I knew I wouldn’t like Liz from the moment I met her. She waltzed into the dining room, her strings of blonde hair piled in a bun atop her head, her skeletal figure drowning in sweatpants and a jacket though it was mid-August, and scoffed at her meal of chicken and rice as if it were a plate of dog feces.
“Uh oh. I can’t eat that.”
The phrase became her mantra, recited in her sandpaper voice at the start of every meal. Yogurt and granola: “Uh oh. I can’t eat that;” turkey sandwiches: “Uh oh. I can’t eat that;” spaghetti and meatballs: “Uh oh. I can’t eat that.” I began to wonder what Liz could eat.
Liz claimed that her picky palette was a result of gluten and dairy intolerances. If she had it her way, she would’ve subsisted on apples and peanut butter, which were the only foods I saw her devour during my six weeks of living with her — and she devoured them. Unfortunately for Liz, our circumstances reduced the credibility of her alleged dietary restrictions. We met at The New Life Center, a residential treatment facility for eating disorders.
My inaugural interaction with Liz was tainted by my shock of being admitted to treatment. In the past twenty-four hours, I had visited my doctor, received startling results on an EKG, spent the night in the ICU, and agreed to enter residential treatment. As I dug into my chicken during my first meal, I began to worry I had made a grave mistake — I was the only sane patient among a pool of psychopaths and neurotics.
I had been placed into the “foundations” dining room, among other new patients and those who needed extra supervision. After 72 hours, if I complied with 75% of my meal plan and did not exhibit abnormal behavior at meals, I could graduate to the “peer support” dining room. A dietitian and a counselor monitored every meal and evaluated the normalcy of our eating habits, though the distinction between normal and abnormal seemed arbitrary.
Each meal gathered patients with a variety of symptoms; the anorexic doused her food in condiments so she’d be less inclined to want it, or she cut it into minuscule pieces to delay the act of eating; the bulimic drank six glasses of water to make vomiting easier; the binge eater pushed food around her plate, still feeling guilty about a recent binge episode. Some staff erred on the side of caution, or perhaps derived enjoyment from wielding power, and rectified the most piddling misbehaviors. One evening, when New York-style pizza was served, I cut into the greasy pie with my fork and knife. The counselor who was sitting with us cocked her head and forced a plastic smile.
“That’s not normalized behavior. Can we eat the pizza with our hands please?” Other staff became overwhelmed and allowed everything to slide — apples were minced, water was chugged, and hot sauce flowed rampant.
The staff also regulated our pacing — 35 minutes for meals and 15 minutes for snacks — and administered supplements at the end of each meal and snack. “Supplement” is treatment lingo for the nutrition drink one received if she failed to clean her plate, and were administered in proportion to the amount of uneaten food. Ignored half of your orange? You’ll get two ounces. Neglected a muffin? Sixteen ounces for you, sweetie. Supplements came in chocolate and vanilla, though neither tasted like the flavor it advertised. Vanilla tasted like saccharine cough medicine; chocolate tasted like chalk. The choice between the two was not one of taste preference but of gustatory torture.
I learned of these intricacies as time went on, but at my first meal, my sole objective was escaping the foundations dining room and graduating to peer support. The contrast between the two dining rooms was stark. I heard muffled sounds of laughter and guessing games drift from peer support. In foundations, the silence was punctuated by intermittent scrapes of silverware against plates and the occasional mental breakdown.
There were only four other patients in foundations. Amy was overweight and refused the meal, opting for a Clif bar instead. Sylvia had scars and bandages up her arms and avoided her food by making morbid comments. “My best friend eats rice too. She killed herself last year.” Austin had a feeding tube that snaked up his nose, down his esophagus, and into his stomach. A pimple on his face burned red beneath the plastic. Terry did not emit one sound during the entire meal. No one told me their names, but each diner had a nametag, daubed with glitter glue and stickers. My own place was marked by a post-it note, bearing my name in lackadaisical script. There was only one other post-it at the table, stuck neatly beside an untouched plate at an empty chair. I wondered about my fellow newcomer — perhaps she’d be normal too. At that moment, Liz burst into the room, denounced her meal, and I decided to hate her.
The counselor bustled to find an alternate meal for Liz — a frozen burrito or a veggie burger.
“I better not miss my smoke break because of this” Liz said. Her beady eyes drilled into the counselor’s back as she rifled through the freezer.
Liz didn’t get the memo about being enemies; to her, our concurrent arrivals fostered an affinity, even a friendship.
“We’re like treatment twins!” she said to me, as the other patients stared at her with baffled eyes. I returned my attention to my chicken and rice.
Within my first few days, I learned that Liz was twenty-six years old and a recovering alcoholic. She wore her multiple stints in detox centers like medals of honor, and she reminisced about benders as if they were childhood memories. She talked about her “urges” to break out of treatment and down a fifth of vodka. On my second morning I found her pacing the halls.
“My urges are real high today” she told me, tapping her foot frantically on the linoleum. Discussing such topics was forbidden in the center, as eating disorders are an addiction like any other, and there were many patients trying to forget the bottle. Liz was impervious to this censorship and prattled on about her relationship with alcohol. Her brashness and her disregard for the rules made her an immediate outcast. No one wanted to hear about Liz’s urges.
On my third day, I sat in the common room, which we called the milieu. I observed other patients play banana grams and watch The Lion King (we were restricted to PG-rated movies). Because I was new, I lingered on the outskirts, not yet embedded into any social circle. I pulled out a crossword puzzle to keep busy until dinner, but before I read the first clue, an alarm started wailing. I snapped my head up thinking there might be a fire and my chest fluttered at the idea of a mass exodus. We only received three fifteen-minute “fresh air” breaks each day, though “fifteen minutes of breathing in secondhand smoke” break would have been a more accurate name. A fire would provide ample opportunity to bask in nicotine-free air. I was so excited, I forgot to worry about getting burned. I waited for a counselor to herd us outside, but no such herald arrived. Instead, throngs of staff members careened towards the front door, and those of us in the milieu followed suit. Our days were monotonous; we were not going to miss a chance for live entertainment.
I followed the other patients to the door, but we were blockaded by the ever-domineering Barbara. I never learned Barbara’s official title, but it will suffice to call her “the boss.”
“Nothing to see here.” She barked as if we couldn’t hear the blaring alarm or see the commotion behind her. Barbara glared down at us, and I could tell hers was not an injunction to disregard.
I sulked back to my chair in the milieu and resumed my crossword puzzle, but my attention was diverted by a veteran patient.
“That alarm goes off when someone leaves through the front door without key card access. One girl did it a couple months ago” she said.
Another new patient looked as intrigued as I felt. “Did they stop her?”
The veteran went on. “No. I mean we’re all adults. But if you leave without signing a 72, they call the police. Something about being a danger to yourself.”
Everyone signed a 72 form upon being admitted. It obliged the patient to give a 72-hour notice before leaving New Life. In theory, the 72 prevented impulsive decisions to leave. In reality, it represented our lack of agency. As a legal entity, I was not forced to be in treatment, but I was painfully aware of the repercussions that might result from my premature release. In the past five years, I had suffered from stress fractures, bone density issues, and dangerously low heart rates; I feared what might be next. Treatment didn’t seem any more voluntary than being incarcerated. We all wanted to know who had shattered these tacit bonds. Whispers about the escapee drifted throughout the halls, but we were forbidden from discussing it openly. Over the next few hours it became evident that only Liz’s chair was empty.
The next day, during our morning fresh air break, I lingered outside on the street corner, avoiding the smokers and savoring the summer sun. I closed my eyes and leaned my head back, willing my skin to become saturated with Vitamin D. A tap on my shoulder interrupted my reverie.
“Look.” My friend Katie pointed a few blocks south to where a figure was approaching us. It moved in a way that wasn’t quite human, trudging with uneven steps and leaning slightly to one side. As it came closer, I recognized the gaunt silhouette, the blonde bun.
“Oh my god.” The counselor who was with us ran towards Liz, who was twenty yards away, staggering near a restaurant patio. She said something and dialed a number on her cell phone; Liz sat down on the sidewalk. I imagined forks full of eggs and waffles lingering inches away from gaping mouths as the brunchers took in the scene.
“Everyone, back upstairs.” Another counselor had come to end our voyeurism. She ushered us inside as we craned our necks, unable to catch a glimpse of Liz’s fate. She was absent the rest of the night, but the next morning, she was back as if nothing had transpired. If it weren’t for her complaints of a splitting headache, I would’ve thought the episode was a Zoloft-induced dream.
At first, it seemed that the incident had put Liz in her place. Her complaining subsided, she was polite to staff, and she complied with her meal plan. But beneath her deferential façade, she was mendacious and determined to find ways not to eat. Many of her infractions occurred in the dining room, right under the staff members’ noses.
On several occasions, I witnessed her slip part of her meal into a napkin or a banana peel. It began with crumbs of bread or a scant amount of raisins, but gradually she managed to hide entire meals in the crevices of her disposables. At the end of the meal, when our plates were scrutinized for traces of food, no one thought to check Liz’s trash. Eventually someone must have ratted on her, because one day our garbage was examined.
Some of her more daring transgressions occurred in the bathroom, which was locked and could only be opened by staff members. Each time someone needed to use the bathroom, a counselor would wait outside the stall. Before the patient could flush the toilet, the staff would check to make sure there was no food or vomit inside. Some recognized how dehumanizing this was and gave our excrement a quick glance; others relished their authority and scrutinized the toilet bowls.
To expedite the ordeal, there were designated bathroom periods. A counselor would sit outside the stalls while the patients lined up, doing their business and receiving flush checks in succession. Bathroom time was busy and chaotic — ideal for Liz’s plot.
She would enter one of the five stalls just like the rest of us. What she did inside was left to my imagination, though I’d guess it involved purging or dumping food she’d hidden during a meal. She’d wait for the sound of someone else’s authorized flush, and at the same instant, flush her own evidence into oblivion. Tales of her antics spread throughout the unit and all the patients began to listen for her illicit flushes.
I was in the stall next to her when I heard it: two consecutive flushes, only one permitted.
“That was an extra flush. Who did that?” The counselor stormed into each stall in search of the culprit. After that incident, Liz was only permitted use of the single-user bathroom in the presence of a counselor.
The more Liz pushed the boundaries, the more the system responded with clout. When she doused her food with hot sauce and ketchup, her condiment privileges were revoked; when she dumped vanilla soy milk over her rice and proceeded to eat it, she was banned from attending restaurant outings. On one occasion, after a meal of deep-dish pizza, she vomited into the kitchen trash can for everyone to see.
We began to detest Liz even more, though not because of our superior morals; we hated Liz because she acted on every impulse we fought to subdue. When I received a gargantuan piece of chocolate coffee cake for breakfast, I yearned to hide it in my napkin, flush it down the toilet and send it spinning into the bowels of the city’s sewer system. As I lifted my fork and put morsel after chocolate morsel into my mouth, every fiber of my being screamed against it. In my twisted, malnourished mind, it seemed unfair that Liz could avoid this tumult while the rest of us faced it day after day.
Perhaps this is why no one wanted to sit by Liz at meals. Katie would often peak into the dining room — locked except during mealtimes — to see if her nametag was next to Liz’s. If it was, she would ask one of the counselors if she could retrieve something from her locker, which was conveniently located in the dining room. Once inside, she would swap her nametag with another patient’s. Eventually, she secured permission from her therapist to sit far from Liz, convincing her that Liz was detrimental to her own recovery. I wished I had thought of it first, and so did everyone else. Within days, the therapists became overwhelmed with requests to sit apart from Liz. The frenzy came to an abrupt end when Barbara announced that no seating requests would be honored under any circumstances.
Perhaps sensing the odium against her, Liz had become subdued, isolating herself and remaining quiet in group therapy. The old Liz was loquacious and enthusiastic; the new Liz hunched in the corner over a coloring book, obsessively shading mandala designs while the rest of us participated. At the beginning of each group, we were subjected to a “check-in question.” Banal queries like “What was your favorite childhood TV show?” and “If you were a color, what color would you be?” traveled around the room, followed by the ever-detested “What is your current internal experience?” When it was Liz’s turn to respond, she would shield her eyes and shake her head, mumbling that she’d prefer not to answer — a Bartleby-esque response quite unlike her former vigor. She began to retire to her room immediately after dinner, only to make a brief reappearance for night-time snack. She would stare glass-eyed at her snacks, no longer motivated enough to claim intolerance. When we weren’t allowed in our rooms, which were locked from 8 a.m. until 5 p.m., Liz curled up on the couches in the milieu. When the milieu was locked, the hallway floor — cold and hard beneath the fluorescent lights — became her bedroom.
Whispers about the arcana of Liz’s past drifted throughout the halls.
“You know she used to be a meth addict?” someone muttered during lunch.
“She told me she’s been to treatment seventeen times. Seventeen.” Though mostly dubious, some of these claims added up. Over time, by combining fragments of information from other patients, and from Liz herself, I built a somewhat-comprehensive idea of her past.
She grew up in the northern suburbs of Chicago and attended New Trier High School, an institution notorious for wealthy, college-bound students. She went to college at Duke, though she didn’t graduate, and judging by her blinding pink tank top that read KAQ, was involved in the Greek organization. She had two younger sisters, both of whom attended prestigious colleges and now engage in anti-alcoholism efforts. I realized that she and I weren’t as different as I had thought. We both attended elite schools and grew up in affluent families. We were both sick enough to be in a residential treatment center. We had both ignored our physiological impulses, malnourishing our bodies to points of hospitalization. I wondered where Liz’s narrative deviated from my own.
“Liz ran away during fresh air break” said Katie. I looked up from The Virgin Suicides, a book I had to keep well-hidden from the staff. Liz fled while she was already outside — no alarm, no histrionics. Annie searched my face for an inkling of intrigue but she would not find one. Perhaps I was jaded after five weeks in treatment, or perhaps discussing Liz’s escape seemed too precarious. I was one week away from discharge and only concerned with getting out — the honest way, I thought.
“I knew she would.” I buried myself behind the book as Katie slumped away.
When Liz returned the second time, she adopted the same façade of zeal. She continued to rebel in subtle ways, though I would not allow myself to care.
On my last day in residential treatment, as I hugged my friends goodbye and made half-hearted promises to keep in touch, I noticed Liz lingering on the outskirts of the horde. She made her way over to me, cautiously, perhaps unsure of how to proceed. When she reached me, we stared at each other for a moment.
“Well, good luck.” I offered.
“Thanks.” More silence. Then we embraced. I felt her bones beneath her layers of clothing. I held my breath against the stale stench of cigarettes.
I always thought I was superior to Liz because she succumbed to impulses I was able to ignore. She broke every rule; I followed rules compulsively. Why, then, did she move to the peer support dining room after one week? Why, despite her benders, was she discharged two weeks after me? It infuriated me. I wanted to see Liz brutally punished. I dreamt of the day when she would face divine retribution, when she’d grovel on her knees and admit to her vices. It’s taken me nearly a year to figure out why.
Watching Liz crumple and fail would confirm that all of my efforts — the summer days spent indoors, the fountains of supplements, the endless procession of pizza, the revocation of my freedom — were not in vain. I wanted tangible proof that staying sick would lead to my downfall, and Liz refused to offer me that. I faulted Liz for holding onto her eating disorder because I was tempted to do the same. By ignoring our similarities, I believed that I could remain immune to the vices that controlled her. The truth is, I will never be immune. Her vices are my vices.
The last time I saw Liz was months after my discharge, when I was participating in an outpatient program at New Life. I was rushing from the bus stop because I was late for therapy. I bowed my head against the chilly November air and became irritated when the walk sign switched to an authoritative red hand. I concentrated on staying warm as I waited, caving my shoulders in against the harsh wind. I thought about the paper I had to finish and felt a tinge of frustration that I was going to therapy instead of the library. I almost didn’t notice Liz sitting on the curb of our familiar fresh air corner, sucking on a cigarette. I didn’t recognize anyone else; Liz was in treatment with a new cast of characters. She glanced at me and then bowed her head. She looked worse than I remembered — her eyes were bordered with plum-colored circles and her cheeks had hollowed out. She took another drag.
It was the scene I had fantasized about. Liz was ashamed of her weaknesses in the face of my success. I lowered my eyes and walked inside.