All you need to know about books at www.booksmonthly.co.uk                                                     Issue 4 July 2008

Through a Glass, Darkly

by Phyllis Owen

Chapter Four

Promptly at ten o’clock Karen walked into the therapist’s office.  It had a high ceiling and the floor was covered with brown-flecked carpeting.  It was spotlessly clean and neat.  A young man in jeans and T-shirt was standing at a desk.  He was tall with broad shoulders and there was something compelling about him.  He walked up to her, shook her hand cordially, and said, “Hello Karen.  My name’s Ross Manning. I’m going to help you get well.”  He gave her a warm smile and she noticed the laughter-lines at the corners of his mouth and eyes.

  Karen mumbled, “Hello.”

  Pointing to a chair, he invited her to sit down.  She sank into the soft upholstery and stared at him curiously.

  He sat at the desk, opened a file and, smiling at her, said, “Karen, don’t be afraid.  I’m not going to interrogate you.  That’s not my way of working.  I’m here to listen, help and advise.  I believe in complete honesty and I hope you’ll be honest with me, too.  Only in that way will we find the root of your problem.”  Though he spoke gently there was an unmistakable firmness in his voice.

 “Yes,” she agreed without enthusiasm.

  “You have anorexia nervosa – the fear of putting on weight, also called the skinny disease.  Do you accept this?” he asked.

 “No, I don’t!” protested Karen as a flame of intense anger swept over her.

  “Don’t get annoyed, Karen.  I’m your friend and on your side,” said Ross placatingly.   “You are very much under-weight.  Until you accept that you have a problem no one will be able to help you.”  He leaned forward, looking at her thoughtfully with his piercing grey-green eyes.  “Fortunately your parents realised what was happening to you in good time.”

  Karen sat silently, looking back at him, unsmiling.

  “First I’ll tell you something about the disease.   It’s purely psychological but has serious physical consequences and can even lead to death.  There are two types: those who starve themselves and those who eat normally but make themselves bring up the food afterwards.  What is so amazing about this disease is that in spite of the dreadful appearance of the anorexic, he or she….” He smiled.  “You looked surprised when I mentioned ‘he’, but it also affects boys on rare occasions. Sometimes they too cannot see themselves as being thin.  We have two young men in the hospital at this moment suffering from the disease.  Excessive dieting is not the only warning sign.  Loss of interest in living, irritability, and becoming anti-social are real danger signs.”

  He paused and carefully studied her face before continuing,  “Anorexia nervosa was once known as the ‘dancer’s disease’.  As you well know, ballerinas have to remain slender and when teenage puppyfat appears they fight it and many have died in the attempt.   We do know more about the disease these days so we are able to help but we must have the patient’s co-operation.”   He hesitated, then, with a quick glance at her added, “Last week a young woman of twenty-four was brought in – or should I say carried in.   She weighed twenty-six kilos.  Had a friend not called to see her, she would have died.  The friend contacted her parents, as she was living alone in a flat in town, and they immediately brought her here.   I can safely say she’s now out of danger but she still has a long way to go before she’ll enjoy good health.   By the way how do you get on with your parents?”

  Karen sat up rigidly in her chair.  She felt a blush rise to her cheeks and thought for a moment before answering. “Well… we have always got on well, but during the past few months….”  Her voice trailed off as she recalled the telephone call.  Tears welled up in her eyes.

  “I know about the phone call, Karen,” Ross said, “but have there been other occasions recently when you were irritable towards them?”

  Karen nodded, sullenly.

  “Why?”

  “They continually interfere.”

  “In what way?”

  “Well, er, mainly about the amount of food I eat.”

  “Tell me about yourself.  What standard are you in at school and what are your hobbies?”

  “I’m in standard nine and I do ballet, tap dancing, music and gym, and I play tennis and hockey,” she replied, relieved that the conversation had moved away from food.

  “Good gracious!  How do you fit in all these activities?” Ross broke in, surprised.

  “Gym we do during school time, so that’s not a problem.  Usually my mother takes me around in the car,” she replied.

  Ross laughed heartily.  “Your mother can’t have much spare time either!   What happens to your school work?  Do you have to fit it in between practising?”

  “I don’t find school a problem but sometimes it’s difficult to fit in my homework,” she admitted.

  “Do you enjoy all these activities?” Ross wanted to know.

  “Most times, but I would like to stay at home, even for just one afternoon a week,” she said, sadly.

  “Why don’t you then?”

  “I don’t want to upset my parents.  They’ve always said that once you start something you must carry on,” she explained pensively.

  “I see,” said Ross, rubbing his chin, his brow creased in thought.

  “How…how…long will this treatment take?” Karen asked, trying to keep her lips from trembling.

  “That will depend on you and how quickly we can pinpoint your problem,” he told her, then, glancing at his watch, he stood up.   “I’ll see you again next Thursday.   Please remember I’m here to help you.”

  She got up to go.  At the door she stopped.  “Do you think I will look fat if I gain six kilos?” Karen heard herself asking, casting a quick anxious look at him.

  “You could put on another ten kilos and not look fat,” he assured her.  “Don’t get the impression that we want to fatten you up.  That’s not the case.  Your body uses food in the same way a car uses petrol.  There’s no measure of how much one’s body needs for energy as some of us have a faster metabolism than others.   Once you’ve reached your goal weight we’ll put you on a balanced maintenance programme so that  you won’t put on any extra weight.”    He smiled at her encouragingly.

  Karen nodded.  It was with a feeling of relief that she left the room and made her way back to the ward.

  An unpleasant surprise awaited her in the form of a large plate of food.  There was a piece of chicken, two medium potatoes, a lump of cauliflower and a few peas.  She stared at the food for some time, aghast.   Her meals were definitelt getting larger.

  As she picked at the chicken she noticed a plastic bag protruding from her locker.   Bending down she picked it up.   Removing the writing-pad and envelopes from the bag she placed it under the quilt.  She glanced quickly around the ward.  No one had noticed what she had done.  The two young student nurses sitting at the table were chatting amiably to some of the girls.   Hurriedly she slipped the two potatoes into the bag followed by the cauliflower.  She smiled to herself.   That was easy, she thought.   After she had eaten the rest of the meal she hid the bag of food in her toilet bag to be disposed of later.

  The next few days she was happier than she had been for a long time.   She became adept at hiding food.  Three days later, before breakfast, all the girls were lined up to be weighed.   Sister Rose was happy with everyone’s weight until she came to Karen.

  “Only half a kilo!” she exclaimed.

  Karen was thrilled.   She had beaten them after all.  But her joy was short-lived when she heard Sister Rose say, “We’ll have to double her food quota.   She’s not gaining as she should.”

  Karen gave a cry of horror.   “But you can’t do that!” she protested, “I’ll never be able to eat more.”

  “You’ll have to learn, my dear,” insisted Sister Rose.  “By now you should have put on at least two kilos.”

  “Two kilos!” cried Karen, in disgust.  “At this rate I’ll be fatter than I’ve ever been.”

  “No, you won’t!” retorted Sister Rose. “You’ve been told that when you reach your goal you’ll go on a diet to maintain your weight.”   She looked at Karen curiously before adding, “Have you been hiding your food, Karen?”

  Karen hung her head.  “No, Sister, how can you suggest such a thing?”

  “Look at me, Karen,” she demanded.

  Karen did as she was told.

  “Now tell me, Karen, have you been hiding your food?”

  Realising that if she did not reply truthfully she would be given a double amount of food, she slowly nodded.

  “I’m surprised at you, Karen,” Sister Rose said, an angry flush on her cheeks.   “I believed in you.  I told the nurse not to watch you any more.   You’ve let me down.  You’ve also let yourself down.  It means you’ll have to be policed at each meal.”

  “Will that be necessary?” Karen asked defiantly.

  “Yes,” replied Sister Rose firmly.   “I can’t afford to take a chance with your health.   Until you show us that you can be trusted, you’ll have to be watched.”

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