I tried to focus on the pink lamp, the one my grandmother gave me on my tenth birthday, before she had the stroke. The thing made me think of her, and when I thought of her, I could make it through what my mind said was impossible, like a 30-mile drive on icy roads in January or a breakup when it wasn’t ever me. If she were alive, she would plead with me to stop this and to please just eat something. Here, I made your favorite cookies, see? Your face is so thin, Sarah, please. Eat.

I didn’t know if I could get up this time. My heart was beating hard against my chest, and the blood leaving it pushed through my veins just as fierce, as if electrical shocks were surging up through my temples and down all the way past my toes. If the intensity picked up, I wouldn’t make it. Emma would find me on the floor, white and gray, still clutching my bed pillow, eyes open and looking out the window to the sky.

“Not today.” I had to talk to myself—to hear myself talk, although my ears hurt from the sounds pushing through them.

“Not today.”

I looked at the lamp and studied the sparkles on the ridges of the shade. I counted the cobwebs stretching across the middle, and I followed the stem, noting how it swirled down and widened out to a gemstone base. That lamp had followed me to every apartment and house I’d ever rented. Next to it, I looked at the photo of Emma and me on Sanibel Island, holding up sand dollars we had pulled from the edges of the sea. We didn’t talk much anymore, ever since she scolded me about my dieting. I looked out the bedroom window, to the budding maple tree, where a swollen-chest robin stepped up a branch and began to sing. It was spring, a time of renewal and coming alive and sunshine. I would hold on. If I could just hold on.

The day you start an eating disorder is one you never forget, because you know you’ve taken yourself beyond the point of rational thinking. Anyone who denies this is a damn liar. It’s kind of like cheating on someone and thinking you can secretly keep two relationships going without consequence. Eventually, you sink yourself so far into illusion, you’re lucky if you can swim out at all.

The psychiatrist—he asked of my family first. How was your childhood? Were you abused? Did anyone hit you? Next, there were questions of perception. How do you feel when you look at the woman on this magazine? Which part of your body do you hate the most? After that, he gave me a pamphlet. It said eating disorders have many triggers, and here are some of them: family dysfunction, OCD, perfectionism, genetics, low self-esteem, the media, peer pressure, hormone imbalance. End of page. And so there I sat, in a room with burnt sienna lounge chairs and shelves of books on human quackery, discussing my triggers. This was what it had come to.

I started with my upbringing, because I didn’t know what else to talk about. My parents divorced when I was 13 and dad ran off with a woman half his age. He got her pregnant, and I got a little brother out of it—Timmy. In the meantime, mom went all Zen and started doing these declutter, detox, decide exercises she got from a book called The 3 D’s of Divorcing. I remember the book because it would sit on the end table with a torn paper marker in it. On the cover was a slim, blond woman wearing a low-cut red dress, her boobs popping out from the neckline as if they were about to conquer the world. Trigger one. Trigger two was self-esteem, mostly from all the fat jokes back in school, which hurt me more than I’d ever admit. If there were more triggers, I would not reveal them to this man they called the “Family Therapist.”

He ordered me to get up. But couldn’t he see how very weak I was? Could he not see how the veins in my neck were barely pulsing, and how my arms hung limp at my sides? How was it that he did not notice?

“Sarah, come on. We’re supposed to at Leah’s by five.”

It was already quarter-to, and I’d been on the floor of my room for at least a half-hour. He had come over to pick up some of Emma’s clothes, while she was at Leah’s helping with dinner. Tonight was supposed to be one of our make-up-as-friends sessions, followed by a see-how-it-goes period. I hadn’t seen Emma in a month, since she’d been spending all of her time at the house of this irritating man who was trying to make me get up. His name was Allen.

“Not doing so hot in here.”

I struggled to finish the sentence without my lungs imploding on themselves. My breath was hollow, and sweat had broken across my forehead like beads on a glass of ice water. My legs were like blocks on the bedroom floor. Allen came in and stood above me, his face fading in and out as I looked upward. I focused on the black rims of his glasses.

“You’re kind of pale. What’s wrong, do you have the flu?”

I tried to tell him but I couldn’t form the words as my diaphragm pushed onto my shrunken stomach. I thought that he had to know; he had to realize by now that his girlfriend’s almost ex-roommate had stick legs with kneecaps that bulged out and away from the legs too far. He had to notice the protruding cheek bones and sunken eyes surrounded by black circles. But under the sweatshirt, he didn’t see the rib cage, or the knobs of the radius bones on each arm, or the matchsticks running down to the hands. He didn’t see the pokes of things that were once breasts. I had hidden all of it under sweat clothes. Anyway, it was spring; not warm enough for shorts.

“Help.”

“Ok, ok. Hang on. I’m going to get you some help.”

I heard a crack in his voice, as if panic had grabbed him by the throat and cinched his vocal chords. He called someone and said how I was passing out on the floor and that I was so thin. What he didn’t realize was how dark things were getting, and how the room was fading right in front of me.

“Can you get up?” Allen asked as he knelt down over me.

“No. Too weak.”

I barely got the words out of me, and what had been Allen’s face became a black tunnel. He was speaking to me, but I couldn’t see him. I was in the tunnel, spinning, spinning, and floating, like Alice through the rabbit hole, and everything went dark. There was nothing at the end of it.

Five bites. If I only took five bites, I would stay under 300 calories. And ten chews. Ten chews for each bite. When I was near others, I would eat five bites, stir my food around, and after that put my napkin over half the plate so they wouldn’t see what was left uneaten. I would be busy a lot. Can’t make it to dinner; I have to work. I ate already. I have a stomach ache. Anything to avoid suspicion.

The first three days were the toughest, when I cut my intake to 500 calories a day. I was so desperate that I could have eaten chewed-off bits of my fingernails. But I knew it would get easier, and within weeks, it did. I had dropped eight pounds. After a while, that horrible, gnawing hunger in the bowels of my stomach had reduced itself to a dull ache, which I tempered with hot water and lemon.

“You look really good.”

The words from the mailroom guy at work had satisfied me more than anything I’d ever eaten. I repeated the sentence in my head the entire week, and I wrote it on the inside of my journal so I could read the words each morning. You look really good. Yes, I do.

I lived in pursuit of those words—and for a while—I heard it almost weekly at the credit bureau, where I sat in a cubicle and analyzed data for eight hours a day. But then something changed. By the time I had dropped 25 pounds, the compliments ceased, and the worried remarks began.

“Are you feeling OK these days?”

“You’re pale, and you’re awfully thin.”

“I never see you eat.”

“If the wind picks up, you’re going to blow away.”

I had excuses. I had excuses for everything, in fact. Food had punished me a long while, and now I was punishing it.

“I’ve been getting migraines, and I’m going to the doctor for it.”

“I just got over the flu.”

“My schedule is crazy. I eat on the run.”

“The wind won’t budge me. I weigh more than you think.”

The difficult times were the holidays, and it was bad enough that those times meant the gathering of family members who never knew when to shut up and stop talking about who’d run for President or the new gay minister at the Evangelical Lutheran church, or why the pies were store-bought and not homemade or why is this whip cream from a can. Worse yet was all the food-pushing and the comments over why I wasn’t having any stuffing or mashed potatoes or pecan pie. But at least it was sweater weather. I could wear the biggest, fluffiest wool blend sweaters and layer them twice, which made me puffy in the end—puffy with bird legs. I could sit back on Aunt Celia’s thick, floral print couch, and sink myself into the thing, unnoticed. I could sit with my green tea and swirl it around in one of her antique china cups with the pink roses, the ones she only brought out on the holidays.

From the looks of it, I was inside an ambulance, because I was moving and there was a clear bag above me filled with fluid. I was rocking back and forth in rhythm with a tube running down to my arm. I could feel a needle inside of me, and the vein it had entered was throbbing like a toothache.

“Hey there. You’re awake. Can you tell me your name?”

It was a paramedic. When the black tunnel was gone, I could see his face. He had a strong jaw line, and blue eyes, like the ocean. His hair was brown, and he had a smile that made me blush.

“Uh, Sarah. Sarah Lawrence.”

“Good. That’s good. Stay with us, Sarah. We’re going to get you better here, so you’re not so dizzy.”

“Uh-huh.”

The black tunnel returned, and I felt myself slip. Then, my grandmother appeared inside the tunnel. I shouted at her so she’d see me, and when she looked at me, half of her face was drooping down like it was about to fall off. The stroke—it had taken the half of her. One of her arms flopped lifeless at her side while a leg did the same. She tried to say something to me, but I couldn’t understand the words. She reached her good arm outward, and at first, I thought she wanted me to take her hand, but she was waving it and shooing me away. She was shaking her head.

“Where am I?”

“You’re in an ambulance. We’re taking you to the hospital. Can you tell me your name?”

“Sarah.”

“Can you tell me your birthdate?”

“November 5, 1985.”

“Good.”

I looked up at the paramedic. He found a thin lump that was my hand, and he held it through the blankets. His hand was warm through the layers, and mine was cold, so cold that I knew my body was fighting to not shut down. I didn’t want what was next in all of this, to be lectured, to be force-fed high calorie drinks that went down like grit, to look at me in a photo—to see bones and skin with nothing left otherwise but eyes that were haunted.

They put me on the third floor of the hospital, in a room with a picture window that stretched the length of the wall. On the opposite wall across from my bed, there was a dry erase board listing my name and my vitals, and who my nurse was on whichever particular shift. Today, it was Judy. On the bottom was the word, “Goals,” with a colon, and after that, the word, “Strength.”

Past the window and across the street was a lake, and on it were a group of kayakers in green and red boats. I watched them glide across the lake as if they were sailing. I imagined myself there, too, turning my arms with the paddle and moving ahead as droplets of water sprayed my face and cooled me. I had become the vessel, the water, and the earth around it all, moving together. I was not in this bed.

“Good morning, I’m Judy. I’ll be with you through five today. How are you today?”

“I’m fine.” I gave her the answer you give everyone when you’re really not ok but you don’t want to get into the emotions part of it.

“I’m going to check your blood pressure and then you can try breakfast.”

I nodded my head as I considered the phrase, “try breakfast.” I sensed her hesitation over the words. She was the one who would take record of everything I put in my body. She would dump the liquid into a cup, hold it up, and take down the number at the measure line. She would write down that I ate half of this or a quarter of that, and she would add up the calories. She would get a negative look on her face, but she would spare the comments for a psychiatrist or a doctor on shift.

“Good morning—I’ve got your breakfast.” The girl from dietary carried in a tray with a meal under a plastic dome. Next to the meal was a cup of fruit and what appeared to be a protein shake, each of them shrouded with a white paper cap. She set the tray on my bedside table and walked out.

“Okay, let’s get your blood pressure,” Judy said. “Let’s get this around your arm.”

She wrapped the cuff around my bicep and the thing contracted and squeezed so hard I could feel it bite into the bone.

“One-ten over fifty,” she said. “That’s good.” I had guessed it was better than the reading just before the ambulance ride, when they thought I was going into cardiac arrest. I had become so weak that my organs had no energy to work. That’s what the doctor said last night to me once they put me in this room. If I didn’t get some nutrients in me, my heart was going to quit.

I looked past Judy, to the window, and watched a flock of geese in the air. They were moving like the kayakers, gliding along as if nothing could hinder them. I imagined myself not here, inside this room, with a heart monitor hooked to me and a needle stuck into my skeleton arm.

“They come back here every year,” Judy said. “Some people hate geese, but I think they’re fascinating to watch. Have you been to the Cascade Marsh?”

“No, I haven’t.”

“You should go after you leave the hospital. This is the best time of year to watch them, besides fall,” she said.

Judy pulled the curtain and closed the door part way. I stared at the tray in front of me. It had more calories sitting on it than all of what I had consumed the entire past week. I planned out how to make it look like I had taken in more than I really did: I could pour some of the liquid down the bathroom sink. I could shove something more solid under my gown. I could ball up some of it in a paper towel and stuff it in the closet. They couldn’t make me eat.

I took the dome off the plate. Under it was a mound of scrambled eggs, and two pieces of buttered toast cut into triangles. I counted up the calories in my head, and my throat got tight, like it was about to close up. What was I going to do? I couldn’t eat all this. I just couldn’t. But I had to try. I reached for the glass and removed the paper cap. I took a sip and felt the vanilla grit go down my throat and coat my stomach. I thought I’d better not take in all of it, or I’d gain weight. I could tell them the shake is making me sick. They couldn’t force me to eat all of this.

A half-hour later, the sun’s rays had cast across the lake, and the reflections were like silver beams dancing on the water. I wanted to watch the geese again and stop thinking about the food in front of me. Just as I pushed the tray away from me, a doctor walked in.

“Good morning, Sarah. I’m Dr. Stevens. I’ll be in most of this week. How are you feeling today?”

“I’m fine.”

“I’m going to level with you: you nearly died yesterday. Your blood pressure and heart rate were critically low, and right now, you absolutely have to get food into your body. If you can’t or won’t, we will look into an NG tube until you stabilize.”

“Ok.”

I knew this man was not going to put up with my agenda. His mouth was straight-like as he spoke, and it curved into a matter-of-fact frown at the end of each sentence. His eyes pierced me with scorn, and they narrowed when he looked over my medical chart. In the end, I would not fool this man.

“How long will I be in here?”

“If you cooperate, two weeks for sure. And then we’ll have you on a partial admission for another two. You need to get stronger. Your body is fighting to survive.”

It was early May, and I drove out of the city for the first time since my hospital stay, north on the highway to Exit 148. My house would be empty later, since Mom had gone back home after an extended visit, and Emma would be at Allen’s. I almost didn’t like the thought of it now—of being alone in that place—with everything silent other than the wall clock ticking its minutes into the darkness.

A couple miles off the exit was Cascade Marsh, the place Judy the nurse had told me about. I got out of the car and walked a half mile to a bench, where I could watch the geese land in the water.

I felt weak today, and by the time I reached the bench, I had to sit down. My legs were hurting, with the shrunken muscles on them throbbing like a new set of bruises. My spine was aching too, and I had to turn a certain way when I sat, so my vertebrae didn’t rub against the backboard. I was still so thin, so very thin, but I was changing. I ran my hands down my hips, and they were no longer hollow. I had gained 15 pounds, and there were parts of me expanding, like a tube getting air pumped back into it.

I heard steps around the bend of the trail, and there was Emma.

“You said were coming out here. I thought I might see what this place is all about.”

“It’s my new thinking spot.”

I wanted Emma to leave. After all, she had replaced our friendship with Allen, and she abandoned me when I was at the height of an eating disorder. What kind of friend does that? Who turns their back on a person they’ve known since they were ten and pretends nothing is wrong? I wouldn’t have done it to her.

“Remember when you got stung by that jellyfish in Florida and your leg swelled up like a balloon? I thought you were going to die. That scared me.”

“Yeah, my leg was pretty bad, wasn’t it?”

“I thought you were going to die a couple months ago, too. You know, I couldn’t do anything to change it. ”

“I know. I’m sorry.”

My therapist said part of my problem was blaming others, and how I would have to own my feelings in order to take responsibility for my behaviors. It wasn’t Emma’s fault that I was insecure and that I could not sustain relationships. I couldn’t blame her for the way I saw myself in the mirror. None of this was about her.

I felt hot pools of tears well up in my eyes. I just wanted to be normal, to look at myself and not have to think about how this part of me was fat, or that part of me sagged. I didn’t want to panic over every ounce of food I put in my body, or compare myself with women on the magazine covers or the girls at the college. It was all so very exhausting.

Emma put her arm around me and we sat still for a while, watching the geese. I put my head down in her lap and she ran her fingers through my hair, starting at my forehead and going downward to the nape of my neck. My grandmother did the same thing when I was young, when mom and dad would fight and dad would leave for days afterward.

A half-hour later, Emma said she had to leave, since she and Allen had planned to paint the living room in his house. She asked what color she should paint it.

“Yellow,” I said. Yellow, because that would feel like the sun. Yellow, because that was the color of sunflowers and bees, and fresh, new things. And yellow, because all I wanted was to be warm and to not fall into dark tunnels.

When Emma left, I lay on the bench and looked upward, into the blue. I put my fingers on my collarbone and ran them across, to the other side. I put them on my ribs and felt each bone as I went along. I touched a hip and felt the knob there. I folded my hands together and rested them across my belly. I could feel the pumping of my heart through my arteries. I didn’t want to get bigger. But I had to stop all of this. I had to change, somehow, or I knew I would die. Emma would find me in my room one day, clutching my pillow and looking out the window.

A flock of geese came in from the southeast and descended on the marsh. As I lay there on the bench, I heard a distant whirring. High above me, a jet plane crossed the sky, leaving a white streak behind it that would expand and then fade away like a lingering puff of pipe smoke. I put my hands over my eyes and widened my fingers. There was only light now, beaming across the marsh and through my fingers and all around me.Paula Danovsky’s short fiction has appeared in Pithead Chapel and Stonecoast Review. When she’s not making up stories, she writes commercial copy and news articles on a freelance basis. She lives in rural Wisconsin, in a house once owned by her grandfather. Her Twitter handle is @Paula_Danovsky.