"let the hunger rule my life forever."


Elena Dunkle two months before hospitalization, May 2006

 Elena Dunkle two months before this chapter 

Read the first three chapters of Elena Dunkle's memoir, ELENA VANISHING


I wake up in a panic, and acid churns in my stomach. A nurse has walked into my hospital room. I was asleep. How long was I asleep? How long has it been since I last reached for the makeup bag under my pillow? Does the nurse see a girl with a bright future ahead of her? Or does he see a sweaty, tearstained mess?

As it turns, out, I don't need to worry. All the nurse sees is my lunch tray. "You didn't eat any of this," he says. "You didn't even unwrap it."

I feel my face settle automatically into a polite, neutral expression: forehead smooth and lips curved slightly upward. And I hear my voice speak in the voice I save for strangers: slightly higher and more childlike than my normal voice, with a gentle lilt. People like that voice. They relax and smile when they hear it.

"I'm sorry," I say. "I fell asleep."

"So, if I leave it, will you eat it now?"

No. There's no way I can force that stuff down. This morning, I had three bites of pudding, and I'm still full. At the thought of more food, the familiar pains knife through me. But if I say that, I know what he'll think, so I purse my lips and arrange my face into a thoughtful expression.

"I don't know," I say. "I'm still sleepy. Maybe later, when I wake up again."

The nurse isn't happy with my answer. He growls and mutters as he takes my pulse and updates my chart.

I like this nurse. Yesterday he yelled at me, but I could tell he only did it because he was worried. Now he huffs, "Anorexia! You and my niece. Two beautiful girls, destroying your lives over a diet!"

I take careful note of the comment: beautiful. This nurse is the fifth person in the last four days to call me beautiful. But worry poisons my relief. What do I weigh now? I need to know the number that's made me beautiful.

"How's the heart?" asks the nurse. "Any pain in the chest?"

"No," I say, trying to keep annoyance out of my voice. That's because there's nothing wrong with my heart.

"Are you noticing any tightness? Any shortness of breath?"

"No." Of course not! One echo exam, and everybody freaks. Doctors read those tests wrong all the time.

"Do you need anything?"

"No thank you," I say with a shake of my head and a smile, as if he's a waiter taking my order. I feel the smile stay smooth and perfect on my face until he leaves the room.

As soon as the nurse is out of sight, I double up in agony, clenching my teeth to keep from groaning out loud. If I make a sound, I know he'll hear me and come rushing back to help. And I don't want anyone's help.

Anger and bewilderment are forms of admiration. It's pity I can't stand. Pity wraps you up inside your problem until the problem is all people see. "Did you hear what happened to her?" they whisper behind your back. "Can you just imagine? No wonder!" And when you do something amazing, nobody's jealous anymore. They hug you and cry and call you brave, when what they really mean by that is damaged.

So I lie still and take deep, quiet breaths. Pain doesn't bother me. I'm not afraid. I'm used to living with pain.

He saw you looking like a mess, warns the voice in my head. You weren't careful enough. You let down your guard.

That's my conscience. We all have one. Mine never lets me settle for second best. There's no place in life for losers.

So, even though the pain in my stomach still has me clenching my teeth in agony, I pull the little makeup bag out from under my pillow and touch up my face in the compact mirror.

Perfection. That's what I want people to see when they look at me. Nothing but perfection.

Anger is honest. Hatred is a backhanded compliment. Envy is the best gift of all. But let them turn you into a victim, and you're labeled for life.

Pity is the sea you drown in.


The psychiatrist sidles into my hospital room and looks grave when he sees my untouched tray. But then again, he always looks grave. He's a short man with sad brown eyes and a limp little brown mustache. He looks like he belongs in one of those old photographs, an explorer in a pith helmet with his arm draped around a half-naked tribesman.

I forget my pain and enjoy the feeling of how much I hate him.

I've only seen this moron for three short sessions, but he thinks he's figured out the solution to the Elena Dunkle mystery. He locked me in the hospital, and he told my parents I have anorexia nervosa. Now he wants to ship me back to the States.

I've lived in Germany for six years. It's a safe place for me, and I've earned that safety through hard work and plenty of angry tears when no one was around to see them. Germans think I'm one of them when they hear me speak. I know how to diss people in two languages. I love the Air Force base where my father works, too, with its neatness and discipline. It's a closed system, a small town, and I belong there.

I even love this hospital. It's like a second home to me. I volunteer here all the time. They're shorthanded right now down at the chaplain's wing because I'm stuck here in a hospital bed.

Being stuck here isn't why I hate the psychiatrist. I can respect drastic action. And I'm not an anorexic, but I know that anorexics are strong, smart people. I'm willing to take his diagnosis as a compliment.

No, the thing I hate about him is that he's still making pathetic attempts to be friends.

There are things I told this guy—little quirks about how I cope with food. If he shared them with the pediatrician and cardiologist, they might go along with his crazy diagnosis. But he's keeping those things from everybody—even from my parents. It's like those things I told him are our little secret. It's like he thinks we're two girlfriends away at summer camp together instead of what we really are, which is a maniac mad-scientist doctor and a prisoner he's locked away by force.

The psychiatrist wants me to be the one to tell my secrets. He actually believes he can persuade me to do this. But I haven't worked this hard this long at perfection just to throw it away.

It's an insult—that's exactly what it is. He's insulting my intelligence.

Now he sits down on the edge of my bed and gazes at me mournfully. "We're running out of time," he says.

I perk up. Maybe he's finally ready to do something on his own. Maybe he's finally going to quit treating me like his buddy.

In a way, it would be nice if he did. I've done nothing all week but wait. There are only so many interesting movies in the hospital library, and they won't let me leave this ward. The restricting is wearing me out, too. I've done my best to eat almost nothing, but it's exhausting to put up that kind of fight. I need a change. I hope he's finally ready to take action.

But no. He sighs and says, "Well, Elena, what are we going to tell them?"

We? Oh, for the love of God, will this loser just man up! When is he going to figure it out? I am not on his side.

"You know and I know how important this hospital stay is to you," he murmurs. "You can't fix this on your own. It's time to bring your parents in on this. Are you ready to tell them the truth?"

I stare straight ahead, and I keep my expression completely impassive. Maybe I can freeze him out. But the psychiatrist croons on in his confidential whisper as if we're Secret Santa pals.

Does he really think I'm nothing but some cute little girl who's going to burst into tears and sob on his shoulder?

"You don't want to disappoint your parents," he says. "I get that. Especially not after what they've been through with your sister."

White-hot daggers of rage flash through my brain and light up sparkling patterns behind my eyes. He shouldn't have done that. He shouldn't have brought up Valerie.

"I'm a perfectionist, too," he says. "I know how hard it is to give up on that perfect image. You think I don't know how you're feeling, facing an unhappy family? I'll tell you something. My wife and I divorced last year, and my daughter thinks it's my fault. She won't even talk to me."

"So that's what this whole thing is to you!" I snarl. "It's a Big-Daddy-to-the-rescue crusade. You failed as a father with your own daughter, and now you've locked up another little girl so you can substitute-daddy me!"

The psychiatrist's mouth flops open, and he stares at me in shock. I have to stop myself from laughing. If he's got me figured out like he thinks he has, he should know that's what he gets for going up against me.

"Have you got a Messiah complex or something?" I say. "Is that what this is all about? You must think I'm going to thank you for doing this. You think you'll win my trust, and we'll fight this big bad problem together, and I'll wipe away a tear and tell you you've saved me."

I pause for breath. My chest hurts. But the psychiatrist just keeps staring. His face is turning the color of raw steak.

"Well, guess what?" I say. "I'm not grateful. You haven't saved me. Go daddy somebody else. I'm not going to be your replacement daughter!"

He jumps to his feet and rushes out of the room.

The psychiatrist mans up, all right. It's the end of Mr. Nice Guy. Within minutes of leaving me, he meets with my parents and the other two doctors in the conference room down the hall, and I go out to the corridor and listen as he makes an ass out of himself. He lays down the law, and he doesn't care what anybody else has to say about it. He's sending me to the States to a psychiatric institution.

The cardiologist argues with him. "I can't definitively state that her weak heart is eating disorder–related," she says. "You've hardly treated Elena. Where's the past history of eating disorder documented in her chart?"

"You haven't consulted with me at all," interjects the pediatrician. "What makes you so sure she's anorexic?"

Amazingly enough, the psychiatrist still keeps my secrets for me. Maybe he's forgotten about them. Or maybe he just doesn't care that he sounds like an ass.

In the hallway beside me, the ward nurses make screw you gestures at him behind the door, and my parents look stunned as the experts quarrel. But for the very first time, I feel a spark of sympathy for my psychiatrist.

So that limp little mustache had some fight behind it after all. I must have hurt his feelings pretty badly.

The cardiologist suggests a consultation at a children's hospital in the States. "They can run tests there that we aren't equipped for," she says. "They'll be able to find the root causes for this problem. She's lost six pounds in the week she's been here. I'd like to see them do a complete metabolic workup."

Six pounds. I've lost almost a pound a day! And I know my number now, the number that's made me beautiful. The relief I feel is so profound, my knees threaten to collapse. I totter back to my room, take off my glasses, and lie down.

Because it's like this: There's fat, and there's thin. Fat is bad, and thin is good. You take a girl sitting in the back of the classroom with her nose in a book. If she's fat, she's pitiful. If she's thin, she's sophisticated and mysterious. People say life's different, but people say there's a tooth fairy, too.

There's fat, and there's thin, and there's no in-between. You're one, or you're the other. But where does fat become thin? And where does thin become fat? In two pounds? Six pounds? Twelve pounds?

The girl in my mirror lies to everybody else. She'd lie to me if I let her. The camera lies, too. I can make my photos look like anything I want. Clothing sizes are clues (size 00 jeans, size XS). But clothes can stretch, and manufacturers change their sizes.

So I hunt obsessively through clues that tell me what people think of me, and I step on the scale twice a day. A number on the scale: that's the one and only thing I can trust. For a week, they've kept me away from the scale, but now I have my number again. I nestle into the pillow and close my eyes, at peace.

People burst into my room. I put on my glasses. It's the psychiatrist and my mother. Their meeting is over now, but he's still yelling—this time at me. It's just a bunch of shit, the stuff he's saying. I act like he's not there.

Yelling means he's lost the argument.

"You won't have that senior year with your friends," he says. "You'll spend six months in a hospital with a tube up your nose to feed you!"

Who is he kidding? Nobody gets locked up in institutions anymore. It's so mad-scientist, I can't help but smile.

"You think this is a joke? I'm serious, Elena! I'm very serious about this. You're getting sent out of here on the next transport plane, and you won't see Germany again."

I take off my glasses. The room blurs into vague, soft shapes, and the psychiatrist loses his angry expression. It doesn't matter what he says. I know my number again. And five people think I'm beautiful.

Eventually, the talk moves into the hall. Then it moves down the hall. I pull out my makeup bag and check my face again in the mirror:

Thin lips, plumped and filled in with gloss. Cheeks, brushed with blush in the hollows beneath the bones. Nose, squashy and powdered over to hide its pores. (God, I hate my nose!) First one brown eye and then the other to check the mascara on their lashes. (At least I have long eyelashes.)

What is a face? Nothing but the sum of its parts. If each part is right, the sum will be right too.

Before I felt the worry over fat and thin, I felt the knot in my stomach. Stress used to gnaw and saw away inside me like a tiny black hole. I learned that in spite of the stress, I could do everything I needed to do: study, make top grades, shop for the right clothes, and put on that perfect smile. Some days, I felt just like Wonder Woman.

The only thing I couldn't do was eat.

At breakfast, I would fight to choke down half a bagel. When lunchtime came, I could still feel it sitting in my stomach, bloating me up. At supper, I was too tired and stressed to cope with the problem of food. I saved my energy to help me get through all the homework.

For months, I was afraid that my struggles over food were going to give me away. I wore baggy clothes and lived in fear of the day when pity would find me and smother me: "You're having trouble, Elena. I'm so sorry for you! I think you're being so brave."

But my not eating turned out to be the best disguise of all.

As the girl in my mirror got thinner, I became more popular. And I didn't have to do a thing! Guys treated me differently. Girls came to me and begged, "Please, please tell me how you did it."

The girl in my mirror wasn't me anymore, so I started avoiding her eyes. They had nothing to say to me. I got used to putting on my makeup one feature at a time: lips, nose, one cheek, the other cheek, forehead, eye, eye. That was all I looked at. I didn't need to look at the whole thing.

Then one night, I woke up out of a nightmare and stumbled into the bathroom and looked in the mirror, and the girl I saw there was a total stranger. The fear of the nightmare was still heavy in my mind, and I felt sure that girl was about to disobey me.

If she smiled when I didn't smile, what would happen to me? Who would I be then?

I haven't looked at the mirror girl since.

But I don't need to. It doesn't matter what I see. It only matters what other people see: cool, calm, in-control perfection that can deal with yelling psychiatrists and still smile.

I put away the makeup bag and try to get comfortable. The mound of blankets does no good; I haven't been able to get warm in longer than I can remember. I close my eyes.

The nice nurse who got mad at me and called me beautiful carries in a supper tray, and the smells rising from it make me sick. I'd like to take a bite to please him, but I'm still too full to eat. This morning I broke down and ate a piece of toast, and it's turned into a hard knot inside my stomach, a rock that the acid churns around. Earlier today, that rock made me throw up three times, but I still can't get rid of it.

You knew it was a mistake to eat the toast, says the voice in my head. Now that toast is rotting in there.

And the thought of my full, hard, bloated stomach full of rotting food makes me shake, until I have to run to the bathroom and vomit again.

But the high of purging boosts me, and the dreamy haze of restriction wafts me along. I crawl back beneath the covers, feeling pure and holy.

No worries now. Nothing.

Nothing at all.


I wake up. It's twilight in the featureless room, that never-quite-dark-enough half-light that means it's nighttime in a hospital. The quiet is complete in the almost-empty ward. There isn't even the click of a keyboard or the rustle of a page from the nurses' station.

The dim room swims. My hands are shaking, and I'm cold, but I'm also drenched with sweat. My chest aches. My heart pounds: the heart with thin walls. Except that's not real, is it?—there's nothing wrong with my heart. Did I dream the cardiologist and her exam? Did I dream the psychiatrist who lost the argument because he couldn't stop yelling?

You'll spend six months in a hospital with a tube up your nose! You'll never see Germany again!

That's crazy. It must have been a dream. It sounds like a bad novel. It sounds like an old black-and-white movie. In my mind, the psychiatrist morphs into a villain in a black cape and hat. They go perfectly with his silly mustache.

But my heart won't stop hurting, and the room wavers before my eyes. I'm not sure I'm strong enough to sit up. Am I having a heart attack? I can't think straight. My arms and legs are so heavy, I can barely move.

Out of the corner of my eye, I see feet by the door. A pair of Converse sneakers. Green scrubs—the hospital uniform of untucked cotton shirt and cotton pants. Red hair.

A nursing tech with red hair is standing in my room.

But when I turn my head to look, there's nothing there.

Over by the bathroom, I see a scrap of floral cloth. A flowered dress. Brown hair in a bun.

A woman is sitting in the rocking chair by my bed. She's huddled into herself, with her head on her chest, in sorrow or in pain.

I look straight at her. But she's gone.

Dead people, warns the voice in my head. Maybe they died in this room.

I try to summon up the energy to feel afraid, but my mind won't focus.

Dead people, says the voice in my head again. Are they still here? Look again.

But I don't look. I won't let them see that I've noticed them. If you ignore something, it goes away, no matter how bad it is.

I close my eyes and sink back into unconsciousness.

"Hey, Elena," calls a cheerful voice. "Are you ready to go?"

Is it the dead woman by my bed? Or did I dream her, just like I dreamed about getting sent back to the States by the villain in the black cape and hat?

I open my eyes and reach for my glasses. The room is full of light. The dead people are gone, and a nurse is pushing an empty gurney over to me.

She says, "Ready to catch that plane?"

Transport to the States. But wasn't it just a dream?

It's a stupid idea. It's crazy!

Mom comes in. She looks tired but still interested in everything. Mom writes books, so she says that everything she learns is useful because in order to write a book, you have to know a little bit about a lot of things.

Before Mom wrote her books, her stories were special, just for me and my sister. But now our special stories are out in bookstores for anybody to buy.

Mom's hair is very short and mostly gray. I've tried to get her to color it, but she says she likes gray hair. She's not wearing any makeup, as usual, even though makeup would hide the starts of creases in her forehead and the tiredness in her eyes. Mom would look better if she didn't let everybody see how she's feeling.

At that thought, I reach for my makeup bag and touch up my face. No worries. This is just a mistake. I don't need to do a thing. At some point, my pediatrician will walk in to stop this insanity, and there will be explanations and apologetic laughter. So I smile at the nurse, and I read her appreciation in her answering smile. "What a mature young woman," she's thinking now. "Such a joy to work with."

You've got her fooled! laughs the voice in my head.

The nurse pushes me down the halls and through the emergency room. It's nice to see the ER, which is one of the places I volunteer in, but I hope I don't meet anybody I know. I adjust my expression in case that happens: slightly bored, mouth in a line, as if I'm putting up with a couple of preschoolers. People need to know that even though there's drama going on, I'm not part of that drama.

Now we're outside in front of the hospital. At least I'm getting a few rays of sunlight. My friend Barbara and I have been working on our tans this summer, but this week in bed has pretty much trashed mine.

Dad finds my gurney. He's in his white Oxford shirt and tie, ready for his workday. He's an important manager who does engineering for the Air Force; a deputy squadron commander, in fact. Dad's tall and a little scary-looking, with thinning hair and a closely trimmed gray beard.

But this year has been too much for Dad. I pretend not to notice that he's crying. I want to tell him not to worry, but it's better if we don't talk about it.

Ignoring things is what makes them go away.

Other gurneys gather on the asphalt drive outside the ER. All around me are wounded soldiers swathed in bandages and casts. "You kind of wonder what it feels like to get shot," one Marine says thoughtfully to another. "Anyway, we've checked that box."

This is getting embarrassing. I should be doing something to help, not lying here like this. Just last week, I met some of these same soldiers and helped get them settled in.

Nurses in scrubs go through the crowd now and prep the patients for transport. They come by and move me onto a primitive-looking stretcher with long wooden rods down the sides. The stretcher has a big feather pillow in a plastic sack that's as heavy as lead. My nurse helps them pull up an ultra-itchy dark green wool blanket that looks like it's been through World War II.

Then they tighten a strap around my middle. Now I can't sit up.

I don't like the strap. I want to protest, but if I do, they'll think I'm scared. I can't let that happen, so I smile at them as graciously as if they've just brought me flowers, and they move on to someone who actually needs their help.

Dark blue buses back up into the drive, just like school buses except for the color and the fact that they don't have seats inside. Swinging doors in the back open, and one by one, soldiers in camouflage fatigues carry us onto the buses and lock our stretchers into brackets on the walls.

I don't want to be carried on a stretcher. I'm not a patient. I'm not a victim! But they heave me into the bus, and I grip the long poles on either side as my stretcher rocks up and down. Then, with a clump, they lock me into place.

"What's wrong with the girl?" I hear the wounded soldiers asking. "What's the matter with her? Will she be okay?" My stretcher is so high that it's up by the school bus windows, where anybody can see me. I can look right down to the asphalt drive below.

Now we're bouncing along the highway. Pine trees flash past my feet, and I feel lightheaded and short of breath.

You've screwed up your heart, warns the voice in my head. It's thin. That's what the cardiologist said.

But the cardiologist is wrong. She can't be right about my heart. And this can't be happening. It isn't happening, is it? It's like I'm watching a movie that's all around me.

The bus makes its way through square beige buildings to the flight line, where the big planes sit. The flight line is a massive concrete field with mysterious stripes and symbols painted on it. It's so wide that I can't see its edges. There's concrete to the horizon.

I've lived here for six years, and I've never even thought of walking onto the flight line. A red stripe runs around its edge, and if you stick a toe over that line, the security guards up in the tower send a jeep patrol with machine guns racing over to find out what you're doing. Breaking red is serious business. No Air Force kid would even think about it. But here I am, breaking red, rolling down the dead center of all this concrete. It's crazy. It's like I've been sucked into the middle of a war film.

The C-17 airplane is big, fat, and ugly. It looks like a metal goose. Its back end is open, with a wide ramp reaching down to the ground. The bus stops, and our nurses unlatch the doors at the back and jump out. The fingernail-screech of airplane engines gets very loud.

Knots of Army and Air Force soldiers start carrying stretchers up the ramp: six to a stretcher, three to a side, like bearers for a coffin. I don't want them to carry me that way, flopped out flat like a dead body. I don't want to watch this movie anymore.

They'll drop you, warns the voice in my head. They'll drop you, and your heart will burst. Feel it? Feel how it's pounding?

I struggle to sit up, pulling at the strap around my middle. My nurse from the children's ward bends over me. "I can't breathe," I tell her in what I hope sounds like a calm, in-control voice. "I think there might be something wrong with my heart."

Impersonal faces and battle fatigues are next to me in the bus. With a thunk, they unhook my stretcher. Camouflaged torsos, tan and gray, walk me under the shadow of the C-17. The noise vibrates my teeth. I can feel them grinding together.

They're going to drop you! shrieks the voice in my head. You're sliding backward off the stretcher!

I can't see my nurse. My heart gives a stab of pain. The hot, humid wind of German high summer rushes across the concrete and blows directly into my face.

"I can't breathe," I gasp. "I can't breathe!"

That's all I remember.

Elena Dunkle in the ICU, July 2006

 Elena Dunkle two days after the end of this chapter