Rubatosis

Trigger warning: Eating Disorder, Death

The room itself is small but clean and beautiful. The fact that there’s two beds in it makes it noticeably more cramped, but there’s a homey coziness in the soft blankets and lace curtains. Ruby touches the plant hanging next to the window; the dry leaves crunch between her fingertips.

“Breakfast is at 8am. Lunch is at 1pm, dinner at 6pm. Your roommate is Zoey, she’ll be here later this afternoon. Curfew is 11pm.” The woman giving instructions is plump, her face lined with concern. Ruby can’t remember her name, but she remembers thinking, this is the kind of woman I might accidentally call Mom.

“There’s a lot of rules,” she ventures, wondering how far she can push Not-Mom.

“The rules are for your own good, dear. I know it’s hard to adjust to, but this is a step back towards normal life. Little by little, you’ll get there. We’ll get there together. Anyway, you and the three others on this floor share a bathroom. Groups are every afternoon at 4:30. You will discuss private treatment with your own doctors. Visiting hours are between lunch and group on Saturdays.” With that, she offers a sympathetic smile and bustles out of the room.

Ruby unpacks slowly, feeling her joints ache every time she stoops down to adjust her towels and t-shirts. They have to be perfectly lined up. When she’s finished, she tries to lift her now-empty suitcase onto the top of the dresser, but somehow, her arms fail her and she leaves it just sitting on the floor while she curls up on top of the bed. Just as the loneliness is beginning to set in, a new girl barrels in with Not-Mom. She’s short, with brittle hair in two sticklike braids, but she seems to have an excessive amount of energy for someone who’s ended up here. Ruby goes through the motions, politely introduces herself, and retreats back under the covers, but new girl Zoey is too intrigued to let her rest.

“Where are you from? I’m from Kinsella. It’s a super small town in Wyoming, which is super super far from here, but there’s really no treatment centers there. There’s just hospitals.But they’re not good ones, not really.” Ruby wills Zoey to shut up, but she doesn’t seem to take the hint.

“I’m from Boston. Not far from here.” Ruby finally gives in and sits up, wondering just how much effort she has to put into this conversation.

“Boston! That’s so cool. My cousin goes to Boston University. I always considered going too, but it’s all sort of been sidetracked now.”

“How old are you?” Ruby asks, mostly to avoid the topic of college. She doesn’t want to have to explain how she dropped out of Tufts.

“I just turned eighteen, two weeks ago,” Zoey beams. Ruby’s jaw drops open before she can stop it. She would’ve pinned the girl for fourteen, maximum. Eighteen? She studies the girl’s sunken eyes, dark circles, irregular teeth, shaky fingers. Luckily, before the conversation continues, Not-Mom calls from downstairs. Dinnertime.

Seven people sit around a wide wooden table, decorated with crocheted place settings. Roast beef, mashed potatoes, green beans, steamed corn. A veritable feast. It’s too bad none of them care. Not-Mom busies herself serving food, washing dishes, adjusting the windows, but Ruby notices the way she sneaks glances at them, sizing up how much they eat. Zoey studiously avoids the roast beef but eats almost a full serving of mashed potatoes and green beans, a feat that earns praise from Not-Mom. The boy with prominent cheekbones sitting across from Ruby attempts to flirt with her, but she’s too tired and stressed to reciprocate. She picks the corn off her plate, but only once Not-Mom gives her the reprimanding look does she touch the mashed potatoes.

After dinner, the doors to the bathrooms are locked. They all retire to their rooms, uncomfortable. Ruby repeats the epithets she’s learned in the hospital, but it doesn’t stop the feeling of being bloated and fat as she tosses and turns in her bed. It takes all her self control to not yak out the window.

“Wanna play a card game?” It’s Zoey again, who seems to have boundless energy and not a care in the world. Ruby just turns to her side and pretends to be asleep.

As the days go by, a somewhat peaceful routine develops. Ruby hates every mealtime, hates the burning guilt every time she tastes the cornbread or gravy, still prefers to stick to the salads, but she grows accustomed to the annoying, loving way Not-Mom feeds them with a vociferous, restless energy. The boy with the cheekbones flirts unsuccessfully on a daily basis; it’s less about her, and more about him not wanting to lose his skills when he leaves, back to the real world. As days go by, she minds Zoey less and less. Sometimes, they even play card games.

It takes a full week before Ruby’s family comes to visit.

“How do you feel? Have you been going on walks? I saw a lovely little swimming pool on the way here, when it gets a bit warmer maybe you could go swimming, get a bit stronger,” her mother says. They both know it’s a useless conversation. Ruby hasn’t worn a swimsuit in three years and she isn’t planning on changing that anytime soon.

“Your bed is so bouncy!” her brother shouts gleefully from across the room. She hates him, for the way he eats so freely, for the way he doesn’t seem to care that his shirt is stained and tight across his pudgy little stomach. And she hates herself, for the way she looks at a six year old boy and only sees his body, her own reflection in him.

“Do you know what rubatosis is?” Her stepfather is a literature professor and she can see it in the way he turns to his trade when he’s nervous. It’s not his fault, but she can’t blame him for blaming himself. “Rubatosis is the uncomfortable feeling of being aware of your own heartbeat. Reminds me of you. Ruby means loyalty, but rubatosis means self awareness. Isn’t that interesting? Something to think about.”

Ruby couldn’t care less about an obscure word like rubatosis, but she appreciates the effort he’s going into. She appreciates the way her mother brings her fresh raspberries from the farmer’s market, knowing that the only gift she’ll ever accept is fruit. She appreciates the way her little brother leaves a plastic plane with her, on purpose, so she doesn’t forget about him. As they leave, her mother hugging her thin body one last time, she wonders where Zoey’s family is. Cheekbone Boy’s three brothers, all bulky enough to fill up big lumberjack shirts, came with a box of coffee beans and gossip from home. The girl with shaggy brown hair from down the hall sat in her room and quietly played with her toddler, her ex-husband watching with a mixture of affection and devastation. Even Not-Mom’s daughter, endlessly talkative, came to visit for an hour. But Zoey’s family is noticeably missing; she sits on her bed, curled up in pajamas, watching stupid rom coms from 2004.

“They couldn’t make it today,” she explains to Ruby later that night, unprompted. “They wanted to visit, they really did, but my sister’s big recital was today, and it was just too far to drive to both places. They’ll visit next week.”

Rubatosis. Ruby lays in bed, in the darkness, and tries to concentrate on her heartbeat. But despite being a little fast, she really can’t say it’s an uncomfortable acknowledgement. It’s peaceful. It proves she’s alive.

Another week passes. Another visit Saturday. Ruby’s family shows up again, fresh raspberries in tow. Her brother exchanges the plastic plane for another one. Cheekbone Boy’s brothers show up again. They bring him a fishing rod. Ruby catches a glimpse of the other girl's toddler wandering down the hall. And once again, Zoey’s family is noticeably missing. This time, she doesn’t defend them, just stares determinedly at the old movies playing on repeat on her laptop. That night at dinner, Ruby eats a full meal for once, and she feels good about herself. But half an hour later, the guilt and the fear set in, and one glimpse in a picture frame sends her running to the bushes in the backyard, where she regurgitates the meal. Staring at the sorry mess she’s made under the hyacinths, she wonders if Not-Mom knows that her carefully, lovingly prepared food will end up being compost for her plants.

Back inside, she pretends all is well, and for a little bit, it is. Then Zoey comes trudging in. She takes one look at Ruby and knows.

“You can’t keep doing this. You’ve been doing so much better, Ruby. And your family is so proud of you.”

“I’m not doing anything.” Ruby has become a good liar over the years.

“Don’t bullshit me. I saw you with your family earlier today. You looked so happy. Why can’t you fight for them? Why do you destroy yourself?”

“You’re one to talk. We’re here for the same reason, remember?” Ruby is dismissive. What does an eighteen year old know about life?

“Ruby, I know you’re making progress. I see it. We all see it. I’ve seen the way you act in group. Why now? Why the backslide?”

“It’s not a backslide. It’s a… it’s a hiccup.”

“Why?”

It’s a good question, and it’s not one that Ruby can answer. How does she explain that she wants to be healthy, that she wants to be happy, that she wants to be a part of her family again, but there is this familiar pit in her stomach every time she eats. The pit is more comfortable than her family life, and that’s just it. It’s bad, it’s nasty, it’s ugly, but it’s home. More than her mother and stepfather and baby brother anyway.

“You don’t have to explain.” Zoey sits down next to her. “Just promise me. You’re not gonna trade your poison for another one.”

“How do you do it?” Ruby asks, looking her in the eyes. Zoey’s the only person who eats regularly, who has energy, who smiles at everyone every day.

“I have never wanted anything more in my life. I just want to be okay again. I want to be like how I used to be. I don’t want to wake up feeling like there’s this big weight on my shoulders that I can’t lift. I don’t want to wake up and feel bad before I even remember what I’m feeling bad about.”

The next day, Ruby eats a full meal and sits with Zoey in her bedroom, rocking back and forth and holding hands. It takes all of her self control (and a little bit of inspirational yelling from Zoey) but she doesn’t throw up. She waits until the food is all digested and then she and Zoey watch old reruns of cartoons from their childhoods and laugh at the stupid plotlines. It doesn’t feel perfect. It doesn’t feel right. But it feels better.

Saturday, when Ruby’s family comes to visit (and Zoey’s predictably, doesn’t) Ruby introduces her to them. Her younger brother wraps his chubby fingers around her bony wrist. Her mother offers her raspberries.

Slowly, Ruby’s therapist begins to assess that she might be better. “You’ve been making remarkable progress. It might be time to consider some sports to help you build up muscle in a healthy way again. There’s a swimming pool near here. Would you be willing to consider swimming?”

Ruby sits in her room, bathing suit covered up by three layers of various shirts and shorts and wraps. It’s too bad she promised herself she would never wear a bathing suit in public again. Not after the sophomore year pool party.

Zoey comes in and notices the bathing suit straps by accident. “Shouldn’t you be swimming?”

“Shouldn’t you?”

Zoey laughs. Throws back her head and laughs.

“I just can’t. I know it’s stupid, I know it’s just us, but I still can’t. There’s too much pressure. I hate beaches, I hate pools, so much.”

“Let’s go tonight.” Zoey’s eyes are gleaming. “Let’s go tonight, when it’s dark and there’s no one there.”

“That’s ridiculous. The pool is locked after 7pm.”

“You can climb fences, right?”

It’s a stupid idea, ridiculous, foolhardy, the kind of stuff that lands you in jail, but it’s also the kind of stuff that 2004 rom coms are made of, and so Ruby finds herself trailing Zoey, down the beaten dirt path to the pool, over the surprisingly short wire fence, and right up to the edge of the water.

“It’s dark. No one’s here except us,” Zoey coaxes, already stripping. Ruby is still hesitant, sweater wrapped tightly around her shoulders.

“Okay, how about this? You don’t want me to see you in a bathing suit, right? So take it off. Take it all off. Like it’s a hospital visit.”

Ruby gapes at Zoey as she pulls off her bathing suit and stands naked in front of her.

“Are you crazy?” she hisses.

“You’re supposed to look sexy in bathing suits. But naked? Nobody at a hospital cares what you look like. This is a purely clinical visit to the pool,” Zoey says, grinning. Ruby gasps as she turns around and plunges into the pool. The shoulder blades poking through her dark skin are remarkably sharp. But the experience is oddly inspiring as well. Ruby rips off her clothes, her bathing suit, and leaps into the shadowy chill of the pool, too quickly to change her mind. And it’s freeing. It’s dark, and it’s cold, and it’s beautifully freeing.

That night, they rush back home, hair dripping wet and laughing so hard their sides cramp. They’re in bed by curfew check, and Ruby curls into her comforter, feeling weirdly warm. She thinks about maybe going to the farmers market with Zoey. Maybe they could get raspberries.

When she wakes up, Zoey is still asleep, so she goes to take a shower. Brushing out her wet hair, she heads back to the bedroom, where Zoey is still asleep. Yesterday must have really tired her out, but it’s almost breakfast, so Ruby goes to shake her awake. And she shakes. And shakes.

Not-Mom comes upstairs, having noticed their absence, but when she opens the door, the scene that greets is heartbreaking. Zoey, motionless, her lips blue and her fingertips icy, Ruby shaking her like a rag doll and wailing. The next few hours are a blur of ambulances and paramedics and police officers. Ruby, sobbing and screaming and writhing, can’t answer any questions, but the coroner eventually determines that Zoey died of heart failure. “Nothing you could’ve done,” he says, sympathetic but businesslike. “She didn’t have enough body fat in her system. Her heart didn’t have enough energy to keep beating.”

Ruby stays in her room for the next few days. The old guest room is no longer cozy; it’s a foreign, dangerous reminder. She plays the last few weeks over and over again in her head. How could she have not noticed? The signs are so clear now. How her spine stuck out, a jarring lump against her skin. Her skin, how it was dry and cracked, her hair, how she shed it all over the room and quickly picked it up. The way she stopped complaining about cramps - she didn’t stop having cramps, she just stopped having a period. The joy, the smiles, the facade that hid the pain. The way she hid the tears in her eyes every Saturday. The way she mashed the food and slipped it into her pockets and up her sleeves under the table, the way her teeth always hurt - no wonder, from all the vomiting.

“You couldn’t have known,” Not-Mom says softly. “Besides, it’s not selfish to focus on your own recovery.”

Ruby lifts a tear stained face. “She focused on my recovery too. We both focused on my recovery, and no one was focusing on hers.”

It takes therapy and antidepressants and effort, but Ruby doesn’t backslide. She eats, she gains weight, she exercises. And she does it for Zoey. Because she doesn’t want Zoey to have to have died in vain. She doesn’t want Zoey to have given up her own recovery for a girl who couldn’t stick to a stupid plan. A new girl moves into what used to be Zoey’s bed, and Ruby tries to help her. And she goes out to eat with her family, and eventually, she leaves the house, hand in hand with Cheekbone Boy. Not-Mom gives her a last hug, and she empties her stuff, and the guest room that used to be her home base is now a guest room again, starched bedsheets and lace curtains. She comes back to visit only once, on a Saturday. The room is still empty; the new girls haven’t arrived yet. Not-Mom lets her sit on Zoey’s bed, and Ruby finally understands the concept of rubatosis. She feels her heartbeat, remarkably strong and angry and alive, a stark contrast to the icy silence of Zoey’s body that one awful morning. It’s beating inside her, the life-force and the energy, and she feels it swelling up inside her. It spills out in a flood of tears, for herself, for her childhood, for poor, beautiful Zoey, who never got to feel this way. Who only ever felt her broken, feeble heart. It’s uncomfortable, to feel her heartbeat this clearly, but it’s right, and it’s progress, and it’s good. And so Ruby stands up and walks away.