Hope and Other Luxuries: A Mother's Life With a Daughter's Anorexia by Clare B. Dunkle
Why I did this, I wasn’t sure. Maybe I had some sort of idea that in a different setting, he would be more rational. Or maybe I instinctively guessed what he was going to do.
Dr. Petras made a beeline for Elena’s room, only a couple of doors away. She must have heard the noise of our “conference” because she was already sitting up in bed.
“You’re going back to the States,” Dr. Petras told her, “to be treated for anorexia. You’re going to spend at least six months in an institution.”
I saw the stricken look on Elena’s face. It must have matched the one on my own.
“We don’t know that!” I hastily interrupted. “We have to see what the doctors in the States recommend.”
But Dr. Petras didn’t even acknowledge that I had spoken. He certainly didn’t acknowledge what I had said.
“You can forget about seeing your friends again,” he continued. “You won’t come back to Germany. Your father will have to give up his job and take an early return to the States.”
“You’re going to make my father lose his job?” Elena cried.
“Hey, wait a minute,” I said. “That’s not true!”
“You can’t take away my father’s job!” Elena said. “You haven’t given me a chance to gain weight on my own. If you’ll give me a few weeks—if you gave me a chance—”
“It’s too late for that,” Dr. Petras said—and am I right that he sounded triumphant? “You won’t have that senior year with your friends. You’ll be in an institution for the next six to nine months, with a tube up your nose to feed you!”
At that point, Elena stopped talking. She lay back down and closed her eyes. Dr. Petras continued talking for several more minutes. The more she ignored him, the louder and more insistent he became.
“You’re getting bussed to the airstrip and put on a medevac flight tomorrow, whether you like it or not! Forget about that senior year. You won’t graduate with your class. You’ll never see Germany or your friends again!”
I couldn’t believe it. I absolutely could not believe what I was hearing. This man may not have understood my daughter well enough to find a strategy that would heal her, but he certainly knew how to turn her most vulnerable, vital dreams into a message of anguish and despair.
But if Dr. Petras had wanted to see tears—and he certainly sounded as if he did—then he might as well have saved himself the trouble. Short of hitting Elena’s kneecaps with a hammer, I don’t think there’s any way he could have gotten them. Elena lay motionless, eyes closed, until he blustered his way to silence. Then he left the room without talking to me or acknowledging me in any way.
As soon as he left, Elena sat up.
“So, about what to pack,” she said, as if Dr. Petras and his furious threats didn’t even exist.
“Elena, I just want you to know,” I said, “that he’s wrong about where you’re going. You’re going to a medical hospital. It’s for your heart.”
“Sure, whatever,” she said quickly, in a tone of voice that stopped further discussion. As upset as I was, I respected her desire not to prolong that unpleasant scene.
For twenty minutes, Elena and I discussed which items to take, and she told me where to find her favorite clothes. Then I left to pack, reassured that at least one of the parties to that discussion had acted like a reasonable adult.
I was up very late that night. First, I packed. Then I finished my read-through of my Wuthering Heights story and sent it off in an email message to my editor and agent. If, just a week ago, I had been thinking that it felt out of place in our lives now, a relic from a darker time, that day’s display of ruthlessness had made the story live for me again.
Emily Brontë was right. This world is a brutal place.
The next morning was transport day. I was up very early, even though I had barely slept. And in spite of my anxiety, I was interested to see how the transport would go. After all, I told myself, how many civilians get to ride in a real military medical evacuation flight?
At this time, the height of both Mideast wars, the military hospital transported wounded soldiers home on two flights each week. Elena would be only one member of this flight’s group of casualties. Her nurse wheeled her outside on a gurney to wait in the early morning sunshine for the blue medical buses to come pick us up. One gurney after another came through the double doors of the emergency room, bringing wounded soldiers to wait with us on the curved asphalt driveway.
Joe stayed with us until the blue buses showed up. He was completely miserable. He had no idea when he’d see us again. But I refused to be miserable. I insisted on seeing this as an adventure. With the long, chaotic day that stretched out in front of me, misery was one more luxury I couldn’t afford.
Elena’s bus was for stretcher patients and nurses only. I rode in a smaller bus with a few other family members and personnel. But at each stage of the orderly process of checking us in, getting our luggage sorted, and transporting us to the airplane, I was allowed to visit with Elena. She seemed to be in good spirits, and I knew that she liked the young nurse who was traveling with her.
Elena’s fellow evacuees were Army and Marine personnel who had been badly injured downrange. Rather than rehabilitate them in Germany and send them back to the front, the hospital was sending them home to be healed and then discharged from service. The soldiers were looking forward to getting back stateside, and as they waited on their gurneys, they joked with one another. I was looking forward to getting to a stateside hospital, too. I felt that we were escaping from a dangerous and possibly unbalanced man.
The worst is behind us, I told myself as I looked out the window of my bus. From here, things can only get better. Maybe this new doctor in the States would know just what was wrong and would tell us that Elena’s heart could still heal.
Our buses pulled onto the gigantic concrete taxiway and stopped next to a big gray C-17 aircraft. Its wide back end was open for loading. Uniformed personnel were carrying the patients up into its metal belly one at a time, teams of six soldiers to each stretcher. Then they came over to our bus, took our luggage, and told us we could walk onboard.
I looked around with curiosity as I walked up the metal ramp. This wasn’t just an exhibit at a museum or an air show. This was an actual working warplane! Cryptic numbers in black stencil lettering ran along the panels overhead, and charcoal-colored nonskid tape striped the floor in chevron patterns.
The wide belly of the C-17 could haul anything it needed to haul. That day, it was flying home wounded soldiers, and their stretchers had been linked together to form several rows of broad, open temporary shelves down the center of the plane: a series of upper and lower bunks held together by special poles. Once we arrived in the States, personnel would carry the stretchers away, and the poles that had held them together would come apart. Then the belly of the aircraft would be empty again, and it could bring back trucks or pallets of cargo or whatever else the war machine downrange needed.
The young nurse who was traveling with Elena waved me over to where Elena’s stretcher was racked into the open-shelf framework. Beside her stretcher, built into the outer hull of the aircraft, was a line of airplane seats. I wouldn’t be facing forward for the flight; I would be looking into the interior of the plane. But that didn’t matter. The plane didn’t have any windows, so it wasn’t as if I was missing out on a view.
Elena’s stretcher was a “lower bunk” for the flight. I sat down in the nearest seat, snapped my belt, and stowed my purse and paperwork at my feet. Then I leaned over to say hello.
My daughter’s eyes were closed. She appeared to be asleep. She must be exhausted to fall asleep so quickly. That was the result of a week of hunger-strike starvation, I thought, and I spent a few seconds worrying about her damaged heart.
“Hey, hon,” I said. “How are you feeling?”
Elena’s foot was sticking out from under the green blanket. It was moving just a little. It made slow, rhythmic swings back and forth.
No response.
Elena’s hands, clasped close to her chest, began to twitch. As I watched, puzzled, the foot that stuck out from under the blanket rotated in a slow circle.
The nurse walked up to greet me with a bright smile.
“Did you give Elena any medication?” I asked her. “She seems to be asleep.” How, I didn’t know—the back of the plane was still open, and medical personnel were dragging in metal crates of supplies. The engine noise was so loud that I practically had to shout.
“No, we were just talking outside,” the nurse said, surprised. “Elena!” She leaned down and gave Elena’s arm a shake.
Elena’s eyelids flickered. Oh, good, she’s waking up, I thought. But no: her eyes were rolling in her head. And now her hands were twisting at the wrists, describing their own slow circles.
The nurse turned and yelled something to the rest of the medical crew, and my daughter’s body disappeared behind green-camouflaged backs. They pushed, called, poked, picked up hands and feet, and dropped them again. They leaned down and shouted into her ear.
But Elena didn’t wake up. She lay completely unresponsive, with her hands and feet gently circling.
Dr. Petras had made good on his threat to force her to leave Germany. He had stripped her of power and control. But Elena had gotten the last laugh. She had slipped beyond his reach.
She had slipped beyond the reach of everything.
CHAPTER THIRTEEN
Ambulance! Now!” yelled a gray-haired man in fatigues. “I’m sorry,” he said, turning to me, “but I have to order her off this flight.”
Elena’s stretcher was already being quick-marched down the ramp. Stunned, I grabbed my purse and paperwork and scurried after it.
“What’s wrong?” I demanded as uniformed stretcher-bearers loaded Elena onto one of the small blue buses. Elena’s nurse and I climbed in behind them. “What’s wrong?” I asked again. “What’s happening? Is it her heart?”
But Elena’s nurse didn’t know. Her eyes were frightened.
As we started back to base, she and another nurse stood over Elena, and between the two of them, they tried to hold her down. But they couldn’t manage it. They weren’t strong enough.
Elena’s body jerked and twisted. The circling of her hands and her feet became more violent. She started to breathe in long, rattling gasps.
“Elena!” shouted the nurses, trying to pin her wrists, but they couldn’t slow the rapid circles.
Red lines appeared on my unconscious daughter’s face and neck. Her circling fingernails were tearing into her skin. Her head was back, and the muscles of her face were rigid. Her eyes rolled under half-closed lids.
Did she have epilepsy? Did she have a heart attack? Was she losing oxygen? Was she going to die?
“Elena!” cried the nurse. She broke smelling salts under Elena’s nose, but nothing worked to bring her around.
My hands were shaking and jerking, too. I almost dropped my cell phone. From a long way away, I heard Joe’s voice.
“What’s wrong?” he was asking.
What was wrong? I didn’t know. Maybe Elena’s heart had burst. Maybe a blood clot had reached her brain.
The ambulance stopped, and techs threw my daughter’s flailing body onto a gurney. Her cheeks were bleeding from the scratches, and her gasps had become long groans. Somebody thrust an oxygen mask over her face, but her circling hands caught its straps and tangled them.
The team of techs raced the gurney down the hall. I ran along behind it, like an extra in my own personal horror movie. The only memory I retain from that journey is the shocked expressions on the faces of people jumping out of our way.
Elena’s groans were wails now, long wavering howls with absolutely no mind behind them. Her eyes were open, rolling so violently in their sockets that nothing showed except the bloodshot whites.
The techs and nurses had rushed us up to the pediatric ward. Now somebody came out to meet them. “Not here!” he shouted. “Emergency room!” So we turned around and rushed away again.
I discovered that we had collected Joe at some point during this hideous parade. As we crashed through the swinging doors of the ER, staff came running up to meet the gurney, and it disappeared into a room at the end of the hall. Joe and I weren’t allowed to follow, so now it was just the two of us, standing outside, panting, trying to process what we had just seen.
Was Elena dying? Did she have brain damage? Was she dying?
The ER doctor stepped out of the closed room to talk to us, looking remarkably calm and completely in charge. His composure steadied my wrecked nerves. “It’s a panic attack,” he said. “I’ve administered Ativan to bring her around. In the meantime, we’re going to leave her alone in the room. Holding her down or interfering with her just makes it worse. We’ll call you from the waiting room when she’s ready for visitors.”
“A—a what? A panic attack?” Joe and I asked, almost in unison. “What do you mean, a panic attack? Are you sure? What’s that? What about her heart?”
“Her heart’s fine.”
“But a panic attack? She’s never had those before. She’s never done anything like this!”
“It’s either a panic attack—or a psychotic break,” amended the doctor. “We’ll know which one it was when she comes around. Go on out to the waiting room now. We’ll call you when you can come see her.”
Joe and I sat in the waiting room for an hour. It was truly an hour from hell. Our only distractions were the military information pamphlets and CNN on the waiting room television.
What I thought about during that hour, I have no idea. I don’t know that I thought at all.
By the time we were called back to see Elena, she had been moved upstairs. We found her lying in the intensive care unit (ICU), next to an impressive bank of machines and monitors. An oxygen sensor clip had taken over one of her fingertips. A clear plastic feeding tube snaked out of her nostril, and the fabric tape that held it in place clung to the tip of her nose like a permanent drip. She lay motionless. She didn’t know we were there.
This was my daughter—my bright, fierce, idealistic daughter, who never stopped moving, planning, talking, doing things, from morning until night. Now, Elena lay absolutely still. She had stopped completely.
The black screen of the monitor illustrated Elena’s state of deep rest: long, slow yellow loops for her breathing, widely spaced green blips for her heartbeats. Everything about her sleep was perfectly even and regular, as if she were on life-support machines that none of us could see.
I dropped into a chair beside Elena and once again set down my purse and the packet of paperwork. My first impulse was to burst into tears. What lay here was only the outer shell of the person called Elena, the part that didn’t matter so much. The other part was her lively eyes, her ever-changing expression, and the millions of shades of emotion in her voice as she jumped from topic to topic: “Guess what!”
But that part was gone.
“Don’t worry,” the ICU nurse told us. “Your daughter was sitting up a while ago. She was talking to me.” But she didn’t sit up and talk to us, even though Joe and I sat by her bedside all evening.
Periodically, Elena would stir, like a dreamer disturbed (all the colored loops and blips clustering together and becoming uneven), and whisper something that might or might not make sense. I couldn’t tell if she had any idea where she was or how she had come to be there.
Elena’s pediatrician came by to see her. He could offer no insight into what had happened. But I knew. In my heart, I knew.
First, there had been the week in the hospital—the week of the hunger strike. Elena had refused food so steadily during this enforced period of “refeeding” that it must have stressed her body severely.
Then, after this week of stress, there had been the all-out attack. There were the threats, and there was the yelling: “You won’t have that senior year! You won’t ever see your friends agai
As I sat by my daughter’s still, frail form, those harsh sentences echoed in my mind, and I knew—I just knew: This had happened the very second those threats began to come true. After all the pain and grief she had gone through with Valerie and after her hesitation to try a new school, she had finally begun to take risks again. She had found a new group of friends and had made a new home for herself by volunteering at the hospital. Then, out of the blue, came this imprisonment and forced exile, and Elena couldn’t bear it. She couldn’t bear to go through any more grief.
So they had put her on the plane, and Elena had fought back. She had fought back the only way she could.
And me? I had let that man lock up and threaten my daughter. After all those years of swearing I would be an extraordinary mother, I had stood there and listened to that dangerously unbalanced quack as he had practiced his shady power plays on my child.
There were no words for the misery I felt.
After an hour or so, two nurses came in with a tall blue pump stand and told us that Elena would be receiving a balanced, nutrient-rich liquid diet. This mysterious medical formula turned out to be strawberry- flavored Ensure.
That made me feel a little better. It was a relief to think that Elena would be taking in nourishment at last.
The nurses filled up the clear bag connected to the pump and started it grinding away. First, the bag was soft pink. Then the tube was soft pink. Then soft pink fluid flowed out of Elena’s mouth and puddled on her pillow, and she choked and gagged, and the nurses ended up having to stop the pump. They couldn’t figure out what was wrong, but they thought that maybe the tube had a wrong bend.
That was the end of Elena’s nutrient-rich diet.
When nighttime came, Joe went home. He had to face another long workday in the morning. But I couldn’t bear to leave my daughter alone again. I already regretted so very painfully the nights I had left her here.