So many people don't understand how dangerous Anorexia can be, or how it destroys a person from the mind out. It really is a mental illness, and without help, it's victims will die. My niece was one of those victims, and my sister gave her daughter to me, crying as she left - praying to God I'd be strong enough to help her find her way before it was too late.

The Silent Killer

“It won’t get any easier Carol. You need to just trust me, and leave.”

Carol tried, but could not free herself of Rebecca’s arms. She was strong enough to do so physically, but emotionally she could not bring herself to peel her crying child from her bosom. She knew this might be the last time she would see her dear Rebecca alive and she couldn’t bear the pain of saying goodbye. Rebecca screamed as I reached around her. Slowly and carefully I pried her hands and arms from my sister’s body. She collapsed in anguish onto the floor, screaming. I held her as she fell and followed her down. I wrapped my arms and legs about the child sitting on the floor before me. I held her tightly as she screamed for her parents, struggling to get loose and go to them. They lingered at the door a moment longer.

“Go Carol. You must just go. I will love her and care for her. I will do all I can. Go now and just pray for us to have strength to get through this. It’s the only chance she’s got Carol. Go.”

Gary put his arm around his wife and gently pulled her out the door as they both choked on tears. I could hear Carol sobbing over the screaming of the child in my arms.

“MOMMA, DON’T LEAVE ME! MOMMA, COME BACK! MOMMA, I LOVE YOU! PLEASE DON’T LEAVE ME!”

Momma didn’t come back - so she screamed to her daddy........

“DADDY, I LOVE YOU! PLEASE DADDY, PLEASE COME BACK! TAKE ME HOME DADDY, PLEASE! I LOVE YOU! I’M SORRY! DADDY! DON’T LEAVE ME DADDY!”

As she heard the front door shut behind them she began the loudest, longest scream.... “AAHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH!“

I just held her tightly crying quiet tears as she wailed and screamed for her mother. Then began the screams at me:

“I HATE YOU AUNT GAIL! I HATE YOU! I’M GOING TO DIE! I’M GOING TO KILL MYSELF AND YOU WON’T STOP ME! I HATE YOU! IT’LL BE YOUR FAULT WHEN I’M DEAD BECAUSE YOU TOOK ME FROM MY MOMMA AND DADDY! YOU’RE TO BLAME WHEN I KILL MYSELF AUNT GAIL! I HATE YOU!”

We sat like that for more than an hour till she was completely exhausted. I wondered if I had the strength to help this child. Was my love for her strong enough to keep her alive against her will? The hospital in Atlanta had given up on her and sent her home to die. They were specialists while I knew nothing of this illness. How could I save this child before it was too late? What had I gotten into?

The weeks before....

It was weeks earlier when this began. My sister had called from Georgia in tears. Her husband, Gary, had been in and out of the hospital fighting depression. The stress was taking its toll on all of their family. Carol was weakening. She didn’t know how much more she could take? Gary seemed to be on the road to recovery, but Rebecca had slowly been worsening emotionally and physically.

Carol wasn’t sure when it began. She just slowly began to realize that Rebecca seemed to be less and less active. She stayed home from school sick a lot. Even at school she would sit so still, hardly moving. Someone would bring her lunch to her each afternoon and it would sit there untouched till it was taken back to the cafeteria. Her brothers didn’t know what to do either. They fetched whatever she wished, and bought her gifts, hoping that somehow they’d find something that would make Rebecca happy again. Nothing worked. They took her to doctors checking for illness after illness - looking for something that could be treated, some medicine she could take to make her well. They only came up with a diagnosis of depression and anorexia. Didn’t sound like much, but listening to Carol you’d think her child was dying before her eyes and there was nothing she could do to stop it?

In a way she was - dying I mean. The child was so severely depressed that she’d lost all will to live. She had just quit eating, figuring that sooner or later life would just expire of its own. I could hear the pain in Carol’s voice as she talked of her daughter wanting to die. They were admitting her to a clinic in Atlanta, Georgia that specialized in the treatment of anorexic patients. Carol hoped it would help but she seemed so very uncertain. They were making plans to take Rebecca to Atlanta. The insurance wouldn’t pay to admit her completely but did cover for her to participate in a voluntary program. I couldn’t see Rebecca over the phone, so had no idea how horridly thin and emaciated the child was, but I could hear the despair in my sister’s voice. I sat on the phone listening, trying to comfort her.

Days passed and Carol called again. I listened, trying to understand what was happening, trying to offer what comfort I could. She told me Rebecca had wandered off from church one day, just started walking, heading to the highway. One of her brothers had seen her, gone after her, and carried her back to the church parking lot. When asked, she replied she was going to go walk into the highway and let someone hit her, that she just didn’t want to live any more. Incidents like this were becoming more common. Carol worried whether she or someone else would be there next time?

Then came the call that shocked me most. They had returned from Atlanta. The hospital told them to take Rebecca home. They couldn’t do anything for her. Without full admittance into the hospital they could not force feed her or save her against her will, the volunteer program was just that - voluntary - and if the person in the program didn’t work with it, then it did no good. Rebecca was now dropping under 70 pounds. I couldn’t remember how tall Rebecca was. I’m only 5'2" and it seemed like Carol’s family all towered over me by a good foot, so how could Rebecca possibly weigh as little as 70 pounds? Carol said she’d been told by the doctor that at the rate Rebecca was loosing weight she had about 5-8 more pounds to go till there would be irreparable damage to her internal organs if it hadn’t occurred already, and she was quickly approaching death itself. My sister was beside herself with grief. She’d done everything to help her daughter - taken her to doctors, counselors, preachers, hospitals. She’d even bribed her with every gift they could possibly buy her. Nothing worked. The child was certain she was fat, ugly and useless. She desired only two things - to be thin and beautiful, then to die that way. At the rate she was going the latter was almost a certainty.

I immediately called the Medical University of South Carolina (MUSC), a major hospital an hour from my home. I found the proper department and talked to a woman at length about Rebecca’s condition. She told me at that height and weight the hospital in Georgia had no business sending Rebecca home, insurance or not, the child’s life was in danger. Money and rights no longer mattered. She told me if my sister could bring Rebecca to South Carolina and stay here with her or appoint a legal guardian here that she would admit Rebecca into their hospital and they would care for her.

I was preparing to call my sister with the news when I was confronted by my husband who flatly refused to allow me to be part of this. He told me this was none of my business and it wasn’t my responsibility to save this child. I looked at him in disbelief and told him this was my sister’s only daughter, and if there was anything I could do to help save her then it was my responsibility. He told me he would not allow it - he would not have that child with her foolish games in his house! For the first time in my life, I stood up to my husband. Up till this moment he had been almost totally controlling of my life, and those of my children. We were caught in our own problems - an abusive environment - but suddenly that didn’t matter to me anymore. Only saving this child mattered, so I stood up to him and told him firmly:

“This IS my concern. This child IS my responsibility, and I WILL do all that I can to help this child. If you refuse to allow me to bring Rebecca into our home, then so be it. I’ll take our children, go live with Mrs. Feath, and bring Rebecca there to live with us, but I will NOT turn my back on this child!”

He backed down some at that point, knowing I was serious, and I would indeed move out if necessary to be able to try to help save the child. He tried one last attempt to stop me:

“What will you do if she dies while she is here? What will you do if she dies in your arms? What about our children, our life? If she dies in your arms you’ll feel so responsible you won’t be able to care for our children!”

He had a valid point - Rebecca could die while here, and it could be in my arms. The thought caused every muscle in my throat to constrict. I could hardly breathe, but I kept the tears choked back and stood firm. It would be hard if she died in my care, but I could not live with myself if she died in Georgia and I had not even tried to help. I turned away from him and went into the kitchen to call my sister. I did not tell her of my husband’s stand against me, or his firm insistence that I leave this matter alone. I did not mention him to her at all, but told her only of the words of hope from the hospital. They couldn’t move here - they were already so behind in bills from all the doctors and hospitals and they had three other children who also needed care. The boys were being torn apart emotionally. It was decided they would come the following weekend, bring the child to me, sign over legal guardianship of her for the summer and hope that somehow she would still be alive at the end of the summer.

The weekend came. I was horrified when I saw Rebecca as she walked up to my door. Her cheeks were sunken in. Her arms hung limply by her side. You could see every bone in her arms and hands. There was nothing to cover the bones but the smallest bit of muscle and skin. I could see the bones of her hips, ribs and shoulders from under the clothing she wore. Looking at her I was reminded of images I’d seen in high school of the holocaust - the many images of Jews in the concentration camps. My beautiful niece looked as though she’d just been pulled from one of those horrid places of death. I kept my thoughts quiet and hugged each of them, welcoming them to my home. My husband stayed in our bedroom. He wanted to turn them away, to tell them to leave. Fortunately they were so caught up in their own pain they did not notice the harsh attitude about him when he did happen to venture from our room.

He went to work the next morning and they went to church with Rebecca. They took her to visit her old friends hoping the reunion of friends would help ease the pain of leaving her here. Rebecca was smiling when they returned that afternoon, but only for a few moments. She tried to tell them she was happy now. It was ok. “Look momma and daddy, I’m smiling, I’m happy. I just needed to see my old friends is all. I’m fine now. Let’s go home!” It was only a game though, one of many. She was determined to get whatever she wanted, and all she really wanted now was to get thin and beautiful, then die that way. She went back to my daughter’s room to get her suitcase, sure they would believe her and take her back with them. We followed her back, and the goodbyes began. It was time for them to leave her.

Anorexia

I didn’t know much about anorexia, but I knew I had a child in my arms that was dying, and I knew she hadn’t eaten a morsel of food since arriving at my house the day before. She also had hardly moved other than to get up to go to the car or come in from the car. Otherwise she just sat limply in a chair, looking like a zombie. Seemed to me there were two things critical to her survival and I wasn’t going to wait till Monday morning as she was now under 65 pounds. I stood her up and walked her into the kitchen. Carol had told me they couldn’t even force her to eat now because if she ate anything she would vomit. Her stomach was so shrunken at this point it could hardly bear even the smallest bit of food. She must eat though. Small amounts every half-hour seemed reasonable. I sat her down at my table and explained to her what was to be.

“You’re in my house now Rebecca. I love you very much, and I’m not going to allow you to starve yourself any longer. You’re not going to die. You’re going to eat.”

“But Aunt Gail, if I eat, I’ll only vomit. You know it. Momma told you so!”

“You will eat Rebecca. What we’ll do is prepare only small amounts of simple foods. We’ll start with a potato today, just one tablespoon of mashed potato with butter and milk in it. We’ll eat just one tablespoon every half-hour till this potato is all gone.”

“You can’t make me eat and if you try I’ll just vomit it up and you know it!” She screamed defiantly.

I took a deep breath, then took her hands firmly in mine.

“Becky, I understand you’re upset. I understand you think you’re fat and you want to die. But I absolutely will not allow this. You WILL eat and your choices at this point are limited only to what I give you to choose. You can choose to eat this bite yourself or I will hold you down by force and put it into your mouth. Then if you spit it out or vomit it out I’ll scrape up all the food bits, spit, vomit and all, and I’ll simply put it back into your mouth and we’ll keep doing this till you have some amount of nourishment inside you so that you will not die.”

She looked at me, horrified, for a moment. Then, realizing that I was serious, she slowly put the spoon to her mouth and ate the small bite of mashed potato.

I took her into the living room at this point to rest and watch TV, but came back to her every half-hour with another bite of the potato. She wasn’t happy at all, but she knew the alternative was horrid and I would do it, so she dutifully ate each small morsel I brought her.

That evening, after getting the whole potato down her I figured it was time to try for part two of her needs - exercise. I told her it was a lovely evening and I always go for walks around the circle each evening and that she was going to come with me. She looked at me in total disbelief.

“Aunt Gail, it must be a mile around this street you live on and you know I can barely walk to the car! How do you expect me to walk all the way around the circle?”

“I don’t Rebecca, but you will try. You will walk as far as you can, then rest, then walk again until we come back home. If you can’t make it back home, I’ll carry you. You’ve eaten, now you must walk. It’s just like with the food, you have only the choices I give you and I do not give you a choice here.”

She didn’t like to lose all control. She put on her shoes and we set out. We reached the corner and she had to sit and rest. Then, when she got up again, she suddenly bolted. She was trying to run away from me. It only took me two large quick steps to catch her as she really didn’t have the energy to run away. I grabbed her there in the middle of the road and held her tight as she began screaming:

“She’s not my mother! She’s hurting me! Someone help me! HELP!”

Great, I thought..... as if I didn’t have enough to deal with! I just held her till she quieted. No one seemed to hear her screams so she finally quit. She didn’t have any more energy to fight. We made it to the next corner slowly. She suddenly fell onto her hands and knees on the road crying miserably.

“I’m dying Aunt Gail, and it’s all your fault! I didn’t have energy for this walk, and now I’m going to die here because of you! I need water and I don’t have any. I’m going to die because you didn’t bring water for me, because you made me do this. I’m going to die and it’s all your fault! I HATE you Aunt Gail!”

Well, I couldn’t have her die and it be my fault because I made her walk and she had no water. Oh, heaven forbid that happen! I took her by the hand without saying a word and lifted her up. She struggled to walk on her own so I put her down and kept hold of her hand as we crossed the street. I guided her up the steps and porch to a door there. I knocked and a woman answered. I held Rebecca firmly and calmly asked for help.

“Mam, please can you help us. I’m walking with this child who is very ill with anorexia. She says she will die here and now if she doesn’t have a drink of water immediately. Could you possibly be kind enough to provide her with a glass of water?”

I’m not sure who was more horrified - the woman at the site of the tall thin child - or the child at the thought that I would be so bold as to go to a perfect stranger and say such a thing! The woman looked at Rebecca with sad eyes and told her to rest for a moment. She fetched a glass of water and waited to see if there was anything else that was needed. I thanked her for her kindness and understanding. She touched Rebecca’s face and told her she would pray for her and hoped she would be better soon. We continued on our way without too much difficulty other than having to rest every couple of houses.

Upon getting home I phoned the police, informing them that I’d been accused of holding a child against her will and harming her. I asked would they please send an officer over to make a report. He arrived, much to Rebecca’s horror and embarrassment! I showed him the hospital files, the doctor’s reports, the legal guardianship papers and explained she had anorexia and was trying to starve herself to death. He turned to Rebecca, took her hands in his and told her that he was so sorry she was so ill. He thought she was beautiful even though she was so sickly just now. He hoped she would be well soon and that she was very lucky to have an Aunt who loved her so much. He turned to me and told me to call if there was anything he or anyone could do to help us. I thanked him and he left.

After that I didn’t have any more argument from Rebecca. I’d set down the rules and been firm and determined. Now she knew she had to eat when and what I said, she would exercise when and where I said, and that no one, not even the police, would save her from me! I also did not give her enough privacy for even a moment to regurgitate food or harm herself in any way. Until she was beyond these thoughts, I, or one of my children, would be at her side at every moment of the day and night!

Unexpected delays from the hospital

We called the hospital the next morning, but it was to be the next week before we could get an appointment. It never dawned on me I’d have to wait. Unfortunately the woman I’d talked to had been called out of town on an emergency. There was no one in the department that knew how to handle the situation. So there I was, stuck with a child that was only pounds and days from death’s door. What a predicament, and you can be sure my husband pointed it out to me and stuck it in my face every chance he had! He spent most of the following weeks alone in our room when he was home. He never missed a chance to be mean and harsh to me, but Rebecca was spared his behavior. He was kind enough not to harm her or be mean to her in any manner. I was grateful for that at least.

So here I am with a child so near death’s door and no one to help her but me. No matter, I’d gotten her to eat and walk. I’d just keep doing that every day till next Monday! If nothing else, at least I could keep her from getting any worse. I didn’t call Carol to tell her. We’d agreed that it would be best to have no contact for at least a week, to allow me to make decisions and focus on Rebecca. They would spend that time in prayer and try to focus on each other. Her whole family was in turmoil. The boys needed emotional help. That was her task for now, to be there for her sons and husband. Rebecca was now totally my responsibility.

It was a long week. If it hadn’t been for the support of my daughter most of all, and help from my sons, I don’t know how I would have made it. Everyday Rebecca ate, bite by bite. I managed to get her to eat a little more than a bite at a time and she ate every hour instead of every half-hour. We’d made progress.

I took her to the MUSC the following Monday and sat while the woman reviewed her files, then did a physical and counseling session with her. Her decision wasn’t what I had expected. She determined Rebecca had a better chance staying with me than by admitting her against her will into the hospital. She noted that after a steady decline in weight for the past year I had, in one week, not only stopped the decline but also put 2 pounds on her! She worried that at the current weight, if Rebecca were put into a forced program against her will she might revolt just enough to lose what little ground we’d gained. It was decided that instead she would do a voluntary program, like the one she’d tried in Atlanta. There was one difference - Aunt Gail would be with her every step of the way, and while it would be voluntary on her part, her choices would be limited and only allowed so long as she continued to recover. A specific chart of goals was made to help her not only achieve a weight of 120 pounds, but to also help her understand it was an appropriate weight for her age and height, and she would be lovely at that weight. We had a long way to go.

She was told very explicitly what would happen in the involuntary program, should she fail to achieve her goals. Rebecca cried, but finally agreed that some freedom and choices were better than none. It was done. I think she felt if she went back with me and pretended long enough momma would come save her, and it wouldn’t matter anymore. She tried. Every time she talked to her mother on the phone she’d beg for momma to come get her, to let her go home, she was fine now, Aunt Gail was horrible to her and hated her...... oh how she would go on till finally I’d have to forcefully take the phone from her. I’d calm my sister and assure her Rebecca was ok, and she must let her stay - to call the doctor before deciding to come for her. On several occasions Rebecca almost talked her mother into coming and saving her from horrible Aunt Gail. It was the doctor at MUSC that intervened, insisting Rebecca had to reach at least 105 pounds before she would agree to her leaving the state - otherwise she would take the child into protective custody and Rebecca would become a ward of the state of South Carolina. I think that’s the main thing that kept Rebecca stranded with me long enough to turn her around mentally - the fact that she couldn’t go home to Georgia.

End results

We went home and spent the next two months traveling back and forth to the hospital three times a week. She would be weighed, checked physically, and counseled on nutrition, health, diet, food, exercise, and emotions. On one occasion she hadn’t gained the required amount for that week and was so distraught thinking they would put her in the hospital. I assured her that it was evident to both me and the counselor that she had finally begun trying in earnest to get well, and that just one setback would be ok, but that we had to try harder.

Rebecca was still defiant and rebellious for weeks, and still thought she was fat, ugly and useless. She still wanted to die, but by being firm and making the path for her, she eventually started to come around. It took two months and more trips to the hospital for counseling sessions than I can even remember. Somehow, something worked. She slowly got up into the 90's and we celebrated! She wasn’t out of danger yet, but she was going the right direction. When my sister finally came to take her home she weighed just over 105 pounds. She was doing well enough the doctors felt she could continue the process at home now and they released her. It took several months before her weight stabilized and some of the physical problems created from the extreme low weight began clearing up. She did finally heal and was able to resume a normal life.

Five years later Rebecca’s story is much better. She graduates high school with honors May 24, 2002. She’s happy, intelligent and as beautiful on the outside as on the inside. It was a long journey for her to be ok, and her family had to go through counseling to be able to continue helping her and themselves, but they all made it.

I saw Rebecca again a year later at my grandfather's funeral. She came up to me, gave me the biggest, longest hug and said:

“I love you Aunt Gail. Thank you.”

And still later - another year - she came to visit, and was riding bikes with my sons. She had an accident resulting in a horrid gash to her knee. We took her quickly to the Emergency Room where the doctor looked at me and my sister and informed us that only one of us could stay with her while he stitched her leg up. She took her mother's hand, cried, and said, "Please momma, can Aunt Gail stay with me?" My sister held back her tears, kissed her daughter's face, then went to the waiting room.

And now.... more than 12 years later - my beautiful niece is married, and has 2 lovely children! I thank God every time I think of her, for how wonderful she is doing now.

But least you think she is well - be warned - once a person suffers so deeply from Anorexia, it never fully lets go. The councilor warned me that no matter how many years pass - that I should always know it could come back, and that I must be ready. It lurks in the deep recess of the brain - and should a particularly traumatic event occur, it can come back full force. That's what a lot of survivors miss - the fact that it's never really completely gone, just ok for now. I'll just have to leave her in God's hands, and pray that if I'm ever needed again, He'll be there to give me strength for her.