Sick Days

by April Bannister

When her heart buys its ticket and packs its suitcase and settles in its window seat to watch the airplane heave up from the soil, she is at home—she has not yet laid in her hospital bed, nor stepped on an airplane herself. When her heart buys its ticket, she feels it, chloroform cold radiating from inside her chest. She panics. Hands clutch at something too deep to grasp, so she flails, alone in her bedroom, alone in the apartment. I can’t die yet, she thinks. There’s so much food I need to eat. 

The reaper watches her from the closet. “Not today,” he whispers to her, knowing she can’t hear him but will soon, so soon. “I’ll be right here waiting for you.”

Her heart breathes. The airplane sputters. Having retracted its wheels for the sky, it grinds them back down, and they meet the runway with a sickening jolt. Her hands float to the duvet, a tremor hitching.

“You’re okay,” she says out loud. “You’re okay. It was just a palpitation.”

The walls stare back at her. “Bedroom of a dead girl,” one wall says to another.

“A matter of time,” the door agrees.

*

“How is your weight?” her psychiatrist asks her.

“Down,” she says, and her psychiatrist makes a note. She doesn’t understand why it still seems to come as a surprise—her weight has been down for the past twelve weeks, ever since she left Minnesota.

He asks her the number, and she tells him. “That’s down quite a bit,” he remarks. “Do you remember where you were when you were discharged?”

Of course she remembers. She remembers down to the hundredth, to the measurement of her waist and hips, to her exact body fat percentage. To him she betrays nothing. “Yes,” she says mildly, and regurgitates the number to him, her highest ever, once a mark of scorched shame but now a triumph, a gold medal, a summa cum laude graduation to be so far from it. Across the grain of computer cameras, she watches his face contort.

“It’s not ethical for me to keep seeing you like this,” he says. “Outpatient treatment is only suitable if you’re medically stable.”

“I am medically stable.”

“You’re malnourished,” he says. “Starving. I don’t need the numbers. I can see it in your face.”

She looks at her reflection. “I can’t,” she says, and shrugs.

“Do you think this is funny?”

She lets the smile slide from her lips, tinted gray, cracked like the top of her favorite molasses cookies. “No,” she says. “No, I don’t.”

“It isn’t,” he says. “I’m putting in an order for labs this week. Come in when you can, okay? Sooner rather than later.”

“I’m busy,” she hedges. “I work nine to—”

“Nine to two. I’m aware. And then you’re remote the rest of the day, and you have time to get other things done.”

“I don’t have time every day. Just because I meet with you—”

“Frankly,” he says, “I don’t give a shit about your excuses. Would you rather tell your boss you need an hour to get labs, or that I’ve pulled your committal and you can’t work at all?”

She has to resist the urge to smile again, not from humor, but bald fear, unbridled fury. “You’re not going to pull my committal,” she says.

“Whom are you trying to convince?”

“I’m medically stable,” she repeats.

“Are you dizzy? Hair falling out? As you say it, ‘freezing fucking cold’?”

“It’s winter,” she says. “Everyone is cold.” Of course her heart takes this moment to surge, but she ignores it, writes it off as anxiety.

“Get labs,” he says. “Any one of your electrolytes comes back bad and I’m putting you back in.”

“Deal,” she says, her teeth crumbling into fine powder as she clenches her jaw.

“And starting next week, you’re coming in person. I can’t let virtual slide any longer. I know it’s more convenient for you, but I’m trying to save your life here.”

“Okay,” she says grudgingly. “I’m telling you my labs will be fine.”

“Maybe. Maybe not,” he says. “I’ll see you next week.”

They both know she doesn’t have a choice.

*

Years earlier, she grows sick like a spider bite—a little pinch, a lot of poison. It is just as quick: a fist to her cheek, tossed her direction by her brother, and she falters, feet like Clementine, thick enough to drown. “It was my day with the bike,” he tells her. Some part of her whispers, But you had it yesterday, and it must have been fractionally audible because he snaps, “You knew I needed it today. You knew, and you still took it.” The bicycle belongs to her, not to him, but he has decided they need to share, and now it is her mistake. “You’re fucking worthless,” he says. “Worthless.” She takes one step away before he catches her by the hair and sends her careening onto the hardwood. He stands over her body and shakes his head.

An hour later it is dinnertime. Her mother hands her a bowl of three-cheese tortellini in a tomato-basil sauce and says, “Go get a show ready, yeah?” Her brother is already seated in the living room. She hesitates. Her heel rotates, and she finds herself on tiptoes, padding in the direction of her bedroom.

Her mom calls her name. She locks the bedroom door behind her.

When she takes a bite of tortellini, the pasta warps in her mouth, salty and wet. Worthless clatters through her skull, and she feels an urge to smash the ceramic blue bowl against the wall, or her forehead, a repeated prayer: please stop, please stop. Her pasta cools and congeals. The hunger comes as welcome pain, something to worship, but she doesn’t yet realize the longing will come without the validation, cravings snapping at her toes and sinking in their teeth.

The poison spreads. In a week, the world looks different. Thoughts of food trail her like a ghost with heavy footsteps—heard but not seen, hunger acknowledged but never appeased. As long as the cycle spins, she doesn’t have to think about him, about hands on her body or the floor against her skin.

*

Her days, these days: wake, weigh, work, water, walk. Then home, dinner, gym, shower, sleep. Tonight she is at the gym, again, as always, to complete the latter half of her daily half-marathon. Mile ten point one and her heart leaps into her throat, clawing at her esophagus. She chokes, flecks of spit fleeing her mouth, and she hurries to slow the treadmill in time. An older man on the adjacent machine passes a glance her way, eyebrows starting to furrow. She leaves her winter coat behind, wallet and keys hidden in the left pocket, takes her phone and breaks into a stumbling sprint to the bathroom. With her luck she worries the stalls will be occupied, but they are empty. As the door closes, she vomits her dinner into the first toilet, followed by an acrid green bile from the depths of her stomach.

Her heart cries out, low and slow in her chest. She presses her palms down on herself, a weak attempt at compressions, while she is doubled over in the stall. As her heart stops its climb up her body and begins to parachute back to the ground, she finds she cannot draw a deep breath. Like a fish dragged from its palace of sea, she takes little gasps of air, tries gulping from the sink, paces around the bathroom in lurching steps. After sixty seconds the vise grip releases and she heaves, her chest finally rising to meet her fingertips.

Her psychiatrist tells her to use mantras in hard moments: I am capable. I am strong. I am courageous. In the dirty gym bathroom, she says to the mirror, “I can fit one hand around my upper arm. Two hands around my upper thigh. It’s all worth it.” She pauses. “It has to be worth it,” she says.

She has three miles to go, and she cannot leave until she finishes. On her way out of the bathroom, she sees her reflection and thinks, I may not be beautiful, but I am so, so thin. 

*

Her psychiatrist stands back and watches her step on the scale. Once they are both seated, he says to her, “Your weight is atrocious.”

“It’s not so bad,” she says.

“Don’t bullshit me,” he says. “Is this not the lowest you’ve ever been?”

It is, and they both know it. “I’m fine,” she says.

“You’re not,” he says.

Rather than calling in a nurse, he takes her vitals himself. As she moves from sitting to standing, her blood pressure plummets, and her heart rate darts into the hundreds. “Not good,” her psychiatrist says. “Not good at all.”

“I’m not bradycardic,” she points out.

“No, not right now,” he says. “You’re just severely orthostatic. And I have the suspicion that you’re probably bradycardic at rest, too.”

She feels a swell of defensiveness. “You have no proof,” she snaps at him.

He points to the blood pressure machine. “I don’t need you to be bradycardic for me to be concerned,” he says. “This is reason enough.”

She softens, though just slightly, just enough for a blue finger to make an impression in her yellowing skin. “Don’t be concerned,” she says.

“The more you say that, the more I worry.”

They watch each other, a wary standstill. “Okay,” he says finally. “Will you go up and get labs before you leave?”

“I just got labs the other week,” she says. “They were fine. Like I told you.”

“I saw them,” he says. “And I want you to get them again.” She looks at her shoes, not so much a caress of rubber against tile but a slap, a heavy fist that makes her think of her brother. “Take the elevator,” her psychiatrist says, so she leaves the clinic and climbs the stairs.

In the laboratory, the receptionist doesn’t ask her name. “Oh, it’s you,” the receptionist says. “You don’t look as cold today.”

“I’m sorry?” she asks.

“The other day,” he explains. “You were in here the other day, weren’t you? Your lips were purple. I said to myself, ‘There’s no way,’ but then I thought, ‘Yep, they sure are.’”

“Oh,” she says to him, at a loss. “Yeah, I guess I feel better today.”

He sends her to the waiting room until a lab technician calls for her. Unlike out there, in the real world, here she is someone. Here they know her by name, by her sickness, a blue ribbon pinned to the protrusion of her collarbones.

*

Until the incident at the gym, she had been free from vomiting since before Minnesota, but now the urge has rebounded, a piranha jerking her toes from her feet. She adds another act to the routine: home, dinner, shower, gym, shower, sleep. Every day she pulls her own marionette string until the roar of release, a violent, dirty act, to choke on her fingernails, like mud, like bad sex. The hot water runs out by the end of the first shower, making her second decidedly more miserable. Dying is cold, she thinks, but mostly it is boring.

At the office, her coworkers have started to take notice. “You look tired,” her boss says to her frequently. “I am,” she tells him. Her officemate asks, “Do you really need your jacket on all the time?” Yes, she answers, yes, I really do. This life may be painful—hard-backed chairs like ice picks drilling into each lump of her spine, heavy aches in her legs, a hissing rattlesnake thrashing its tail through her chest—but it is comforting to know she gives herself exactly what she deserves, nothing more, nothing less. For her there are no off days. No sick days for the sick.

*

In her psychiatrist’s office, he takes her hands in his. “Poor circulation,” he comments.

“Well, I could’ve told you that,” she says.

He checks her weight. It’s down. He makes a note.

“Have you seen your labs yet?” he asks, and her body tinges blue, slick ice spreading from her fingertips. This time it is fear that chokes her heart.

“No,” she says. “I didn’t have time to look.” It’s not true. She got the email, but couldn’t bring herself to view it. Something within her told her what was coming.

“You’re hyponatremic,” her psychiatrist says. “Probably from water intoxication. You’re drinking so much water to stave off your hunger that you’ve diluted the sodium levels in your blood.”

“I don’t even drink that much,” she mumbles.

He dismisses her, as she knows he should. “And your glucose is shit,” he says.

“What is it?”

He tells her the number.

Her body temperature drops another octave, but all she can do is stare at her thighs, monstrous in her own image, thick, distorted. “Please,” she whispers to her psychiatrist. “Please don’t do this to me.”

“I’m sorry,” he tells her, and she could slap him because she knows it’s genuine. “It’s already done.” He hands her the paperwork, filled out—Order to Return to Full-Time Inpatient Mental Health Commitment. “We’re at a point where it’s life or death,” he says. “The options are you go into the hospital or you won’t make it out alive.”

“Can I go back to Minnesota?” she asks in a small voice.

He shakes his head. “They can’t take you like this,” he says. “The vast majority of treatment centers can’t take you like this. You can be admitted medically here, but you and I both know there are no programs within the state.” He pauses. “It’s my recommendation that you go to Denver.”

She knows what’s in Denver. Everyone like her knows what’s in Denver.

“How does that make you feel?” her psychiatrist asks. “Does that make you feel validated? Knowing you’ve gotten to a point where they’d take you?”

“No,” she says. Her voice escapes too quietly. “It makes me feel very lonely.”

*

Denver approves her admission and agrees to transfer her after five days in medical. When she boards the plane, she is not thinking of her heart, but her legs and arms, not the pain, but the compulsions, the checking. How quickly, she wonders, will she lose it all, this body she built from scaffolds of bone? “Most people are self-conscious,” a doctor at the local hospital tells her before she leaves. “Most people aren’t happy with how they look.”

She acknowledges this with a nod, and dismisses it. “Most people aren’t willing to die,” she says.

“And you are?” the doctor asks.

She only gazes back at her. Look at me, she wants to yell. Isn’t it obvious?

But that would be too simple, too easy to say yes, this illness has taken my loved ones and my job and my hair and my teeth, but it is only to lose another pound, to look a certain way. The doctor in Iowa wants to know why—why the tornado chasing when she is such a smart girl, smart enough to know better? She doesn’t offer the doctor an answer, nor does she fully understand it herself. She knows that smarts have nothing to do with it. She knows if a tornado were raging in anyone else’s skull, they, too, would chase it in circles, letting its whirlpool sweep them closer, closer, because maybe at the eye there comes an insight. It isn’t about the pursuit of death. Death is merely a hobby, a side hustle. It’s more about—

More about—

In Denver, the doctors say, “You haven’t been hungry for days, or weeks, or months. You’ve been hungry for years.”

“Yes,” she says.

“Aren’t you tired?” they ask. “Isn’t any part of you willing to give up the fight? Even just for one day? One week?”

She contemplates this. “Recovery,” she finally says, “tastes best on an empty stomach.”

But that, too, would be too simple. Not about consumption, not about calories, her currency. Not about food at all. More about—

More about—

She has been through this process before, once, in Minnesota. She can measure with her fingers the changes that come when she unlocks her jaw and opens, not wide, not like a baby bird, hopeful, but just as defenseless, just as desperate. “Are you afraid your family won’t recognize you?” the Denver team says. “Your friends? Your coworkers?”

“I’m not afraid of that,” she says.

“No one who loves you will ever want less of you,” the psychologist says.

“They don’t want me anyway,” she says.

It isn’t about weight restoration. It isn’t about those she has loved, and lost, to the hunger years, all the times she said no, I can’t come with you to get ice cream, sureI’llwalktherewithyoubutit’stoomanycaloriesIhavetogotothegymit’stoolateatnightIalreadyspentmyintakefortheday. It isn’t about self-hatred, even though the hatred is a shock blanket, protection from her brother and the hardwood floor of her childhood home. It isn’t about her brother. It isn’t about anyone at all.

Eight hundred miles from home, she lies alone in a hospital bed. Stickers hold tight to her chest, wires crawling down her scaphoid stomach: smoke over fire, and so on.

As the doctors watch the monitor, her heart takes a step toward her skin.

 

April Bannister (she/her/hers) is an MFA candidate in Fiction at Arizona State University and earned her BA in English and Creative Writing from the University of Iowa. Among others, her work has appeared in The Raven Review, The Pittsburgher (formerly The Dog Door Cultural), The National Collegiate Honor Society’s Journal of Undergraduate Research and Creative Activity, and The Foundationalist.