By: Patrick Mathiasen
Matt is sitting in his room in the hospital on our psychiatry unit, leaning back in his chair. He is tall and thin, so thin that it’s almost frightening to look at him, his ribs showing through his white T-shirt.
“Good morning, Mr. Kelsy.” I say. “How are you doing?”
Matt has curly brown hair that almost touches his shoulders, and a thick beard and mustache sprinkled with white and grey. I guess that he is about 50 years old. I reach out to shake hands with him, and his grip is damp and weak.
“Not good.” he answers.
Matt Kelsy begins to speak in a rapid, shrill voice with the words shooting out one after another.
“ It’s three o’clock in the morning and I remember going through the shelves in our refrigerator, eating everything that I can get my hands on. Everything! Grapes and apples and oranges, broccoli and bread and hummus, peas and carrots and left over chicken and steak. I crammed the food into my mouth and washed it down with orange juice and grape juice and milk. I eat and eat until I feel sick and I can’t eat anymore. And even as I finish the last piece of broccoli that I coat with peanut butter the guilt starts. It starts again.
I walked slowly out of the kitchen, trying not to make any noise. I don’t want my wife to hear me. I don’t want to wake her. And as I pass the counter I see the candy bars. Hershey’s milk chocolate. I quietly strip the wrappers off of the bars and stuff the chocolate into my mouth one piece after another. I bite down on it and the chocolate melts and slides over my tongue towards the back of my throat. Down it goes one piece and another and another.”
“And then I see the sweet rolls. My wife bought them for us last week, to eat for breakfast. I try to figure out if I can get away with eating one of them, but then my calculations drift off and I reach over and grab one of the rolls and it’s all over. I eat all six of them, one after another.”
“All of them?” I ask.
The question hovers between us.
“All of them.” he says. “Every last one. I eat all six of them, and now I really feel sick and the nausea washes up over me, coming up in my throat as I push the door to the bathroom open and flip on the light.
“This is my life. This is it! I lose weight, and then I binge on as much food as I can eat. I’ve been doing this for I don’t know how long?. I starve myself, and my weight drops off until I hit that magic number of 120 pounds.
That magic number. I am six feet two inches tall, and I weigh 120 pounds. When I hit that number I spend the next two days eating thousands and thousands of calories, searching for something that I can never reach. It’s never there! Never! Its like I reach out to touch a promise that I can’t quite put my hands on. I’m close. I can feel it, like touching a beautiful tailor made suit that I can’t afford. Then it’s gone and I start the cycle all over again.”
Matt leans further back in his chair, and he laces his hands together behind his head. He is wearing a hospital gown of thin cotton, and the material drapes over him onto his concave abdomen.
“When did all of this start, Mr. Kelsy?”
“When did it start?” he repeats. “When? I remember I wanted to get in shape. I must have been in my mid -forties – at least ten years ago. I thought about it and turned it over in my head and then I met with a personal trainer at the gym - Jacob. Jacob was great! He helped me set up a diet and an exercise program, and at first it was all wonderful – almost beyond words wonderful. I had been fat all of my life. That was my nickname in the second and third grades: “Matt the fat water rat.”
Matt went on.
“The kids taunted me. They threw it up in my face until it stuck to me like celluloid, like pieces of gooey dough. God I hated it, I hated it and I ate more and more to try to drown out the sound of their voices.
But it didn’t work. Nothing worked. The children kept making fun of me as I moved up through the grades into High School, on and on every day, Matt the Fat Water Rat. And then when I got to college people just began to look at me out of the corners of their eyes, watching me walk past them when they didn’t think that I was looking. They made jokes when they thought I couldn’t hear, pointing at me when they thought I couldn’t see them. I weighed 450 pounds. 450 fucking pounds.
He was waving his arms in front of him, now. Like he was trying to grab ahold of something.
“I wanted to lose weight. I wanted to lose it in the worst way. I began to diet and I watched the pounds drop away and the excitement built up. My clothes began to hang loosely. It was great. Great!”
Matt smiled broadly.
“I kept weighing myself – twice a week, then three times a week, then every day. Each time the scale dropped a few ounces, it was a rush. Each time it raised a little bit, my emotions crashed down and I felt desperate.
My personal trainer became a god to me. My exercise program grew until I was running several miles a day and doing pushups and sit-ups and jumping jacks and any other exercise I could fit into my day. My weight dropped and dropped, from 350 pounds to 300 to 250. Down it went. I kept at it and people around me noticed and began to ask me questions. ‘How did you do it?’ they asked. ‘What’s your secret?’
But there was no secret. No secret way to lose weight. It was all in the discipline. In cutting down on the calories. I kept losing weight, down to 180 and then 175 and 170 pounds, and with each tick of the scale I got more and more excited. I exercised every day, running five or six miles in the morning before work, doing my pushups and sit-ups on my breaks and always looking at myself in the mirror every chance that I had. I had to buy new clothes. My old ones swallowed me like a big canvass with no shape to it. It was unbelievable.”
I nodded, as I listened to Matt.
“My colleagues at work, the ones I hadn’t seen in a while, stopped me in the halls to stare and ask me if I was really who they thought I was.” He said. They asked me if I was sick? They stared and stared, and then they congratulated me. Most of them couldn’t believe that I had lost so much weight without surgery or anything. And the envy floated between us.
Even my wife couldn’t believe it. We had been together for over 15 years, and all of that time I had been overweight. Fat. Now she saw the pounds fall away, and she had to listen as I calculated the calories in everything – everything – that went into my mouth. I drove her crazy She began to resent my obsession with food, and eventually she began to resent me. You see, she was overweight as well, not fat like I had been, but she had her own struggles with food. And then to hear me talk about food all of the time, well, it was just too much. We began to argue, to fight about all kinds of things.”
I nodded again.
“I’m not sure when it happened, but at some point I passed over into a place where I could think of nothing but food.”, Matt said. “I counted my calories, keeping track of everything that I put in my mouth. I weighed myself over and over again. I kept exercising until there was no longer any flab on my body.”
“Then the compliments stopped,” he said. “People noticed my weight loss, but now they saw that it had gone beyond healthy and into a place where I looked as if I were sick. They no longer came up to me to tell me how good I looked. They stopped asking me how I had done it. There were strange looks in their eyes, and people were no longer impressed. They were worried about me.
My wife was worried about me, too. She wanted me to see a doctor. She thought I was sick. She thought maybe I had a cancer, or something awful.”
Now the smile dropped from Matt’s face.
“I wanted to return to the excitement that I had felt. But I couldn’t get there. It wasn’t there. It was gone. So I began to experiment, to try to get the rush and elation back. I would eat more than usual for a day or two, and then attempt to strip away the ounces by eating nothing for the next two days – weighing myself all of the time. I began to push harder and harder. I starved myself for a week at a time, and then I would begin stuffing myself with all kinds of food to gain the weight back.
I captured the highs again, but only with the food that I stuffed into myself. After months of denial, it was like opening up a secret vault deep inside of me – touching something open and raw. It was wonderful. And best of all, my weight stayed the same.”
“How did this bring you here, into the hospital?” I asked.
“Food became a drug.” Matt said. “I pulled into out of the way gas stations to buy candy bars, I slipped into the bakery to purchase pastries, I crept into the kitchen late at night and pulled open the refrigerator door to kneel before the food like an altar. I felt alive, alive, and then the game spun out of control.”
Matt stopped talking and stretched his arms out. For a few seconds it was quiet except for the sound of a heater rattling in the room. Then Matt picked up his story again.
“Yesterday morning at 5am I was running across the I-90 bridge, coming from Seattle, pushing myself to run faster and faster. I was trying to keep up a rate of 6 minutes per mile. The sun was just rising over the bridge, and fog hung close to the water in a kind of grey blue mass. I kept thinking about food, and the thoughts filled up my head and pushed everything else to the side. No one else was on the bridge, and only an occasional car passed me as I ran through the cold air.”
He paused for a moment.
“I don’t know when I stopped running, but I did.” Matt said. “My memory stopped for an instant, like a gap in a film, and the next thing I knew I was standing up against the railing on the side of the bridge – looking down into the water. Only I wasn’t thinking of the water, or the day, or anything else. All I could think about was a maple flavored scone sitting in a glass case at a Starbuck’s coffee shop.”
Matt’s eyes grew larger, and they shone brightly.
“The inside of my head filled up with the scone, and it spread out and out until it pushed against the inside of my skull and that’s all there was for me to see. A smooth rounded scone covered with a thick maple frosting. My favorite pastry. I looked over the railing and down into the water, but all I could see was the pastry in front of my eyes. I reached out towards it with both of my hands, stretching as far as I could over the railing, leaning out over the water until I stood on my tiptoes and then on only one foot shaking and trembling and imagining a piece of the maple scone dissolving on my tongue.”
Was Matt hallucinating? I wasn’t sure. The line that exists between the real and unreal, between imagination and hallucination, is hard to grasp sometimes. It’s like trying to close one’s hands around a piece of the fog.
“But I couldn’t quite reach it. I was so close, but I couldn’t get my hands on it.” Matt said.
“The next thing I remember, I was in the water. I don’t remember falling. All I remember was the cold, cold water. It was so cold I couldn’t breathe and I remember flapping my arms around and the thought stuck in my mind. I can’t swim. I can’t swim.”
“You didn’t jump?” I asked.
“No! No! No! I didn’t jump. Goddamn it, I didn’t!”
Matt looks sheepishly around the room, and then at me as tears appeared in his eyes.
“Just take your time, Matt. Take your time. Tell me what you remember.”
Matt takes a deep breath. He leans forward, and puts his hands on his knees.
“I don’t remember falling at all. And that’s weird, because it must be a least 30 or 40 feet from the railing on the bridge to the water.”
“Yeah. At least 30 feet. All I remember is being in the water, with pain running through my legs and arms and head. It’s so cold. I’ve never been so cold before. I really can’t swim, Doctor. And I know I’m gonna die.”
Matt pauses. His eyes cloud over, and he struggles to go on with the story.
“I reach out in all directions, trying to get my hands on anything to hold onto. But there’s nothing there – just the water. Then this dark green rises up to my mouth and over my head, and everything turns black and silent.”
“That sounds terrifying.” I say.
“It’s the last thing I remember. The last thing, and then I’m falling into a warm dark place and I see nothing and everything all at once and then the screen goes blank and I feel warm, like I’m covered with thick blankets.”
“Do you know what happened after that?” I ask.
“Not really. I remember hearing these voices above me, coming from a long way away. Then I see white leaning down over me, white coats swirling around.”
“You were in the hospital?” I ask.
“Yeah, I guess so. The Emergency Room. But I didn’t know where I was. I was looking up and I couldn’t breathe and somebody was pressing down on my chest and there were wires and tubes and needles sticking into me and then I was in an elevator staring up at the ceiling as the door closed.” “And now here you are.” I say. I want to say something insightful. Something profound. But my words sound flat and dull, like a stone sinking through water. Matt stares at me, and his eyes widen until they gleam.
Matt sat staring at me for what seemed a long time, that afternoon. He was silent, and I didn’t think that he would speak again. But just when I thought our session was over, he looked at me and smiled.
“I’m hungry,” he said. “I’m really hungry, Doctor!”
Matt started to laugh, and the sound of his laughter rang out into the air, out into the corners and spaces of the room, into the places where it is very hard to see one another.
Patrick Mathiasen is a writer and a Psychiatrist, living and working in Seattle, Washington.