My new doctor doesn’t suggest that coffee isn’t a proper breakfast, simply nods at Maurice. He prepares a cup without asking how I take it. Black, two sugars. Sugar is worse for you than fat, but I went through a phase in high school where I ate exclusively fat-free foods, and sugar stuck.
“It’s decaf,” Maurice says apologetically as he hands it to me.
Caffeine is considered a mind-altering substance, so they don’t allow it. Plus, I might chug it to burn extra calories.
Dr. Mackenzie gestures to the couch in the living room.
“You’re not going to force breakfast on me?” I ask as I sit.
“Would you like me to?” Dr. Mackenzie asks. She faces me at an angle, sliding off her shoes and tucking her legs beneath her. I’m wearing sweatpants and a ragged oversize sweater. I feel underdressed and pull my sleeves over my wrists.
“Obviously not.” I take a sip of the coffee. No shitty rehab sludge here. This is French press.
Dr. Mackenzie isn’t holding a pad or a notebook, nowhere to scribble an observation in my file. She simply looks at me, as if I fascinate her. If this place requires a record of my weight, my scrapes and scars, then surely it requires a record of my doctor’s thoughts, too. Maybe Maurice and Izabella are also expected to report their impressions of me and at the end of each day all three of them will disappear to scribble notes on what I said, noting every mannerism—that I sat cross-legged like a child, that I bit mynails or picked at my cuticles. I imagine all their notes neatly organized in a file with my name on it.
I meet my doctor’s gaze. Her face would be symmetrical but for a smattering of mismatched freckles across her nose.
“So what’s your approach here?” I ask finally. “Not CBT, clearly.”
“Why not?”
“Because then you would’ve forced breakfast on me,” I answer. In cognitive behavioral therapy, they focus on (you guessed it) the behaviors around your disorder, putting you on a schedule of what to eat and when, as though meals were a homework assignment.
I don’t want Dr. Mackenzie to see how relieved I am that she’s not forcing me to eat, so I keep talking, trying to sound clinical and detached, like this is all so boring to me.
“And not family therapy, either, because I’m here alone.”
They tried that when I was younger. Grandma Naomi never missed an appointment. Mom’s attendance was sporadic, and eventually the therapist agreed that we made more progress without her. (We didn’t make much progress either way.)
“Internal family systems?” I ask. “That’s all the rage these days. Or maybe you’re out there with psilocybin? It’s going to be more popular than Prozac before long.”
“Have any of those approaches worked for you?”
“Obviously not,” I say again, though I smile a little so she doesn’t think I’m blaming the doctors, but myself. So she’ll know I’m agoodpatient who wants to get better, not a difficult one who fights every step of the way. “I just like to know what I’m getting into.”
“Why?”
“It helps me manage my expectations.”
“And why do you want to manage your expectations?”
Apparently Dr. Mackenzie is taking a traditional talk-therapy approach. Answering all my questions with questions until I accidentally reveal my deepest, darkest secrets.
When I was underage, my therapists shared their observations with Naomi (and Georgia, if she remembered to ask), but after I turned eighteen,it was as though a wand had been waved and my family no longer had any right to hear about our sessions together.
Think of all the families who send loved ones to places like this, desperate for help, but not allowed to ask for details, blindly putting their trust into strangers who keep secrets for a living. The privileges of doctor-patient confidentiality spread far and wide. Even when a patientwantstheir data shared, it isn’t easy: They have to fill out forms, sign legally binding documents.
I take a deep breath, picturing a room lined with tall cabinets filled with files for each patient Rush’s Recovery has ever had: doctors’ observations and diagnoses, the hints they’re trained to pick up on as they gather information the rest of us don’t know enough to recognize.
Files, including mine someday, stubbornly protected by doctor-patient privilege, even after each patient’s death.
14Florence
Evelyn asks the questions therapists always ask, trying to get a picture of the life that led me to their couches. Halfway through her interrogation, sick of the way she stares at the tattoos snaking up and down my arms like she’s searching for evidence of track marks between the ink and the skin, I say, “We could save a lot of time if you just look up my bio.”
My mother hates my tattoos. They mean I can’t be buried in a Jewish cemetery. I told her I don’t want to be buried at all.Cremate me,I said,turn me to fire and scatter my ashes to the wind.Mom looked so horrified at the idea that I knew she’d ignore my wishes. Luckily, she’ll die before me, statistically speaking. Probably, my kid will be in charge of what happens to me. Hopefully by then she’ll be free of Mom’s brainwashing.
“Why would you prefer I read about you on the internet than talk with you about your life right here, right now?” Evelyn asks.
