Boys and anorexia
Happy days … Richie aged 10, during a family holiday, just months before the onset of his illness.
At the age of 11, Amanda Webster’s bright, inquiring son Riche complained of feeling depressed and, over the following weeks, developed a preoccupation with his weight and daily calorie intake. Frighteningly quickly, he spiralled into a full-blown and ultimately life-threatening eating disorder. As Riche became daily more tortured and emaciated, Amanda, her husband, Kevin, and their two younger children, Andy, 9, and Louise, 5, watched in horror as he also fell victim to a range of debilitating, food-shunning, obsessive-compulsive behaviours. Trained doctor Amanda, desperate to keep Riche out of hospital and an emotionally traumatising force-feeding situation, decamped with him from the family’s Byron Shire home to a specialist clinic in Brisbane.
It was trench warfare, an endless battle with no tea breaks. If I'd thought about it before, I would have assumed anorexia popped up at mealtimes - a fight over food, and then on with the day.
I didn't realise the illness controlled every waking moment or that it affected every aspect of life. And each week brought new challenges. Every minute spent with Riche seemed indelibly imprinted on my memory, but the details of most other aspects of my life vaporised the minute Kevin told me.
"Kevin and I were left with no idea of how to manage Riche's illness" … Amanda Webster with her husband, Kevin. Photo: Sahlan Hayes
On Saturday, after we had clawed our way through the morning ritual of the 4am, 7am and 10am protein shakes, we headed down to the car, all of us eager to get to Games Workshop [where teen boys play, and make models for, tabletop war games]. Andy scooted into the back seat of the car. Riche, as usual, picked his way across a tripwire of invisible calories before he lowered himself into the front seat. When we reached the Myer car park, stage two of Operation Games Workshop swung into action. Andy and I, without ever discussing it, took our positions on either side of Riche. Our eyes swept from side to side as we searched for potential hazards. Experience had taught me that, besides the obvious hamburgers and hot chips, a bag containing cereal and tinned food, or a sticky-fingered toddler, could just as easily spoil our day.
Andy walked with his slender frame held taut, his face, so like my absent husband's, bent towards the ground and his arms held stiffly by his sides. I worried briefly about the effect of all this craziness on him. The statistics showed that siblings of someone with anorexia were at greater risk of developing the illness themselves.
My attention swung back to Riche. At 12 years of age, he was still wearing the same size 8 trousers he'd worn the day we'd first visited the Footprints of Angels clinic six months ago. His T-shirt billowed around his torso and his sandals looked old and shabby. His toes had worn deep depressions in the leather, but he refused a new pair.
A look of fright appeared in Riche's eyes whenever I asked, which left me wondering if this was because he feared that new sandals might be contaminated by calories, or if it was because anorexia had stripped him of all sense of self-worth. Maybe he thought he didn't deserve new sandals.
The usual greetings - "Champ!" or "Riche, how are you, mate?" - welcomed him at Games Workshop. Andy slipped in quietly, keeping a watchful eye on his brother. I retreated to my bench outside the store and took out my sewing. The security man wandered past. We had been on nodding terms for a couple of months. "How's Mum's taxi?" he said.
"Hanging in there." If he'd looked closely, perhaps he would have seen that my fingernails were ripped and torn as I slowly lost my grip on our former life.
Games Workshop had somehow become a calorie-free haven in Riche's mind. It wasn't just the no-food-no-drink policy. He had recently started touching the books, despite knowing that other boys handled them. He had also taken to bringing in some of his models so that he, too, could game. In this store, he looked, with his stick-figure body, oversized head and long hair, like an anime cartoon that had come to life.
The previous week, the dietitian had wanted to discuss with Riche why he was able to take his Warhammer models into Games Workshop and join in with the games, when everywhere else taboos formed insurmountable barriers. This knowledge would supposedly provide the key to solving Riche's fear of calorie contamination. He could be shown that the same principles applied elsewhere. He would be able to sit on seats, walk down the street without dodging scraps, touch people ... by crikey, he might even be able to touch food.
Nice theory, but fundamentally flawed. As I was learning, very slowly, obsessions are not based on everyday logic. They involve magical thinking of the I-can't-step-on-the-cracks-or-else variety. Somehow, Riche had mentally tricked himself to make Games Workshop safe. If he were to delve too deeply into why he could touch things there, the spell might break. He would lose his only pleasure in life.
Riche understood this at some level. He begged me to stop the dietitian from "spoiling it". So I marched into Footprints and asked that Games Workshop be left alone. The dietitian reluctantly agreed, but complained to other staff about my "unco-operative" attitude.
I had counted on a good two hours' time out on my bench, but Riche emerged from Games Workshop after only an hour, shuffling and squirming.
"Can we go? I need to go to the toilet." The refrigerator and the toilet: the twin placentas that supplied Riche with his nutrition and removed his waste and tied him (and Andy, and me) to the womb-like safety of the townhouse.
I fetched Andy and we wove our way back across the mall, which was hamburger-free for once. Our luck held through the sunglasses and tie racks in Myer. We waited, Andy and I flanking Riche, for the elevator to arrive, and then we stepped in, all of us on full alert, ready for a possible calorie ambush at one of the lower levels. But not today: not a doughnut or ice-cream cone in sight. We were home free.
The lift doors opened to the familiar sight of the orange markers indicating P3, our level. Riche took his usual exaggerated step across the potentially contaminated threshold of the lift. Andy and I shadowed him as he picked his way across to the stairs that led down to our level. With the car just metres away, I allowed myself to relax. So Riche's scream from halfway down the stairs caught me off guard.
"I can't go down there. I'll get fat." He jerked and squirmed and flailed at the air like someone caught in a swarm of bees.
I looked past him and saw the french fry, two centimetres of it, squashed on the step.
"Calm down." I glanced around to see if anyone else had witnessed Riche's outburst - he was difficult enough to manage without an audience. "It won't hurt you. Calories from that chip can't float through the air and, even if you trod on it, they can't get through your skin." It was the old trap, the same one that had snared the dietitian: thinking logic could argue with anorexia. But Riche's starved brain wasn't going to fall for logic. He knew, beyond doubt, that those calories were out to get him and that I was part of the general conspiracy to make him fat.
He hesitated, and then he appeared to realise that he had no option but to continue down. He attempted to leap the last two steps, but his sandal caught the bottom step. His foot skidded from under him and he landed heavily on the concrete floor, then screamed and staggered to his feet.
God, I thought, he must have fractured his wrist. But Riche held out his hand to show me the source of his distress - car oil smeared on his palm. I could almost see his thoughts: car oil feeds car engines so car oil contains calories. He tore at his hand and sobbed. "Get it off me. Please get it off me. It's making me fat."
My heart pounded so hard it seemed to fill my chest. I gulped in the petrol-fumed air as I tried to think my way through the dilemma.
"Let's get to the car. I've got tissues in the car. I'll wipe your hand."
Riche took off, but instead of heading towards the car, he ran towards the ramp that led up to the street. He seemed oblivious to any danger from cars. Maybe he even hoped to be hit, wanted simply to obliterate his mental agony. I raced after him and overtook him easily in his weakened state. I didn't want to agitate him further, so I didn't touch him. I just blocked his way and moved down the ramp towards him, edging him down to our car. With my left arm still outstretched to block his escape, I opened the passenger door.
Riche sobbed and climbed in with his hand held away from his body. "Please get it off me. It's making me fat. Look how fat my arm is."
"Let me put your seat belt on and then I'll wipe it." I knew that once I had him strapped in, he couldn't run away because he couldn't touch his belt buckle. I fished in my bag for a tissue and reached for his hand.
"You haven't had any food in your bag, have you?"
"No." A lie. "Never."
I dabbed at his hand and splashed some bottled water over it.
"I'll clean it again when we get home." I shut Riche's door and hurried to the back of the car. Andy crouched there, his face white with shock. He opened his mouth, but instead of words, angry sobs burst out. Tears flooded down his cheeks, his nose ran, and his body heaved. He fell against me, and I wrapped my arms around him.
Riche started as soon as I got in the car. "I'm not having the next shake."
I ignored him and concentrated on getting the car out of the car park.
"You can't make me have the next shake. I'm so fat, I'm not having the next shake."
"I heard you the first time," I said. "We'll discuss it when we get home."
It could hardly be called a discussion. While I scrubbed Riche's hands under the running tap in his bathroom - my touch presumably the lesser of two evils - I listened to him repeat the same thing over and over. "I'm not having the next shake. You can't make me. You just want me to get fat."
My gut churned at the thought of talking him through a shake. I couldn't do it. I would probably throw the damn thing at him. I went into my bathroom, splashed my face with cold water and fought back the waves of nausea. When my heart rate had slowed, I went out to Riche.
"We'll miss this shake," I said. "But it's not because I think you're getting fat. It's because I understand this is difficult for you."
In time, I would come to understand that arguing with a starved brain is like flicking a switch when the electricity has been disconnected. It would take months of persistent weight restoration to re-establish the connections in Riche's brain. But I had learnt by then, at least, that I had to forgive my lapses and move on.
The air in the townhouse crackled with Riche's fear and my agitation, so I hustled the boys into the car and we set out for Mount Coot-tha Botanical Gardens. Fresh air and a change of scenery sometimes helped to get Riche back on track. But today the gardens failed to work their magic. Riche set a cracking pace, his eyes fixed straight ahead, oblivious to the beauty of the old elms and oak trees as we walked through the cold-climate section.
Andy and I glanced at each other and slogged on up the path after him. Riche's mental state showed no sign of improving. His breath came in short ragged gasps. He pumped his arms, piston-like. Every few metres he balled his hand into a fist and punched his thigh as if to punish himself for his weak and well-upholstered body.
We reached a shaded grove of trees on the side of a hill. On one side an embankment cut sharply to a creek, which long months of drought had reduced to a trickle. A sweet, sickly smell rose from piles of native figs, fallen from the trees above and rotting among the rocks in the creek bed. Riche stopped. He lifted a leg to climb up on the stone-walled embankment and in that instant, as I realised what he was up to, I grabbed his shirt and yanked him back with brutal force.
"You try to throw yourself down there and I'll have police and ambulance men here before you know it and you'll be out of my hands. They'll put you in a locked ward and force-feed you, and I won't be able to visit. There will be nothing I can do about it. Do you hear me?" My voice had risen to a hoarse shriek.
"Okay, okay." Riche's voice trembled.
One part of my mind was appalled by the shouted threats; another part acknowledged that I had simply learnt to use whatever leverage I had to keep him safe.
I stomped back to the car, furious at this illness that would make my son want to kill himself because of a few drops of oil on his hand. Andy, head down and shoulders slumped, looked as if he wanted to disappear inside himself. Riche walked ahead, throwing anxious glances over his shoulder at me every few seconds until we reached the car.
That afternoon, the walls of our rented townhouse closed in on me. I looked at my piles of books, my baskets of patchwork fabric and the irritatingly tasteful furniture, and I wanted to scream with the fake cheerfulness of it all, this feeble pretence of a normal life.
I thought I might sneak out for a coffee if Riche had calmed down. I could see that Andy needed attention - he sat with his knees drawn up to his chest in the far corner of the sofa reading, or pretending to read - but, not for the first time, he would have to wait. I had nothing left to give.
I crept upstairs and looked in on Riche. My heart plummeted when I saw him pacing around and around his room with an open book in his hands. He looked up and stared at me with dark, hopeless eyes.
"Sit down. You missed your shake. You can't afford to burn those calories."
Riche wordlessly resumed his reading, and increased the speed of his seditious pacing. Soon he was jogging around his six-metre circuit.
"For God's sake, Riche, stop or I'll ..." I had no idea what I would do. Riche ignored me, his eyes glued to the page, although I doubt he was taking anything in.
I remembered the prescription Dr S had given me for antipsychotics, and sent up thanks that I'd had it filled. If ever there was a time to give it a go, this was it. I slipped downstairs and found the box containing the medication in the pantry.
It looked innocent enough. Who would imagine these paper-thin wafers contained a drug with the power to control thought? I had to slip a wafer from the foil into Riche's mouth without it touching my fingers - my sweat would dissolve the wafer - and without him realising what I was doing, because I knew he would never agree to take the Zyprexa. I went upstairs.
Riche looked up as I entered the room, but he continued to jog. I reached out and grabbed his arm as he passed me, and as he opened his mouth to protest, I popped the foil and released the wafer into his mouth, a high priestess with an unwilling supplicant.
"You f...ing idiot." Riche tasted the medicine and realised what I had done. The look on his face scared me, a look of demented rage that should never be seen in a 12-year-old. His eyes blazed and he lurched at me, white-knuckled fists raised. "I'm going to kill you, you f...ing idiot."
I broke out in a sweat and backed towards the door. "Riche, if you kill me, who will look after you?"
"I'll kill you and then I'll kill myself."
"Calm down." I tried to keep my voice level, even with the blood roaring in my ears. "It won't harm you. I gave it to you because it's not good for you to be so upset."
I waited for the Zyprexa to take effect. The psychiatrist had told me it should make Riche less agitated, and the information leaflet in the medication box listed drowsiness as a common side effect. I expected Riche to become sluggish; possibly to sink back on the bed. Instead, he came charging at me with his fists flailing.
I could feel my breath quicken and the roaring mount in my ears. I raised my arms to deflect his blows. I felt the sting of his bony forearm catching the side of my arm. Riche backed away and started pacing around the room, still cursing, while I stood and watched helplessly.
Time collapsed in on itself. Seconds became minutes, minutes became hours. The world outside the room ceased to exist, and every detail inside it became crystal clear. The wardrobe door hung open to reveal a pitiful collection of clothes - uncontaminated ones - crammed into a wire drawer. Thick layers of dust collected on empty Adam's Ale water bottles on top of the bookshelf. Riche's cherished copy of Triss stood at one end. Other books and magazines were piled haphazardly alongside a couple of unopened birthday presents from former school friends on the shelf below. On the far side of the room Riche's bed was unmade. Opposite me, filtered light through the thick beige curtains cast a jaundiced hue over everything.
I took a deep breath of the musty air. Riche was still pacing. His face was convulsed with anger and he was muttering, but his voice seemed to come from a great distance and I couldn't make out the words.
I felt tired and heavy, wanting to leave the room but unable to make the effort to lift my feet. My throat tightened as I waited for Riche's next move; I could feel the pressure building inside my skull and wondered vaguely if this was how my mother had felt before her aneurysm burst.
When I tried to speak, the words came out in useless disjointed sentences. Riche snarled and charged at me again, swearing while he punched my upper arms. Where did he get the strength?
I could hear a whimpering sound and it took me a moment to realise it was coming from me. And that was when something in my mind switched off and began to erect, brick by brick, the white wall that would close off the rest of that afternoon, swallowing several hours of memories in the process, so that all that remained were flashes of Riche's furious face. At long last he collapsed onto his bed.
Downstairs, I threw the remaining Zyprexa wafers in the bin and sat for a while with my head in my hands. But the merry-go-round we rode never stopped. Soon I had to wash my hands and prepare for the next shake.
When Kevin rang that night he had no idea of the emotional shit storm he was walking into. "The guys are planning a surfing trip," he remarked lightly, and the longing that rippled through his voice threatened to drag my feet out from under me. I grabbed the kitchen bench to steady myself.
"Are you f...ing kidding? You're not going."
"I didn't say I was going. I was just telling you." His voice like sandpaper.
"You just don't care, do you?" The words flew from my mouth. "Do you have any idea what I'm going through here?"
"Of course I do. I know it's terrible."
"Then don't talk to me about goddamn surfing. Why haven't you asked how Riche is?" My face felt hot with anger. "It's all you care about. Surfing and work."
"I'm sorry," Kevin said. "I'm sorry."
"Can't you at least try to sound sorry?" And I raged on. I'd fallen into a routine as repetitive as Riche's protein shakes.
But Kevin was by now a veteran of my tantrums. He seemed to understand they came from a sense of helplessness, and his tactic was to persevere with his apologies until he hit the right tone and I relented. When he eventually asked me how the day had been, I calmed down and told him.
"He acts like he's possessed, doesn't he?"
"He is," I said.
I had come to think of anorexia as an evil demon. And in truth, it possessed our entire family. Every single one of us. In many ways we were alone in this ongoing disaster. Footprints of Angels had enabled me to keep Riche at home and, through them, I had found a suitable doctor to monitor him. This had saved him from hospitalisation and quite likely had saved his life. But while we shelled out thousands of dollars for individual therapy for Riche - which seemed to make little difference with getting him to drink the shakes - Kevin and I were left with no idea of how to manage his illness as a family with a united front, bumping up against each other in a fog of ignorance and despair.
On this occasion, however, I knew where to find some stop-gap assistance. I had a couple of bottles of chardonnay tucked away in the pantry, so I pulled one out after Kevin hung up and poured myself a glass. The tepid wine going down made me wince, but after a few good swallows the temperature no longer bothered me.
I settled into the gathering shadows of the night. A four-glass night.
Postscript: Riche, now in his 20s, has completely recovered from his illness. He is at university and looking forward to a career in science. He is still a Warhammer fan.
Edited extract from The Boy Who Loved Apples: A Mother's Battle With Her Son's Anorexia, by Amanda Webster ($33), to be published by Text on July 2.
From Good Weekend