My friend who died

It’s my third day as an inpatient on the eating disorders ward, and all of us have gathered for ‘psycho-education’. A colourful pie chart, labeled ‘prognosis’, is projected on a screen. The nurse explains: “One third of all people with anorexia will fully recover. One third will get better, but will remain vulnerable for relapse”. The orange piece of the pie indicates the thirty percent of people who will continue to struggle; which leaves us with the smallest portion, highlighted in red. Ten percent will die. “That’s one in ten”, the nurse says.

In the room with me are nine other girls, who, like me, struggle with severe anorexia nervosa. One in ten; who will it be? That strong one who spent the past ten years of her life inpatient, yet continues to fight for recovery? That lovely cheerful one who took me under her wing in these first few days? Or myself, the neuroscientist who one day decided to stop eating? Then I see Rowan, and I know she’s the one.

Now, many years later, I sometimes wonder how I knew. Rowan was not the skinniest among us (the first and foremost criterion on which I had rated the girls in those first days). Her record of prior hospital admissions was not all that impressive either (a second very important criterion in the social ranks of anorexia patients, as I would later learn).

Rowan was the worst liar ever, but her eating disorder made her tell lies again and again. At mealtimes, Rowan’s food seemed to dissolve in thin air rather than disappear in her mouth. Before stepping on the scale, she drank water to meet the clinic’s weekly weight gain requirements. She wouldn’t deny it when I asked her about it, but I wouldn’t buy it if she would. Her face just radiated shame and despair. The clinic we were at relies on us taking responsibility for our own recovery: no feeding tubes, no force, and no ‘surprise!’ chocolate cakes. Here, you fight hard for every ounce. Rowan fought, but she kept loosing. I wanted to hug her, hit her, hold her, and shake her up all at the same time.

A few weeks before I’d be discharged, Rowan went home. After falling short of the required weight gain for yet another week, she had admitted that her actual weight, without all the water, was several kilo’s below the number on the scale. Not surprisingly, her treatment was terminated and Rowan was sent home.

In the years that followed, the lives of Rowan and myself slowly but steadily diverged. I took small steps forward; from inpatient to intensive outpatient to weekly sessions. I took up my studies and found a job. Rowan, by contrast, went through an endless series of waitlists, clinics, court orders, hospitals, tube feedings and closed wards. Every time I visited her, I thought of that short time in the hospital when our lives ran in parallel. We both looked at the same pie chart. I wonder if she thought “that ten percent, that’s me”.

Four years after we both left the hospital, I stand next to Rowan’s coffin and hold her hand. It feels exactly like Rowan; cold and bony. I stroke her cheek that’s just as cold. I like to think that as Rowan died, the other nine of us will live (although I understand just about enough statistics to know it doesn’t work like that).

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