Be.liev.a.rex.ic

FIFTEEN-year-old Jennifer is willing to admit that she needs help, but the Samuel Tuke Center is a far cry from the peaceful, supportive hospital she was expecting when she talked her parents into signing her up for inpatient treatment for bulimarexia, a disorder that combines the traits of bulimia and anorexia. Anorexia was her goal, but she claims to have lacked the self-control. Bulimarexia is a step above bulimia; in the deadly hierarchy of eating disorders, she observes, “Anorexia is flawlessness. Anorexics are iron-clad in their willpower, untainted by overeating, ever.”

Based loosely on the real-life experiences of author J.J. Johnson, who went into inpatient treatment for an eating disorder in the winter of 1988-1989, this young adult novel does not shy away from the unpleasantness of either eating disorders or the recovery process. The narrative is interspersed with lists of rules from the Samuel Tuke Center, which have been lifted wholesale from Johnson’s actual treatment plan. This includes such gems as supervised bathroom visits, strict descriptions of meal requirements (patients are allowed up to three “dislikes”, and there is a careful definition of what counts as garnishes or gristle and what does not, calories are counted, and there are no bathroom breaks during or after meals). The rest of the story has been largely pulled from Johnson’s own diary, which may account for the clarity and accuracy of voice; Jennifer sounds like a fifteen-year-old girl, albeit an intelligent and insightful one, and she displays all the foibles and blind spots that one might expect of a very sick teenager without ever becoming unlikeable.

“Will you get the monster out before you kill it, or will you murder it while it’s still in me?” she writes, about her impression of the admission interview. “Will I walk around, always, with a monster carcass rattling around inside?”

Johnson uses structural shifts in the narrative to create a sense of Jennifer’s dissociation from her body and self as well as her slow return to health. While the whole book is dated like a diary (covering the period from November of 1988 to January 1989), the early chapters are written in fractured, second-person prose, with a brief aside into the rose-tinted fantasy—clearly culled from a steady diet of after-school specials—of how Jennifer expected treatment to go. “After a few weeks Jennifer emerges from the hospital, walking between her parents’ arms, holding a bouquet of balloons leftover from her room. She is still skinny, but she will be okay. […] Fade to black, roll credits.”

The reality turns out to be very different.

The Samuel Tuke Center looks “like a shabby two-floor motel,” situated in a squalid part of downtown Syracuse and surrounded by a chain-link fence. The interior is smoke-stained and institutional, with row upon row of locking doors, and by the time Jennifer really starts to second-guess her decision, it’s too late; her admission interview has convinced both the director, Dr. Wexler, and her parents that she has a very serious problem indeed. On Monday, November 21, 1988, she is admitted for treatment.

What follows is a brutal, disorienting introduction to institutional life. The nurses are brisk, impersonal, bordering on hostile, her roommate is sullen and uncommunicative, and on her very first night one of the other patients has a screaming meltdown and has to be sedated. Her charge nurse, an unlikeable woman whom the patients call ‘Nurse Ratched’, accuses her of ‘tanking’—gorging on water to artificially inflate her weight for weigh-in—and later, more disturbingly, of hiding rolls of quarters inside her vagina. It is clearly not the haven she expected; in Jennifer’s fragile, overwhelmed state, it seems more like a house of horrors.

Slowly, though, she begins to find a place there. Her psychiatrist, Dr. Prakash, is both kind and insightful, and she manages a kind of uneasy camaraderie—even friendship—with the other girls inside. It is the slow shift of perspective as Jennifer begins to emerge from her disordered thinking patterns that is perhaps the best-executed part of this book; the narrative becomes intentionally smoother and more coherent as the story goes on. Jennifer’s black-and-white, perfectionist worldview begins to soften enough to admit flaws—her own, her parents’, even those of the staff in the facility. The imperfections feel very real: perfection is impossible, success is not inevitable, but there is always hope.

J.J. (Jennifer) Johnson is a former youth counselor and young adult novelist. She grew up in Norwich, NY, and graduated from Binghamton University in 1996. This is her third novel. To learn more, check out believarexic.com.