.”   Moreover, I have never thought of my ED as a person or being or personality or presence.  My eating disorder is a part of me.  Sometimes, it is me and I am my eating disorder.  My eating disorder follows me everywhere and so does It.  But right now, my eating disorder is swallowing It up.

My eating disorder is swallowing up It, and it is swallowing up me, too.   Maybe anorexia is like a snake that is eating me, and It that is within me, and I am passing along the snake’s body as I am digesting.  You can see me there because I am a lump, an irregularity, still visible, but trapped within this snake’s body.  Eventually, I will be broken down and digested, or, possibly, spat out.

Just as I am starving myself, I am starving It.  Over the past month, I sucked the life out of It.  It is shriveling and dying.  You have to take care of It, nourish It and cherish It and hold It in your arms.  Instead, It is so hungry that It cannot even cry out for nourishment and love anymore, and I do not hear its whispers and temptations.  I called this progress, and it was.

It controlled my thoughts, yes.  It scrambled my thoughts, yes.   But I starved It and It lost its power to do those things.  But now, my thoughts are skewed and slanted.  Now, my thoughts have turned against me, against my body and my brain and my life itself.  My thoughts are clear now, clearly set on one self-destructive goal.

But are my thoughts really clear?  Because when you starve yourself, you can’t think clearly.  I know sometimes I can’t concentrate, and my head doesn’t feel right, and I feel feverish and faint.  I know sometimes I am very, very slowed down.  I can’t walk very fast or very far.  I am dragging my feet and my mind drags, too, and my life drags around in the mud like the book bag a child has dropped to the ground beside him, and can no longer carry over his shoulder.

Now I suppose it’s time to open the book bag.  I need to open the book bag and peek inside.  I don’t need to take the books out, or read them, or even read their titles.  I just need to open the book bag, if only for a moment, when I’m ready.  But maybe first I need to drag the book bag to the side of the street, so it won’t get hit by a car or truck.

When I’m ready.

An Open Letter to My T Following Our Phone Conversation

Dear T,

I am glad you called.  I am glad that you were considerate enough to listen to my request and honor it.  I am glad that you understood my intense fear of the Death Place, and were willing to take the line in the contract that mentions sending me to this place out of my contract.  I am glad that although I don’t feel I can entirely trust you, some of my trust and faith in you has been restored.  Mostly, I respect you for respecting me and listening to me and not being overly rigid.  Strict does not mean rigid, after all.

During our conversation, I was tempted to say, “I cannot do what you require me to do.  I cannot gain weight.  It is a losing battle.  I am denying myself nourishment.  I have been lured back into deprivation,” but this I did not say.

See me.  Hear me.  Believe me.

Julie

An open letter to my T

Dear T,

You have not responded to my phone calls.  I assume this has been deliberate.  I assume that you are not budging on our contract. I assume this means that because I signed it, the contract will not be reviewed until at least Tuesday when we meet next.  That leaves me with the rest of today (Friday), the weekend, and Monday, to deal with the contract as it now stands.  I cannot deal with the my intense fear of the Death Place, and this threat of your sending me there more or less against my will.  Right now, I have more or less given up that you will call.  Right now, I am hopeless about the days ahead.  Right now, I am weak and starving, and cannot move onward from this abyss.

Julie

Sitting here

I have no will to nourish myself, none at all.  I feared for some time that I would be so weak that I wouldn’t be able to walk over to the phone and pick it up when it rang.  Finally, I forced myself to drink a bit of OJ, and now I feel a little better–much better, in fact.

This is not working.  I do not know where to turn.  My T has betrayed me.  I cannot trust her anymore.  The world has turned against me now and I don’t have the strength to fight back.  I don’t have any power left in me.  My body is my enemy.  The air I breathe seems poisonous to me.

My T should be calling–soon I hope.  I have begged her to call.  Sometimes, she chooses not to, and leaves me to make my own decisions.  It is not my decision.  I am asking her to do a favor for me.  Perhaps she expects me to just deal with this contract?  If there is any decision on my part–to eat, or not to eat–well, I am powerless to make this decision.  Fate has made it for me.

The contract is not working

I left a message for my T requesting that we try a different approach, that the contract was not working for me.  I said that it was making me feel that my treatment team had betrayed me.  I said that having the contract in place was causing me to have increasing difficulty eating.  I requested a different approach.   I suggested that possibly the contract was causing me to have rebellious feelings toward my treatment team.  Also, I said that I suspected because the contract was in place, my depression was returning.

My therapist is strict.  I doubt she’ll budge on this despite my pleas.

I’m scared about what will happen over the next four days until I meet with her again on Tuesday.  Today, when I took Puzzle to the vet to get her rabies shot, I nearly fainted, and it had nothing to do with my toothache.  Though my original plan was to walk home with Puzzle, I knew I had to get food into me–at least juice–fast, before something terrible happened.  I took a cab home and felt better once I got into the cab.

Seems as though I have scared It away, too.  I guess I am not eating enough even for It to survive.

Bad news

Today I felt yucky enough as it was with this tooth problem.  I wanted to blow off therapy, but she charges if you don’t show up.  My head hurt and I felt sick overall.  But I trudged in, taking my chances, knowing that if I started to feel even yuckier, I’d have to take a cab home, which would cost me nearly the amount I’d have to pay for the canceled session.

I must have known though.  Of course I was expecting some kind of blowout after yesterday’s trip to see my primary.  My weight was not good.  My doctor wasn’t happy with me yesterday.  I was expecting a lecture.  What I got was this:  A contract.  A very strict contract that involves being honest with everyone and not falsifying my weight in any way.  I have to have healthy vitals and lab work and…gain weight.  And if I don’t, I end up in the ED hospital, which I have lately been calling the Death Place.

It was with great difficulty that I signed this contract.  I do not want to gain weight and I find it very difficult to eat.  Just this morning when I woke up I was thinking about how fat I am.  I have very little confidence that I can follow this contract.  But not following it would be worse.  Much, much worse.

The Death Place is just that–it is not living.  I won’t be able to go on with my life if I end up in that place.  I know what it felt like getting out of there the two times I was in there, the second time especially, getting out and feeling the shame of feeling incredibly fat, having gained so much weight so fast, and I will not survive a third time.

But I ate a little tonight: two bananas and some milk and some yogurt, which means nothing right now, because I have to keep this up somehow, and I know I’m not going to be able to do this without some kind of help.  I don’t mean going to the hospital.  I mean something else.

Here’s the scoop

The tooth thing started around December 30 or 31.  You read my previous article.  I was in McLean Hospital Jan 2 for three weeks, so I was unable to get the tooth looked at.  When I showed the tooth to the doctor at McLean, I showed him the upper, not my lower, teeth, when he checked for an abscess (he was not a dentist, but a regular doctor) and I don’t think there was anything to see there, anyway, that was visible to the eye.  I was in a lot of pain, though, and couldn’t bite down on anything solid whatsoever.  They put me on this mush diet.  No wonder I didn’t eat.

After a while, the tooth seemed to stop hurting.  I had been convinced that the problem was a loose upper tooth, and then, I thought, the tooth had tightened up somehow, so I was glad that the problem was “solved.”  I went  home.  I ate very little.

One day, I bit into something hard, and then felt pain.  For the next few days, pain. I woke up in the middle of the night one night convinced that a whole bunch of my left upper teeth were loose.  It is in fact possible that they are…I don’t know at this point.

Two days ago, I finally saw a dentist next to the CVS in Watertown Square.  This was assembly-line dentistry at its finest.  I was truly scared.  I filled out their forms, including, in the “serious illnesses” section, “Anorexia Nervosa,” and “Psychiatric Disorder.”  I listed my medications.  Then, there was another sheet to fill out.  I don’t recall the details.  I did mention that my mother might help out with added expenses if needed.  Big mistake.

But what did I know?  I was shown into a room off the main waiting room.  The dental hygienist was businesslike, and didn’t do anything to put me at ease.  She took x-rays, saying, “Bite this,” not realizing that biting was painful for me.  She shoved the x-ray thingy in and out of my mouth, and even if I didn’t have pain, I would have minded her insensitivity.

X-rays finished, she then cleaned my teeth.  Must say, I was scared, but it didn’t hurt.  Needless to say, the entire procedure grossed me out.  She found some loose teeth up front.  I asked, “What will happen to them?”

“It depends,” she replied.

And that was all she said about that.

Another hygienist came in, glanced at my x-rays, and mumbled, “root canal.”  So that’s what it was.  But…Medicaid doesn’t pay for root canals!  What did they expect of me?  I knew that root canals were very expensive.

“You need a deep cleaning,” she said.

“What about my loose upper teeth in back?” I asked.  “The ones that hurt?”

“They are not loose.”

But she had not tested them or anything.  Nor did the dentist, when I saw him for…was it two minutes?  Three?  He touched one tooth.  One.  Glanced at my x-rays with one eye.  Said my teeth were “all chipped and broken.”

“Come out to the waiting room,” said the hygienist, “and I’ll show you your Care Plan.”

The “Care Plan” consisted of a statement of proposed future expenses:

Crown: $1,050
Pre-fabricated post and core: $370
Root canal: $1,175
Total:$2,595

The second page:

Periodontal scaling $245
Periodontal scaling $245
Periodontal scaling $245
Periodontal scaling $245
Composite three surfaces $245
Composite three surfaces $245
Total $1,470

Total Treatment Plan (All Phases) $4,065

The hygienist said to me, “Take this home to your mom and see what she can pay.”

I muttered something vague about my mother not living with me, put on my coat, and came home.

Later, I cried thinking about having all my teeth out someday.  The first association I had was the dread and fear of my mother laughing at me wearing dentures, laughing and cackling and making me feel bad and ashamed inside.

By nighttime, the shock had worn off, and I knew I’d never go back there.  But I knew I needed my tooth pulled and I might as well have them do it and get it over with, since they had my x-rays, and Medicaid would pay for it, anyway.   I called them first thing in the morning.  I had an appointment (with my primary care doc) at  1pm, so I tried to get an appointment for the evening.  The receptionist said, “Wait a minute.  That dentist doesn’t take Medicaid.”

“Huh?”

“He doesn’t take Medicaid.”

So then I knew what they had done.  When I had written that my mother might help out, I meant maybe 50 bucks.  They thought: big money.  So they set me up with the contracted dentist.  WHAT DID THEY EXPECT?  I AM ON MEDICAID, YOU IDIOTS!

I called a different dentist and set up an appointment for next Tuesday.  This one is right near my home.  I actually started crying on the phone while talking to the hygienist.  She explained many things to me.  We had a lengthy conversation.  She told me to have my primary care physician prescribe an antibiotic.  The other guys hadn’t.  My primary decided not to give me one, either, as it turned out, but this was after carefully examining me.  I stopped by at dentist #1 and picked up my x-rays, then brought them over to dentist #2.  When I got there, they told me that they found out that I have to see an oral surgeon to get my tooth pulled, because of Medicaid regulations, and that they couldn’t do it themselves.

I came home.  I called Medicaid to find oral surgeons.  “Franciscan Children’s Hospital,” he said.

“I beg your pardon?”

“Franciscan Children’s Hospital.  You want the number?”

“I’m 53.”

“Oh, sorry.”

He gave me three numbers.  They didn’t seem too close by.  I asked, “Do you have any closer to Watertown?”

“No, these are the closest.”

The first was to Franciscan Children’s Hospital.  The second has its first opening in May.  The third was closed for the day.  It wasn’t yet 4:30.

I looked on Medicaid’s website, and found a number of oral surgeons much closer to my home.   I will call them tomorrow.

For a while tonight, I felt pain all over my teeth, then it radiated to my whole head.  I wondered how much longer this is going to go on.  I wondered just how dangerous it is to have a bad tooth like this for a long time.  I wondered how many people go for long periods for bad teeth either because they don’t know any better, or because they have no insurance, or because they’re homeless, or locked up, or cannot afford to pay, or are afraid to see a dentist.

I have never been homeless, but I
didn’t know any better
am on Medicaid
was locked up
cannot afford a root canal
was afraid, very afraid, to see a dentist.

Also, I was ashamed.  Ashamed of what years of neglect may have done to my teeth.  Ashamed of the role that my self-starvation may have played.  Ashamed of the fact that I am a mental patient seeing yet another doctor for yet another ailment.  Ashamed that I am skinny.  Ashamed that I am so fat.  Ashamed that I feel pain and complain of pain and succumb to pain and cry out in pain.

For the tears I wept when I spoke with the hygienist this morning, though, I am grateful.  Because it was through these tears that I saw hope.  I saw a connection. And it had nothing to do with my tooth or my pain or my dentist ordeal.  I felt a release of emotion in me.

She was very kind.  “You are going to feel very better soon,” she said.