Photo by Ilie Adrian
The inpatient unit of the eating disorder facility is bleak, and a putrid odor permeates the air. A desperate girl must have poured her Boost down the vent, or worse, puked down it. Last night, I found a large chocolate chip cookie stuffed in the couch cushions. Someone snuck it out of the dining hall and hid it here, too terrified to eat it during lunch. They check our pockets after meals, and the toilets before we flush, but eating disorder behaviors still happen. We’re all coping in any way we can.
That’s the one thread that draws us together—we are all so afraid.
Snow falls gently outside, and the mountain is pure white against a dark gray sky. They blend together, incomplete on their own. We too, are incomplete. It’s freezing in here, but I can’t tell if it’s the temperature of the unit or my inability to regulate temperature. My hands are mottled and blue, and I can’t stop trembling. My arms and my legs ache from refeeding syndrome, which is a condition where the electrolytes in the body drop to low levels in response to the reintroduction of nutrition.
I stand up and everything goes black; my heart flutters uncontrollably. The dizziness is so profound I think I’m going to fall, so I slump back into my wheelchair. Resigned. Terrified. I’ve been at the Center for only two days—a place that has become too comfortable over the years. And my brain is still as fuzzy as a vintage TV with a broken antenna. I can’t string a sentence together, but I don’t notice that yet. I do know that I can’t find the right words. I keep trailing off, unable to access a simple thought. And I’m a writer, dammit. I’m articulate; I tell stories for a living.
Correction: I was a writer. I haven’t picked up a pen in almost a year.
I’m thinking about the journey I’m about to embark on. How I’ll have to gain weight. With all that is happening, the thought of living in my body is what hurts the most.
I scribble nonsense in my journal, feeling unusually ill. I’ve done this before, but something, it occurs to me, could really be wrong. I wheel myself to the nurse’s station to complain. A nurse with long dark hair, dressed in scrubs, asks me what’s the matter.
“I don’t feel well. Were you guys supposed to run a renal panel this morning?”
She says they were, that we’ll do one now.
“I can’t move my legs right,” I say. “Something is different.”
She raises an eyebrow. “You’re gonna feel like shit. You’ve really done it this time.”
“I can’t even stand up.”
“It’s just refeeding. Want some Tylenol?”
“Forget it,” I mumble. “It’s probably nothing.”
They draw my blood, “just in case,” and someone helps me to the couch. My brain grows more nebulous than ever.
Hours pass, and I’m unaware of my surroundings. I remember only a little of that day, but eventually a nurse practitioner rushes to the couch. “Your labs are terrible. I really think we need to go to the ER. Your sodium is dangerously low.”
They rush me into a little room, where a nurse shoves a plastic tube up my nose. She instructs me to swallow hard while drinking water. I gag, and my throat aches as she guides it into my stomach. Then, they give me salt tabs and Gatorade to get the sodium up. Someone jokes about setting up a salt lick at the nurse’s station. “Nutrition,” she says as punches buttons on the feeding tube. “That’s what you need the most.”
This is all my fault, and yet I can’t help it. At this point, the Center is the only thing keeping me alive. Anorexia will eventually kill me. It seems I’m incapable of recovery. I’ve been at the Center, fighting for my life, more months out of the past few years than not. This is devastating to my children and husband, and I see no way out. Especially because the brain fog won’t let up. If I can’t write again, I see no point in living.
Three years ago, I was in recovery. Hell, I’d even considered myself recovered. It wasn’t just that my weight was restored; I was thriving. I wrote six novels in several years; my debut had just been released. I’d published short stories and poetry in literary magazines. I went back to school and got my BFA in creative writing. I’d landed my first literary agent. I was living my best life.
Then the stress of Covid and the loss of my father precipitated a relapse. A relapse so exquisitely painful that it wiped out my career, ravaged my family life, and created an obsession that has made me care about nothing but altering this body. I’d thought I was done with all that, but eating disorders are insidious. They can recur at your weakest moment. Now, I come here, sick and desperate, and each time they fix me. Then I go home and get sicker than I was before. My doctors say my heart can’t take another hit. And yet I am so scared to let go…
I spend seven difficult months at the Center, restoring weight, as well as my mental and physical health. The process of getting better is grueling. I spend five weeks on a feeding tube, five months in a wheelchair, and I don’t see my family in person at all during this time. I miss my children so badly it physically aches.
It’s the fact no one talks about when they romanticize eating disorders. They don’t just make you skinny. Malnutrition damages the brain, sometimes permanently.
I hope it’s not too late to find my words.
Sarah is my nurse practitioner throughout my time at the Center. And she keeps fighting for me, even when I cannot fight for myself.
At the sixth month of my treatment stay, she approaches me in the residential unit, where I am now ambulatory and feeling less depressed. I haven’t started writing yet, but they assure me that recovering my career is as possible as healing my relationship with food. At forty-seven years old, I’m not so sure. I’ve had this disease for most of my life. Can I really change now?
Sarah hands me a yellowed paperback, and says, “Happy six months.” It’s a 1985 printing of the classic A Man’s Search for Meaning by Victor Frankl. I flip through the pages, tears welling in my eyes. Sarah has annotated and underlined throughout the book, which is about a doctor who survived the Holocaust. It’s a message about hope and the power of positive thinking, even in the bleakest of circumstances. I feel a little ashamed. My experience is nothing like the Holocaust. All my pain has been self-inflicted.
“I’ll give it back to you tomorrow,” I say.
“No, you don’t need to.” She smiles. “It’s a gift.”
The Center is filled with people like Sarah—people rooting for us to beat this terrible disease. My therapist and dietitian. The nurse practitioners and care techs. Why can’t I do it? Why is this so damn hard?
Eventually, I am physically well enough to go home, though I’m still not convinced that recovery is something I want. My agent is waiting for a revised novel from me, one I’ve been working on seemingly forever. I’m trying to claw my way out of this coffin I buried myself in, yet it feels impossible. I write a few sentences or even a paragraph, only to lose concentration and give up. I’m still dizzy. In the aftermath of the relapse, I discover that my relationships are shattered too. My kids and my husband are so angry; I failed to show up for them. I don’t know how to grieve the loss of my mind. “You’re just gonna do this again,” my 20-year-old daughter says. “Everyone tells me it’s not your fault, but I can’t help being angry.”
I eat dinner the night she says that. And the night after that.
I go to a partial hospitalization program during the day. I desperately want to discharge from it, but the therapist and dietitian insist I’m not ready. It’s mind numbingly boring. Part of me wants to get out so I can lose all the weight I restored, especially if I’m never going to tell stories again. My therapist says I’m catastrophizing, that this writer’s block will lift if I keep eating my meal plan. Creativity and stress don’t mix, and I’m pressuring myself too hard.
At least I want to write again. Maybe it’s a good sign. Maybe this means I’m ready to move on in life, to leave this disease behind. Each time I choose not to exercise or to eat my meal plan, I feel horrible guilt, but I push forward. I don’t want to maintain this weight, but I do want a life. I’ve discovered that I can’t have it both ways. If I want to create, I have to nourish my body.
It’s hard to untangle myself from the eating disorder, this entity that has become a strange sort of identity. Am I a writer? Am I a mother and wife? I didn’t choose the eating disorder, but I can make the painful choice to let it go. Years ago, when I was in recovery, I said the eating disorder wasn’t worth it. Please let this be true, because Sarah is right. My heart can’t take another hit.
I can’t take another hit.
So I fight. I fight harder than I ever have in my whole life, unsealing the casket I buried myself in. It’s a long climb up, and there are a lot of missteps, but I have to remember that it took years to get me to this place. I’ve been through some shit–I lost a husband; I raised two kids alone for years. I can do this, I keep telling myself as I step down in levels of care to intensive outpatient, which means I get to go home at noon. Feeding myself three meals and three snacks, I grieve the loss of my daily workouts. I promised my treatment team I’d maintain this weight, which is a little low–but they are making concessions for me, too.
I am working on my book again. It’s not thousands of words per day, like I used to do, but it’s 500 and then 1000. My fingers fly across the keyboard, the tapping like music, a melody. I’m going to get the next book turned into my agent, even if it takes me a long, long time. She’s been patient with me. Hell, everyone has been patient with me. I can’t seem to make myself eat consistently, but I’m doing it most of the time, and my intentions are good. I’m trying to stay at this weight. My fingers are anchored to the keyboard, and my words, however feeble, are keeping me motivated. Because I’m a writer. No disease can take that away from me.
I get a job writing content for a magazine online. It’s not my dream career, but I’m getting paid to write again, which makes me feel good about myself. Ironically, I write about food. I start repairing my relationship with my husband and children. It’s a grueling process, and I have so much to prove to gain their trust back. I must push away the guilt and shame and offer myself the same self-compassion I give to my friends. My body is damaged from all I’ve done, and I’m making peace with her, too. I remind myself that everyone struggles. I’m not alone in it; I’m part of this common humanity.
We’re all riding this wave together, just trying to get to shore. I never want to go back to the inpatient unit. For once, I’m not triggered by the thought of the women there, with their rail thin bodies, because I know they also have broken brains. I used to say all of the things I didn’t want from recovery. I had a therapist once ask, “What do you want, Melissa? I’m tired of hearing what you don’t want. No one is gonna stand at your funeral and say, ‘Well, she was thin,’ because your weight is the least interesting thing about you.”
I finally know the answer to that question: I want to be a mother, a writer, a wife. I want to take back the identities I had before this relapse. I want to know that life is worth living, even if the brain fog never lifts, even if I never publish again. I want desperately to say I’m sorry and mean it. To know humanity like Viktor Frankl did, even if my horror was lived inside a warm and comfortable treatment center, though my starvation was self-inflicted. I want to love and be loved. Maybe what has happened really is a gift, because I can’t imagine these revelations without the struggle. Oh, it took such work to get here. It’ll take more still.
But as soon as I pick up that pen again, I realize that I’ve been writing the next chapter of my story all along. Because I’ve always been a writer, maybe since before I knew how to read, even. We all have stories to tell; we all need a voice.
This is mine.
Melissa Colasanti-Woods has a BFA in creative writing from Boise State University. She has been published in Lithub, Crimereads, Memoir Magazine and others. Her novel, Call Me Elizabeth Lark, was released by Crooked Lane Books in 2021.
Image courtesy of GoDaddy.