Hope and Other Luxuries (18 page)

“So, if I understand you,” I said now, “you're basing this diagnosis of anorexia nervosa on three monthly weigh-ins.”

“She's underweight,” Dr. Petras confirmed.

“But what else supports the idea that she has anorexia?”

“She lost eight pounds in one month,” he said.

“But she gained four pounds in one month, too,” I pointed out, “from the first month to the second month. Both of those first weights were within the normal range. Isn't anorexia nervosa a chronic condition? How chronic can it be if she was at normal weight two months out of the three?”

If Dr. Petras had attempted to educate us, I wouldn't have felt so emotional. But his manner was very stern—almost hostile. I felt that he was keeping things from Joe and me and deliberately saying as little as possible. But why? We were Elena's caregivers. We had to be involved.

“She lost eight pounds in one month!” he snapped. “Doesn't that mean anything to you?”

“Of course it does!” I said. And really, why was I even having to say that? “But I'm still not getting from there to anorexia nervosa. There could be a serious medical issue behind weight loss like that. Don't you need to rule out physical factors first? Have you contacted Family Practice to schedule blood work?”

And I thought of my cancer. It had triggered weight loss.

“No, I haven't scheduled blood work,” he said. “I know what she has.”

But how? How could he know what she had before he ruled out medical factors? Was this another Dr. McKinney, reaching for that “hysterical child” diagnosis?

Logic
 . . . I told myself.

I started over.

“If I understand you,” I said, “you're not saying that Elena told you she hates to eat. In fact, you haven't told us that you've learned anything about her eating habits. Has she told you she's been trying to diet?”

“She lost eight pounds in one month. Of course she's trying to diet.”

“And she
told
you that,” I said.

But Dr. Petras didn't answer.

“So,” I said after a minute, “she
didn't
tell you that.”

He gave a shrug. “Well, it's obvious.”

Was it really obvious that Elena was on a diet? Did this man know how hard it was for that girl—and for her family members, too—to manage to hold on to weight? Did he take her family's naturally high metabolism into account? Or did he just assume she had been dieting because we women, all we want to do is diet, right?

How I hated that hysterical female crap!

Logic . . . Logic . . . This isn't helping
 . . .

“What about the Zoloft you put her on?” I asked. “She's been on it for two months, and you increased the dose last month. Could it have caused her weight to vary? Could it have caused this sudden weight loss?”

“No, it couldn't,” Dr. Petras said.

Yes, it absolutely could. Loss of appetite and weight loss are common side effects of Zoloft, especially in children and adolescents. It isn't unusual for Zoloft to cause a child to lose more than 7 percent of his or her body weight. But I didn't know this then. I hadn't had time to educate myself.

“Look, I'm not going to argue with you,” Dr. Petras continued. “Your daughter has anorexia nervosa. I'm putting her in the hospital until she gains weight. And that's how it's going to be!”

I felt completely bewildered. I hadn't realized we were having an argument. Silly me, I thought we were consulting together to try to determine the best medical course of action to help one of the three most important people in my life. But it felt as if Dr. Petras had deliberately forced me into a position that would allow him to say this.

Could he actually put Elena into the hospital, even without our permission? I wasn't sure. Our status in Germany, connected to a military base overseas, did put us into a somewhat vulnerable position. Overseas military doctors have greater latitude than civilian doctors do back home. It could be that Dr. Petras was within his rights to do this, and he certainly acted as if he was.

But in one way at least, this hospitalization wouldn't be a bad thing. It would give us the chance to bring other doctors into the picture very quickly. Putting Elena into the pediatric ward automatically meant having her care overseen by the ward pediatrician, and that pediatrician
was bound to order the important medical tests I was thinking of, tests that could take weeks to order in this busy wartime hospital if Elena weren't an inpatient there.

Eight pounds of weight loss in one month might mean a very serious medical condition: lupus, hepatitis, a metabolic disorder, or even leukemia. The sooner we knew if one of these conditions was present, the better.

So Joe and I exchanged glances, and we wordlessly agreed: we wouldn't fight Dr. Petras on this. A couple of days in the hospital might bring us important answers. But I looked at the expressionless expression that shouldn't be on my daughter's face, and I felt torn and deeply distressed.

For another adolescent, this might not be an issue at all. A few days of pampering in the hospital might seem like a spa vacation. But not for Elena. She hated bullies. And this was the girl Dr. Petras was forcing into care, against her will and over her parents' authority.

He had bullied her entire family at a single blow.

When Elena was barely old enough to stand up, I took one of Valerie's toys away from her. Little Elena didn't cry. She picked up a wooden block and toddled after me. She followed me around the coffee table, clutching its edge for support. I stopped to pick up another toy, and Elena managed to catch up—and she whomped me in the back of the knee with her block.

When Elena was in grade school, she had a teacher who bullied a little boy in her class. The boy wouldn't answer back, but his ears would turn bright red from humiliation. And whenever Elena saw those bright-red ears, she would see red herself, and she would launch into a verbal attack on the teacher. For a grade-schooler, she came up with some truly insightful insults.

“Mrs. Dunkle,” the teacher would tell me, “you need to talk to your daughter!”

I did talk to Elena. I asked her if she wanted me to tell the teacher what I thought of an adult who took out his own unhappiness on small children.

“No,” Elena said. “That would make it worse. Last week, he lectured us for fifteen minutes about not carrying tales to our parents.”

“But if he knows I know what this is about,” I said, “then at least he won't punish you anymore.”

“Punish me!” Elena laughed. “He sends me to the library! I get to sit and read books while everybody else is outside in the cold.”

Bullies didn't just make Elena angry. They awakened in her an idealistic drive to rebalance the universe. I knew that if she saw this as a bullying situation, she would fight it with everything she had.

Joe and I went down to the food court to order Elena her favorite pizza. By the time we brought it back to the pediatric ward, she was sitting on a hospital bed, wearing a pair of green nurse's scrubs as pajamas. She hadn't pulled the covers up. It was as if she would be on that bed only for a few minutes. She set the pizza aside, smoking hot and deliciously cheesy, without so much as a glance.

“I'll be fine, Mom,” she said firmly as I hugged her good-bye.

I was afraid I knew what Elena meant when she said this. She meant that she would show not one speck of weakness. Worries rose up and buzzed around me like a cloud of gnats. How could a child psychiatrist understand so little of this child's nature?

“Please eat,” I told her. “It's for us, not for him. I'll miss you! We want you home.”

Elena sat like a statue. The blank mask was still on her face—that expressionless expression that had no business being on her face at all.

“I'll be fine,” she said again in that same firm, even tone.

Which wasn't the same thing as
happy
.

Or
well
.

J
oe and I walked out to the hospital parking lot together. He was worried, too, but he was more practical than I was.

“A week, max,” he said, half hoping and half predicting. “It can't take her long to gain weight.”

Then he kissed me and drove back to his stressful workday.

I got into my car and took the familiar turns on autopilot. Part of my mind was watching the sparse traffic on the German autobahn, but the rest of it was a chaos of emotion.

I'm a storyteller. I have to have a story to tell. That means I have to have some sense of where things have come from and where they're going. But at that moment, I had absolutely no story to tell about the events of our lives.

The family's going through a rough patch right now . . . My girls—well, they're brilliant, but they do have their moments . . . Oh, sure, we have issues like everyone else, but we're all right, really
 . . .

No, none of those. All I had were worries and questions.

The more I thought about the meeting we'd just been through, the more confused and upset I felt. I went back through it, trying to find the moment where we had miscommunicated, the moment where we had gone from consulting to arguing. I couldn't find that moment, so I went back through the phone call. I couldn't find the moment there, either.

From the very beginning, Dr. Petras had been hostile. He had maneuvered from the first as if he were facing enemies, people he didn't respect. But why? When he had consulted with us about Valerie, he had been warm and sympathetic. Why had he changed?

My heart whispered the answer:

Because
one
child might have problems, sure. But what can it mean if
both
do?

And I remembered Dr. Petras's unfriendly eyes:

What did you
do
to them? You bad mother!

I am tremendously proud of my mother. In the years before career women were common, she became a professor at quite a young age. And later, when the head of her department pointed out that professors ought to have a PhD, my mother went out and earned her PhD. She's a scholar from the tips of her typewriter-key-blunted fingers to the depths of her vertical file cabinets. To this day, she proofreads manuscripts for publication. She's spending her retirement straightening out footnotes and block quotations.

My mother is an extraordinary person. But when I was young, I was determined to outdo her. I was going to become an extraordinary
mother
.

Long before I brought my babies home from the hospital, I had already decided that I would be an amazing mother. My children would be read to and sung to; they would hear nursery rhymes and attend story hour; they would go to the scientifically best preschool and have the scientifically best backyard play set. They would have the right kinds of toys and the right kinds of friends. They would learn and grow and blossom in ways I had only dreamed of.

My children, I vowed, would never once enter the doors of a huge public school, to be bullied and bored the way I was. They would have early education, small class sizes, and homework help, and they would grow up confident and loved.

From the moment I found out I was pregnant, I began reading the right books about education. On the backs of Joe's and my dedicated frugality, we sent our girls to the best preschool in town. We bought them gender-neutral toys and games. We let them watch only age-appropriate shows. I read books on nutrition and, with my limited culinary skills, I worked to prepare nutritionally dense meals.

No sodas in my house! Sugar was a drug. No cable TV for us! We were building neurons. It would have been hard work if watching my girls grow up hadn't been such a joy.

But now . . .

What did she
do
to them—that mother? What did she
do
to those girls?

The morning after Valerie's overdose, Joe and Elena and I couldn't just hide at home and lick our wounds. Joe's squadron had prepared a picnic, and as its deputy, he needed to attend. As an officer's wife, I had helped with the preparations, and there were things I had agreed to bring. All the people who were important in our social life were there: colleagues, associates, subordinates, bosses, babysitting charges, and friends.

So we showed up just long enough to do what we had to do. And we said it. We faced the world, and we said it:

“We were up all night with Valerie in the ER. No, Valerie wasn't in an accident. She overdosed. She took a bottle of pills.”

Somehow, the hard, grinding reality of hearing those words out loud under the sunshine and blue sky felt more real to me than the long hours we had spent the night before by Valerie's bedside. Is that because I'm a storyteller, so focused on telling stories that telling my own story felt more real than living it?

“No, Valerie hasn't been released. She signed herself into the psych ward.”

Because lies don't help. Lies create vulnerability. The truth carries its own severe, Spartan pride.

Did I see it in their eyes that day—that stern, hostile look?
There she is, that mother—that bad mother!

No.

I heard, “Look after yourself, Clare. Get help if you need it.”

It's the only thing I remember.

The wife of our group commander was at our squadron picnic. Her husband oversaw our squadron as well as another one, and as the full colonel who commanded us, he ranked as royalty in our small world. Among the officers' spouses, so did his wife.

I knew her, of course, but we weren't friends. One didn't befriend royalty.

Petite, slim, and pretty, with bright black eyes and hands that fluttered in the air as she spoke, she had always reminded me of a songbird.
Her daughter was beautiful and talented, earning top grades at the university. But her son had disabilities so severe that he couldn't speak.