An Anorexic’s Nightmare

I’ve been out of touch.

Quite literally.

My waking hours are wasted spent “running to doctors,” as my grandmother of blessed memory would have put it.

So many doctors, so little time.

And the striking thing, the thing that literally renders me speechless, is that none of them ever touch me.

Not even with gloves on.

They “listen” to my heart and lungs through the three layers of clothes on my torso: camisole, tee, and blouse. 

I’ll let you in on a trade secret: the stethoscope has to go on bare skin.  Otherwise all you hear are three layers of cloth moving against each other: scritch, scritch, scritch.

They don’t look into my eyes, nose, or mouth, although volumes are written there.

Nor do they palpate my abdomen, which, if they did, would give them a surprise, since I have a couple of tender masses in there.  In fact, my erstwhile gastroenterologist, who had it firmly in her mind that I had IBS before she examined me, mashed into my belly like a jackhammer, and while she watched me peel myself off the ceiling, she mumbled, “Hmmmm.”  Yet she did not question her diagnosis.  I fired her.

I got a shock the other day when I requested a copy of my latest MRI from a specialist who had only touched the affected part of my body one single time, out of the several times I’ve seen him.  On that first visit he did pretend to listen to my heart and lungs.  I had a sweater on that day in addition to the above mentioned layers, so his exam was extra special.

When I picked up my MRI report, the receptionist handed me a copy of the clinic notes from my most recent visit.

It said:

“Well developed, well nourished white female in no acute distress. 
Pupils symmetrically reactive.  Cranial nerves grossly intact.  Trachea midline without deviation.  No jugular venous distension.  Heart: S1, S2 normal, no friction rub or gallop.  Lungs clear to auscultation and percussion without wheeze or rales.  Abdomen soft, non-tender, no masses…..”

In short, whether or not you know the jargon, here is an entire “normal physical exam,” none of which was ever done. 

This is the gift of EMR, Electronic Medical Records.  It provides a default “normal” physical exam, altered only if the provider inputs other findings.  One would think that this amounts to falsifying medical records, wouldn’t one?

When I was a medical student, we (or at least I; I can’t speak for the other students) practiced this catechism of normal findings, writing it longhand over and over until I had it memorized in my sleep.  That way we knew what was normal and what was not.

There were two differences, though: in my day we actually wrote things in paper charts.  We had to write really fast, so our notes looked like this:

“WDWNWF in NAD C/O SOB x4H”

Translation:

“Well developed, well nourished white female in no acute distress complains of shortness of breath for the past four hours.”

The other difference is that we actually laid hands on the patient.  We had them undress and put on a gown so we could lay the stethoscope on their chest and close our eyes and listen for those subtleties and nuances of the music the heart makes.  I remember silently cursing chest hair: scritch, scritch, scritch….

And if we didn’t examine something, we wrote: NE (not examined).  But we were not allowed to not examine something, unless the patient objected, in which case we wrote:  PUC (Patient Uncooperative)!

Although we are no longer allowed to describe physical findings in strings of acronyms (although we are apparently allowed to falsify that we actually examined the patient), there is one acronym I will never let go of, especially now that I am getting some practice being a patient.  It is:

WNL

Which is supposed to stand for

“Within Normal Limits”

When I was a student we had an inside joke that WNL actually stood for

“We Never Looked”

Only nowadays, it’s no joke.

Oh yes.  The Anorexic’s Nightmare.

I lost two inches because my spine in collapsing.  Therefore, my BMI is now 25!!!!   I’m suddenly overweight! 

How did this happen?

It’s not fair!  It was that rice I ate yesterday.  That must have been it.  Oh, wait!  I ate a cookie!  Gaaaaaa!  And I’m not bulimic, so I can’t do a thing about it! 

Gaaaaaa!!!

Packed With Wholesome Goodness

And it’s heart-healthy, Zero Everything, Good For You, and 100% Whole Grain (OK, the grain is white flour, but still).

Where have I just come from, dear readers?  Planet Claire?  Well, yes, and they also have grocery stores.

I would like to find the advertising executives who work for the companies that use this vapid copy. 

Can I write for you?  I can put together asinine slogans such as, “Filled With The Wholesome Goodness of Heart-Healthy Whole Grains.”

I actually saw a number of combinations of these exemplary examples of advertising copy, as I was cruising the aisles looking for what I really wanted, which was of course buried among the Good-For-You foods.  I don’t really like things that are Good For Me, as a rule.  I mean, I do like them, but at the moment I am too depressed to prepare them, let alone eat them; so I am making do with Heart-Healthy microwave meals, which are much too small for the calories contained.  Did I mention I’m a recovering anorexic? 

It was really terribly amusing to amble through the aisles noting the repetitive, monotonous descriptive cliches.  Any reasonably motivated blogger could make a pile of money cranking out Zero, Good For You, Wholesome Goodness, with a little Delicious and Nutritious and maybe Yummy thrown in to clinch the deal.

Since all advertising has to adhere to the Stick To Eighth Grade level of literacy rule, I guess “Scrumptious” is out of the question.  It’s ninth grade.

On a positive note, I discovered a brand of gluten free Oreo knock-offs that promise to be “Wonderously Rich.”  Splendid! 

They made it as far as the van before I took a scissors to the wrapper and sampled them.  It was my duty.

I don’t know about Wonderously Rich, but let me tell you they are CRUNCHY and DELICIOUS!  It’s very difficult to find crunchy and delicious gluten free cookies.  I ate two.

Speaking of ad speak, what’s this garbage about (fill in the blank)-free?  What are these things “free” of?  Disease?  Germs?  Lead?

Caffeine.  Gluten.  Lactose.  Fat.  Sugar.

Hell, in the olden days we used to say things like, “sugarless candy,”  or “skim milk (that’s fat-free), or even “diet pop,” which might have been sugarless, but it was never caffeine free.  What’s the point?   You want a bump, maybe you don’t want 240 calories (you want to know the caloric content of anything?  Just ask any anorexic), but decaf soda?  Ridiculous.

It was an uplifting experience, strolling down the supermarket aisles and sneering at the creme-filled, whole-grain, heart-healthy cupcakes.

Bon appetite!

Ana Gets Wrecked

I’ve wavered between telling y’all more about my horse-life, or more about my life-long struggle with anorexia….and decided that I’d give Ana one more round for today, and then on to more horsey adventures!

After we moved too far away for me to get to the stables, I fell into a deep depression.  I wrote maudlin poetry, drew frightening pictures, and read dark books like The Death Ship by B. Traven, all of Herman Hesse, and anything I could find to satisfy my morbid fascination with concentration camps, which had burned up most of my ancestors.

I took long walks in the fields with my dog Honey, and would lie on my back in a grove of pine trees for hours, listening to the sigh of the wind in the branches, inhaling the resinous fragrance, losing myself in the sensation of floating out of my body in trance.

On Saturdays, I went to art class at the important art college where my dad was a professor.  Since the age of five I had attended Saturday Class.  It was Mandatory. The only allowable excuse for not going was to have a fever.  Otherwise, I went.  On one hand it was part of the culture of my family, to be immersed in the arts, and on the other, I think it may have had something to do with my being out from under my mother’s feet.

As a fourteen-year-old, I attended the Teenage Class, which encompassed the entire high school age group.  This was both good and bad.  There were many older kids who came with enthusiasm for art and an ambition to get into college-level art school at the prestigious institution where we studied.  Then there were others whose main ambition was looking to pick up chicks.

I was so naive, I couldn’t tell the difference between a lamb and a wolf, or a wolf in sheep’s clothing.  Pardon the cliche, but it was true.  I knew nothing about sex beyond Caroline’s parakeets and what I had seen the cows and bulls doing in the pasture next to our house .  It was horribly bestial, and I ran off whenever I heard the bellows and hootings of the bovine mating ritual.

So when Richard, a lanky seventeen-year-old with shoulder-length honey-colored hair and a shaggy beard approached me, I thought he was just the coolest thing. He talked sweet and said I was beautiful and went on about all kinds of high-falutin’ philosophical bullshit, and asked me out.  My mother said no, but he could come over to the house if he wanted to.

He wanted to.  I don’t know what was going on in my mother’s head, but she allowed Richard and I to visit in my room, with the door closed.  Years later, looking back, I see the scenario and admire Richard greatly for having the self-control not to pounce on me like a cat on an unsuspecting mouse.

But he did have something up his sleeve, and that something was a joint.  Oh boy!  What a thrill!  I had heard all about pot from my dad, who regularly cussed out his students for coming into the studio stoned, and I was dying to see what all the shouting was about.

We lit some incense–a lot of incense, like four sticks–to cover the smell, and then we lit up.  It was good stuff.  I coughed my brains out.  Richard laughed.  After I recovered, he gave me another hit.  And another.  Pretty soon we were both giggling uncontrollably.

I’m wrecked,” I said, nearly choking with hilarity.  Richard exploded into laughter and lost his hit, spluttering.

I’m hungry!” I said, puzzled at the sensation and the thought.  I wasn’t hungry.  I was STARVING.  I had to have something to eat.  NOW.   I got up and ran downstairs to the kitchen, leaving Richard upstairs to finish the joint.  I opened the fridge.  AHA!  There was a container of cold spaghetti and meatballs from last night’s dinner.  I grabbed it, got two forks, and ran back upstairs.

We giggled and gobbled spaghetti until it was gone.  Still hungry, we both tromped downstairs to raid the kitchen.

My mom was lying on the couch reading.

“Glad you guys are having such a good time!  Help yourselves,” she chirped.  I guess she was happy to see me interacting with another human being, and apparently enjoying it.

We went for the ice cream, took it out to the back stoop, and polished off a half gallon of butter pecan.  By then my stomach, unaccustomed to being so stuffed, was complaining loudly.  It was time for Richard to go, and I was glad, because I was really afraid I was going to throw up.

Richard very kindly left me a couple of joints for my solitary smoking pleasure.  And that was the beginning of my dope-smoking days, and the end of Ana.  Sort of.

Riding For My Life Part Three: Wimpy

In a fit of irony, the stable owner named my bucking bronco “Wimpy,” after the very first Quarter Horse sire to be registered with the American Quarter Horse Association (AQHA) in 1940.  “Wimpy” was anything but wimpy.  As we saw in the previous installment of this series, Wimpy II was happy to bite, kick, and generally try to kill me in any way he could dream up in his horsey mind.  My personal mission in life was to gentle him.

After the backward crash incident, he suddenly gained respect for me, a little creature one-tenth his size, and decided he’d better settle down and go to work.  When I had his walk, trot, canter, and gallop under control in the ring, and had taught him to change leads and side-pass, I took him out on the trail.

Oh boy, that was some fun.  As soon as I got him on the trail and headed into the woods, he took off like a cannon ball galloping full tilt down the trail, the bit between his teeth so I that I couldn’t control his wild career.  Wimpy, my foot.

Tree branches whipped me in the face.  My glasses flew off.  By some miracle, I raised my left hand and my glasses thwacked right into it like a scrub nurse smacks the handle of an instrument into a surgeon’s hand.  I didn’t try to put them back on, but hung onto them for dear life until Wimpy wore himself out and slowed to a respectable trot.  I rode the son-of-a-gun all afternoon for that, till he and I were both exhausted and dripping with sweat.

“That’ll teach you,” I muttered as I untacked him and rubbed him down.  His muscles quivered with exhaustion, and I was afraid he was going to “tie up.”  Tying up is when a horse’s potassium or other mineral levels get out of balance from over-exercise or other stress, or else their muscle cells start leaking, and their muscles start contracting out of sync.  They fall down writhing and are in danger of their kidneys shutting down.  It’s a very dangerous condition and can be lethal.

I stayed with him a couple of hours, until I was sure he was going to be OK, then wobbled my way home on my bike.

I was starving after that adventure, but by force of will ate as little as possible at dinnertime.

“You’re looking really good these days,” bubbled my mother.  “It must be all the exercise you’re getting, riding your bike and the horses.”

I do believe my mother has an eating disorder.  “Looking good” in her lingo means “You lost weight,” or at least “You’re thin.”

I reveled in her approval.  Getting Mom’s approval meant everything to me.  It took a lot to get it.  Good grades were expected.  Making good art was expected, since both my parents were artists and I had taken Saturday art classes since I was five.  But “looking good” was a big step up from “fat ass,” and I determined that I was going to look really good.

We moved again that year, and the stable was too far to get to by bike.  Both of my parents worked in a town far away, so they didn’t get back until after six in the evening.  It became my job, at age fourteen, to prepare supper.  I didn’t mind it, since I love to cook.  Fortunately they were so grateful to have dinner waiting for them when they got home that they did not complain when I created experimental dishes such as spaghetti with raisin sauce, or egg foo young swimming in a sauce created from random liquids found in the refrigerator door.  They ate it without complaint.

I didn’t eat it, beyond tasting while cooking, and spitting the food out after tasting.

That year I was a freshman in high school.  Having started the year skinny, I garnered the respect of the girl population and the lust of the boy population.  I was invited to join the cheerleading team (Cheerleading!  Me?), which I declined.  I wasn’t the cheerleading type, and I hated the snotty girls on the squad.

I found, though, that the hypoglycemia that accompanied the anorexia caused my brain to be fuzzy–not good for Advanced Placement English or Latin Three, my favorite classes.  So at lunchtime every day I picked up a chunk of peanut butter fudge in the cafeteria, and nibbled on it all day to keep the brain fuzz at bay.

At last I reached my weight-loss goal: seventy-eight pounds.  I could wriggle in and out of my size one Junior Petite jeans without unbuttoning the top button–but I couldn’t stop.  My brain knew I was thin enough, but every time I looked in the mirror, all I saw was fat.  So I kept on with my rigorous weight-loss program, and joined the Cross-Country running team at school.

My mother looked at me with admiration: “Boy, you’re sure looking good.”  But now, I didn’t feel like it.  All I felt was fat.

Riding For My Life, Part Two: Hello, Ana

That fall Caroline’s big sister went off to college.  Caroline had to confine her voyeurism to her mating parakeets.  The big Thoroughbred went to a new home, and I was horseless all that winter.

The name-calling and mocking continued unabated at home, and since I really was a bit pudgy, the kids at school were relentless.  Twiggy made a splash as Model of the Year: “Thin was In.”  I stumbled through that school year by immersing myself in Latin.  I took a bullying beating for that one too (“Egghead, Dork, Brain), but I didn’t care because I knew they were just jealous.

By the time school got out that summer between Junior High and High School, I resolved that things were going to change.  I would not enter High School pudgy.  I would be Thin.  Very Thin.  I hatched a plan.  Half a piece of toast with butter, sugar, and cinnamon for breakfast, with black coffee; a blob of peanut butter for lunch; and as little for dinner as I could get away with.  The latter turned out to be easy, since my mother approved of my efforts to lose weight.

Since I had lost “my” horse, I looked to the nearest horse-source: the riding stable in the center of town.  It was around five miles from our house.  I mounted my Schwinn three-speed and pumped my way mostly uphill to the stable, marched in, and announced to the owner that I would be willing to clean stalls and tack in exchange for an hour of riding a day.  He almost fell over backward with joy.

I started that very day, mucking out stalls, tossing the manure and soiled bedding into a wheel barrow and toting it to the manure pile out back.  It was back-breaking labor, but I counted the seconds until I had finished and would get my first ride.

The owner looked at my sneakers and clucked his disapproval.  I flushed, knowing that sneakers were not only inappropriate, but forbidden, because one’s foot could slide through the stirrup and get caught, leading to a bad accident.  He pointed me to a pile of cast-off riding togs left by disaffected (and wealthy) pupils.  I found a pair of tall boots only two sizes too big, and a pair of baggy English britches to go with them.

He nodded his approval and pointed to a ragged-looking, skinny nag.  I eagerly took up a rubber curry, brushes and mane comb, and soon had him looking as presentable as he was going to get.  I tacked him up with saddle and bridle, led him out into the arena, and clambered onto his back via the mounting block.  The owner watched as I steered him around the arena, demonstrating my expertise at posting to the trot.  The poor old horse could barely manage a canter, so I didn’t press him.  My hour passed before I knew it, and I led my mount heaving and steaming into the barn.  His name, I found out, was Kelso, named after the great race horse.  I wondered if that was someone’s idea of a bad joke.

Kelso and I became best friends that summer.  I was soon allowed out of the arena with him, and we wandered the wide network of trails that sprawled behind the stable.  With care and patience, Kelso soon filled out, and became sleek and fast.

As Kelso was filling out, I was, to my great satisfaction, shrinking rapidly.  I learned to recognize the dizziness of hypoglycemia as a welcome sign of becoming thinner.  I abandoned the noontime peanut butter in favor of spending more time working and riding.  My English riding britches started falling off me, and I had to dig through the cast-off pile for a smaller pair.

I noticed that as a thin person, my mother’s rants meant less to me.  They lost their sting.  I was Thin.  I was In.  I forged ahead with my campaign, determined to get as willowy as possible.  What was possible, I didn’t know.  I only knew that for the first time in my life, I felt in control of Something.  And that Something was Me.  My life.

In the meantime, the owner of the stable got a trailer load of horses in from Out West.  “Green-broke,” he called them.  As I later discovered, “green-broke” meant that someone had been on their back before.  It did not mean that someone had stayed on their back.

He called me over and pointed out a fine-looking gelding, about fifteen hands high (a “hand” is four inches).

“Think you can ride him?” he asked casually.

“Of course!” I snorted.  What a foolish question.

“Tack him up, then, and take him out in the arena.”

He was a little skittish in the cross-ties, and shied violently when I tightened the girth.  He clamped his teeth firmly when I went to put the bit in his mouth, and bit me good when I used the horseman’s trick of sliding my thumb into the space behind his teeth (called the “bars”) to make him open his mouth.  That just made me more determined, and we had one hell of a fight, until I had saddle and bridle both properly on, and lead him out into the arena.

He wouldn’t stand next to the mounting block, so I pulled him up to the fence.  No sooner had I got one foot into the stirrup and the other off the ground, preparing to swing into the saddle, when he commenced bucking.

Well, there wasn’t any choice at that point but to swing my leg over anyway and try to get as much purchase in the saddle as I could, given the commotion that was going on underneath me.  I managed to catch the other stirrup on the fly, and remembering my riding master’s chant, “Keep your heels down, keep your heels down,” I kept my heels down and stood up in the stirrups, hanging on to a piece of mane, until my wild one wore himself out and stood heaving and snorting beneath me.

“That’s a good boy,” I said, trying hard not to shake.  I turned his head and walked him gently around the ring counterclockwise, then turned him toward the fence and rode him clockwise.  Then I urged him into a trot, but when I began to post he stood straight up in the air, teetering.

By the dictate of what instinct I know not, I stood up in the stirrups, keeping my heels down, and sprung off backward, keeping hold of the reins.  The horse crashed down on his back and I let go and jumped out of the way.  He thrashed in the dust of the ring and struggled to his feet panting, his eyes showing white with fear.

I walked up to him, talking to him gently, and took the reins.  The English saddle on his back was smashed.

I led him around the ring until both of our jitters calmed down a bit, then turned and headed for the barn.

The owner was standing there grinning.  I was petrified: a good saddle smashed, a horse nearly killed.  For myself, I thought nothing.

“Well,” he said around his cigar, “You’re a good little rider, aren’t you?”