My leg is sore – metaphor

She was 12, it was October. I heard her from inside the house and went out to her, “Mum, mum, my leg is sore.” An anguished tone to her voice that I had never heard before. I figure even then she didn’t know how to address a problem she didn’t think she should speak of. I joined her outside on the steps. Gemma had wanted to start out on a run–the idea cut short because of physical problem.

“Where, here? Just below the knee?” I took her to the doctor. In Gibsons there was a relatively large medical clinic at Franham Road and Gibsons Way. You could get an appointment straight away with one of the doctors there, even if your own doctor wasn’t in, and it didn’t matter, “a doctor is a doctor.” I can’t remember if the doctor she was seen by was a male or female. This being Covid-19, September 2020, I picture the doctor with a mask on.

The doctor wasn’t interested in the knee. “I know what this is. I don’t know enough about it. This is serious. Your weight is one-third less than it should be. Your whole body is affected–your organs, brain, and heart.” I didn’t know what to make of this–she was too thin, but in danger? I looked at her and she was unconcerned and didn’t seem in physical pain any longer. The doctor continued, “A paediatrician will be on the Coast next week. In the meantime, you cannot take ballet, you cannot run cross country, you cannot walk to school.” I was taken aback–not even walk 15 minutes to school?

I felt bad, there must be some wiggle room here–to be able to run cross country with the after school team and with PE, and ballet–she was taking two classes per week with a ballet teacher, new to her, who encouraged more classes, and I really should have turned that down, but what is easy, and what there is enthusiasm for? No one would want to dampen enthusiasm! But, no. The doctor was unwavering, serious, a big Stop sign in front of our faces. We left the appointment intrigued and quiet. Discussion ought to have started there. But we were both dealing with our disappointments and the unexpected.

~

The hospital program was in the City at BC Children’s Hospital. It was November and my mother was ill in St. Paul’s Hospital. She had been sick for about 10 years, with a stomach ailment that meant her digestion would not move along, no peristalsis taking place to move stuff along the digestion tract. I figured she broke her stomach–a lifelong smoker, she couldn’t taste food very well (was my theory), so lots of pepper and spices and piles of food at dinner time. Too much food at once, and, I reasoned, she broke her gut. She was also a Scotch drinker. I have heard hard liquor called “rot gut” and I think that’s the reason–your gut can only take so much, and then, it rebels, just quits. Truth is Mother’s condition was considered congenital–she was born with it, an anomaly, and it was going to happen no matter how she lived.

Upshot was I had my daughter in one hospital, my mother in another, I was commuting an hour and a half by car and ferry to teach high school, and both of them could die. My mother loved to eat, she couldn’t eat, she survived on TPN for 10 years. Mother died November 27, 2004. Gemma was admitted to Children’s November 8, 2004. My mother was concerned about her. In the spring when there was a high school zone track meet at Swangard Stadium in Burnaby, my mother, who was in a weakened condition but cheerful, had accompanied Gemma and me to the meet, sat with the team, and cheered Gemma on. Gemma refused to eat lunch until all of her events were done, then Mum offered her a chicken salad sandwich, beautiful, with mayonnaise, and I was surprised Gemma ate it up. “See?” said Mum. Nothing to worry about. Fast forward to autumn. I can’t remember whether Gemma was at Grandma’s funeral.

At Children’s Hospital Gemma gained 1 kg the first week. I think she was upset–and she never met the goal again. She was in hospital, with a school room, regimented times for preordered meals and snacks, sitting down to eat six times per day. The ward closes over Christmas, empties out and she was home in frail condition. In February I went to visit her and the psychiatrist said, She is uncooperative and we cannot treat an uncooperative patient. So I put her and all her stuff in the car, phoned the school that I would not be back for the foreseeable future (a year and a half), and took her home on the ferry. I remember taking her to school in the car each day. I remember going at lunchtime to see that she was doing her part–I remember checking with the band teacher, who said she had left early for the washroom, I remember waiting at her locker, and I remember her arriving in time for the end of lunch, all red in the face, having been on a run. Another time a neighbour phoned, having seen her in the neighbourhood, Grantham’s Landing, running, and I was grateful and got in the car to go and find her and return her to school. I was patient, I could do this, could do it forever. Gemma would come back to us with time. And she did. There were monthly appointments at Children’s–we took the car on the ferry, drove to the hospital, physical check-up with nurse, doctor, and then psychiatrist, and home by 6:30 PM, picked up her brother at Michelle’s house, and made dinner if her dad hadn’t already. The process was crazy-making, but I had a leave-of-absence, a lot of supportive acquaintances.

Dissecting Behaviour: why not act?

I wondered why I didn’t act, to do something that would have prevented catastrophe. This morning I woke up, very little sleep, thinking I understood something about my past that predicted my inaction when it counted.

Perhaps experimenting with feeling threatened and feeling threatening my brother would chase me around the house–at home alone together or if our mother heard she would shout his name with an angry tone. I think we considered it a natural sibling thing. I didn’t know what I feared, but I knew the right thing to do was run. We would start out angry or intense, he would say something disparaging about my friends, or knock something from my hand, or I remember he turned off the tape recorder, I was taping music from a movie on TV and he had to interfere. I would be defensive, verbally or wack him and, run. Eventually he would laugh and leave me alone. Maybe I laughed too, with relief–it was over, I was okay and only a little literally bruised. It was all in fun though I had no fun. At dinner time we behaved normally. Nothing wrong, we had run it out of ourselves. We might have our secret (sibling-rivalry), but for the moment, all was apparently well.

When it didn’t serve my brother he sometimes lost his temper, in sports getting penalties for poor sportsmanship (smashing the ball against the floor after a whistle), and at teachers, losing out on academic recognition because he had an attitude and a bad temper. Years later I heard a radio interview, “Depression in youth is not sadness; it is anger.” I found the information shocking as a revelation. It fit with what I knew–an angry boy, suffering depression as an adult. Something else I heard was, an infant that experiences trauma at birth can have psychological scars in adulthood. Mother said, “He was black and blue” (and probably should have been a C-section) but in those days, who knew.

Children of royalty are surrounded by influencers and our children are no less precious. People try to help them. I would have treated a pet better, a voiceless thing. She had excuses, explanations, and only me, so the effect was reassurance but not happiness for either of us. I should have recalled that, with other hospital admissions to regain weight she would be happier straight away. Angst, irritability, continued and it was contagious.

From the time we met, my husband had occasional melt-downs of apparent anger or angst. After quite a few years (when it was affecting the kids) I realized there was a pattern and pointed it out to him–every 3 to 5 months he would disintegrate; bellow about being misunderstood, world against him, and us siding with the rascally world. We had small children and my husband would get out of sorts, erupt in a sort of argument, “Things shouldn’t be thus, and, there!, you are!, (me), disagreeing with me–always siding with them (whoever).” I think it might be a socialising reflex to respond to grumpiness intending to sooth or reveal the benign truth, with things like, “Possibly you misunderstood. You feel this way, but they probably never thought of it as a put-down. Possibly they misunderstood,” or whatever.

2016, twenty-seven years into our marriage, husband experienced occasional visual migraines, experiencing loss of time. Going to evening class, 5th of 6, on Anger Management, he had to pull over. He thought he was hungry, but then couldn’t remember his PIN for debit purchase at 7-Eleven. So he called me, got an ambulance, and we met in Burnaby emergency. He was diagnosed with epilepsy, spells he could predict from how he felt. He was told to avoid flashing or blinking lights on TV, and given medication. Some of “our arguments” over the years may have been after TV news or shows that included blinking lights. Driving that night would have included oncoming lights. He was disoriented.

About 8 years into our marriage we had a typical argument battling for affection or intimacy. Of course this never makes sense, you don’t get angry when your partner is uncertain of the answer for, “Can we have sex.” But, there you go. I ran (a familiar feeling) from anger in the house. I ran out the door and onto the deck, on the snow and ice. I ran around the perimeter of the house and he was outside so I ran back in, made my way to daughter’s room and lay down between the wall and the bed in her room in the dark to sleep. I was aware he searched and was awake when he peeked into the darkened room and could probably see my feet, and I slept, there on the floor.

Recently my husband simply corrected me and I was aware several times that it gives me an awful feeling through the chest and stomach, say when we are working together on painting, things like that. And it cuts, I can feel a stone in my stomach and I think I have always been this way. She experienced this from both of us.

All this to say–this morning I recognised my behaviour last summer, as incapable against the confident, irrational eating disorder (aka my daughter, my pet) telling me what to do and think. And my husband, deciding for “us” to sell the condo and move to the interior–in spite of having a daughter across town struggling with mental health problems. She seemed fine, text and phone calls, but I think I knew better. Did I know? I convinced myself to concentrating on staying-the-course, by reflex or habit, as someone else is in charge. The object is to maintain the status quo, accept what is provided as a framework. There’s been a study of crabs in the ocean, they are bold or shy. Action decisions are personal and not predictable across all individuals. Responses may not be altogether unpredictable, but it depends on circumstances, like influencers.

If I understood in my subconscious that the ED was driving her (making stuff up), then my own behaviour was to smooth things, make what was dealt appear to be fine. It seemed a much bigger a-ha when I woke today (very little sleep last night and working at 3 PM today).

I did not act. I felt crazy, but was maintaining control by sticking to habits. She called to get picked up and taken for a drive. “There is a little bit of white fluff on your cheek …” “Oh, that is probably from the tape from the feeding tube,” but it was just a speck of white satin. How did she have an answer ready?

Visually, things were seriously dangerous. We stopped the one time at the back of Lions Gate Hospital and I wanted her to get out and I could take a photo with the sign, “HOpe.” But she wouldn’t, “Let’s go Mum. This is annoying. Take me home.” We spoke of mild things, not too much about recovery or treatment–because she said she was in the intensive programs at St. Paul’s. Her weight was low, the light on the panel for the front passenger seat was on–indicating 65 lbs or less, if I had cared to look up what the light meant before she died (I looked it up after she died).

I think the idea of treating the most valuable relationship in my life, as no more deserving of attention and appreciation as I had been given, had to do with being accustomed to despair and making-nice. Act normal and things will settle down to being normal. I figure we were both terrified. I wanted the status quo to begin to work–behave like normal, including the assumption that she ate food when she was at home. And she wanted me to guess, to figure out her lies, and to save her against the disorder that made her lie.

Personality and experiences worked against us. We were out of sync. Fear took away common sense. Words and reflexes meant both of us were disarmed. No one to intervene, even the slightest concerned comment would typically have steered me in agreement towards appropriate suspicion, realisation, and determination, and dramatic action, against dread, fear, and indecision. But the disease ran its natural course. Service to others is perhaps treatment. I am in prison and there is no parole.

What if … (what she wanted)

The evening I keep going back to was sometime between Jan to Mar, 2019. Gemma and I have arrived at her building after a drive, we get out of the car, I walk her to the door and, as we start to say good bye, Julie comes out the glass door.

Reframing what happened, what it meant, and the long-term upshot of not acting when “doing SOMETHING” would have saved both of them–the reframing provides me with satisfaction of knowing how the story should have ended (or the encounter at least). Everything that hinges on that brief moment.

“Oh, hi Julie. How … are you doing,” Gemma said. Julie looked gaunt, tired. She had makeup on, and a coat that I admired, and high leather boots on the skinniest legs, except that I couldn’t see the legs for the boots. I had seen Julie before. I found from Facebook Messenger, Aug 28, 2018, I had left the book, Orange is the New Black with Julie to pass on to Gemma, and Julie messaged Gemma to hand it on. But here was going to be a conversation.

I thought, Poor thing, she looks like a former lady-of-the-night, broken down and, sadly, she isn’t taking care of herself. If only she would decide to look after herself (how naive). I should have known better. Gemma had an eating disorder, obviously Julie had an eating disorder too. My thought was, “Ask about her fine coat, it is top quality, it reminds me of the fabric and tailoring in the dress that I got in Italy years ago,” but I didn’t ask. I recoiled. Visually my response was to look away and then look from one to the other with only mild interest.

“Oh, I’m alright. Just going for a walk I guess. How are you?” Julie asked.

“This is my mum,” Gemma introduced us, and I acknowledged hullo. I was feeling uncomfortable. I think I felt visual pain on her behalf, but annoyed with Julie for not taking care of herself, impatient that the conversation was happening–signs that I needed to act. Ache with regret. I waited until the two had greeted, commiserated about “Okay, and not bad,” with some undercurrent of understanding. But I decided for myself that Julie had lead a rough life and that the two of them hardly knew one another. Nothing could be further from the truth.

Stop me if I’ve told you all this already, but? What if I had acted? Worksafe for safety on the job says, “See, Think, Do,” See it, think it, do it. I see that Julie is in terrible shape. I think: Julie is in trouble, I must help. I do “an intervention,” so that Julie is not left vulnerable, so frail that I must have known she could not last long in her present physical condition. I don’t know when this was, January? March? Julie died mid-April.

“Julie,” I would say, “That is a beautiful coat. It reminds me of a dress I bought in Europe, beautifully tailored. I have never owned anything like it since.”

“Oh, thank you,” Julie would say. “I made this myself,” (I learned later that Julie took courses in design and fashion construction), or she said, “I got this in Italy a few years ago. I am into fashion, I like nice things.” People who are emotionally stuck, with anorexia for example, cannot label their emotions–it did not occur to me that I was experiencing any emotion.

“It is so nice!” I gushed (was I too tired to put thoughts together? Was I so visually shocked that I could not be polite and helpful?) “Julie, I feel sad.” I got her attention. “I am worried about you. I think you have been bullied … by anorexia. I can take you to safety. Gemma and I just got back from a drive–the car is right there, see? You and Gemma climb in the back, buckle-up and we will go to the hospital, near where I live.” She would have said no. No she wouldn’t have. Gemma would not help me. Yes, she would have. Gemma was trapped–if Gemma got involved in helping Julie it would trigger her own anxiety about anorexia and she would feel like it was pulling her under.

The two girls, women, in the back of the car. Every night I drive the two to the alternate hospital–a second opinion, new venue. Evening surrounds us, city lights, we cross the bridge, right lane into North Vancouver, up Capilano to the Upper Levels, three exits until Lonsdale, down Lonsdale, slide into emergency and quietly, friendly, invite the two to come inside and register at the desk to be seen, treated, feeding tubes, vitamin k, hydration.

The most recent addition to this nightly saga is that–maybe in real life Julie waited for her moment to exit through the main entrance of their building. I feel Julie may have waited for Gemma–with her mother and a car. Julie may have thought, “Gemma’s mother will help me. Take me to safety.” I reframe things that happen, I make stuff up–but I believe it is possible this is true.

Until I saw their correspondence (same building, but using social messaging), I didn’t think that Julie knew Gemma. Their communications back and forth, Gemma was so kind–Julie began by sending a Photoshopped painting that she had come across that resembles Gemma (a proper oil painting, William-Adolphe Bouguereau, that was altered to make the subject look in worse shape than anyone could be in). Gemma saw it and agreed, it looked like Gemma, but then kindly asked, “How are you?” It is all there.

Then a half year later I knew Julie was in trouble. I didn’t think to do something, it didn’t cross my mind. I did not think one inch in front of me. Instead I was relieved when they finished chatting. For another half year I didn’t think about the meeting, until after Gemma died. Then I realized, to save Gemma, I, we, would need to save Julie first. Even Erin–with two additional allies may have been okay. If even one thing had been different, nothing would be the same.

The expression, “one thing lead to another …” down that same rabbit hole. Life, instead of looking forward imagining a future, is looking back imagining a past. I think the only cure for being this stuck, is service to others. It has been mentioned down the ages. Filling life, which may have helped Gemma with her OCD, can be the answer for what I’ve got. Sure hope so. She believed in God. I thought I never would understand. But I do. God have mercy.

~

Their dialogue. Aug 6, 2018 Julie messaged Gemma with the distorted painting, to communicate, “does this remind you of anyone ???!!!” and “even her little hands look like yours !!!! how uncanny.”

“Oh my god! Ha! Where is this from?,” replied Gemma.

“I think from a digital design site …it has peoples’ portfolios done with [A]dobe programs,” Julie said.

“I want to look healthier but yes the resemblance is uncanny! Especially when I had longer hair!” and “How are you Julie?”

“I know and also the painting is such a classic style and i know you love to read…. I’m not doing very well to tell you the truth. Something is really bothering me lately but i don’t know what !! 😏” and “Even your hair in your profile picture is the same style and texture as this image !”

“Ha yes! You’re right about the hair! I’m sorry you’re not doing well. I’m in [hospital]. I’ve been here before but not for a few years. I’m doing the right thing though and using the support. There is always a bright side- I’m taking this as an opportunity to jumpstart my recovery, and also to learn about health care/occupational therapy (my career goal),” replied Gemma.

Julie wrote, “Oh dear…yes i am all too familiar with that place. Good for you for taking advantage of the resources. I always thought it was weird how they made me go there so much and then the outpatient program suddenly ended. Sometimes the hospital is a safe place to be. I used to have to go there at least 4-6 times per year but that ended in 2012. I never thought i would EVER say this; but i kind of miss it. I hope you get a little bit of nourishment b/c you are so capable and adept at so much. it’s really quite rare…but i guess alot of very intelligent people suffer 😘🌷

“How come you don’t have to go anymore? Are you not with VCH?” Gemma asked.

“I am with vch but I’m on my “step-out”…plus it is very hard for me to trust care providers because of issues in the past so i don’t know if i want to “step back” in.”

Aug 8, 2018, “I think I understand a bit how you feel. It’s hard for me to trust doctors who have certified me before. Even though I know it was to save my life. I hope you continue to look after your health and best interests, and to pursue your wonderful artistic passions dear Julie ❤️

“Yes…it is the most terrifying thing to me. It made my ed so bad. I hope you are tolerating things. Let me know if you need anything or if you ever want to chat i’m here. Just went to the quest store in new west. Such a cute little town here 🌸😘

“You are a tough cookie Julie. You have been through a lot of hell but you’re not alone. I know it’s hard but it is the eating disorder that creates all this shit and fear for us. Quest in new west? Is it a new one?”

“Pretty new i think it’s always got nice veggies for SO cheap. Yes i know ultimately it is the ed that is the culpit …but i get suicidal from any weight restoration so it’s hard for me to find motivation for anything beyond maintenance. Would like to put more stuff back in my life….ie work & school …. Are you going to be in any groups at vch? I have to go back soon or it will be past the 6mo max for step out.”

“I liked insight into action. I’m so sorry that happens to you with weight restoration. That is incredibly painful Julie. Maybe when you are healthy again and no longer need to restore those thoughts would diminish?”

“…unfortunately for me it doesn’t work. I know alot of people suggest that your brain gets better when u get better nourishment but of all the years (25+) that i have had experience it’s only made things worse. I wish it were not like that b/c i love my family very much.” and “You would be such a good occupational therapist !! Vancouver definitely needs more that’s for sure !!!”

“Thanks Julie. My goal is to recover from anorexia and to help others. I love talking to you and I appreciate your honesty. You can always be honest with me. I know how difficult this is. And it’s different for everyone. Hold on to your truth ❤️

“That would be lovely if you could recover. You are so smart and charismatic. So much to offer the world …and you have alot of life ahead of you too 🙌” and “Omgosh forever waiting for the 17 oak errrg”

“Yes I know the feeling! I used to take that bus when I was an inpatient at Children’s to my choir practice downtown at Christ Church Cathedral. It takes forever”

Julie replied, “It just broke down too!”

“Ack typical 🙁

“That must’ve been weird in childrens hospital. Did you always live in vancouver?”

Aug 12, 2018, Julie messaged, “How have you been doing? Do you ever get panic attacks? I have been getting really horrible ones l8ly”

“Nope I’m ok! I’m getting through my Saint Paul’s stay. Although it’s mentally and physically the hardest thing I’ve ever done and I feel awful, I have good support through friends and family and I’m fighting the thoughts myself. I have some autonomy I feel despite being certified, and I’m working hard to get stable. I’m sorry to hear about the panic attacks Julie. What do you think they are about? Is there anything that helps? Can I do anything?”

“I don’t know why….usually i get them if i’m feeling weak in body but not tired in brain. There has been no hot water for about 2-3 days except for a brief hiatus last night. Can’t wait for bedtime and it’s only 4 😣😣 want a shower !!!!”

“Hot water is important! What are they bloody thinking turning it off for that long!? Did you get any notice at all?”

Reframing: ED as AN + OCD

So I came to conclusion, probably part of the grief process. Woke up feeling push-pulled through the time she had left. Doubt, guilt, should want to do this or that. Should want to go on a road trip, should want to buy a different house.

All these shoulds represent going against one’s own nature. I felt uncomfortable doing things, thinking I should want to do things–travel, visit, socialize. In my heart of hearts I wanted to remain open to paying attention. I wonder if it is part of agoraphobia? I don’t like earphones, headphones, movies, concerts, TV. Let me read a book or do a puzzle and then quickly I am available. I can jump up and come or go for her. I can think.

I had a compulsion to stay busy with paid work. That is the opposite, that means I was not available quickly. But these were little, short-term temp jobs. I asked her just once, “Hey, I’ll come for a visit, we can play Scrabble, I’ll just …”

“No. I told staff at the front, no visitors.” But, I only asked her the once. From there I thought I was being obedient. It was rigid thinking. She had rigid thinking because of the anorexia (or the OCD). I was the dutiful person who would help out by doing what I was told–but what is required is flexible analysis, and revisiting. Ask. Then ask again.

Ask yourself, “What would she do?” Answer to that was, “She would do something cheerful, like bring flowers (even though request was no visitors).” She would not be stuck on texting. She would try Facetime–that would have revealed her secret. Gemma would pay a surprise visit, even just to the staff–to meet them and ask after the patient, “How is she?” She would be kind. She told me the expression, “Given the choice whether to be right or be kind, be kind.” Healthy Gemma would have chosen kind. Happy and kind. Not concerned, disappointed, and doubtful. She would have got it right.

I heard from Erin’s mother today. Erin died an accidental death at home but it may have been ED connected. She had been on the unit in, maybe sometimes at the same time as Gemma. The doctor being scrutinised was the same, or at least the name was familiar, one of multiple medical people involved on the ED ward. Her daughter spoke of Julie, and how “the system” let Julie down (there is no system). Erin’s mother said the psychiatrist released Julie to her own care, to go home. 100% predictable result. For sure the doctor can point to the Mental Health Act, which says a patient has a right to refuse treatment. But I see it as negligent, that the patient who hasn’t the capacity to make a decision, nor the mass to be a viable human, then keep them, persuade them, section them, to stay on the ward–you cannot be “conflict averse” and uphold the oath to “Do no harm.” To release a patient that is a threat to themselves is unconscionable. I don’t think they will get in much trouble over this–doctor, doing the best they know how, under the circumstances, to treat, or release girls, women, one after the other after the other. People indifferent to recovering. Ambivalent about feeling better than indifferent.

I will never know who or how many, over at least five years, have been turned out because “they decided” to go with the anorexia, rather than recovery. While I thought that the definition of anorexia is refusing treatment–it might be the combination of anorexia plus OCD. After researching OCD on the net the other night, I think what drove Gemma’s illness was OCD. She could treat the noisy, bossy, nasty, self reproaching accompaniment going on in her head, by focusing on something. While she focused on food and restricting behaviours, the noise was not so bad. Giving up anorexia meant the OCD was back with a vengeance.

She could quiet the OCD her with restricting and thinking of food 100% of the time. Mental health is complicated. Medical intervention helps. But medical people can be conflict-averse and cave easily to the demands of the mental health monster. Once the supporter sides with the illness, the patient feels they were not worth the trouble. Patients with eating disorders can feel unworthy of treatment thinking, “I’m not sick enough.” Or even, I’m not sick at all.

I was a supporter who believed Gem when she said, “It has to be for myself; I can’t recover if it is a demand from other people.” She said it was the reason other attempts failed. I figure other times did not fail–she gained weight and health and her happy outlook came back. If she got busy she became vulnerable to not maintaining her weight–the OCD came back as her defences got frail, and she lost weight and judgement.

“I’ll recover for myself,” is a fake goal that maintains the illness. “If I do it for myself, it will stick.” You just have to do it and not for anyone, because the illness will find a hole in motivation–“Me? I don’t feel like it just now. I think I’ll take a rest and someday decide to do it myself.” Cod-swaddle. She was tricked by her own sense of purpose.

Anorexia is a monster. OCD is even worse. Patients would like to keep the anorexia, because they feel it defines who they are (whether that feels like strong, restrained, confident; or sick, needing care and attention). On the other hand, the patient would like to get rid of the noisy OCD. One article said, “With a tumour on your brain, would the surgeon decide to remove some of the cancer, and leave some of the cancer?” To rid yourself of OCD, and keep the compulsion to restrict–not going to happen.

You will always have the OCD but you can learn to keep it under control. Mask it with mal-coping behaviours that relieve the OCD, and now you can’t stop the behaviour or the noise–self-chastising talk becomes overwhelming. Overwhelmed people seek help.

What siding with the illness sounds like, “You’ve chosen discharge? You’ve decided it will work for you to isolate and treat yourself?” Death sentence. Eleven specialised years of education and a naive or ill-prepared psychiatrist can be just as dumb as the next person. Disaster.

Not Dead, Just Gone

We admitted to each on the drive home that we each had a hard time at points today. Went for the walk, Dundarave by streets and seawall back to Ambleside. We dropped Elena’s office chair at the transfer station, having painted at her’s last week. We stopped by Home Depot for hooks Sam needs for ladders on the van. I read my book and iced my arm–texting on the phone last night, or using the roller last weekend, or dishwashing at Mangia E Bevi Monday and Tuesday.

It’s June and she died in October. Nights are a few hours of sleep and then wide awake, redoing some episode of interaction with Gemma in the 20 months prior to her death. Reworking the conversation, saying things that should have been said, explaining my loneliness to her, when she said, “no visitors,” and avoided our prying to find her admission was fictional. She got us; she got us both, she really did.

The book I’m reading, “Maybe You Should Talk to Someone,” Lori Gottlieb, fits right in. The idea that I should have sought therapy last summer–but everything seemed so transparently understandable. I thought I was worried about my relationship with Sam, I thought he would be worrying about us too, while he and Ian (26) worked in Gibsons and stayed in the fifth-wheel, and I was working temp here in Vancouver.

We thought she was in hospital, safe in recovery. The irritability didn’t diminish, and whenever she was hospitalized for recovery one would notice she would be more cheerful and talk about people and things. There were no people in her calls with us. We should have remarked to each other how boring her calls were. Her days seemed pretty dull and it all sounded like work, “Oh they are calling us for mealtime now.” I didn’t ask much about things like the name of her personal care worker while she supposedly had the feeding-tube. A staff member who would be right there with her, if there had really been one, if she were really in St. Paul’s. We both admit that we know the hospital so well from past admissions, we were relieved she found her own way there and could get an admission when she needed one. Stupidly ignorant of how those other admissions were big plans and not sudden and simple. She learned about the OCP bed at outpatient from one of the girls at outpatient programs who explained how she had been in it on an emergency basis while waiting for a bed. The OCP bed would not have a phone bedside, so her cell would make sense.

Tired. Going to bed early. The thing I sat to say is, She stopped living and that’s all. True, there is a hole in our hearts. While she was across town in her place, she was there, living. Now she’s not living. And that’s all. We can go on having conversations in our heads with her. We can examine the mistakes we made, agony, thinking of the wasted opportunities, silly, foolish. Like in June, a pedicure? No thank you. Messing around on the computer. I figure she went to the library. Why didn’t I go with her, even just for her to have her toes done? And a 30 minute swim five nights in a row, instead of calling her, in August. Not wanting to stress or trigger her about exercise. If she were in hospital she would not be stressed about my walks or swim. I could have just gone to the hospital, didn’t need her invitation, “no visitors,” how stupid. I felt good about Gemma in recovery, Sam and Ian working away together, enjoying each other’s company. I felt good working days and being home on my own evenings, tidying just my things, the place for sale, enjoying the place on my own.

Is it only frightening and sorrowful because I have so many regrets? I feel like I’m going down a too-steep slide, when I remember writing the letter of complaint about the therapist, and ending with saying, You got to know her thoughts. It was too much to ask that she repeat her feelings for me, or us. Now, I’ll never know her thoughts.

The world is the same though it seems so foreign. She didn’t die. She’s just not living.

It Gets Worse

May 21, 2020. The middle of the night angst, routine, but now it includes Julie.

Memory of standing by the entrance door to their building Gem greeted Julie, dressed in nice clothes, a nice coat anyways, small and shrunken like a little old bird. I cringed inside, at the sight of her, felt pain crease my brow, thought something like, “God, why would she do this to herself?” The “God” part should be seen as a question to oneself, the why part is because compulsive behaviour is not a choice. They actually knew each other quite well. I didn’t know. I thought theirs was a nodding acquaintance.

What do you do when you don’t know what to do? Late night studying in the dark I have concluded, I should have collapsed right there, prayed out loud, “God, help me to figure out what to do for these girls?” Taken them by the hand, hugged them, asked them for an answer. Asked them to get in the car, I’d drive them to Lions Gate Hospital, an alternative to St Paul’s where they’d both apparently been felt to be worthless (unknown and unremembered by me), for their apparent decision to restrict.

It wasn’t one person that I didn’t act for. “Forgive me the things I did and things I left undone.” It was the two of them. I cringed and didn’t act. That is a crime. I was in a position “to know better.” But I didn’t. I honestly didn’t know that I should do something. I thought they barely knew each other.

“Let me drive. Get in the back. Hold hands. I will take you to safety. I will drive to urgent care entrance at the hospital. They will know what to do. They will do things that will make you safe.” Perhaps it was February or March when we encountered Julie at the door. I think she died in April and Gemma died in October. It all came together these last two nights in the middle of the night. I play the encounter over and over, I stand aside, the two meet, I say nothing, I worry Julie is too ill to continue. I feel that Gemma is headed that way. I allow myself to think that Julie’s is a decision. I let myself believe that Gemma is going to programs in order to be admitted to intensive treatment–even while she is doing courses. I think I felt we were walking a tight-rope, don’t upset the apple cart, things are in motion … the illness had me in its grip. Bystander syndrome, watching like it was a stage.

There Was No Secret

It occurs to me, there was no plan. She was backed into a corner. I figure we put her there.

Sa Jul 20, we (Ian, Gem and I) had got back from the lake, on way home had stayed at Auntie Susan’s condo at Whistler. Shoulda coulda gone right to hospital when we hit town. We dropped Ian at the condo. Sam saw Gemma and was agitated. He says he saw her and was upset. She was at home and we were here. But I can’t understand, how could he be all riled up if she was there. But he figures we had dropped her at home. Maybe he and I drove her on to hers, we could have stopped at emergency instead, we dropped her and her stuff off at her place, and then came home. And that’s when Sam started in about 911. Kind of a delayed reaction …

The secret was spontaneous–Sam remembers something like, she asked me on the phone, “Is Dad serious about calling 911?” He was concerned. He had tried Barbara, “Confidentiality means I can’t tell you anything.” Gem said, I have an appointment next week, I’ll be ready to go in then.

M 22 Jul Gemma texted, don’t worry, I’ll be seeing Dr. Klassen tomorrow. I phoned the ED clinic office, “I can’t tell you anything, due to confidentiality–but I can tell you Dr. Klassen is not in tomorrow.” Sam texted Gemma–Oh, said Gem, I was mistaken, I’m going on Friday. Sam texted, Get back on track. Gemma texted, Okay, thanks Dad.

There was no Dr. Klassen appointment. She hadn’t been to the ED clinic since Sep 18. It was Sam that said, “I’ll call 911,” to have her hospitalized. So, hospital was our idea, and, no visitors was her idea. She didn’t plan to lie. She didn’t plan a secret. It was where we were going to put her, so, she sort of … went there herself. Only it was fiction. She thought, “They will figure it out and come for me. Then I’ll be in trouble. Then I will really have to go to hospital.” She was annoyed. But that’s the way it would have to be.

Only we didn’t pick at her story. I didn’t go to her landlord to check her “empty” place. I didn’t go get some flowers and take them to her in hospital–even if I can’t see her I can leave them for her with staff. I didn’t do that. I didn’t go buy a Scrabble game and take it for her, even no visitors, a visitor unseen would still be heartening. I took her at her word.

I thought I knew, good things were happening–recovery, and I figured not to bother her, or burden her with me or my thoughts or news good or bad. I didn’t want to tell her I went for a swim at the rec centre, I didn’t want to ask if she knew about the fugitives on the run–a terrible news story.

I could have stopped at the library and got her a big bag of books. But I pictured the unit, so familiar, and the book case in the walkway by the TV, and the books there. She told us she was reading and watching movies. Anne Frank, she said, hadn’t read it in a long time, she said. Just like me, she said, up in her little garret.  I don’t think she said, Hidden. Hiding. But she might have.

I was itching to go see her, but I thought I would refrain from ruining it, behave. Stay away as she thought it was helping.

After 6 weeks I saw her and she still looked terrible. Gemma! But, she told me she was in the program, just a weekend at home. I have get various evening drives mixed up, maybe she had “a pass,” one time, too. Another time she texted me to pick her up at 3:00 at the hospital, but not if I was too busy. And I texted her quite a while later that I could do that. And she took a while to come out of the hospital … she was never there. She had to hurry from wherever she had gotten to and come out the hospital door by the parking. And I had no problem with that. I must be the stupidest person in the world.

In debrief letter Barbara told Gemma, You feel terrible about lying to to your parents, but you can go forward anyhow (about the spoiled admission, the discharge that came after a melt down, she told us she was discharged a couple weeks after she was). We knew she was on the unit that time, Clara helped her take her stuff for that admission. But she had let us off the hook, “No visitors,” her idea. I didn’t know family supporters are considered essential or “no visitors” would have been the give-away. I only learned things after she died. I thought no visitors sounded reasonable. That she had her own way to recover, and I would honour her wishes.

She painted herself into a corner. The fake hospital admission, a lie, she figured we would be mad about that. The no visitors–she probably forgot all about that, and we were staying away to honour her–but she figured we wouldn’t stay away, we would find out she had lied once we finally came to visit.

Hints that I can remember were, emails and texts, reading Anne Frank reminded Gemma of herself in her little garret (did she say, hiding, in her garret?). Another hint was, “on a pass, Burger King.” I accidentally texted back to Sam though, “Burger King??” And late in the day he wondered what that was about. And Sam got, “Went to Denny’s.” And he asked her in phone conversation, and she listed what she had had.

By that time she was probably thinking of food 100% of the time.

Past admissions to intensive treatment and she would start to sound happy and relieved right away. Control was wrested from the anorexia, she was forced to give it up, and things were all good, she could relax. That’s all it is. She didn’t mean to lie.

We were going to call 911. She had to think of something. She didn’t want to lose the anorexia. She could recover all by herself at home.

In the Age of Covid-19

Covid is hard on people because it leaves you inside your head. Having lost Gemma, I find her there, again and again.

What if. What if I couldn’t stand to be lied to. What if I subconsciously knew the story she wove didn’t make sense–but, to keep the peace or something, I didn’t disturb the fabrication, just played along? This can’t be exactly true, but it’s been 6 months, and I can sort of see. I was stubborn about the lie. I thought she was being silly, sure. But I pushed to get past the lie–something’s got to give.

She said in the spring, “I’m not like them.” We were by front entrance of Glynn Manor public housing, Gemma’s place. I was dropping her off, she told me about ‘Julie’ that died in the spring, and that other girl, the one that lived in Glynn Manor, too, bird-like and too frail to last long. But we didn’t speak truth to her either. We chatted, as if starvation is normal. Gemma wanted to know, should we, would I, should we go to the funeral? I don’t know whose, must have been the bird-like woman, maybe her name was Julie.

What if. So then Gemma asked, Can I come stay? Better if she had simply said, I’m coming to stay. I was annoyed at the time, Sam had the condo on the market. If it sold and the subject-to place sold, we’d be homeless. What were we selling for anyway? Had I agreed with him to sell? No, I was dragged into it, agreed, but with a mind to maybe this will fix something. Gemma had said, “That’s weird. And I won’t be moving up there.” Sam thought it would be perfect for her. I felt cringy. Even now he says, “It wasn’t really for sale anymore. It wasn’t really on the market.” But I had said at the 3 months mark, Good let’s take it off. But, no. It’s not really on the market anymore anyway. But.

What if. I was mad at Sam (all about me). A year earlier I was working in classroom after school and Gemma came by. Where had she been, where had she just come from? I don’t think I asked, assumed it was from programs, at East Hastings clinic, I don’t think I asked, “Hi Gem! Good to see you, how are you?” Kept working, marking at the centre table. “Not good. I got discharged from inpatient …” I think she explained about the burnt pasta and panic that ensued. I expressed encouragement, “Can you get back in?” That is what she meant when she said things like, “You need to validate me! My thoughts and feelings.” I needed to say, “Gee that’s too bad. Would you like my help with anything? Want to try for some sort of plan?” But instead I asked her, told her, “… back in the program.” More of the same.

I could have got a cab, or maybe I had my car that day. “Get in the car, we’ll go to the other hospital, to emergency, get you some help.” But I didn’t. That time or another, she left the classroom in a huff–I should have gone after her–grabbed my purse and caught up in the hallway. But instead I called out to her, “What about me?” I think I was annoyed with Sam that he didn’t care about me or anyone (all about me). God. Selfish girl, no insight into Gemma’s pain. Just let her go. I don’t know whether she went home? She must have. I could have gone with her. We should have talked. Was I playing “tough love” or something? Bear the consequences of your decisions, if it’s leaving me, or panicking in the program and discharging–but you can initiate another admission? What did know about it though? What a terrible human being. Sam blames everyone else–being distant or something. But I know it was me (all about me).

I see similarities in my relationship with my mother. Today is her birthday (she would be 90 today. It’s 4/20, she didn’t like when it became marijuana day, though she loved her cigarettes. It had always been “Hitler’s birthday,” she sighed). My mother looked at me without seeing anything that needed help. We talked, but I think in the same way she was distracted. I thought of her as sort “other” as well. I’m sure I tried to ask for help, and she wasn’t there for me either. I am my mother. Only, way worse.

What if. It was really the end. Gemma had pretended to discharge F Sep 27. Greta Thurnberg was in town and the streets had been full of protesters. I was working temp and all I had to do was take a bus after work, “But she’ll be tired, and happy to be home in her own place.” I went over the next day and we went for a drive. Was Sam with me? He denies having seen her in months. I don’t think that is true. Did Gem and I go visit Maple Wood Farm petting zoo, and then I drove to the back of Lions Gate Hospital, “Look at the place that Dad painted,” Shakespeare House. She wouldn’t get out of the car. And I looked in the windows admiring Sam’s work, realizing my phone was in my purse in the back of the car, and, I looked up and down the street trying to figure out geographic names to … What? To call 911, an ambulance. But Gemma was just out of hospital, I thought, and poised to go back in, she said. She was invested in the St. Paul’s program, she said. I should have figured, “Let’s get a second opinion.” I should have driven around to emergency. I should have called an ambulance. “Gem, look at the sign, HOpe Centre,” and I wanted a picture, I really did. “Hope … Gem.” But she wouldn’t get out of the car.

The last night, the Monday before the Wednesday that she died, October 7. We went for a drive. Southlands, and I stopped the car to chat, I think at the top of the treed path that leads to the water, by the First Nations reserve land, evening. She seemed to find some humour, “Would you rather be a …” walrus or kangaroo, whatever it was. Her game from forever. No one liked it. Maybe it was a sign, from forever, when she tried to get us to play she wasn’t well. I wanted things to be better, or at least feel better, another game, an adult game, how about Truth or Dare? But I didn’t say it. It would have been perfect.

When she was supposedly in inpatient treatment I should have noticed–other admissions, as soon as she got help, her mood relaxed, she was cheerful. The whole “no visitors” thing would not wash. She loved us to come. She didn’t get more annoyed, she got happier. In July that should have occurred to me. Now this was October.

What if. I knew it was lies, and I didn’t like being lied to, and I felt she owed me some … I don’t know, respect? All about me. So I said, No, to the game. Drove towards home, her eyes weren’t seeing any of the scenery. Up Cambie, then right on 70th or so, I slowed and swerved slightly to maybe pull in, in front of some random house to … talk. But something felt urgent. Nothing was right, something was desperate–don’t stop, something needs to be done. I.had.lost.my.mind. “I thought we were going home?” Small voice. Me, covering up my desire to “do something” but I knew not what, “I just wanted to extend the drive, I wanted to have a look at this area, always something I haven’t seen …” What if I didn’t like the lie, I was annoyed and angry, semiconscious of being lied to. She couldn’t tell the truth–anorexia wouldn’t let her.

God forgive me. There is nowhere to do to get back time or take back words. Brainless is no excuse; she is the one that was undernourished. A rock and a hard place. She couldn’t tell the truth and I couldn’t stand the lie. What if I was that mean on purpose. “Where is Gemma? What have you done with her? Give her back!” But I didn’t say it. I didn’t park the car, fall down in the road, call 911, get an ambulance, minutes from help. I let a lie carry her away. She didn’t let it–she could not help it. Illness is cruel. Selfish confusion and I didn’t do, anything. To help her. Can’t you tell me? No. I can’t. Anorexia took her choice and her voice. What if I knew?

Those Big Sobs, Regrets

In the movies, those big sobs are real. The heaving, weeping, gasping. I took her university card down off the tack board, and her volunteering id card, hung on the lanyard on the tack board. I put one to each eye and wept, “Silly. She was just being silly, Gemma was being silly, silly.”

Her brother, just turned 26, I could hear water running, was in the shower. I must spend time with him. The anorexia took so much of life, I never knew him, now is time.

He doesn’t seem to be consumed, not like I am. Mine is entirely regret. So many chances to discover the lie and get her into hospital, so many opportunities over 17 months, April, 2018 to October, 2019. But the anorexia spoke for her, “Mum, take me home, why are we here?” Parked across from the back of the hospital on the North Shore. Pretty street, I got out of the car to look at the sign, HOpe Centre. “Gemma, get out and look. Get out to see this sign, I can take your picture …” I think I had picked her up from home, with the notion that she had just been released from St. Paul’s Hospital (or maybe was on a pass, if it was the day she said to pick her up from the hospital, and I did, I waited for her in the parking lot), and she was due to go back in (or I dropped her back at the spot I picked her up, watched her go back inside the hospital–after “her pass”).

God was knocking on my brain, “Take action.” How did I miss doing something? It has happened to me before, totally unrelated instances, where I lived to regret not taking action and I felt God was knocking (hint hinting) but I didn’t understand what I was experiencing was brain telling me to act.

The young woman that approached us in Squamish, she was an angel with a message, “I have seen this before.” I needed to ask her, “So what should we do?” Not dismiss her with thanks, the notion that Gem was already in treatment (she wasn’t) and that all it took now was patience (I asked no one to help me understand. I asked nothing).

My last face-to-face conversation with Gemma (driving in the car, Cambie to Southlands and back) was, “I don’t understand,” while I thought she wanted me to agree with the anorexia. “Tell me that you understand, Mum, tell me that you support me, validate my feelings.” Something like that. She often was annoyed with me, irritable, she was at me to validate instead of pointing out other viewpoints–I thought of my knee-jerk response of pointing out other positions as socializing, “See, there are other ways to look at this.” Other people are not intentionally evil, things like that.

She explained her position and my reflex was to say, perhaps it is not as bad as all that? But that made her annoyed (and her dad said too). “Why do you take the other’s side? Can’t you just ever agree, and see it from my point-of-view?” I guess what one says is, “I hear you, yes that is too bad.” But I think I would say that more readily than Sam, her dad, who would say, “Yeah, what a f**ing idiot.”

Just agree with me Mum, validate my feelings, tell me you understand.

Sobs of regret–this all needed talking about, so that I could understand the health emergency that it was. She could NOT wrest control from the anorexia by herself–she needed an advocate to take her by the wrist and walk her into Emergency. I thought she was going to change her mind–she couldn’t change her mind. It was controlled by the anorexia. I sob, weep, gasp, for not fighting to defend Gemma from the illness. God forgive me.

M 23 Mar 2020, Irony of Covid-19

Dear Lynne, Thank you for the card. ‘Thinking of you’ and then I’m thinking of you, which helps a lot because then I’m not thinking of me. What kind of lousy, where does the mind, go, what type of

Dear Lynne

Thanks for the card. Funny, I was thinking of you too–and wondering if you had been off to see Marta in Spain–as things started to fray. Covid has us on holiday, trapped, sort of. There’s laundry, groceries, dishes, reading, email, News feed on the phone–repetitive, alarming, society slow to get a grip–now there are people purposefully breaking lock-downs. Mental.

And all the while thinking of Gemma. This time last year she was taking Bio 12, in order to become a Lab Tech through VCC. She had signed up during an Open House at Vancouver Community College, then delayed it a year. She got 2 anatomy courses in the fall, in case she wanted to go into Occupational Therapy–but then thought an easier course, a shorter career post-secondary.

Last summer was Cluculz Lake (I couldn’t figure out why Eating Disorders Outpatient Clinic hadn’t nabbed her before or after her spring course ended. Her answer was that there wasn’t a bed at 4NW St. Paul’s but there would be after Cluculz.

How convenient, I thought it, so god knows why I didn’t pry, and just say. Or maybe I did. Always an answer.

And, looking at horizon thinking, why didn’t I drive to Prince George Regional instead of hitting the highway! I think I believed the St. Paul’s Hospital explanation, knew we were on the edge, and felt ‘Fast!’ to Vancouver.

I was brainless. And then St. Paul’s admission, but “no visitors” as a strategy. I phoned (and cell phones did a lot of harm–use Facetime!, don’t text or chat, ask hospital for bedside phone #!) But we knew routine at 4NW so well.

I argued, but only once, “I’ll come and see you,” hopeful and happy, things going the right way towards recovery, but she was annoyed and firm. I think I could’ve worn her down but for some reason I never bugged her again to visit, trying to be supportive? I can’t say. Texting, calling. Staying busy. The condo was for sale, we had an offer on a house in Salmon Arm, a yard, a garage, a workshop, a fresh beginning, though she had said, “No, I won’t be joining you there,” a misguided attempt at shifting-gears for life and recovery.

Then after six weeks she “got out,” she called, “Want to go for a drive?” I picked her up at her place, 7th and Cambie. At two lbs a week there would be a visible change. I drove over and she came out and I was shocked, speechless, thinking, “I want my money back–you aren’t any better!” I said, “Does St. Paul’s know what they are doing?” Just out for a pass, have another two weeks. What I didn’t know was a year earlier she had a self-admission and argued about finishing lunch on day 10, and a dietitian said, Finish, or Feeding Tube, or Discharge? And anorexia chose discharge.

Sam said, “I never heard of that admission,” but remembered her friend Clara (now living in Montreal unfortunately) helped Gemma take her stuff on the bus for that admission. I was working, a couple months until retirement, Sam was on the Coast, seasonal work painting. Ten days later she was on the street, headed back to her bachelor. We didn’t know. And she never went back.

Mental Health is really hard to understand. Fear I guess. Truth is what we believe. We default to assuming, fiction with trimmings is fact.

Gemma was a lit’ major. Do you know much about metaphors? What do you think of this, “It (the eating disorder) is like having to let go of a log in order to swim to shore.” Me, I see this rapid flowing river. So, long ago, she asked me, Would you let go of the log? I said I could perfectly understand hanging on to that log. Wrong answer. It’s not a river, it’s a lake. How am I to know. One has to let go of addictive behaviour and swim to shore!

So it turns out (now this would be funny if it wasn’t so dreadful) she told her therapist I was in agreement, it is too hard to let go of anorexia. Her therapist apparently thought I was, too. She carefully explained (according to meeting notes–$150 and they forward meeting notes after a therapy appointment), the therapist said, Well, your mother loves you and doesn’t want to see you hurting.

If the therapist had asked us to attend appointments? I could have cleared up the river versus lake miscommunication! I drove Gemma to some of those appointments. I thought the therapist was busy helping Gemma find a way free of her fears. Instead her form of therapy sort of sought issues that might be propelling the disorder. Like? Dumb parents. And Job #1, first you’ve got to eat. Seldom did they discuss food. After years with this therapist, she finally said to Gemma, You seem to be afraid I might have you pink slipped (committed) but Gemma, you need to know I would never do that.

Problem was, Gemma wanted someone to prevent her from continuing–she must have been surprised, dismayed, terrified, to learn, the therapist was not keeping her safe and accountable.

I wasn’t on the same track as Gemma. Neither was the trusted therapist. Gemma quit after a couple more weeks. That was in March. The therapist wrote, You are taking a break from therapy, I will inform the dietitian (weekly meal plan, collaboration, $65). So, therapist left Gemma in the hands of the dietitian. Gemma was a fan of the dietitian’s podcast, “Eat Cake,” about staying fed and healthy, science and nutrition.

Gemma made it to late April with dietitian, made and cancelled appointments (over and over). After Gemma died the dietitian was upset and consoling, trying to figure it out. She said she knew Gemma was afraid (to be hospitalized; and to be a disappointment in their trusting relationship). She could not follow the meal plan. Though we all knew that she always had a plan to follow the plan, starting tomorrow or next week.

Gemma’s pretend admission had one strange but joyful wrinkle. She continued to sneak out, to volunteer at Banfield Extended Care Home. Staff and patients there worried about her but didn’t want to say. She volunteered, serving Thanksgiving lunch (pureed a lot of squash, to wheelchair patients) the day that she died! She loved working there. I think it fit perfectly with something I read–with anorexia one seeks to feel special and to feel mastery. Staff and patients at Banfield appreciated her cheerful, capable abilities, volunteering with flowers, a cooperative activity “helping” patients arrange flowers for their room, day-old that Whole Foods let her wheel up to the care home (did she move the flowers the three blocks?), and then with “home style breakfast” at first once and then at least twice a week. She loved working there. But she outdid herself, natural consequences. Fell asleep that night.

She was so mixed up by that time. She must have thought we were all crazy. I think she wanted us to see and do something for her. Take her, argue, but be firm. Wrest control and get it done. Like she fights except if you fight (too).

She’d say, “Do I look sick to you?” I’d say, “Yes, you look like someone who belongs in a hospital.” I needed her to go and I told her and she said, Yes, okay, working on it. But she was allergic to hospital, ashamed she couldn’t control her own impulses. Thrown out for not obeying. But it wasn’t “her” choice.

We took a drive to Squamish in May, Sam, me, and Gemma. We stopped at the visitor centre for snack. A stranger, about her age, came to our table to say, I’ve been where you are. We chatted, thanked and assured this young lady that Gemma had a professional team working with her. I thought she was doing ED Outpatient clinic pre-admission program (East Hastings clinic) and from there they had sectioned Gemma at least twice in past years. But now I don’t think she was. The girl drifted off to say hi to a fellow, a mutual acquaintances to do with rock-climbing. If I had known, we should’ve driven right to Lions Gate Hospital. But, reassured at that point that it was all in-hand. Did she say so or did I just think that? An adult, she assured us it was in the works–or was I reassured by residual assurances and could have questioned everything on that day? An angel with a message but sense of anguish, treading carefully, told by unreliable source what to think, “It’s all taken care of,” patience is all, meant I didn’t recognise God, knock knocking.

Then July was Cluculz Lake for a week. A week at home, then we could join my brothers’ families for a week at Parksville, cousins and their kids–“Is it okay with you if I don’t go to Parksville?” Of course, of course. She conjured up an admission (East Hastings Clinic was her route in a few times before, in such bad shape, committed in an emergency, or a self-admission, so it was reasonable to my weak mind that she would be admitted). “There isn’t a bed but there will be after Cluculz.” I spent a few days at Parksville, and she was admitted. Then I came home and called to go see her, but deflated entirely, I knew she had said no visitors, but I figured she’d have forgotten, and be glad to see me. Her Jul-Sep “admission,” fiction.

Sam phoned her every evening after work from Gibsons camp, I texted her enthusiastic newsy bits from temp work, office jobs, purposeful, sometimes dull. Both of us, Sam and I, felt conversations were a bit one-dimensional. I was a bit Polly-Anna in conversations. In the past, if I had thought about it, she was relieved and happier when she was settled in hospital. The pressure to obey anorexia was off, control taken. But we were walking on eggshells, stilted, effort to be cheerful on my end, but not newsy on her end. After six weeks she was home. She called and I picked her up from her place, excited, anticipating seeing her, on her road to recovery. I was so alarmed (jokey notion, Do they have a money-back guarantee? I want my money back!)

In the late afternoon, evening I think we went to Maple Wood farm, as we had done before, we had only a little time to see cows, goats, pigs, chickens, before they closed. Then (I think it was the same evening) we drove to see the work Sam had done, painting the Shakespeare mental health building, behind Lions Gate Hospital. I got out of the car, “Come and see inside the building, the work Dad did.” No. I walked around the bushes and up the ramp, peered in the windows, realising I didn’t have my purse and phone, they were in the back of the car. I walked up the path past the bushes, in view of the front of the car, now and looked around, wondering what the names of the streets were. Did it flicker through my mind to call 911? I would need to describe where to find us, at the east side of the hospital building, names of the cross streets.

I had it in my head to show her the sign on the new building, “HOpe Centre,” a photo with that sign. I asked her to get out of the car, see the sign, Hope Centre? See the building Dad painted for Robbie? Get out of the car, have a look? Pleasant street, nice “house” of offices, to show off Sam’s work. I figure she thought I was trying to trick her. Maybe I was. She argued, “Mom! I’m tired. What’s wrong with you? I just want to go home!” said Anorexia.

Prickly people are the ones that need us most–when Sam’s mother died in 1994 we somehow made it to the early service in Gibsons, a sermon by the interim priest. I thought it was about my own mother, but it was meant to remember–it fit perfectly. Gemma’s words hurt me–I had been snarly with my own mother about things–must be mother-daughter natural thing–breaking the bonds wouldn’t be possible unless we saw things differently. Not knowing Gemma had not been in hospital at all, I felt I was stumbling around, my fake cheer and sincere hopefulness. Gemma, Gemma, look at this, oh look at that. Words taken personally and they hurt me, and I didn’t know she was hurting and I didn’t know how to ask, What is going on for you?

She sounded reasonable, her impatience wasn’t out of place if she was tired and had to get dinner at home (she wouldn’t accept invitations, go out or have us in). She wanted to go home.

Seventeen months from being kicked out of St. Paul’s (day 10 of a 3-months admission). And a thousand opportunities to get to the bottom of things. “What would Jesus do?” and “Let us pray.” Gratitudes?

End of September was girl’s night at Whistler at Susan’s place. I worked Friday, went to Lynette’s for dinner, Kim and Susan came over. Susan went home, the three of us had a sleep over. We made a nice breakfast, and drove north on Cambie, past Gemma’s. I experienced a minor impulse, “If I turn left I’d be at Gemma’s.” But the thought was maybe a flicker. Resisted, this was a little time off. No reason to falter. IF my brain were functioning, a reason to stop by Gemma’s was to stage “an intervention” where we four call Gemma, “We are outside. We’ll take you for a drive?” and take her to a hospital. A choice between three, 3 blocks to VGH, 10 minutes to St. Paul’s, 25 minutes to Lions Gate Hospital which is only 20 minutes from the condo.

No plan formed in my weak brain. We continued through the city and up to Whistler for 3 nights, Saturday to Monday. Through the weekend I texted Sam in Gibsons, and Gemma at hers, relaying what was going on, for me.

Nightmare. On Monday we drove back from Whistler. I dropped Susan at home, then took Lynette and Kim to Lynette’s, removed things from the car. They took trips inside while I parked. But then I got groceries for Sam downstairs at the grocery. Kim and Lynette had to find me there, so I could drop Lynette at an appointment. With Kim I stopped on impulse by Gemma’s and phoned her from outside to cheerfully ask if we could visit. She was pleasant and open to the idea of us coming up. But Kim protested, she hadn’t had lunch. So Gemma and I agreed to meet later for a drive. I took Kim all the way home, so we could make soup from good leftovers. Then I drove Kim to Lynette’s.

Picked up Gemma for a drive. It crossed my mind to head downtown, but office tower canyons and I decided to drive to Southlands instead. Gemma had visited at a coffee place with Sierra earlier, before Sierra’s appointment with the dietitian. Gemma seemed tired. Gemma got light-hearted, with a game, “Would you rather be a …?” But I was on edge, grumpy, conscious of being silly. It crossed my mind, “Another game … like Truth or Dare, something grown ups could play.” But I didn’t say it. That would have been the perfect game! We drove and I noticed she wasn’t seeing anything. I didn’t ask, “What’s on your mind.” I thought I knew. She was being stubborn. Something with treatment was wrong. She had to focus on recovery.

Heading back we got to Marine and Cambie. “Just tell me that you understand me and support me. Trouble with you Mum, you never validate feelings, you always just counter what is said.” I had heard this one before. Sam and Gemma found fault, when they tell me their experience of a situation, but I say, “Well, maybe something else was going on for that other person,” like a cranky customer, or Sam getting road rage at someone or finding a store clerk or wait-staff not up to his standards of serving properly. “You always take someone else’s side. Can’t you just agree for once?” I often countered by characterising my impulse as wanting to sooth the situation, “I find it important to try to socialise you guys. You tell me your take-on it, but I immediately see the possibilities from someone else’s point of view, and I feel it helps to suggest you consider …” “Yes, but it’s so maddening! Just agree sometimes. We only want to be heard!”

Cautious on a tightrope. Irritability is a marker of anorexia (hungry, after all). Don’t take words personally, be strong, not sad. Prickly people need us the most. I wasn’t up to the task. Not even close.

Gemma wanted me to tell her, I love you, I support you. But my mind was shredded. She wants me to agree with the anorexia?! To not be mad and find other visions of the near future, she wants me to support “her” with anorexia, and to see it from anorexia’s view! We were both anxious and sort of crying, despairing by then. I was at about 73rd on Cambie, I turned east, “I don’t understand, I don’t understand.” I had an impulse to park the car. Stop, just stop. But I felt I couldn’t stop, don’t stop. Something wrong with stopping, this is urgent. She said quietly, in a kind of frail, scared voice, “Where are we going, I thought we were going home?” “Oh, I thought I’d just add a few streets to the drive, I always like to see what else there is, areas I’m unfamiliar with, see what’s there.” So I didn’t pull over. Didn’t call 911. I drove her home. We hugged good-night. I worked Tuesday, texted her Wednesday regarding the Thanksgiving lunch at Banfield for the bandits, and she replied that it had been busy, pureeing squash. Sam found her on Friday. We figure she turned on her phone with relaxing sounds to fall asleep on Wednesday. Her pills were lined up, ready to take in the evening.

It is March, 2020. In the age of Covid-19, perspective is that people can get sick and die. We need to use social-distancing. People are dying alone. If she got this far, she would see the irony in it, having suffered her isolation, now everyone can see her point of view, validate and know enough to understand.