An Apple a Day (26 page)

But I didn't understand any of that until I met Tom. I simply didn't believe I could recover. Anorexia was (and still is) the most powerful force in my life, but before Tom I didn't have a strong enough reason to take it on. So Tom, thank you:

        
•
  
For the hundreds of breakfast trays you've carried up to hotel rooms to spoil me, those elegantly sliced fruit platters and silver coffee pots (when I know you'd prefer to stuff down a bacon sandwich, skip your shower, and hit the road).

        
•
  
For presenting me with a set of proper Moleskine notebooks, like yours but in a range of rainbow colors. It made me feel like a bona fide journalist—and the very next day I got my first commission from
Harper's Bazaar
.

        
•
  
For not minding my spoon fetish: for accepting all the small silver spoons that have turned up in your kitchen drawer since we met, even though they don't go with the rest of your cutlery set.

        
•
  
For the way you astonish me by sometimes eating bacon and sausages at breakfast, chicken and/or turkey at lunch, and steak at dinner. That's a lot of animals in a single day . . .

        
•
  
For going around the corner to Sainsbury's to buy Slimline Tonic for me on rainy evenings when I've given up alcohol again (even though we both know you have an ulterior motive—to pick up another bottle of wine).

        
•
  
For sending me postcards from every town you visit—Slough and Coventry and the other dodgy trips I didn't come on (my mailman thinks I'm really weird)—and for doggedly writing those daily updates on the weather, the mad landlady, what you've had for dinner.

        
•
  
For that night in St. Moritz when you called the hotel's room service for mint tea and then had a mini-midlife crisis: “What am I doing? How did it come to this? I'm nearly forty years old, sipping mint tea in a bathrobe!” and we both nearly died laughing.

        
•
  
For putting aside
Stella, Style
, and
You
magazines plus all the review sections for me from your extensive Sunday newspaper delivery every week without fail.

        
•
  
For the study you've created for me across the hallway from yours—for clearing out your golf clubs and cricket
paraphernalia and transforming it into a writer's room (although the green baize card table from your parents wobbles when I write).

        
•
  
For the promise of our trip to Hell Bay, for the promise of a real writing desk, for the promise of a daybed . . . a girl's got to have something to look forward to, right?

        
•
  
For your sense of entitlement—those ludicrous statements such as: “This bedroom is the size of a cupboard, I shall need an upgrade; I went to see my parents and they only served me a chicken pie; I would have gotten into Oxford but the interviewer didn't like me . . .”

        
•
  
For getting your shirts professionally laundered and ironed at the dry cleaners around the corner. I tell you it's a waste of money but I'm secretly glad you'll never ask me to do it.

        
•
  
For all the plane rides together, for helping me survive the agonizing long-haul flights (or just drinking enough red wine to knock yourself out), and for those three days on the tarmac with “engine failure” in Chicago, Newfoundland, Boston, and finally London . . .

        
•
  
For always packing the soft tracksuit bottoms and candles and massage oil, for making me cozy wherever we go, for caring if I'm warm, for running around Aberystwyth trying to find decent hair conditioner.

        
•
  
For understanding my thing about hygiene and for (mostly) taking a shower every day when I'm with you, for accepting that I need multiple showers/baths daily, for washing your hands after you've come back from work on the tube and before you hug me, for understanding that I have to wash my hands frequently in public places.

        
•
  
Further, for changing into clean “flat jeans” so as not to transmit the dirt from the London Underground onto the sofa, bed, or chairs.

        
•
  
For pretending to be pleased with the electric toothbrush I gave you last Christmas out of concern for your dental health, for sometimes even using exfoliating face wash.

        
•
  
For running me a deep bath—at the right temperature and with the best, the only, Ren Moroccan Rose Otto bath oil, every time I'm close to losing it.

        
•
  
For putting up with my frizzy-hair days and not reacting when I laugh at yours—should two people with such terrible hair really be allowed to procreate?

        
•
  
For (just about) coping with my insane need for privacy and independence and my horror of being someone's property; obviously I'm awful at this business of relying on others, but I'm learning.

        
•
  
For the jewelry:

            
*
  
The diamond earrings from Antwerp (you'd barely dropped me off at the train station before you were having a run-in with the shop owner).

            
*
  
The amethyst-drop earrings from Windhoek, that fortnight when we broke up and you sobbed your way around Namibia in an open-topped jeep, sending tear-stained letters from the desert and incoherent emails while I sat at my office desk and tried to hold it together.

            
*
  
The Tiffany silver “bean” necklace (or is it a tear-drop?) that you gave me on our anniversary in Barbados in a real Tiffany box and turquoise bag with white ribbons.

            
*
  
Best of all, the green emeralds from Colombia, which flash in my ears like tiny rocks and which you negotiated in a back-room deal with shady local characters.

        
•
  
For coming to Leonard Cohen concerts with me all over the globe, and for loving his music almost as much as I do . . . we've only listened to
The Essential Leonard Cohen
what, 5,000 times?

        
•
  
For rescuing me from the bathroom in Krakow when I slipped and cracked open my chin, for calling the ambulance, for those hours in the waiting room while I sat in the emergency room, for gripping my hand really tight while the Polish doctor sewed me up
without an anesthetic
.

        
•
  
For not shouting at me for leaving oil and tire marks on your pristine hallway. It's impossible to carry a bike up those stairs without touching the walls, but I will repaint them, I promise.

        
•
  
For not minding that I woke you up last night (and most nights when I can't sleep), for holding me and telling me rubbish stories, for the plans we've hatched and the books we've devised and the journeys we've plotted in those sleepless hours from 2–5
AM
, for all the night talking; thank you, Tom.

Chapter 14

An Ovary Scan and a Moving Van

I
t's the first day of August, the day of the scan. I've waited months for this appointment and I'm hoping for good news. The last time I had this scan, nearly three years ago, there was no indication of any dominant follicles. In other words, the eggs were not maturing, so the ovaries weren't releasing eggs; hence no menstruation or conception. Although I haven't completely ruled out taking the fertility drug Clomiphene, I know that natural weight gain is the safest route to getting my periods back.

The scan—the “transabdominal and transvaginal ultrasound,” to give its full name—is the only certain way to see what's going on in the reproductive system. After my efforts at gaining weight, today feels like the moment of truth: I alternate between hope and pessimism. In optimistic moods I tell myself that of course I'm making progress: I've been eating healthy, nourishing food, and I've cut back on the exercise; it's all good. My body is resilient, it will respond and recover; everything will happen just as nature intended. I even allow myself to daydream a little, usually when cycling around town: what if I'm already fertile but just don't realize it; what if I've already conceived? I remember what the experts have told me—that it is possible to get pregnant without having periods. But for every positive thought there are many
more negatives. I'm like a stuck record sometimes, saying to my mum, to Tom, “But why is nothing happening?”

My worries are enough to fill an ocean and more. What if the extra pounds have no effect whatsoever—could anorexia have left me permanently damaged? It's the kind of story you see in
Heat
magazine all the time: “crash-dieting made me infertile”—unscientific, sensationalist, but alarming. What if my ovaries have gone to sleep forever? To be honest, I don't have a plan B at this stage; Tom and I have never discussed adoption or egg donation or surrogacy. It's way too early for that. Right now, all our hopes are focused on the scan.

I don't tell anyone, not even Tom, how tense I am about this. If I were religious I suppose I'd be on my knees, but instead I just worry and hope and then worry some more. Last week, in a panic, I emailed Dr. Robinson, and received this reassuringly scientific response.

Your body will work when it detects enough fat: that can be at a BMI of 19, 21, or even 23. Usually it happens around BMI 22. Regarding ultrasound scans, there are three stages. Stage 1: ovaries are small and little is visible within them. Stage 2: multi-follicular stage; ovaries are larger and full of roughly equal small-sized cysts, around 5 mm in diameter. Stage 3: the dominant follicle where one follicle grows much larger than the others, around 16–18 mm across, is often associated with ovulation if weight and nutrition are maintained. Fourteen days after ovulation a period occurs (unless you become pregnant). Therefore, the further you are along the stages, the more likely you are to ovulate
.

So far, so good; it all sounds perfectly logical. Except, as Dr. Robinson always reminds me, things are never that simple.

The closer you get to a healthy BMI, the more likely you are to ovulate . . . However, the relationship between weight and ovulation is not 100 percent—the body is never black and white. The scan might be reassuring, but it's just as likely to show that you need to put on some more weight
.

More weight? How can I put on more weight?

The last lines of his email tell me what I want to know—and what I've asked him so many times before—but each time, it keeps me going:

You can be reassured that in the majority of women with anorexia nervosa who have recovered, the system recovers and fertility is normal. One further point, the ultrasonographer might comment on the lining of your uterus, which is very thin in anorexia and gets thicker as you put on weight
. . .

It's miraculous and infuriating and rather magical, the way the human machine calibrates itself. All those invisible calculations and transactions between cells—too little body fat and hormone levels plummet, eggs don't ripen, the uterus thins. When you're starving the womb becomes an inhospitable place for a baby, with good reason. And yet everything else carries on—the heart pumps, the lungs breathe, and the brain stumbles along; so many complex systems interacting to keep the essential parts of the machine functioning, even when you're not bothering with food or care or rest.

If I ever get to the end of this drought I will never take a period for granted again.

* * *

So, the long-awaited scan. It's a Wednesday afternoon, one of those uncertain late summer days, when sudden sunshine gives way to thundery showers almost hour by hour, the lead-gray London skies broken up with weird shafts of sunlight. I meet Tom outside Belsize Park tube station and we walk up to the Royal Free Hospital. It feels strange to be back in the place where I came for my appointments in the Eating Disorders Unit. The hospital has recently had a million-dollar refurbishment so it looks different, but it still stirs vivid memories of the misery and coldness of those eight years. I don't say anything to Tom as we walk past the sign:
ADULT PSYCHIATRY, THIRD FLOOR
.

In the spotless new reception room (full of pregnant women) we hold hands and chat lightly about work, the weather, the weekend, but not about the scan. I don't really know what we're talking about because my stomach is knotted up with nerves. Only a few minutes after my allotted time, a sonographer appears at the front desk and calls my name. Tom squeezes my hand, and I go through to the imaging suite with her.