There are four of them I see often – two sisters, wrapped as if for a snowstorm on the sunniest day, strangely knobbly and terrifying thin: a sweetfaced woman who smiles at me, not a curve to the body, hair like straw and that stunned look in the eyes. And the older woman flatpacked into old sports clothes, who goes through every vegetable in every crate, buying one of each, her face as white as paper, her voice unpleasantly bossy which is as good a device for keeping people away as any.
Serena was the first anorexic I ever met – tall (1.73 m) with shining nut brown hair and sea green eyes, she weighed about 39 kg. Superficially she was a tall slender girl with a first in social anthropology. (I never checked). She would eat two enormous meals and throw up in the privacy of the bathroom, which never smelt, and then live on lemon tea for a week. She told me a full set of mythologies about accidents and operations that went wrong, plastic procedures that didn’t show and she knew a great deal about her condition, about the race between her and it. And that was far more absorbing and interesting than her on/off, in heaven knows what terms relationship with the scion of a famously wealthy family who whisked her away for a week in Paris or a few days in the sun every time she got near facing up to herself. Her parents were in understandable thrall to her horrible symptoms, I don’t know about her psychological complexities. When last heard of, she was living in New York with equally gaunt Siamese cats.
As soon as you mention eating disorders, everyone has a theory, whether based on information, experience or hearsay. It’s probably fair to say we can describe how the pitch is marked out but not the game. It varies. Maddeningly. In a world where large numbers of people don’t have enough to eat, there is something very disturbing about people starving themselves. And the symptoms are so dramatically awful, that there is a whole group of people who don’t think any further. On a spectrum which includes starvation through bulimia and yoyo dieting to over eating , anorexia was defined to me by a vividly descriptive phrase: “a disordered relationship with food”.
There was the woman I interviewed for camera who talked about eventually “seeing” herself on her knees at the toilet bowl, about to stick her fingers down her throat and was for the first time able to commit to a measure of help. There was the patient of the Harley Street specialist I worked for whose weight went from under 9 stones to 14st and back again, a monstrous calorific switchback that she watched as if it were happening to somebody else. And the girl with the horrible history who wondered if I would come up to Oxford to meet her (I did): she became a radio researcher, then went into tv reality shows which were perfect for her, shallow, time consuming, no interest in anybody who wasn’t on screen, no time for food, no time for relationships. She killed herself.
“Life in Brief” is a column in the “I” newspaper, an obituary, often of people you have never heard of and this week it was about the elder daughter of former French President Jacques Chirac, a woman who suffered from anorexia and depression since she was a teenager. After many attempts to end her own life, she died of a heart attack (the heart takes a terrible beating in eating disorders). Whatever the agenda of the parents in this case, Madame Chirac endorsed a specialised clinic for anorexics and her daughter Laurence was shielded as much as possible from the attentions of the press by living on the family’s estate. Think about it – wealth, status and achievement – and a child who wants to die.
Just because you don’t understand the form of somebody’s suffering, it doesn’t follow that it doesn’t exist. Pain is and people suffer from it, from minor forms that they can wrestle with and move on from, to major difficulties which impact on their ability to live in a form which makes life acceptable to them or anybody else.
To be a witness of another’s suffering is hard to do. Medical personnel train to do it and they don’t always manage. Occasionally life throws up extraordinarily motivated people who manage by grace and skill to be of use when the rest of us give up. I can’t draw a useful line in this argument between physical suffering and mental suffering because they are part and parcel of the same thing. It can’t be “proved” but I believe it to be so. Years ago in a publication I read “Doctor, doctor ‘there’s a pain in my psyche” and that says it all.