The Skeleton Cupboard (25 page)

“I worry about why she drinks.”

“What do you think is the reason for her drinking?”

“She's sad.”

“Do you have an idea about what she's sad about?”

Mollie put the soggy nibbled biscuit down with a sigh; her face was red and tight as she looked at me directly.

“She's sad because when I leave her, she'll have nothing.”

My heart sank. Unless I challenged Mollie's belief, I realized that she'd always feel responsible for her family. She didn't want that. Of course she didn't.

*   *   *

A few days later I was racing around the streets of a small village suburb in North London, filled with panic. Mollie was angry—and she was missing.

Our lunch in the small bistro a few roads away from the hospital had started well. Mollie looked pink and healthy, albeit distracted, after our short walk and had confidently ordered herself some food. Our goal was to practice eating in public, something Mollie had an intense phobia of.

She was brilliant: focused and brave. If she seemed anxious, I put it down to the newness of the situation and pretended not to notice, to encourage her. As we ate, she was just an ordinary young woman having lunch.

And then it all changed.

“Mummy told me you spoke to her on the phone.”

I nodded, my mouth full.

“Apparently you want a family meeting.”

I swallowed. “Yes, we haven't had one and I thought it would be helpful.”

“Why?”

I was aware that Mollie looked serious.

“Well, you are doing really well, and it would help to engage the whole family to think about how things will be when you go home and—”

“Mummy was upset. She told me that you wanted to discuss how the whole family is part of my illness. Why did you say that?”

I felt the familiar feeling of being pinned down by this bright young woman.

“I certainly didn't want to upset your mother, Mollie, definitely not leave her feeling that there was a need to apportion blame here.”

“Who said anything about blame?”

Already I felt on the back foot, defensive.

“Well, this isn't about blame but just some understanding of how you all function as a family and how you can support each other when you are back home.”

“Mummy said you used the word ‘role.' What were you talking about?”

I paused.

“Seriously, you've upset her. Why did you do that?”

I looked up at Mollie, who was getting red in the face, tears of anger pricking her eyes.

“The word ‘role' is not meant to imply blame, Mollie, and I am sorry for upsetting you and your mother. What I meant was for us to explore how the family may contribute to the difficulties that you have.”

Mollie threw down her fork. “Yeah, in other words, blame. Whose fault is it that Mollie is the anorexic?”

I wiped my mouth on my napkin. “Mollie, are you more upset that it sounds like I am looking to blame members of your family or that I have upset your mother?”

Mollie snorted in exasperation. “You know how Mummy is at the moment. You've seen her at her worst. She can't be upset any more than she already is.”

“It wasn't my intention to upset your mother, and I will make sure I help her see that. But given our recent conversation about your worries about your mother especially when you leave home, I think that your protectiveness of her and your anxiety about her need to be talked about within the family.”

“Well, I don't.”

“Well, why don't we spend a bit of time thinking about it together? Perhaps feeling you can't leave your mother is part of why you became so unwell.”

Mollie looked at me incredulously. “How?”

“Well…” I paused as I chose my words carefully. “Perhaps your leaving home as the youngest is something you worry your mother would find so painful that you are struggling with making that next step in your life.”

“But I'm getting better!”

“Mollie, why don't we pay and go back and talk about this somewhere less public?”

Mollie pushed her chair back from the table. “I don't want to talk about it, and I won't talk about it.”

With that she ran out of the café, leaving me to pay hastily and then rush out onto the street after her. But she was already gone.

*   *   *

Forty minutes had now elapsed and I hadn't seen Mollie. This could be an almighty disaster—her first outing on my watch and now she was wandering the streets on her own.

There was so much that couldn't be talked about. Should I have had that conversation with Eleanor on the telephone? Was my psychology shorthand, the jargon of the profession, too blunt and insensitive, implying blame? Why did I get into the detail of Mollie's anxiety about her mother in a bistro? Was it a mistimed intervention?

My heart was racing and I was contemplating returning to the ward without Mollie when I saw her sitting at a table outside a café opposite the hospital. Relief flooded through me as she waved me over.

Mollie sat with two cups of tea. She pushed one toward me.

“I'm sorry,” she said.

“Mollie, I was worried about you.”

Mollie looked down. “Yeah, I know. I'm sorry.”

“Look, no problem now. Are you OK?”

Mollie sipped at her tea. “Yeah. I just needed some space to sort out my head.” She looked intently at me. “I know what you mean about all this, and I think you are right.”

My tea was still warm enough to drink.

“What am I right about?”

“About Mummy, about me.”

I stirred my tea. “So how do you feel about finding a way to talk about it as a family?”

“Like I don't want to, but I know we should.”

“Why?”

Mollie paused in thought. “Because Mummy has to learn to live without me.”

*   *   *

I left a meeting with Chris at her university office in a daze—she was really pushing me on my dissertation and I needed some space to clear my head before traveling back to the ward. It was a warm late-spring day and so I jumped on a bus and rode across London until I got to Marble Arch, where I alighted and walked into Hyde Park.

I had finally arranged a family meeting with Mollie and I needed to focus.

Everything about her felt fragmented in my mind—strands of thoughts and ideas seemed disconnected and muddled. I just couldn't pin a coherent narrative around Mollie, her restrictive eating, her need for intense control and her relationship with her parents.

The sun was bright and the air clear and so I walked to the lake, bought myself a coffee and sat watching the families strolling past, excited children throwing bread to the ducks and geese, concerned parents keeping them away from the water's edge.

A small child in a red duffle coat was insistent on running toward the large birds and scaring them. He found it hilarious, but his increasingly frazzled mother did not. She began by coaxing him back to the table she shared with other mothers and their more compliant children with promises of biscuits and chocolate milk. But he wasn't having any of it.

I felt sorry for the mother because I could sense that she was becoming increasingly embarrassed as her friends tried hard to ignore the struggle she was having with her child. The little boy continued to run up and down the edge of the lake, flapping his arms wildly as the birds scattered in all directions. The mother jumped up and ran toward her son, then knelt behind him putting her arms around his waist and clearly whispering in his ear for him to calm down. But again the little boy was having none of it.

The geese returned to the water's edge and, getting agitated by the presence of this exuberant child in a bright red coat, started hissing. At this point the mother had clearly had enough and abruptly stood up, grabbed her son under her arm and walked back toward the table. The little boy descended into the most almighty tantrum, screaming, kicking his arms and legs wildly, and as much as the mother tried to reposition him in her arms so she could hold him more elegantly, it was clear that this little chap was not going to play ball.

The mother glanced up at me, clearly embarrassed that her son was attracting attention, and so to spare her blushes I quickly looked away and leaned forward to pull some papers out of my bag. I took a slug of coffee and started to sort through the papers until I came across the one written by the family therapist and my guiding clinical voice, John Byng-Hall. Holding the paper that I had read many times, I gazed across the lake as Mollie's narrative began to coalesce in my mind.

Mollie was the glue that held her parents' marriage together; she had already helped me to understand that. I thought back to the early days of my placement, when she was extremely underweight and unable to feed herself, and remembered how often her parents would both be there together with her in the hospital, holding her hands and talking, as a family should.

However, as she had become healthier and changed from that helpless baby whom we needed to feed to a more independent functioning young person able to feed herself, the animosity between her parents became more apparent—in particular, her mother's vulnerability became more acutely visible.

Mollie was right. She couldn't leave her mother, because if she did, what would her mother have? Eleanor's role had been to be the mother, a role she had fulfilled with commitment and care. For her, the loss of her youngest child, the child she had to inoculate her against the loneliness of her role in her marriage, was clearly more than she could bear. With alcohol, I realized, Eleanor was self-medicating pain that must have been overwhelming for her as she contemplated the loss of her final child from her life and faced a future where she was both unhappy in her marriage and unclear about who she was and what her place in life was now to be.

This all began to make more sense—clearly the anorexic Mollie who became unable to function, could not feed herself, was unable to do basic tasks because she was so weak and therefore had to be helped to walk, to self-care and to eat, was regressing backward into her mother's open, needy arms. By being so underweight that her periods had stopped, she ceased to be a reproductive woman.

Mollie had become the helpless baby again, the baby that her mother had so longed for more than seventeen years previously. In being so, she was fulfilling her designated family role by managing their well-being. Mollie was providing her mother with the baby that she was desperate to keep and enabling her parents to unite around her critical illness, which helped them to function as a couple, united as concerned parents.

As the sun shone steadily onto the surface of the lake, I began to see things more clearly. How could this young woman be freed from the bind of the role that she had been given? It clearly wasn't just a case of helping her learn to feed herself again and providing her with the tools to challenge her underlying belief that she would only ever be a failure if she gave in to her body's instinct to nourish itself. The family had to be helped to understand what Byng-Hall called their “script.”

However, it then struck me, with a sinking feeling, that Mollie would never be free of her anorexic self. If she was too thin to go to medical school, then she would never be a doctor. If she was too weak to look after herself, then she could remain at home and be cared for by her mother. If she remained dependent and attached to her mother, then she would also enable her parents to remain married despite the groaning chasm within their relationship. Although she was getting better now, as the situation between her parents continued to deteriorate, with her father mostly away and her mother drinking heavily, Mollie would have to stop eating again. She was totally and utterly trapped.

My heart lurched. I pushed the paper into my bag, gulped the dregs of my cold coffee and made ready to go back to the ward for a meeting with Eleanor and Mollie; Robert was, yet again, away on business. Christ. Why had it taken me so long to pull this all together?

*   *   *

The Northern Line was, as usual, slow, and so I got back to the hospital later than I intended. I looked at my watch—shit, I was literally minutes away from my session with Mollie and Eleanor.

As I walked into the ward, I began to feel unsettled. Mollie was not in her bed space, and the place was unusually quiet; it felt like a morgue.

“Where have you been?”

“Sorry, Linda, I got stuck on the bloody Northern Line.”

“Listen, we've got a situation and we're having an emergency ward meeting. You'd better come now.”

Although I was desperate for the toilet, Linda's face and voice made me follow her into the clinical room immediately. Everyone was present—I'd never seen the whole ward team in one place at the same time. The consultant stood at the front of the room, his face completely ashen. I sat down.

The consultant nodded in my direction and then began to speak.

“Thanks for all getting here. I've just had a call from Mr. Richardson, Mollie Richardson's father, to inform me that Mrs. Richardson, his wife, was killed this morning in a car accident.”

My heart stopped.

“Mr. Richardson was unable to give me any precise details, but it appears that no other vehicle was involved.”

My brain started spinning wildly—had Eleanor been drunk behind the wheel?

“Mr. Richardson is currently on business abroad and attempting to get an immediate flight back. One of Mollie's siblings is coming back from the US, and the other two are coming in as soon as they can. Understandably, this is a tragic time for the family.”

No one could speak. We were all stunned. Despite our combined years of training in a field where we often had to hear the most desperately sad stories told by those we treated, none of us seemed at all able to process this news.

The consultant turned to look at me.

“Mollie has not been told as yet, and Mr. Richardson specifically requested that you should be the one to tell her before her siblings arrive, and if you feel you can manage that. I think that given your relationship with her, that would be the most appropriate. Linda, perhaps you'll sit in too.”