Yesterday, the big nutritional and societal issues that trouble me did not seem so far away. It was an unusual day as my afternoon was devoted to working with children as part of a new project I am involved in.
In the morning I saw a client who at age 42 weighs 371 pounds and requires a cane. She had recently come to me with uncontrolled diabetes and pending renal failure. Surprisingly, she had made some pretty profound changes in the time since I had last seen her and had greatly improved her blood sugar levels. When I asked her what explained the change, she said being spoken to about her kidney damage; and her love for her nine-year-old daughter made her face that big mighty river that flows through all of us.
I encounter many common themes in my work, and often the same ones coincidentally present themselves repeatedly in the course of a month, a week or even a day. One of my current recurrent themes, represented by that client, has been women in their early forties with way too much pain and far, far too many pounds and medications to bear. I always wonder, where did this story start, how did it get so extreme, how was it not prevented?
These questions often leave deep indentations as I press my fingertips into my forehead while bowing over my desk. On some days, the pressure is so deep I can almost feel my prefrontal cortex. But, yesterday, I knew I needed to ready myself for the children, so I yanked my hand down away from my head and put on my happy face. Little did I know the answers to my rhetorical questions lay in these young kids who awaited me.
First, was a beautiful, very precociously developed, thirteen-year-old girl who hates her body and by association herself. As I was speaking with her she picked up her cell phone, pushed a button and brought it to her ear almost as unconsciously as brushing a hair behind one’s ear. As I asked her to put the phone away, I fumbled looking to offer her a better connection with me. I asked her and her mom a few of the perfunctory questions but my words sounded hollow. Even at her age, I could tell there were already too many chapters to her story and too few cutesy nutritional clichés that could assuage her experience of being fat.
Next, was a six-year-old boy. He is a big boy at 100 lbs. He was accompanied by both of his very big parents who were eager to help their son as well as themselves. With the boy quickly picking his way through the things in my crowded office I needed a distraction fast. I passed the dad these fun picture cards I have where different scenes are creatively constructed out of fruits and vegetables–while asking the mom for some history.
Dad did successfully engage the boy while Mom described to me that he started on whole milk as a one month old infant because her WIC checks for formula were stolen. Since then he has always drank a lot of milk at will without limit–until very recently. How much milk did she say he drank a day? Why had she not gotten new WIC checks? Already, six years of details had passed me by due to my split attentions. What else was already missed in this young boy’s story and by how many people? Done looking at the cards, the child slid off his dad’s lap and came and stood right in front of me. He asked me the hardest question to answer simply–Is milk good for you?
And then, a lovely, smart and very insightful thirteen-year-old came and placed her presence before me. Within the passing of our first few shared sentences, she told me that she doesn’t eat breakfast or lunch at school because she does not want the other kids to make fun of her. At 271 pounds she has lost the right to eat in peace. A right so assumed we don’t even define it–has already been denied this child–and who knows what else has accompanied this loss. And dinner, she eats in her bedroom in front of the television.
Her mom, full of appropriate concern then joined us. She assumed responsibility for a household with much dysfunction in regard to structure and care associated with food and eating but she was more guilty of love than neglect. Still, her daughter now has abnormal glucose and insulin levels, has had to undergo an ultrasound for an ovarian cyst related to hormonal imbalance, suffers from depression and has already been on a number of medications for various issues.
Though the session was over, I apologized for having to go. I felt a shadow hanging over me–the connection between these children’s stories and those of the women who I described above. Is it already too late for these kids? Is their situation already too extreme? Was too much already missed and not prevented? And, is twenty the new forty?
But, I had to rush out to go pick up my own daughter. It was her birthday–my, seventeen came suddenly.
In health, Elyn
My Plate Haiku
Spread peanut butter
On whole grain, sweet, dark brown bread