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A Brave Woman's Battle with Anorexia




Depression and Anorexia

A personal essay by Paul H. Belz


Early evening at the mall redefines its population. Cosmopolitan chaos best describes the mix of nearby office workers shopping on their trip home, store workers changing shifts, ordinary shoppers, the school crowd, and a greater racial and cultural balance than any other Baltimore mall can boast. All mingling and most rushing somewhere.

The vortex of this chaos is the grand atrium in the center of the third floor. This is what main street rush hours must have resembled in cities of yesteryear. Humanity converges on this central space from four directions and two levels of the huge two hundred store, four-level shopping mall. It’s an upscale suburban mall, with construction premised on attracting shoppers from households with million-dollar incomes in the Baltimore region. The rich shop here and the poor take buses from the city to escape crime, cool off in the summer and window shop. Aesthetically and architecturally, it’s gorgeous as modern malls go.

It’s an easy place to be anonymous.

Out of this maelstrom of humanity, a lithe, skeletal figure emerges every evening of the year. Always alone, she appears out of nowhere and briskly climbs the grand, curving staircase which embraces the elegant, marble-clad central fountain. Instead of dissolving into the easy anonymity the mall offers, however, this woman makes a courageous effort to grasp independence, identity, and self-worth. She will play out a ritual for survival that has been repeated daily for over three years.

Atop the steps, the fourth floor of the mall becomes her realm until closing. Sarah begins to walk. She walks faster than any of the mall’s many regular walkers whose doctor-prescribed or self-imposed regimens dictate that they exercise in such a ritualistic fashion and safe environment.

The next several hours are the highlight of her day. The corresponding hours become the highlight of each ensuing day, like an old scratched music record with the needle stuck in a groove. And so it’s been for over three years. While she is walking she escapes the demons that have plagued her for most of her life. But the demons await her return to the apartment where she lives alone supported by government disability payments.

While she is walking, she is in control. She makes the rules here, not the crippling demons within, not her judgmental family, and not the oppressive society in which she is unable to function.

Sarah knows most of the evening employees or shop owners of the fifty specialty stores on the fourth floor. As she cruises the quarter-mile circuit it’s as though she’s a forest creature patrolling her territory. On the fly she waves at or comments to most of the store personnel, regular shoppers, and walkers whose routines bring them into superficial contact with her. She refers to them as “her only real family.” After several hours of walking she mingles with store personnel as they complete the day’s bookkeeping and close their shops. About an hour later her social life is over for the day. Unlike the main streets of bygone years, this main street locks its doors at night.

It’s easy to get to know Sarah if one walks at her pace and doesn’t expect her to pause for a chat. She’s approachable and friendly. Nevertheless, anyone who walks too slowly and fails to keep abreast might be left behind in mid-sentence. She won’t look back to say goodbye. This is her world and she makes the rules. It’s the only time in her life when she is in control.

Sarah turned forty years old this past July. She’s a combative “Leo,” opinionated and outspoken against bigotry of any kind. She is also anorexic. At 5'7" she has a cadaverous look about her, distracting an observer from the physical clues suggesting a once-beautiful woman. She styles her blonde hair in pigtails and always wears brightly colored gym shorts, defiantly refusing to camouflage her skeletal limbs. The fourth floor of the mall is the least congested, which is why she adopted it. But even on a floor dominated by women’s wear, hence sparsely populated by loitering youths, she receives a merciless and relentless barrage of condescending comments, cruel stares, and intentional jostles from teens. They occasionally spit on her.

Anorexia nervosa is not her only affliction. Sarah is obsessive-compulsive. She sleeps until the afternoon and walks before arriving at the mall. Often she takes her third walk of the day when she returns home from the mall at ten or eleven p.m., braving the blackness of her neighborhood. On such walks she has been struck three times by “hit and run” drivers, spending a month in the hospital after one of the encounters. She doesn’t take a day off from walking the entire year. To end each day, at about twelve a.m., she will ingest over 3,000 calories from predominately junk food. Much of that food is stolen and much of what’s consumed is purged.

She suffers from clinical depression. If one engages her in conversation suicide will be a frequent topic. Anti-depressant drugs caused severe side effects so she discontinued them. Emphysema resulted from a childhood immersed in second-hand smoke. Dyslexia makes reading difficult for her and hypoglycemia is another of her life’s challenges. The latter illness caused her to join the young trick-or-treaters at the mall’s annual Halloween candy give-away. Unselfconsciously and without a costume she shuffled from store to store filling a large shopping bag with candy.

Institutions and half-way houses have been prominent in her life and she lives alone without health insurance. The now shattered but always dysfunctional family of her childhood lived in Texas, Minnesota, Pennsylvania, Connecticut, Massachusetts, Florida, Maryland, and Delaware.

Enrollment in seven successive colleges is a testament to her tenacity, but a degree has yet to be obtained. She had hoped to pursue a field combining her twin loves of art and nature. She had hoped to marry, have children, and settle down. Hope has been replaced by bewilderment about how to get off the self-destructive treadmill of unproductive rituals and onto a fulfilling life path. Her American dream over, now she just hopes to survive another day.

Every few months Sarah’s father visits the fourth floor of the mall. He always arrives after her walk has begun. For an hour-and-a-half he sits on a bench facing the promenade. At five minute intervals his daughter is in view for about five seconds as she completes another lap of her walk. He doesn’t walk with her and she doesn’t sit with him and neither speaks or makes eye contact during the precious few seconds of physical proximity. Each is acutely aware of the other’s presence. Conversations between them have historically ended acrimoniously, leaving this dysfunctional dance, this silent communion as their only remaining contact in life. By the time the walk has ended, her father is gone.

To the people whose healthy lives bring them into regular contact with the mall and its environs, Sarah has become a fixture akin to the mall’s fountains and mythologically themed statuary. She is part of their entertainment. She is part of what makes the mall an interesting place. Sarah manages an engaging smile and a wave and will converse with anyone she perceives as congenial and non-threatening. Hundreds of people know her name. Many of them give her advice. None can solve her problems. One well-meaning Samaritan, startled by her appearance, stopped on the highway where she jogs and offered to take her to a hospital emergency room.

The physical appearance of Sarah belies high intelligence, a level of insightfulness, and a degree of understanding of her own problems and their potential solutions that startles a new acquaintance. Three reactions are quickly evoked and one suspects this scenario is familiar to all who suffer from clinical depression; (1) The urge to chastise: “If you understand your problems so well, why don’t you take constructive steps to solve them?”; (2) The grip of a frightening empathy: “This person is as intelligent and as interesting as I am and but for the grace of God, there go I.”; (3) An overwhelming desire to give advice, which will only serve to annoy the depressed person.

As the mall winds down its daily life cycle of activities, it becomes a lonely place. One of the last to leave every evening before the doors are locked is a tortured soul with little self-esteem. For a few hours she has been in control of her life, roaming a tiny universe where she could pretend to be the master. She has smiled and been friendly in the face of ridicule where most would probably withdraw in rage to a cocoon-like existence. She has made another herculean effort to create a day with purpose, or a day which could produce hope for a more meaningful tomorrow.

But for Sarah, today was exactly like yesterday, and tomorrow will be exactly like today.