Butter

Names have been changed to protect privacy.—Ed.

 

When I passed her doorway, I sometimes caught a glimpse of Beth sitting on her hospital bed, her body gathered into itself, all sharp knees, elbows, and cheekbones, her milk-pale skin aglow. She had shoulder-length brown hair, a smattering of caramel-colored freckles, and bright-green eyes. Beth was the leader of the girls on the inpatient eating-disorder unit, and the others huddled around her like skinny ladies-in-waiting. If they were with her in her room, I’d hear their voices lower as I passed. I imagined their collective exhale once I was gone.

I often arrived at group therapy or art therapy to find Beth whispering with my roommate, Lesley, their heads snaking close together like a hydra’s. At nineteen I yearned for their acceptance. I would never get it.

I had bulimia, and 90 percent of the patients on the unit were anorexic. Beth was about as deep in the throes of anorexia as one could go. Her thin, angular face looked like a Picasso drawing. There was a hierarchy with the sickest girls at the top, and everyone looked to Beth as an example. Thanks to some recent weight gain, my once-scrawny arms had a nice layer of life-sustaining fat on them, which made me too heavy to be liked.

I remember complaining to the nurse the day I arrived. “They hate me here,” I choked out. “You get used to it,” she said. No, I thought, I won’t, but the nurse was right. I did get used to it. Still I remained baffled as to why I allowed Beth, who was so sick and so mean, to wield such power over me.

 

That fall I’d arrived at Evergreen State College in Olympia, Washington, weighing ninety-eight pounds and shivering. Bone-skinny, my body could not retain heat. And though I could rock a size 2 baby-doll dress (it was the late eighties), I was jealous of my classmates, who had juicy, healthy bodies and ate candy bars without apology. At Evergreen I encountered women with PhDs discussing how marketing campaigns capitalized on women’s insecurity while simultaneously supporting patriarchal ideals designed to disempower us. For the first time I had an explanation for why I believed I did not deserve to eat, and that only in the tiniest body did I have any worth as a human being.

Instead of finishing my freshman year, I became one of the eleven patients on the fifth floor of Ballard Community Hospital. We lived two to a room and filled our days with nutrition classes, private sessions with a psychiatrist, and group therapy sessions. The hospital was in the center of the Ballard neighborhood, two miles from where I currently live. The unit has since been replaced with doctors’ offices, but sometimes, driving past, I’ll look up and imagine us all still there, sitting across from one another in the dining room, a nurse sliding a blue plastic tray from the cart and calling out a name (each girl was assigned a precise calorie count), the air smelling of overcooked broccoli, Secret underarm deodorant, and coffee.

I could describe my disorder. I could tell you in detail about the day I drove to a McDonald’s, ordered five Big Macs, consumed them in quick succession, and then purged. But that moment shouldn’t hold more significance than a thousand other moments when I overate or starved myself or flew through step-aerobics classes and went straight to a doughnut shop—my feeble and uninformed attempts to outrun emotions I didn’t want to feel. The symptoms of my disorder seem beside the point.

The misery of my bulimia—the acid-burned throat and stinging gums, not to mention the disgust I felt purging—was enough to make me wonder if I would be better off dead. Stewing in self-pity, I pictured my divorced parents standing side by side at my memorial service, feeling guilty for not having paid more attention to me.

In the hospital I continued to be the type of person I’d always been: a rule follower, ingratiating herself to the authorities, reviled by her peers. Beth hated me instantly in a way she could not help. In the dining room one day she informed me that, since I didn’t require a heart monitor or IV fluids, I wasn’t legitimately sick. If I’d had the courage to offer a retort (which I definitely did not), I might have said, It’s making me sick to sit across from you. Instead I sighed and poked the grayish peas with my fork.

One of the rules in the dining room was “No inappropriate food talk or fetishizing food.” On my second day in the unit Beth took the seat across from me and began to tell jokes.

“How do you find a lost anorexic? Tell your dog to go fetch a stick.”

The nurse scolded her, but Beth laughed and continued.

“Why do anorexics eat other anorexics? Because they’re low fat.”

I could not refrain from laughing.

Beth moved on to a calorie-counting game. “Apple,” she said.

Without looking up from her tray, Lesley said, “Just saying ‘apple’ is ridiculous.”

Beth smiled tightly. “Small apple.”

Someone else said, “Eighty-nine calories.”

Seeing my discomfort at all of this, Beth smiled. “Oh, it’s against the rules. Sorry,” she said. “I forgot you like rules.”

I reeled with a helpless rage. Conditioned to control my anger, I experienced it not as an energy but as a sort of anesthetizing force.

 

Each patient met with a psychiatrist four times a week. Mine, Dr. S., wore colorful ties and had salt-and-pepper hair draped across his forehead. He gave me worksheets with faces meant to represent emotions, which he described as fleeting mental states hardwired into us. I listened with rapt attention. Having a conversation with an adult male who didn’t dismiss my feelings made all the bingeing and purging almost worth it.

After my parents’ divorce, my father had relocated to Alaska, a place whose landscape I could conjure more easily than I could the man himself. No one who knows my father would call him an emotionally available person, but as a child I’d blamed his indifference on myself, as though I, his only daughter, were the cause of it. So when Dr. S. asked, “How do you feel?” I made him repeat it so I could revel in the experience of having a man listen to me.

I complained to Dr. S. about Beth. I told him she didn’t even eat her lunch and mocked me for putting butter on my food. If one wouldn’t eat in the hospital, I wanted to know, where would one eat?

Dr. S.’s eyes crinkled in a thoughtful way. “Group therapy is a good place to bring topics like this up,” he said.

In group we sat in a circle on folding chairs. As you might expect, the sessions were tense and combative. Imagine six or seven or ten traumatized, half-starved young women competing for advantage while a therapist played referee. Group definitely did not feel like a good place for the insecure, fat-padded bulimic to ask the anorexic when she planned on eating.

“I am not that sort of person,” I told Dr. S. When he inquired as to what sort of person I might be, I sank deeper into his couch.

Did I not see, he asked, how Beth’s anger, while frightening to deal with at times, served as a protective force? “Don’t you think some of her abilities, honesty, and emotional expression could be beneficial in certain scenarios?”

All I knew was Beth averted her eyes when I entered a room and sighed loudly when I spoke, as if my every word confirmed my stupidity. In return I feigned disinterest, made myself as small as possible, and apologized for any perceived slight.

 

I went on absorbing Beth’s hostile digs until a new patient stole her attention from me. Louise had a round face, dark curly hair, and a generous, pear-shaped body. Her weight seemed concentrated in her thighs. When she arrived at lunch for the first time, her figure filling the doorframe, Beth’s eyes brightened as if she were an African lion coming upon a gazelle. I could practically feel my tormentor’s focus lift off me. But the relief soon gave way to another dilemma: Having been the recipient of Beth’s bullying, would I sit idly by as her negative attention flowed toward Louise? But how could I, the bulimic nobody liked, call out her behaviors?

Beth turned her body away from Louise at lunch. Her eyes glazed over when Louise spoke. In group therapy Beth sobbed and shared that she’d rather be dead than fat. Aware of Louise’s presence, the therapist jumped in to remind us that these feelings were a manifestation of the illness and not technically “hateful.”

Not long after arriving on the unit, Louise took up smoking. We had a designated smoking room, and during breaks I would spy her in there, sucking on a cigarette as though her life depended on it. I think she’d read somewhere that nicotine could speed up your metabolism.

In the dining hall Beth would twitch her nose and say, “Why does it smell like cigarettes?”

Louise would stare stoically ahead.

During one particularly harrowing group session, Louise revealed that she’d been raped repeatedly by an older cousin, starting at the age of seven. At thirteen, fearing she might get pregnant, Louise reluctantly told her mother, who called her a dirty whore. Although the visits with the cousin stopped, Louise never felt safe after that. Whenever she and her mother argued, her mother would say, Maybe your cousin should come for a visit.

“I was fat by then,” Louise told us. “I don’t think he could have held me down.” Her voice was so stripped of emotion, she might have been reporting that her bagel at lunch was stale.

Most of us there had been sexually assaulted, but Louise’s tale wasn’t just a rape story. It was a mother story. The mother of all mother stories. Finally Beth broke the silence with “Well, that’s pretty fucked up,” her voice sour as a pickle.

A girl named Erin scowled at Beth and blurted out, “Jesus fucking Christ, Beth, what are you so angry about?”

If I were to rate experiences in group therapy—which admittedly would be a weird thing to do—Erin’s question would be one of the best.

Unaccustomed to being called out, Beth paled. Erin reddened. I felt both envious of and afraid for her. The tension was so great, my knee started bouncing up and down. Beth looked at me and said, “You would have a fit,” and I just guffawed. Soon all of us were laughing and crying. I remember thinking, snot streaming down my nose, Yes, I would have a fit, but I do not feel sorry for it.

The therapist running the group flicked her eyes at the clock on the wall. Three minutes remained. All therapists watched the clock, which meant all of us watched the clock.

Another strange thing with group: girls often waited until the last few minutes to drop a horrific story. Because of this, we wouldn’t arrive at the crux of our discussion until the end.

“You did a good job today,” mumbled the psychologist, who had kids at home to take care of. “We’ll pick this up tomorrow.”

I couldn’t believe we’d all be left to stew on what we’d just heard for the rest of the evening. What, exactly, would we “pick up” tomorrow? Would we talk about Louise’s rape and her mother’s response? About Beth and her routine obnoxiousness? About Erin’s bravery in standing up to Beth, who would no doubt punish her for speaking out? About how I’d sat there feeling shame and frustration while remaining as silent as a paperweight?

By the time I got back to my room, my skin felt hot, and my throat was tight. Sadness and fear and rage squirreled through me until my vision blurred and I began sobbing. Hot, angry tears. Ten minutes later Lesley returned to our room, found me crying uncontrollably, sighed, and went to get a nurse.

“It’s nothing,” I said to the nurse. But I couldn’t stop. I followed her down the hallway, and she made me a cup of tea while I continued to bawl, unable to offer a reason for my outburst. The therapists described such moments as either a breakdown or a breakthrough. I didn’t know which this was, only that I felt like shit.

I remained a snotty, phlegmy mess for the next few days, disrupting groups and mealtimes. During each session with my therapist, I went through an entire box of tissues. After the third tear-soaked hour, Dr. S. suggested an antidepressant.

I protested: Wouldn’t medication derail the “therapeutic process”? I made air quotes with my fingers.

Dr. S. chuckled and explained how the goal of treatment was not to process every emotion but to obtain a degree of stability so I could return to college, resume classes, and find a therapist, whom I would probably need to see for a very long time.

I cried for a few more days then agreed to take the pills.

A selective serotonin reuptake inhibitor, Prozac requires one to two weeks to show results. Twelve days later I woke up feeling lighter, freer, almost buoyant. At lunch, when I smeared butter onto my roll, I looked up to see Beth’s eyes narrow and her lips curl.

“You aren’t going to eat that?”

In my memory this scene has a nostalgic, sepia-toned quality: mostly black-and-white except for the yellowness of the butter and the yellow sunlight streaming through the window and striking the crown of Beth’s brown hair, illuminating individual strands. Her words, by the way, were the same ones I had said to myself dozens of times in my junior and senior years of high school: You aren’t going to eat that? It had become a kind of silent rallying cry, reinforcing my own belief that I’d rather be dead than fat. It was easier to blame my unhappiness on my body than on factors outside of my control, like my absent father or my stepfather’s explosive moods. It was easier to starve and binge and purge than to deal with high-school counselors telling us girls we could be anything we wanted to be while offering few role models and little practical advice on how to prepare for college or a career.

You aren’t going to eat that?

Beth’s words both horrified and excited me. The previous week I might have felt compelled to cower, but now I was amazed. How often does the outside world so perfectly mirror your interior life? How often does someone give voice to all the crappy put-downs you’ve inflicted on yourself? How often did I get the opportunity to look into the eyes of that someone and act not from fear but from hope—not just for my own health, but for Beth’s as well? I could not heal an eating disorder in five weeks. I could, however, eat the butter. And I could say, without sarcasm or criticism, that, yes, I was going to eat the butter, and that Beth should too.

 

It seems impossible now, but it was common knowledge on the unit that Beth had lined her pockets with plastic baggies (provided by her sister), and in the dining room she would sneak food into the baggies so it would look like she had eaten it. They didn’t force-feed anyone, but if you didn’t eat everything, down to the pat of butter beside the roll, they poured you out a portion of Ensure commensurate with the calories of the food left on the tray. How did Beth manage this deception, with nurses hovering nearby during mealtimes? Why did none of us rat her out? I think patients and nurses alike expected a certain level of defiance from Beth, and we sadly drifted along with it, because drifting was easier.

But one night, buttressed by Prozac-induced courage, I sauntered down to reception and told the nurse about Beth’s ziplock bags and how she slipped pats of butter into her pockets. I also reported how Lesley, who was on exercise restriction, did aerobics for hours in our bathroom. In other words, I betrayed them. The nurse at reception that evening, a plain-faced woman with jet-black hair and an expressionless demeanor, nodded and said, “They will know it was you.”

I shrugged.

Walking on slipper-covered feet back to the room, I could feel vibrations, as if from electrical wires running beneath me.

The following day Beth and Lesley stared in my direction but appeared to look through me. At dinner Beth announced, “No one likes a snitch.” Everyone at the table snapped to attention.

“It’s me. I snitched,” I said.

I could almost hear the girls wondering, What happened to her? I forked up a piece of meat loaf, a dish I would forever after associate with hospital settings.

I remember Erin saying later, “You’re different. You can tell that you’re different, right?” She and I were sitting at a table in art-therapy class, clipping images from magazines—pictures of food and women’s bodies meant to represent health, which we would then glue to poster board. The room smelled like glue sticks and Erin’s strawberry shampoo.

“Sure,” I murmured, and we went on scissoring magazine pages in silence.

Louise had disappeared a few days earlier, whisked away to a psychiatric ward for what I suspected were threats of suicide. Perhaps all the anorexics saying they’d rather be dead than fat had taken their toll. By the time she’d left, she was a two-pack-a-day smoker.

Nowadays eating-disorder treatment programs do not put people who binge-eat in the same unit with people who have anorexia. Though the underlying causes might be similar, the outward manifestations of the illnesses are different enough to require specialized treatment protocols for each. This seems logical but also like a lost opportunity. Without Beth, would I have been able to recognize the way I bullied myself? Would I have been able to quiet my own mean, angry inner voice? I don’t have any answers.

Erin’s words—You’re different. You can tell that you’re different, right?—pointed toward my eventual discharge and a terrifying future in which I would not have a psychiatrist meeting with me every other day to help me understand and process my emotions. I would not have Beth, whose physical and emotional fragility mirrored mine in ways I was still struggling to understand.

But before I had a chance to worry too much about my own departure date, a shocking announcement came: Beth’s discharge had been ordered, effective immediately. After seven weeks she wasn’t hitting the necessary benchmarks, and her family’s health-insurance provider had canceled coverage. Against the doctors’ advice, her parents had signed her discharge papers. Beth weighed eighty-eight pounds and still wore a heart monitor at night.

My final memory of Beth is of her being wheeled down the hallway while I stood in the doorway of my room. Her ankles were crossed, and her body appeared to collapse into the wheelchair. Her hand was pressed against her eyes so she couldn’t see us. If there was a moment to say something, anything, that might have been it, but the shock, along with the frightening question of what would happen to her, kept me quiet. I found myself feeling strangely grateful for Beth’s presence those past few weeks and experienced a deep sense of loss at the thought of never seeing her again. Who would sigh exhaustedly when I entered rooms? Against what force would I now pit myself?

Departures in that setting were always fraught. We’d been taught to view transitions as tiny deaths of varying consequence. But with Beth’s absence an emptiness filled the unit. She had always been just a sick anorexic girl, but she’d also been a larger-than-life Athena whose flaws and strengths had formed an archetype of what it meant to be female in the world: angry and uncompromising and mean but also humorous and sharp-witted in ways I think about still.

 

I soon returned to my old life: A hometown that had never felt like home. Friends whose presence no longer registered as friendly. Parents consumed with their own busy lives. At Evergreen my classmates fearlessly ate Ding Dongs and Doritos, and my professors led philosophical discussions about the meaning of life. Neither the Ding Dongs nor Plato provided answers to my dilemma. I got through the first few months as I’d been taught: one day at a time, one hour at a time, one minute at a time when necessary—much as I imagined Beth, Erin, Lesley, and Louise were doing, wherever they might be. Because how else did one navigate life except by focusing on the tiniest moments?

Once, in Seattle, about eighteen months after I left the unit, I thought I saw Beth on a street corner. I followed her several blocks before she turned her head and I realized it wasn’t her after all. Of course it wasn’t.

It would take many years for me to understand that what she and I had shared was stronger than friendship. We’d been sick together.