At my sickest, a lover once folded a blanket over my shoulderblade before curling against my back to sleep. People visibly recoiled when I passed, or looked back over their shoulders in a double take that I could never help but notice. From the outside, nobody understands the seemingly wilful hunger of those of us who waste away, nobody really understands the hold that it can have, its awful power.
I know now that the impulse I have to starve comes from exactly the same place as my impulse to write: hunger, like writing, is a mediator. It stands between me and the world, between my self and the things that might cause it harm. Hunger is addictive, and it is intensely sensual, pulling the body between extremes of hyper-alertness and a foggy trance-like dream state. And like writing, it lets me stand clear, separate and intact; it lets me stand on the outside. I spent years determined to stay on the outside. Because I wasn’t, I was sure, one of those women.
The problem, I realise now, was that I’d never met one of those women. I never really did until my first admission to a hospital day program, five years after my travel to Sri Lanka.
When I agreed to the admission, I still didn’t think that I belonged in an eating disorder program, that my hunger was malicious. I knew that I was noticeably underweight, and that I was still struggling to manage my physical condition, to eat enough to fuel my body without throwing up in the process. I’d scan every restaurant that I went to upon entering, to make sure that I was seated close to the bathroom or the door; I had become adept on picnics and at parties, ducking out, mid-conversation, and scampering for the nearest plant or wheelie bin. (‘Fucking junkie’ a man once spat as he walked past me, when I was doubled over behind a tree after an early café breakfast with my best friend.)
By the time I was admitted, I’d spent two years visiting an outpatient clinic, at first fortnightly, then monthly, walking past the locked psychiatric ward and up three flights of stairs to its set of narrow corridors; at the height of my illness, even this exertion left me dizzy and unsteady on my feet. I still thought that my main problem was anxiety, that the stress and exhausting worry that were constantly coursing through me were exacerbating the vomiting that was the main symptom of my physical illness. I never once thought that the way that I was eating might be exacerbating the stress with which my body and my mind were both racked. A psychologist had slowly encouraged me to attend the clinic, suggesting only, carefully, that the doctors there would be experts at putting broken, undernourished bodies like my own back together. I remember showing the clinic’s dietician, during my first appointment, the food diaries I’d been asked to keep over the preceding fortnight, and stating straight up, ‘I’m not anorexic.’ I didn’t realise then that she must hear this all the time, and barely registered her response, ‘You certainly eat as if you are.’
In these two years, I hardly progressed at all. I realise now this was mostly because I could not recognise the complex nature of my hunger, and so I couldn’t understand the help the doctors there were trying to extend to me. I went alone to these appointments, waiting on one of the plastic armchairs lined up in a row past the reception desk, always alongside other thin and anxious women with flaking skin and darting eyes and knees that were constantly jigging up and down, out of both nervousness and a desire to burn more energy. I didn’t talk to them, tried to avoid their gaze.
I can’t remember, now, what I talked about with the psychiatrist in my appointments, my memories of these visits are cloudy with a strange combination of malnutrition, boredom, exhaustion and fear. But I do remember the one day that my regular doctor was away; his substitute was forthright, crisp and far less gentle in her manner than he had ever been. She said, after closing my by now bulky file, ‘You know you’re not getting anywhere here,’ and I had to concede that she was right.
I called the hospital from a café up the road from the clinic, feeling somehow, and somewhat irrationally, that the decision to do so wasn’t really mine to make, that my hand had finally been forced. I’m also not sure that I would ever have gone ahead with the admission if I hadn’t thought that I would write about it later. But even as I walked, on the first day of my admission, through the building’s bright blue door, after a round of meetings, measures, blood tests, heart checks and the reading of a rule book as thick as my spindly wrist, I still remember thinking, even then, that I’d have nothing in common at all with any of the other women I might meet there.
Because I wasn’t, I thought, one of these women.
One woman hadn’t had a bath in seven years, and always showered in the dark. Another would spend eight-hundred dollars every week on groceries, and seven hours vomiting each night, the blood vessels beneath her eyes bursting with the pressure. One had permanent callouses above the knuckles on her right hand, where they crashed against the backsides of her teeth. One woman walked circuits of a shopping centre so as to not be caught exercising, another had to wear padding underneath her feet in order to be able to walk at all. One woman stepped every hour, on the hour, onto her bathroom scales, another chewed eighteen packets of sugar-free gum each day. One would eat undercooked chicken once a month in the hope that she’d get salmonella. One would eat brussels sprouts for breakfast.
In the hospital, I bore these women a strange kind of witness; a split kind of witness, for weeks. Where I didn’t want to be involved, didn’t think myself included, but couldn’t help but recognise myself reflected in the stories that they told. We moved our bodies in similar ways, curling our feet under the knobbled bases of our pelvises, bouncing our knees beneath the dining table as our meals were served, biting at our cuticles and lips. So too, the similarities between our secrets, the strange behaviour we tried to keep hidden, the discomfort we felt within our skins, were almost physical. I felt outside myself, borderless, I didn’t know where witnessing stopped, and I began.
I kept a notebook in my first days in the hospital, but barely touched it. As I listened to the other women talk, hesitantly, at times angrily, often in tears, and I heard them voice so many of the things that I’d kept so long silent in myself, I knew immediately that it could never be my place to write about them, to speak for them, to use their stories to add colour to my own. I realised that these women were some of the bravest but also most vulnerable that I had ever met, and that to turn them into kooky characters in my writing would not only violate the privacy that the hospital was so careful to protect for us, but also do them violence. I realised, at last, that this story was not about them, but about me – even as I’d been denying that fact for years.
Under the hospital’s supervised schedule of meals, I was suddenly forced to be without my hunger, and I walked out of the building every afternoon feeling skinless, almost painfully permeable. I walked down Broadway, the shuddering of trucks and passing buses vibrating through my bones, the footpath crumbly and frayed. I sometimes caught my reflection in the dark shop windows and was shocked by the glassiness of my own face. I’d buy a cold drink at the Hot Devil Bakery, defiantly sugarfree and fizzy. I’d sit quietly on the bus – I’d been forbidden to walk home, in case even this small act of exercise was a compulsion – and press my fingers against the stiff fibres of the seat, the cracked rubber seal of the window. These grubby, communal surfaces were a kind of landing pad. I couldn’t change frequency so easily.
Because inside the hospital we were contained. Inside, no one could find what we said unimaginable. No one could think us stupid or indulgent or precious. No one was horrified when we cried over our plates of ravioli, limpid and almost visceral in its red sauce.
Our days, at least, had in-built structure. We arrived in time for morning tea and left forty-five minutes after afternoon tea, with lunch at 12:30 sharp. We were carefully watched during our meals: no breaking food up into little pieces, no eating food in any set order, no dunking biscuits in tea, no over-use of condiments, no counting chews, no reading labels, no tiny bites, no one thing left on the plate at all. Our meals were time-limited, with warnings given when we had ten, and then five minutes to go. One woman ate so slowly and tearfully that she had to shovel in most of her meal in overloaded forkfuls in those last minutes. Another tried to hide a whole potato in her pocket. We all hugged our stomachs and were silent after every meal. There was a grey box of tissues in the corner of the room.
We were weighed once a week, wearing pale-yellow paper gowns with elasticised cuffs and open backs, facing away from the numbers on the scale. We kept our gowns in a metal locker with ventilation gills, in zip-lock bags designed for storing food, our names written in texta on the label on the front: Contents: Fiona. Each afternoon, we picked up breakfast cereal, canned fruit and longlife milk in a brown paper bag to have for breakfast before we left home the next day. I turned the cereal into cookies and the tinned pears into cinnamon muffins and fed them to my family and friends. I didn’t want to eat them, and couldn’t bear to waste them, but the people I would give them to, I knew, would never think them a burden.
Every week, once a week, we were escorted outside, to practise eating in the world, where we knew our meals would not be correctly measured by a dietitian, where we’d have to choose, and where we could not be contained. Our first excursion was to a café on Glebe Point Road, we walked in the hot and stagey light of mid-afternoon, unspeaking, and in a ragged single file. I bit my lip, and felt it, full and sweet between my teeth. A dalmatian on a leash was curled in the doorway, it sniffed at the air as we entered and I was sure the café staff could smell fear on us too. We were given one minute each to place an order for a piece of cake. No one ordered coffee because we weren’t allowed skim milk.
We were the biggest group in the café that day, and we’d walked beneath a building site to get there. A blond man in the scaffolding had wolf-whistled, at this group of young and slender women walking by.
Our days, at least, had in-built structure, to take advantage of the changes to our chronically starving brains, which had hardened, physiologically, into obsessionality and rigid, repeating patterns of thought and action. My hunger, and its rules, have been with me, always, for almost all of my adult life. My days have for so long been structured around meals, a constant accounting of what I have and haven’t eaten, what I can and can’t still eat, what I need to do to still feel safe. I still don’t know who I am without my hunger; without its structures that support me too, its scaffolding.
Sometimes we went grocery shopping together, with an occupational therapist and a dietitan, and then cooked: we weighed out ingredients to the gram. We trimmed the smallest streaks of visible fat from our meat. One woman had no idea where to find butter in the supermarket aisles. Another refused to buy feta from the deli because it had no nutritional information panel. One had never before seen a leek. We wore blue latex gloves in the tiny kitchen, scrupulous about hygiene, and either tried to control each process as we cooked, or shrank back to avoid touching the ingredients entirely.
I had to leave the kitchen on the day we cooked risotto. I sat on the carpet in the next room, squeezing my temples with my knees. I already felt it choking up in my throat, as glutinous as craft glue.
This is the crux of it: what cannot be imagined from the outside, the breathless bodily panics, the unbrained terror, how I sweat and shake and bite down on my nails. I know it’s inconceivable, outside, how the very idea of a plate of rice can make my mind seize up and stutter, as if the grains themselves were predatory. But this is how we lose our selves in this disease. We’re instinctual in these moments, animal; and we’re eaten up in each of these small acts of disappearance.
Inside the hospital building, a converted, two-storey house with high ceilings and a vague dampness in the walls, we waited a lot. We could listen to music, but not dance. We could stretch, but not walk around, we were forbidden to step into the small courtyard, lined with plane trees, at the back of the building. We weren’t allowed to talk about what we’d eaten or why we were there, but it was impossible at times, not to mention the things that were obvious to us all. We stayed in the one room, its walls painted sky blue, its couches hard as lozenges, a whiteboard that was never really clean.
But what we found was solidarity, when none of us had felt solid, somehow, for years. Our exterior lives often had very little in common – in a discussion on exercise, for example, one woman added horse-riding and sailing to my suggestions of yoga or riding a bike. But our interior lives were as eerily congruent as project homes, though I’d spent at least eight years, by this stage, denying that we shared anything at all.
This was because my illness started with a physical condition, still very rare and very poorly understood. I was nineteen years old, and suddenly I was vomiting without any volition after most of my meals. It took almost eighteen months for my specialists to find a diagnosis, the weight dropping off a body that rapidly came to alarm me. I was advised to cut out of my diet the foods that I thought triggered the vomiting, and I did, by ever-increasing increments, until the ground shifted somewhere, and hunger became my safest state. Because my illness started with a physical condition, because I recognised, and didn’t want and didn’t like my too-thin body, because I didn’t purge by conscious choice, because I was still eating, however limitedly, I thought that I was different. I realise now that this was partly because of my own misconceptions about the nature of anorexia, and the people who fall victim to it, but this is also the way the illness operates, by deception, by a long series of constraints that tighten so slowly that they’re barely noticeable at all.
I thought, for so long, that I didn’t have anything in common with these women, and I sometimes think that’s the biggest tragedy of all. Because if I’d only recognised this earlier, before eight entire years of illness had gone by, I may have found the help I needed sooner. I may have been able to stave off my hunger before it managed to establish itself so fully and firmly in my life. I might, by now, be well.
One woman had slipped discs in her lower spine from vomiting, another had chronic bladder infections and damaged kidneys. One had had reconstructive surgery on her oesophagus because the juices of her stomach had been leaking into her lungs. Three women in their mid-twenties – myself included – had osteoporosis of the hips or spine.
One morning, about a month in, I realised that I’d been witness to the slow display of a quietly unfolding beauty in these women. That each week they grew more lovely. Some of this I’m sure was purely physical – the too-thin amongst us became less angular, our faces fuller, skin and hair alike lost their flakiness and pallor. So too our clothes looked better-tailored on our bodies. But it was more than this. I’d watched them all uncurl their tightened shoulders, unhang their heads, untuck their knees from underneath their chins. One woman, whose every word had seemed, at first, like it was being dragged out from her chest began to joke in a beautifully acerbic way, her mouth unpinched and her whole face softened around it; another had grown a laugh that shook the ceiling. This, I thought, is so much like a second adolescence, each time seeing a woman, glorious and gorgeous, emerge from somewhere underneath a brittle and anxious body. I went to a book launch one evening, and was told that I looked like a cherub with my newly-rounded cheeks.
I still knew that I would write about it later, and kept a vocab list on the back pages of my notebook. You’ve been deskilled, it says, do some down-arrowing, take a helicopter view. And all of these rules you taught yourself.
Shortly before my discharge I spent a Sunday in Thirroul, driving the hour-long coast road alone, a solitude I hadn’t had for weeks. I was visiting three of my friends, all writers, who were staying in a barely-stable cottage on a cliff for the weekend. I felt relaxed on the road, I shouted along to songs with my windows wound down, and spent the afternoon sitting on the grass, watching the ocean. We took photos at lunch in a local café. The two boys went for a swim, and we two women talked about bodies, about illnesses, and about transition, about how hard it is to change. My friend hugged me when I left and I couldn’t stop thinking, the whole way home, of the lamb sandwich sitting in my stomach, how we’d laughed at the waitress when she’d cleared the plates and said Too much bread is too much bread, you know?’
I didn’t know how I could bring what we did inside the hospital out into the world. I didn’t know if I’d be able to keep visible the things we’d given names to, the things we had made clear. With symptom reduction comes space, I had written in my notebook, but I didn’t know if I could grow to fill the space I was discovering, if I’d be able to stay vigilant each day. I still don’t know. I still, sometimes, am left bereft.
But what I hadn’t expected was the heightened sensitivity when I came out. An instructor at my gym, a space I was protectively easing myself back into, equated the calories spent in one class with one small Easter bunny. ‘You just worked off the ears!’ she cried between songs, ‘Now for the head!’ A waiter brought a brownie to my table with my coffee and called me ‘naughty’. I got angry when my mother tried to share her birthday chocolates, when my housemate had just honeyed toast for dinner, when a friend bought a dress that didn’t fit because she was planning to lose weight after the holidays. When my university sent me an email about the Low-Fat Options Now Available on Campus.
I kept in contact with those women. About a month after the last of us was discharged, we met for a drink in a fairly new bar, just around the corner from the discreet, pebblecrete house where we had been confined. We all ordered vodka with lime and soda; fresh lime, not cordial, we all ignored the complimentary popcorn placed on a small tray before us. We sat on zebra-print couches, away from the door, where the first cold air of the season kept bursting through. One woman, the oldest among us, had worked for nearly ten years before her admission for Jenny Craig. She had needed to start fresh afterwards, and had found a job at a recruitment agency. She’d lost weight since I’d last seen her.
She had been to Friday drinks a few weeks into her new position, and after a few hours, a few beverages, one of her female colleagues had approached her at the bar. ‘I’m onto you,’ the colleague had said. ‘You’re a sister.’
‘Sorry?’ she stammered, ‘A sister?’
‘Were you AN or BN?’ she asked.
She denied that she knew what her colleague meant, but was holding her wine glass before her, in that hand with the thick callouses raised above her knuckles – these are called Russell’s Sign, after the doctor who first identified bulimia nervosa, BN, as a condition in its own right. The colleague laid her own knobbled fingers against them, and repeated:
‘You’re a sister.’
It’s a strange family to have found and to hold to, but even more powerful to know, at last, that I can’t any longer stand clear.