A Single Slice

I was hungry.

I was uncomfortable in a lot of other ways too. The surgical tape that kept my nasogastric tube in place had irritated my cheek. The result was a patch of scabby, raw skin, roughly resembling the outline of a heart. My nurse, Denise, had taken the time to cut shapes out of the tape before sticking it to my face, a gesture that was so kind it made me feel miserable. My throat ached from the tube itself, even days after it had been removed. I figured that was normal, shoving a plastic tube up your nose, down your throat and into your stomach isn’t the definition of comfort. I was also freezing but too weak to pull the extra blanket I had been provided up over my chest. I was experiencing all of this discomfort yet feeling hungry caused me the most distress. This was because it was affecting me mentally much more than it was physically. Over the course of my eating disorder, the hollow pain that resulted from skipping meals was one of the first things I was able to overcome. My first “accomplishment.” The first moment of satisfaction that ultimately sent me spiraling, landing me in my current situation, stuck in a hospital bed being force fed like some sort of humanoid foie gras. The fact that my body was beginning to readjust to a regular diet and my hunger cues were returning terrified me. I had been forced back to square one. Everything I was in control of was slipping out of my fingers and I was helpless to stop it

Denise opened the door, causing me to jump despite the fact I’d been expecting her. She checked my vitals three times a day, every day, before each meal. She didn’t seem to notice I’d been startled. Her eyes were fully focused on the cart of medical equipment she was pushing. She was a very short woman, and the bustling activity of the hallway was clearly visible over her head.

“How are we doing today, Miss Emily?” she asked without looking up.

“Oh, fantastic. Could run a marathon. You going to let me out of here today?” I asked, my voice weak.

Denise turned her attention to the mess of cables that dangled off the cart. She took a moment to wrestle with the rubbery cords. After freeing the blood pressure cuff, she got right to work, strapping the coarse band around my forearm, and snapping the heart monitor clip over my index finger.

“She’s still got her sense of humor I see,” she responded, holding in a chuckle.

“You know me,” I tried my best to smile.

Denise began pumping the blood pressure monitor. I held my breath as the cuff became uncomfortably tight, exhaling in tandem with the machine itself. I had mixed emotions as the cuff was removed and I watched my skin fade from a blanched, papery white to my normal olive tone. When I was at my lowest point the lightest pressure against my skin would result in a pale, lingering imprint. I knew I was supposed to be grateful that I wasn’t malnourished anymore. I tried my best to be, but my body’s knee jerk reaction was still to release a rush of anxiety at the new development.

“Get excited girl, we’re having a good lunch today! BLT. Yogurt. Some fruit. A crepe. All good stuff!” Denise said pulling me back to reality.

She knew I hated surprises. As soon as I’d been switched to solid foods, I began hounding her for details about my meals so I could mentally prepare myself. At first, she was reluctant to give in, but I wore her down and now she would rattle off the menu before I even asked.

“The bacon’s going to be hard,” was my only response.

“Try your best to enjoy it baby, your mom’s coming to eat with you today. Here let me help you up,”

Denise gripped me under my armpits and lifted me into a sitting position. She balanced my chest on one arm as she fluffed my pillows, leaning my shoulders against them so I stayed upright. I should have been embarrassed. I was a twenty-two-year-old woman who had to be propped up like an infant just to eat, but after everything my eating disorder had put me through, embarrassment was rare.

“I’ll be right back with the goods,” Denise called on her way out the door.

I leaned heavily into my pillows, trying and failing to not overthink. I knew why I stopped eating. I knew exactly why and that was the worst part, because even though I knew why, and I was fully aware of the repercussions, I couldn’t stop. I had been an anxious person my entire life, my anxiety constantly morphing throughout my twenty-two years into whatever would affect me the most in the moment. Things took a turn for the worse after my father passed away from Leukemia. I started college shortly after his death as well as a new job in order to pay for school. All my free time went towards helping my mother care for my two younger siblings. Six months of this went by and I felt so overwhelmed I couldn’t bare it. I was engulfed in a constant state of anxiety. I felt detached and completely out of control, but I couldn’t run from my responsibilities. So, my anxiety evolved and attached itself to something I could control. That thing happened to be food.

There was so much guilt that came along with my disorder it was almost unbearable. But nothing was more unbearable than the fear that resulted from ignoring the rules that regulated my anxiety. My eating disorder had such a strong grip over me my fear of disappointing it was stronger than my sense of self-preservation. This fact increased my guilt and anxiety ten-fold. Did I not love my family? Did I not care about my friends? How could I do this to the people I loved the most?

Denise walked back into the room, now carrying a large tray with a pink cloche and some plastic cutlery balanced precariously on top. She laid the tray gently across the rails of my bed. I felt my neck grow hot. I tried to thank her, but my anxiety had crawled up my throat in the form of bile, cutting off any opportunity to speak. I settled on a weak smile. Denise watched me expectantly, making sure I didn’t pull anything funny. She didn’t have to worry, there was no way I’d risk going back to tube feeding. I opened the cloche and studied the food.

Ok, a BLT. It’s got turkey on it, a lean meat, I can do a lean meat. The bread and bacon will have to go down last, I need a second to handle that. Yogurt? That's alright, I never cut out yogurt. Is that cantaloupe or honeydew? I hope it’s cantaloupe. And…?

“What the fuck is that?” I demanded before I could stop myself.

Denise shot me the kind of tight-lipped side eye that could scare a grown man. She was nice but she didn’t take attitude.

“Sorry,” I managed.

Denise glanced down at the item I was pointing at incriminatingly. It was a slice of chocolate cake, innocent enough in the eyes of the right person.

“I guess they were out of crepes today,” she said with a sigh.

“What am I supposed to do?” I asked panic in my voice, “can you make sure they don’t have anymore?”

“What you’re supposed to do is enjoy it, baby. You know how it goes, everything on that plate you gotta eat. You can’t get better if I let you bend rules,”

I nodded, tears filling my eyes as I tried to stop myself from hyperventilating right there and then. I wanted to sob, partially because of the panic I was feeling but mostly because I was a grown woman losing it over a piece of cake. It was so humiliating.

Denise patted me on the back.

“You sit tight. I’ll go get your mom from the waiting room,”

I did not sit tight. In fact, as soon as I heard the door click shut, I summoned all my energy and reached across my bed to grab the pen and pad of paper that sat on the bedside table to my left. After retrieving the items, I managed to push myself back into my pillows, breathing hard from the effort. I didn’t have the energy to sit up by myself but as soon as my anxiety demanded something of me, I could find the strength. I would find a way to move mountains if it meant I could relieve some of the stress that bubbled in my stomach.

I eyed the desert. I estimated the slice was probably around one eighth of an entire cake, but I couldn’t be sure. That’s where the paper and pen came in. I set the slice upright and settled the paper on top of it, gently tracing it’s outline with the pen. I then folded the paper along the lines I’d drawn, ripping it to create a rough triangle. I proceeded to line up the triangle with the edge of the cake, rotating it slowly to make a circle, leaving the ghost of a cake in its wake.

Ok, so if this is an eighth of a cake and there’s at least two eggs in a cake, which is 180 calories then that’s 23ish.

Deep down, I knew what I was doing was crazy. I also knew the outcome wouldn’t even be close to accurate, but I couldn’t stop, I needed to scratch that itch, to retain that small amount of control. The door to my room swung open and I nearly jumped out of my skin, throwing the paper and pen back onto my nightstand and knocking the fork off my tray in the process. My mom still wasn’t aware of how bad I’d gotten, and I wasn’t going to show her now. Luckily, Denise had pushed the door open while still speaking to my mother, both of their faces were turned away from me.

“Hey honey,” my mother smiled when she caught sight of me, “what do we have today?”

I smiled back, pointing towards my tray. I had missed her. She slid one of the plastic chairs that lined the wall up to my bed, sitting in it backwards so she could face me while resting her chin on her arms.

“That looks tasty,” she said.

I wanted to be like my mom. She was so strong. She’d raised three kids as a young parent and never complained. She rarely raised her voice or got frustrated. She took care of herself when she was sick and if she felt overwhelmed, she went to her therapist and worked to feel better. I wanted to know how she handled everything with such grace. Why was I so weak? Why did my mind crack with the slightest pressure? Why couldn’t I stop myself from hurting her?

“What’s going to be toughest today?” she asked me.

“The cake,” I replied.

“We’ll start with that then,” she answered.

I picked up my fork and poked at the slice. I tried to steady my breathing.

“Remember Teddy’s last birthday? He had a cake just like this one,” my mom said, referencing my youngest brother.

“Yeah, I remember,”

I had avoided it by faking a stomach ache. I didn’t want to fake anything anymore. I wanted to spend genuine time with my family with no obstacles. I lifted a forkful of cake to my lips. I was crying now, large tears that made noise as they rolled off my cheeks and hit my hospital gown. My mom reached out and grabbed my hand, squeezing it tightly. She used the sleeve of her other arm to wipe my tears away.

“You got this,” she whispered.

And I did.