Strangers to Ourselves Read online

  Begin Reading

  Table of Contents

  A Note About the Author

  Copyright Page

  Thank you for buying this

  Farrar, Straus and Giroux ebook.

  To receive special offers, bonus content,

  and info on new releases and other great reads,

  sign up for our newsletters.

  Or visit us online at

  us.macmillan.com/newslettersignup

  For email updates on the author, click here.

  The author and publisher have provided this e-book to you for your personal use only. You may not make this e-book publicly available in any way. Copyright infringement is against the law. If you believe the copy of this e-book you are reading infringes on the author’s copyright, please notify the publisher at: us.macmillanusa.com/piracy.

  To my parents

  PROLOGUE: RACHEL

  “Someone better than me”

  In the early weeks of first grade, I made a friend named Elizabeth. She was the oldest child in our class but tiny, with thin, knobby limbs. We connected over the game mancala, dropping marbles into a wooden board with fourteen shallow holes. I avoided other classmates so I’d be ready when Elizabeth asked me to play. Somehow she always did. I felt that I had willed our friendship into being.

  I asked my mom why Elizabeth’s house, in Bloomfield Hills, a wealthy suburb of Detroit, smelled so different from ours. I was disappointed that her answer—laundry detergent—felt so ordinary. Elizabeth’s house was so large that I was sure she got lost in it. She had a yellow canopy bed, a walk-in closet, a swimming pool. She showed me how when she brushed her blond hair it got even lighter. Her family had a refrigerator in their basement devoted just to sodas, and one day Elizabeth proposed that we feed Coke to our knees. We tried the experiment in her babysitter’s car and laughed as Coke dripped onto the seats. It seemed incredible that there was only one way to drink.

  At home, I sometimes pretended I was Elizabeth. I walked into rooms and imagined I didn’t know where they led. It seemed like a fluke, a bit of bad luck, that I had been born as me rather than as Elizabeth. I remember waking up forlorn after a dream: I was given the chance to become Elizabeth if I picked the right seat on the school bus. I walked past thirteen rows, overwhelmed by the opportunity, and chose the wrong seat.

  I had just turned six, and the boundaries between people felt porous. During music class, I was assigned a seat between two boys: On one side was Sloan, the tallest kid in first grade. He had a perennially runny nose, the snot greenish. On the other side was Brent, who was chubby and breathed so heavily that I sometimes checked to see if he’d fallen asleep. Their physical attributes seemed contagious. To protect myself, I tried to sit at the centermost point of my chair, as far away as possible from both boys. If I moved toward Sloan, I felt I’d grow too tall. If I inched toward Brent, I’d become fat. My older sister, Sari, and I had watched a news segment about an obese man who had a heart attack in bed and then had to be removed from his apartment by a crane. We tried to imagine the logistics: Did they have to knock down the walls? How did they attach the man to the machine? I decided to err on the side of Sloan.

  At lunch, everyone in my class was required to take at least a “mouse taste” of each dish—one noodle, a single pea. Many years later, my first-grade teacher, Ms. Calfin, told me, “You’d just sit there looking at your mouse tastes pensively, and I’d be like, ‘Go ahead! We only have twenty minutes! Keep going!’ But it was a slow roll.” Two weeks into the school year, I asked for permission to visit the bathroom after lunch. “Do you have to go potty?” Ms. Calfin asked. She said that I told her that I just wanted to look in the mirror.

  A few days later, I wouldn’t touch the mouse tastes that Ms. Calfin had put on my plate. She asked if instead I’d be going to the salad bar, where I sometimes got croutons. I tried to hide my grin when I said no. She looked at me carefully and made an expression that I didn’t know how to classify—it looked like a frown and a smile at the same time. I could feel her contemplating who I was, and her focus was exhilarating. I loved her and worried that my feelings were unreciprocated. It seemed to me that she preferred the stolid children whose mothers volunteered at school.

  For the next two days, I mostly refused to eat or drink. I don’t remember my reasoning, only the reactions of the adults and my vague sense of pride. I got the idea from Yom Kippur, the day of atonement, which we’d celebrated the week before. It was the first time I realized that it was possible to say no to food. The decision retained the religious energy from the holiday and carried an aura of martyrdom.

  I went to Hebrew school three times a week and liked to entertain the idea that I had some invisible channels of communication with God. Several times a day, I prayed for my family to be healthy until we were “eighty-seven years or older,” repeating “me and Mom” several times, because our survival felt most important. I remember walking on the pebbles in my dad’s girlfriend’s backyard and realizing that every step had been preordained by God. But the epiphany was eclipsed by self-consciousness; I felt that maybe I was having my burning-bush moment. The content of the revelation was secondary to my desire to distinguish myself as someone capable of having one.

  On September 30, 1988, I told my mom that I was so dizzy I felt I would bump into a wall. I had barely eaten for three days. She took me to the pediatrician. “I was thinking, ‘Well, they’ll give you some fluids, and then I’ll take you home,’” my mom later told me. She described me as an exuberant and silly six-year-old. But my dad’s girlfriend, Linda, who became my stepmom, recalled that in her presence I was the saddest child she had ever known. When presented with activities that she assumed would excite me, I often replied with the same phrase: “What’s so big about that?” Linda observed that I had an unusual ability to sit completely still while silently crying, often at the kitchen table. My dad would tell me to eat and I would refuse, sometimes for more than an hour, until he gave up and drove me to school.

  My doctor noted that I had lost four pounds in the last month. Until recently I’d had a normal diet, he wrote, “consisting mostly of pizza, chicken, cereal.” He described my “current accomplishments” as “running, jumping, riding two-wheeler.” For “personal/social,” he noted that I was bored. He advised my mom to take me to Children’s Hospital of Michigan, in Detroit, where I was admitted for “failure to eat.” A psychiatrist there described me as a “well developed but very thin female in no acute distress.”

  After interviewing my mother and father, who had divorced a year earlier and were still fighting over custody, one doctor at the hospital wrote, “Her mother states that her father pokes fun at obese individuals, and the father did not protest this statement.” My father, on the other hand, proposed that my problem originated with my mother, who was “overly concerned with foods.” She did stockpile so many whole-grain breads that, when we opened the freezer door, loaves bought at farmers markets around Detroit would sometimes topple out. But she had a relatively normal, if passionate, relationship with food. Like many women her age, she occasionally tried to diet, with flagging conviction.

  The week before my hospitalization, my mom kept a journal for me—I couldn’t write yet, so she transcribed as I talked—but I shared no details about my state of mind, only chronological accounts of my days interspersed with questions like, “Where does a snake’s diarrhea come out of?” and “Why don’t people have tails?” My mom, who had recently broken up with her boyfriend, kept her own journal too. That week, she recorded a dream—she was always documenting her dreams—in which she asked a gardener to take apart our house brick by brick. “All that remains is dirt and the cement shape of the house,” she wrote.

/>   On my first evening at the hospital, a nurse presented me with a tray of food, which I refused. My mom was hungry, so she ate it instead. “They got very mad at me,” she told me. “I was not to confuse what I ate with what you ate.” The next day, the nurses gave me an IV, because I’d become dehydrated.

  My medical records do not present a coherent picture of why I wasn’t eating or drinking. One psychologist wrote, “Clearly, her symptoms are an expression of the pathology in the relationship between her mother and father.” Another observed, “Rachel attempts to look inside herself to understand and resolve her intense feelings related to her external world” but struggles with an “over-complicated thought process,” leading to a “self-condemning attitude (i.e., I must be the problem).” Although the description could apply to almost anyone, the doctors concluded that I had “an unusual case of anorexia nervosa.”

  Anorexia has often been described as a “reading disorder,” brought on by uncritical consumption of texts that present thinness as the feminine ideal. I was only starting to learn to read. I had never heard of anorexia. When my mom told me the diagnosis, it sounded to me like a species of dinosaur. The Japanese scholar Takayo Mukai, a former anorexic, describes a similar sense of disorientation when encountering the word in the 1980s, before anorexia was well-known in Japan: “The eight-letter-word was just an empty envelope, unstamped and unaddressed.”

  My father and Linda went to our local library and read the only book they could find on the subject: The Golden Cage by Hilde Bruch, published in 1978. Bruch, a psychoanalyst known as “Lady Anorexia,” began writing about anorexia in the sixties, when the illness was obscure. She hypothesized that novelty was essential to the disease, which she described as a “blind search for a sense of identity and selfhood.” She predicted (inaccurately) that, once a critical mass of girls became anorexic, the incidence of the illness might decrease, because it would no longer feel special. “The illness used to be the accomplishment of an isolated girl who felt she had found her own way to salvation,” she wrote. “Each one was, in a way, an original inventor of this misguided road to independence.”

  My mom also read about the illness, mostly from the psychoanalytic perspective that was dominant at the time, and internalized a common message: the mother was to blame. “It’s I who has caused all the pain—and the original injury,” she wrote in a spiral-bound journal that she often carried in her purse. She turned this realization into an indictment of her own character. “I must own that I have a propensity to be mean and to hurt,” she wrote. “What I do, sometimes, to my children, is mean—though I think I try very hard to protect them.” Neither my sister nor I remember her doing anything approaching mean, but she believed what these books told her about herself. In notes for a conversation with my doctors, she reminded herself to be “humble,” and not to “claim to understand what’s happening.”

  The word “anorexia” felt so powerful that I was afraid to say it. I was learning to sound out letters, and words felt like tangible entities that somehow embodied their meaning. I would not say the names of any foods because pronouncing the words felt like the equivalent of eating. “If such terms were used in her presence,” a psychologist wrote, “she would cover her ears.” I wouldn’t say “eight,” because the number sounds like “ate.” I was upset when one of the nurses, frustrated by my stubbornness, told me that I was a “tough cookie.” My mother was more sensitive to my concerns, and when I asked about the condition of my hospital roommate, a girl with diabetes, my mom avoided the word “sugar.” She explained, “It’s like the opposite of what you have.”

  I was assigned a young psychologist, Thomas Koepke, who was soft-spoken and nurturing. I answered his questions with as few words as possible. I had a vague fear that, even when I stayed silent, my thoughts were being transcribed and printed from the back of my head, like pages released from a printer. In an evaluation that today makes me self-conscious about the career I have chosen, another psychologist wrote, “Rachel handled herself in a way that she appeared to very consciously be aware of her ability to control the interview.”

  Koepke told my parents that the doctors on his team had no evidence of a child as young as six having ever been diagnosed with anorexia. Nevertheless, they moved me out of the room that I shared with the girl with diabetes and to the fifth floor of the hospital, which, as far as I could see, was racially divided. At the end of the hall were Black children with sickle cell anemia. In the center, where I was placed, was a small group of white girls, all older than me. Due to malnutrition, some of their faces and arms were covered with lanugo, the soft, feathery hair that coats the skin of newborns. Every morning, we were weighed while wearing our hospital gowns, our backs to the scales.

  The girls often spoke of their “privileges.” If we completed one meal, delivered on a tray to our beds, and the nurses didn’t find any large crumbs on our laps, we could call our parents. If we finished two meals in a day, our parents could come to the hospital for an hour-long visit. But the consequences for abstaining from food were severe: skip two meals, and we were assigned to bed rest. To use the bathroom, we had to page a nurse, who would record our “output.” We lost our freedom to watch television or visit the game room, where children with other illnesses played. The threat of a feeding tube—the punishment for losing too much weight—hovered over every meal. I didn’t realize that the tube would go inside my nostrils. I imagined a huge tube, like a covered slide, that I would live inside.

  * * *

  ON THE ANOREXIA UNIT, I was assigned a new roommate, Carrie, a twelve-year-old with straw-colored hair. I asked her, “Do you think I’m weird?” so many times that she eventually said, “If you ask me one more time, I will say yes.” She knew all the nurses on our floor and had become close with other patients. I viewed her and her friend Hava, who lived in the room next to us, as mentors. Hava was twelve and beautiful, with sharp features and long brown hair that she didn’t brush. There was something rugged and wild about her that reminded me of heroines of books about settling the American frontier. She kept a detailed journal of her hospital stay that was inflected by the therapeutic language through which she was learning to understand herself. A precocious student of her surroundings, she entered a rhapsodic mode after meeting me: “For god’s sake the girl’s only 6,” she wrote. “Look at her!” She went on, “Let her trust an adult and release her childish behaviors hidden somewhere within that taut, stiff body. I bet she is just waiting for somebody to reach out their hand for her to clasp on to!”

  Hava may also have been unduly influenced by the spirit of Yom Kippur. She went to a Jewish day school and was terrified, she wrote in her journal, that she would not “be written in the book of life”—God’s record of those who deserve to live another year. She blamed herself for “not achieving a state of holy perfection.”

  There were other similarities between us: Hava’s parents were also involved in a prolonged and hostile divorce, and they, too, joked about obese family friends. They “always made fun of the Ornsteins and called them the Oinksteins,” she wrote. She had a friend like Elizabeth, too: a girl she not only admired but wanted to become. When she played at the friend’s house, she wrote in her journal, she liked to imagine that she lived there and would never go home. Her handwriting was so similar to mine that recently, when reading certain passages of her journal, I became briefly disoriented and assumed I was reading my own words.

  When I met Hava, she had been hospitalized for nearly five months. Her mother, Gail, visited Hava’s sixth-grade class and tried to explain Hava’s extended absence. “Even though Hava’s very thin,” she told the class, “she thinks she’s very fat.”

  Hava, who weighed seventy pounds, seemed conflicted about whether her mother’s explanation improved her social status. In her journal, she listed “what I wish I could like about myself,” which included “my personality,” “my intelligence—my grades,” and “my feelings.” She had dreams in which she was “plea
ding with my peers and suddenly I received their total acceptance and understanding,” she wrote.

  In the playroom, where everyone vied for the one Pac-Man game, Hava befriended a thirteen-year-old who was pregnant with twins. When Hava complained about the strict eating rules on the anorexia unit, the pregnant girl’s mother casually mentioned that Hava could burn off calories through exercise. “She’s the one who made up my mind that I’d do jumping jacks tonight,” Hava wrote.

  I was in awe of Hava and Carrie’s friendship, which solidified around mutual goals. “Carrie and I compared our bones, skin, color and thinness,” Hava wrote. “If Carrie weren’t here I don’t know where I’d be!” They seemed to go through cycles of weight loss and gain together. When they were on the upswing, the nurses let them visit the labor-and-delivery unit, where they gazed at the newborns. Some of the babies had “needles and everything stuck in them, so it made me real thankful,” Hava wrote. “I just wish it could be easier to have a meal without the feeling of guilt.” When the nurses weren’t watching, Hava and Carrie paced the halls until Hava had trouble breathing; they also volunteered to distribute lunch trays to other patients—“that was my exercise for the day,” Hava wrote.

  I hadn’t known that exercise had anything to do with body weight, but I began doing jumping jacks with Carrie and Hava at night. I no longer let myself sit down, so as not to be a “couch potato,” a term they taught me. Nurses came to each room on the anorexia unit with a rolling cart of young-adult novels. After I arrived, they began including books for younger readers, like the Berenstain Bears, the Clifford books, and the Mr. Men and Little Miss books, including Mr. Strong, a book about a man who ate eight poached eggs for breakfast, a detail I found monstrous. I learned to read in my hospital room while standing up. When nurses entered our room, I tried out my new skill by stringing together the five or six letters on their name tags.