What I Lost by Alexandra Ballard

Sixteen-year-old Elizabeth Barnes finds herself entering Wallingfield Psychiatric Facility for treatment of her anorexia. In the lobby Elizabeth meets Lexi a very thin girl from Long Island Massapequa who will be her roommate. Elizabeth and her parents meet Elizabeth's therapist,  Mary who  tells them that it is almost snack time. Mary explains that every day the girls meet in the dining room for breakfast, lunch and dinner and that there are three snacks each day. Sally the nutritionist will work with Elizabeth to set up a meal plan and at every meal a nurse will check to see that everything has been eaten. Every morning weights and vitals are taken but numbers are not revealed. Elizabeth is also scheduled to have a bone density test done. 

First snack is horrifying to Elizabeth because it consists of milk, one muffin and one apple. Willa tells her if she doesn't eat, Kay the mean monitor will force her to drink Ensure. Elizabeth is unable to eat most of her snack but Kay lets her off because it's her first day. Willa who has hidden all of her muffin under her shoe has to drink an Ensure.

Elizabeth's roommate Lexi who exercises at night, tells Elizabeth she has been in treatment before and has had both an nasogastric tube and a stomach tube. Elizabeth's first breakfast is a nightmare as she struggles to eat all the food on her plate. Not being used to so much food at once, she vomits up her breakfast and is made to drink Ensure. Lunch is even more difficult, because it includes salad with a dressing.

Group therapy for Elizabeth's cohort is run by Marci, a twenty-something counselor. This group includes Elizabeth, Lexi, Willa, Beth, Jean and Margot Camby who is someone Elizabeth once knew from ballet class when she was six years old. None of the girls are eager to participate but to spare Margot, Elizabeth mentions about hating the lanugo (fine hair) that is growing all over her body.

Lunch is even more difficult for Elizabeth; she manages to eat everything but the salad which she must eat with salad dressing that she describes as "unhealthy" and "disgusting". Kay insists that she will have to drink an Ensure but with the support of Willa and Lexi,  Elizabeth manages to eat the salad.

As Elizabeth goes through treatment, she discovers an inner strength she didn't know she had. That courage will be needed as she confronts her own problems, struggles to deal with her parents and must find her place at school where she faces bullies and the fallout from social media.

Discussion

What I Lost offers a poignant, candid treatment of anorexia that will help readers better empathize and understand this serious mental health illness.  Ballard knows her subject well and has captured many of the ritualistic behaviours and the thoughts experienced by those with an eating disorder. Through the experiences of both the main character, Elizabeth Barnes and several of the secondary characters, the author also demonstrates how difficult it can be to overcome anorexia. She also presents some of the consequences anorexia can have on the body, but also offers hope to those who are impacted by anorexia.

What I Lost begins with Elizabeth's admittance to a treatment facility and focuses on portraying her struggle towards recovery. When Elizabeth arrives at Wallingfield she is in a state of denial; she believes she doesn't belong there. But her frame of mind is quickly revealed when she catches a glance of herself in the mirror above the fireplace in the common room. "That girl made me sick. I hated catching glimpses of her. It didn't matter where --whether in a mirror, or a window reflection, or on my phone screen after a group selfie."

Her state of mind reveals that she is focused on being thin, especially when she sees Lexi. "Her purple hoodie and black leggings hung off her like clothes on a hanger, and her legs, folded beneath her, were so thin they made her feet look too big for her body. My cheeks burned. I felt inferior. She was so much skinnier than me." Elizabeth notes that although she has her dad's genes, she is now skinnier than her mom, something she is proud of.

However Elizabeth's illness quickly manifests itself at Wallingfield when she struggles to eat her first snack. Unlike some of the other girls there however, Elizabeth does force herself to eat. This is a hint that deep down, Elizabeth wants to get well. This is further demonstrated when Lexi explains how the treatment center works. "You can either refuse to do everything, and then eventually they'll kick you out...Or you can do what they tell you, get fat, and go home.." But Elizabeth wonders "What about girls who want to get well?", a thought she quickly suppresses.

After her first group therapy session Elizabeth realizes that she feels understood at Wallingfield but she also wants to go home and have a normal life. "These girls got me. And yet...a part of me wanted to cry. This wasn't normal. I wanted to be home, listening to Spotify with Katrina, studying for my SAT's, reading Hamlet, and training for states with my cross-country team."

In therapy Elizabeth begins to explore some of the factors that have led her to where she is now. Elizabeth believes that her mother wants her to be thin. At first she can't tell Mary this because she doesn't know how she will react. Elizabeth knows her mother has "expectations" or hopes. "Hopes for my appearance, anyway." Memory of a shopping trip to Macy's brings up what Elizabeth's mother's hopes are. "Our shopping trips usually led to horrible fights where I begged her to leave me alone and she told me that if I let her dress me, I'd look great. You just have to purchase the right clothes for your figure, she'd say. You don't have the right body for the juniors' department. But the juniors department was where all my friends shopped, and I wanted to shop there too. And sometimes the things she hated on me, I didn't think looked that bad. Until she pointed out the flaws -- my hips, my thighs, my chubby knees." 

When her parents become involved in both group and family therapy Elizabeth must deal with intense conflict as she begins to realize that her mother's view of food is not a healthy one. In family group therapy Elizabeth decides to be honest about what's happening. "No one would ever have guessed my mom was anything besides a naturally thin woman who'd won the genetic lottery unless they ate with her." During a family phone call that includes her therapist, Elizabeth realizes that her mother's behaviour during meals makes her feel "ashamed that I was such a pig" and "ashamed of my appetite". Her parents' inability to confront this leaves Elizabeth feeling vulnerable and disappointed. Eventually Elizabeth is forced to confront her parents over her mother's disordered eating during the facility's lunch with parents. " 'Mom! It is so hard to eat when you're acting like that. You're supposed to model normal behavior for me!' Before Wallingfield I'd watch Mom eat and feel guilty if I ate more than she did. Now, though, I saw her eating for what it was. Screwed up..." As Elizabeth gets further into her recovery she recognizes her mother's disordered eating and understands her denial because she experienced the same thing.

Seeing the other girls struggling with the effects of anorexia on their bodies has a lasting impact on Elizabeth. When Lexi reveals that her anorexia has damaged her heart possibly irreparably, she tells Elizabeth "Be scared for yourself. Really, really scared, because that's what's going to make you better." Elizabeth knows from her previous support group twenty percent of girls never recover from anorexia and she doesn't want to be one of those girls. Yet Elizabeth continues to struggle. When Sally meets with her to plan  her meals, Elizabeth has the unrealistic expectation that she can cure herself while limiting her food to 800 calories per day. At the same time Elizabeth knows she has to eat if she wants to recover - a conundrum for many people suffering from anorexia. Elizabeth knows the increased food intake is changing her body and she states, "I was mourning the body I was losing each day a little, too."

As is the case with many girls with anorexia, eating begins to heal the body and the brain, something Elizabeth soon begins to recognize. "I did have things to be happy about. I'd finished my lunch. In fact, I was proud to report that I'd finished every meal and snack in the past week. Because of that, I felt better both in my body and my brain. I wasn't psyched to be gaining weight, but my thoughts were clearer and they moved through my head faster." 

In the end several factors help Elizabeth to eat and begin to recover; she begins to confront the unhealthy approach to eating that her mother has and how that has affected her, she fears damaging her body as Lexi and Margot have done, and she realizes that she wants her life back and wants to be healthy. Ballard makes all of this seem realistic because Elizabeth still struggles with how she views her body. "I did want to stay how I was and eat pancakes. There were healthy size 0 girls. Why couldn't I be one?" The most important thing is that Elizabeth decides to get well for herself. "And right then I knew. If I went home and started to restrict my eating again, I would shrivel up like a dry plant. If I ever wanted to run again -- to live again-- I'd have to get better. And I'd have to do it for me."

And when she returns home, she almost immediately falls into her old pattern of lying and trying to get around eating. This too is a realistic portrayal. In the end, it is Elizabeth who owns her illness and decides she wants to recover. "Did I want to spend my life bouncing in and out of treatment centers, have bone scans and waiting for the bad one?...If I skipped lunch I'd find a way to skip dinner. Then breakfast, and lunch, and dinner again. It wasn't a slippery slope. It was a straight free fall, and I knew it." 

Ballard includes several subplots involving Elizabeth's friends which serve to provide context and setting later on in the novel when Elizabeth is released from treatment and must return to school. Elizabeth receives a series of mysterious packages which she believes comes from her ex-boyfriend. Ultimately, these packages help her to work through what happened between them, to heal from that experience and to recognize her own strength. There is also a second storyline involving her continued bullying by a classmate which Elizabeth faces with grace and courage. With her new found strength, Elizabeth with the help of friends and family, confronts these challenges and continues to move forward.

Overall What I Lost is a realistic portrayal of someone struggling with an eating disorder. While Elizabeth's recovery may seem somewhat fast-tracked, her timeline of actively restricting is relatively short. The longer disordered eating occurs, the more entrenched the behaviours become and the more difficult it is to remove them and the accompanying thoughts. Balland undertook considerable research for her book and this is evident throughout. The ending is positive and hopeful  - which is something people with an eating disorder need to know. Recovery is difficult and hard work but there is hope!

Book Details:

What I Lost by Alexandra Ballard
New York: Farrar Straus Giroux      2017
390 pp.

A Trick of The Light by Lois Metzger

"Anorexia takes a terrific person and turns him into a lying, moody, deceitful, self-centered manipulator."
                                                                                                              Darpana

Lois Metzger has written a novel that accurately and with great sensitivity, explores the world of anorexia and bulimia. A Trick of The Light specifically deals with a teenage boy who develops anorexia when his family experiences a crisis. Anorexia is a hidden disease among adolescent boys because it isn't as common among males and it also doesn't have the apparent physical repercussions that starvation has on the female body.

Mike Welles is a fifteen year old who lives in Belle Heights in Queens, New York. Mike's mom Regina (Gina) is a professional organizer and his father, Douglas, is a lawyer.

Mike and his best friend, Tamio Weissberg have just seen the 1933 version of King Kong at the neighbourhood theatre that shows only classics. Mike and Tamio met in sixth grade at Belle Heights Middle School and have been friends ever since. They share a love of stop animation or stop motion cinematography.

Shortly after this and before the beginning of grade ten, Mikes family begins to fall apart. His mom seems to spend most of her time sleeping and not going to work. When she does to to work, she seems disorganized and struggling. At the same time, Mike's father is never home, instead focusing on working out at the gym. Mike enjoys eating but one day notices that he has been gaining weight, particularly around his belly.  When he asks his father if he can accompany him to the gym his father refuses, much to Mike's disappointment.

While out on an errand for his mom, Mike encounters a classmate, Amber Alley, who is a loner and bit weird. Athough Mike has no interest in her, the voice in his head tells him to talk to her. Mike goes into the flea market where he spies himself in a mirror. He looks fat and wonders how he got that way - at least that's what the voice in his head tells him. He decides to buy the mirror even though it will cost him all the money he has in his wallet.

The first day of grade 10, Mike's homeroom teacher, Mr. Clayton introduces a new student, Valerie Braylock. Mike thinks she's beautiful and discovers that she is a ballet dancer. He tells Tamio that he is in love with Valerie.  When he asks Valerie out a few days later and she refuses, Mike thinks she doesn't want to go out with him because he's fat. Later on he sees Valerie in the hallway talking with Tamio leading Mike to believe that Tamio has gone behind his back and that he and Valerie are a couple. Mike's day only gets worse when he arrives home and his father announces that he is leaving the family for a younger woman whom he met at the gym. This leaves Mike completely unmoored  - "My dad's gone...my mom's a wreck."

The voice inside his head convinces him that his parents don't matter, that he can be fit, he can be strong, that he can control the chaos."Strong body, strong mind, strong enough to master the chaos." So Mike begins restricting his food intake; he skips breakfast and lunch. He meets up with Amber who seems to have a wealth of knowledge about food. Mike goes with Amber to the grocery store to learn about different foods. When he asks her where she gets her information from she tells him that it comes from her best friend "Anna". Mike quickly moves from not just restricting his calories but also begins to exercise, running, doing sit-ups and pushups. Since he's often left alone at home, he begins eating what he wants when he wants.

By October, Mike's mom notices that he has lost weight but he refuses to be drawn into a discussion about his weight. His mother begins making dinners again but Mike finds he simply cannot eat. Distraught that he has to eat dinner, he calls Amber who provides him with ways to lie to his mother about what he's eating. Mike's mom gradually starts to pull herself together- she begins doing the laundry and making meals again as well as seeing a therapist. But as she begins to heal, she notices that Mike is unwell, withdrawn, unhappy and that he's lost a significant amount of weight. She also recognizes that he is wearing lots of bulky clothing and seems to be complaining of the cold.

At this point several people attempt to intervene in Mike's life. One of them is his friend Tamio who has never stopped begin Mike's friend and who is genuinely concerned for him. He confronts Mike about how he looks, showing him a picture of a haggard, skinny man. But Mike gives Tamio the brush-off. His mother's concern leads her  to take him to her doctor but the doctor doesn't seem concerned. Even his physics teacher, Mr. Clayton expresses his concern to Mike.

The turning point comes when Amber is hospitalized for an irregular heartbeat and other problems. By this time Mike has lost so much weight that he is unable to concentrate, has little energy, is cold all the time and blacks out at home. His mother forces him into hospital to be treated.  He will not be released until he has regained 90 per cent of his body weight. To achieve this goal, Mike is not only treated physically but he also sees a therapist. It is the beginning of a long journey back to wellness.

Discussion

A Trick Of The Light explores the issue of anorexia in boys, something that teen novels rarely do. Author Lois Metzger excels at capturing the typical thought processes an anorexic experiences. Much of the cognitive distortion comes about as a result of starvation and that is why the first approach is to have the person eat. Food is the anorexic's medicine. As the person with anorexia begins to regain weight, the persistent thoughts about food and distorted views of themselves can be addressed.

A perfect example of the distorted thinking that Mike is experiencing is given when the tiny voice inside Mike states "I think parents generally do their children more harm than good, and Mike's parents are no exception. They don't seem to care about him." And it is this voice, the anorexia, that narrates the story until almost the very end of the novel when Mike begins to recover. Metzger is not the first author to utilize this approach for a novel on eating disorders, but she does an excellent job.

Like Mike, many teens with an eating disorder are high achievers, and they may also be perfectionists. The often think they are ugly, stupid and unworthy. Anorexia is a way to gain control in their lives, when things seem to have gotten out of hand. In Mike's situation, the family break-up along with his mother's distress were the triggers for his need for control. He was left to fend for himself emotionally and physically at a time when his home life was unraveling. Without the support he needed as a young teen, his attempt to bring some sort of order into his life, led to disordered eating.

In what seems to be a paradox, the best way to treat an anorexic is to completely control almost everything about their eating, deciding what they eat, to portion size, and how much they eat. They must be treated like toddlers until they are able to relearn how to eat properly. The therapist and her explanations about what the eating disorder had done to Mike were realistically portrayed in A Trick of the Light. She was able to show Mike how the eating disorder overtook his life so that the only thing that remained was the eating disorder. Very little was left of him so to regain his health he had to reclaim himself.

Author Lois Metzger includes an Author's Note at the back of the novel in which she describes reading an article about a boy with an eating disorder. She managed to talk to that boy and his doctor and family as well as other families of anorexics in order to better understand this deadly illness. It took Metzger ten years to write this novel. In the process she has incorporated a great amount of information into her novel that will definitely be of help to parents, siblings and friends of those who are suffering from anorexia. This information will help them understand the lengths an anorexic will go to hide their illness and perhaps ways to help them. The author also provides a short list of resources in her note. One resource that can be helpful is James Lock and Daniel Le Grange's Help Your Teenager Beat an Eating Disorder. 

A Trick of the Light exposes anorexia for the difficult and dangerous mental health issue that it truly is. 

Book Details:
A Trick Of The Light by Lois Metzger
New York: Baltzer and Bray    2013
196 pp.

The Opposite of Hallelujah by Anna Jarzab

Sixteen year old Caroline Mitchell, known as Caro is angry that her older sister, Hannah is coming home to live after an eight year absence. Hannah left home at the age of nineteen to enter the Sisters of Grace, a fictitious contemplative order located in Middleton, Indiana. Narrated by Caro, The Opposite of Hallelujah begins her story when she was nine and told classmates at her Catholic school that her older sister was dead, earning her the nickname "Caroliar". When Caro's parents confronted her over her lie, she tried to defend her actions. She has now rationalized her behaviour those many years ago by indicating that she was never given the words to know exactly what happened to Hannah.

Now in high school, Caro doesn't want her sister home and she doesn't want to go with her parents to meet Hannah at the train station. Caro hasn't seen her in four years, having refused to visit Hannah at the convent. Caro's parents haven't said much about why Hannah has left Sisters of Grace so Caro doesn't really know what has happened to cause her to leave.

But when Hannah arrives home it is obvious that something is terribly wrong with her. In Caro's words, Hannah "looked gaunt and drawn, tired and pale and fragile, like a porcelain doll that had been badly propped in its stand." Neither her parents nor Hannah will really open up about about what is going on. When Father Bob comes to the house for a visit, Caro is at first cynical towards him but after talking to him, she wishes her sister would talk to their priest.

Caro's personal life isn't going so well either. Her boyfriend Derek is also returning home at the end of the summer after being away for almost two months at camp. Caro wanted to meet him instead of going to pick up Hannah but that wasn't an option. So when he doesn't call or text her, she calls her friends Reb and Erin to ask them if she's going to get dumped by Derek. In an attempt to beat Derek to the punch, Caro shows up at his house to break up with him only to have him break up with her first.

But this frees Caro to forge a friendship with a much more interesting and caring boy named Pawel Sobczak, who speaks Polish and French. At first Caro isn't too open with Pawel about her family, carefully avoiding any mention of having an older sister and not inviting him over. But eventually she can't hide this fact forever, and Pawel guesses that she is not an only child. In order not to look mean and uncaring and so as not to have to explain her sister's difficult situation, Caro once again takes to lying. She tells Pawel that her older sister has just returned from working in the Peace Corps in Africa. This is a lie that will come back later on to haunt her.

Meanwhile at home, Hannah's fragile emotional condition continues to spiral downwards. She spends most of her time in her room and doesn't eat much. When Caro is asked by her mother to clean her bedroom closet (what mother doesn't ask her daughter to do this?) she discovers some of Hannah's old boxes in the garage. It is there that Caro unearths a hint of what may be troubling her sister.

Eventually, everything comes to a head in Caro's relationships with Pawel and Hannah. Caro's parents insist she invite Pawel over for dinner and it is at the family table that Caro's lie comes back to haunt her. When her family learns what she has done they are horrified. This time Caro cannot claim she doesn't have the words to understand. She must face up to why she keeps lying about her sister. Caro's explanations to Pawel ring hollow and destroy his trust in her. Caro is forced to finally talk to Hannah and apologize.

When Caro seeks out Father Bob for "confession" he helps her understand that her choice to lie has repercussions, some of which might be permanent. Caro is worried she is not a good person, but Father Bob tells her that this choice and that her past choices do not dictate her future. He also suggests that God's universe is a work in progress and suggests that Caro try creating something instead of always destroying things. Can Caro redeem herself and heal her relationship with Pawel? More importantly, can she discover what happened to Hannah and help her and her family heal?

After Caro confronts Hannah about what happened years ago, Hannah becomes seriously anorexic, requiring hospitalization and a feeding tube. Caro's conversations with Father Bob help her to understand how Hannah may have ended up so ill and how to help her.

Discussion

The Opposite of Hallelujah handles the unusual premise of a young woman returning home after leaving the convent with sensitivity and in a refreshing way. The positive portrayal of a Catholic priest has to be one of the outstanding features of The Opposite of Hallelujah. Father Bob of St. Robert's Parish (an unfortunate co-incidence of names) is a genuinely caring priest who through his conversations with Caro, intelligently discusses, some very heavy concepts including free will, discerning the will of God, the nature of the universe, the different types of religious life, and the complementarity between science and faith, the nature of forgiveness and suffering and guilt.

Their relationship is probably the most interesting in the novel. Caro is initially quite cynical and even a bit disrespectful towards Father Bob. He doesn't have any profound words of wisdom for her. But she finds herself seeking answers to tough questions from him and it is through intelligent discussion with Father Bob that Caro begins to understand her sister and many other things too.

Caro doesn't really understand what her sister's contemplative order was like and why her sister might have joined one. Through Father Bob, readers learn what a contemplative order is (the focus of the vocation is prayer) and how it differs from active orders which work in teaching and nursing for example. Father Bob doesn't have the answer as to why Hannah might have joined a contemplative order. He does offer some interesting ideas though, 'It appears that the contemplative life didn't' bring out Hannah's best self," Father Bob said. 'It didn't fulfill her in the way it should have if it was her true, lifelong vocation. That's nothing to be ashamed of.'

Father Bob eventually helps Caro to understand how Hannah, consumed with guilt, couldn't forgive herself and ultimately shut God out of her life. Father Bob tells Caro not to run away from what scares her and to face her mistakes because in the end they must be dealt with.

By creating an intelligent priest character and making him have a degree in astrophysics, Jarzab has created a character whose intelligence is never in doubt. He is both scientist and priest and he shows the complementarity of science and faith. Father Bob helps Caro grow from the self-absorbed girl who cares only about what she can get from others to someone who is trying to be better and to think about how others perceive her actions.

The overall character development in this novel is excellent. Even secondary characters such as Reb, Erin, Derek and Pawel are well drawn. Although he has a small part in the novel, Derek evokes strong emotions (for being a jerk) and the exchanges between Reb and Caro are realistic and filled with humour.

There are many other interesting topics readers may be introduced to in the novel including Rube Goldstein machines, the paintings of Escher, and single-bubble sonoluminescence. The Opposite of Hallelujah is one of the best books this year. It's long, at 449 pages but well worth the effort. Highly recommended for readers who enjoy novels that focus on relationships.

Book Details:
The Opposite of Hallelujah by Anna Jarzab
New York: Delacorte Press        2012
449 pp.