Wednesday begins stickily humid and disconcertingly hot. Disconcertingly, because I have anorexia, and anorexics never feel hot. Today I am, uncharacteristically, sweating, though my hands and feet remain cold. They are always cold; poor peripheral circulation. Acrocyanosis, the doctor had called it.
Otherwise known as the inability to hold a chilled glass of champagne, or Matthias’s hand, because I cannot afford to lose what little heat I have. Or wearing two pairs of socks under layers of blankets in the summer, shaking for hours, unable to sleep. Acral coldness. As lonely as it sounds.
The day does not improve as it progresses; I am served half a bagel and a mound of cream cheese for breakfast. Consequently, the morning walk is miserable. I am short with Papa on the phone.
I change into clean and dry clothes when we return. My irritation is harder to shed. However, just then I hear the door and the mailman. My first smile of the day.
I wonder if V. wrote to me.
She did!
Dear A.,
I think I like having a pen pal. Last night was fun with all the girls. It was actually my first time watching the Olympics, but don’t tell Emm!
I saw you struggle with the bagel and cream cheese at breakfast this morning. It’s a difficult one for me too. But we did it. They say it gets easier with time.…
Across from me, Valerie is in her spot, of course, reading a letter of her own. Her hair is in a tiny bun at the top of her head, like mine. It looks even smaller, and so does she, compared with the sweater she is wearing; two sizes too big at least, I guess, and obviously a man’s. Boyfriend? Father? Brother? Too early in our friendship to ask. Perhaps in a few letters, I tell myself as I reach for a sheet of paper from the communal stack, when—
A shriek.
We all look up and around. Valerie, holding her hand up: paper cut. The letter she had been reading and its envelope are on the floor. Her index finger is red and bleeding abundantly all over the place.
Asteatotis: dry and scaly skin. Another symptom of anorexia.
The condition can lead to profuse and prolonged bleeding from superficial cuts. I know this from experience; a pair of scissors, a knife, a sweater that is a bit too rough, air that is even slightly dry or cold, the edge of a letter or envelope …
And blood is flowing everywhere: on her hands, down her sleeves, on the sweatshirt. Emm is the first to react. She runs to the nurse’s station for supplies and help.
Sarah withdraws, feeling faint. Julia is staring curiously. I take Valerie’s hand and with a wad of tissue paper try to blot the blood.
Her hands.
Pellagra. Hyperpigmented and scaly plaques. Vitamin or protein deficiency.
Lanugo. Downy fine hair, to preserve body heat, covering the entire body.
I would not notice either, normally; Valerie always wears long sleeves. The nurse and Direct Care arrive and take over. My red tissues and I step aside.
Valerie is swept out of community space before any of the other girls faint. Emm, of course, is right behind Direct Care. The rest of us wait.
Just a cut, dear, but we must clean it.
We can all hear the nurse’s voice.
You may need stitches. Let me see. Pull up your sleeve.
Suddenly, her voice is silent. For a full minute, then,
Emm, thank you for your help, now please leave. Go back to community space.
I am surprised not to hear her object to this. Emm returns with a look on her face I have never seen before.
Are you okay?
I ask.
She nods.
Is she?
She hesitates. Then, as if she were dropping something very heavy, she whispers:
She cuts.
Dermatitis artefacta. Skin lesions, ulcers, bruises, scars. Valerie, placid Valerie, cuts herself. How could any of us have guessed?
Her possessions are still on the floor, but my hands are still stained with her blood. Emm picks them up before I ask her and sets them in Valerie’s spot.
The letter she was reading sits, face up, staring me in the face. My curiosity wins over my well-bred discretion. I do not touch it, but from where I sit:
Dear Valerie,
Happy birthday, sweetheart. I’ll be in town this weekend to celebrate.
I look away. I should not be reading this. She had not mentioned her birthday.
Soon, Valerie, good as new, returns. I am allowed to wash my hands. Back in community space, I hesitate: what had I been doing before this?
My letter to Valerie. My blank sheet of paper. Suddenly I have nothing to say; Valerie’s hands put yesterday’s Olympics and this morning’s breakfast into perspective. Whatever I write now will be insignificant. But I had promised I would. I think of how happy her letter had made me only a short while ago.
I could write this girl a thousand superficial letters, except I know her now. I know it is her birthday and I know she cuts. Pen to paper:
Dear V.,
That paper cut must really sting. I hope it heals quickly.
May I ask whose sweater you are wearing? Does it mean something to you?
You do not have to answer my questions. I know they are personal. I would just like to get to know you a bit better. If you are willing. I like having a pen pal too.
A.