When I was asked to write an “afterword” for this novel, I was hesitant and more than a little afraid.  I wrote the book eighteen years ago as fiction, and though everyone who knew me knew it was based on a part of my life, I didn't really want to announce it in print. But I made the quick and painful decision to say yes, hoping that in doing so I might help someone else get better. Because I did.

     It took many more years than it should have. It took an irrevocable and incalculable toll on my body and spirit. It didn’t have to happen that way. I could have and should have gotten better sooner, if I’d had the kind of help I needed. I’ve learned a great deal, and if I can shorten someone else’s suffering by saying these things, then it’s worth everything to me.

     Three weeks after I finished writing Second Star to the Right, in September of 1980, at the age of 23, I collapsed on the street and cracked my head open. I was unconscious for 45 minutes, and when I came to, I was being brought into Bellevue’s emergency room, covered with blood. I am 5’6” tall and weighed  88lbs. I’d had a severe concussion and needed seven stitches.  The cause of my fainting  was an electrolyte imbalance, the result of excessive vomiting, laxative abuse and starvation. I was terrified. I was contrite. I vowed never to abuse my body again.

      Within 24 hours I was back to starving, throwing up, and abusing laxatives. Thus began the worst decade of my life.

     I had a job as a writer for a major publishing house. I had my own apartment,  a fifth floor walk-up studio, in Manhattan.  I had friends. I derived satisfaction from my work. My first novel, Hey, Dollface, had been published in 1978 while I was still a college student, and  had been very well received. I was in traditional psychoanalysis four times a week with a highly recommended psychiatrist, an “expert” on eating disorders. It was expensive. My parents helped me financially. Yet my life became increasingly consumed by anorexia and bulimia. My days and nights revolved around not eating, or eating and vomiting secretly. The details are ugly, embarrassing, deeply upsetting. I will not list them. I don’t need to. It was hell. Anyone who has experienced it or watched a loved one go through it knows that.

     I hated having to set the clock back every autumn for Daylight Savings Time, because it meant  I had one more hour to live through and contend with. I cried when I received a tablecloth as a gift from a relative, because I couldn't imagine a life in which I would have use for one. I had to stop taking the subway to work because I was too weak to walk up and down all those stairs . I couldn’t go out for a simple meal or engage in any kind of normal social life. I was a slave to this illness.  I never visited my beloved grandfather in Florida—he begged me every winter to come—because I couldn’t stay in his house and conceal my symptoms, and I couldn’t stop, and I  felt horribly ashamed.  My grandfather died in 1989. 

      I tried and tried and tried to get my life under control. I had professional help. I had a loving and supportive family. I had caring and attentive friends. It didn’t matter. This illness is an addiction. It takes over. I was not in control. And as I had known when I wrote Second Star to the Right, time is no healer. Things didn’t get better. They got worse.

     I began developing stress fractures in my feet, which made walking very uncomfortable. I was diagnosed with osteoporosis. My teeth were an expensive, painful, endless mess, due to such frequent exposure to stomach acid. I was always tired. I always felt sick. I didn’t even remember what it was like to feel well.

     In early 1989, at the age of 32, I’d reached the end of the line. My physician was beside himself. He cared about me and didn’t know what to do and he was afraid. He made me afraid. I had been lucky, but luck runs out. My electrocardiogram was abnormal. My potassium level was 1.8 ( the normal range is 3.5-5.5.) My heart could have stopped at any moment, without warning. My physician told me in no uncertain terms that  even if I were hospitalized, nothing could be done to save me.  I was in serious danger of sudden death, and probably wouldn’t make it through another month without a drastic change in my behavior.

     I was desperate. With nothing left to lose (literally), I informed my psychoanalyst that I was interviewing other people. This was very difficult for me to do, and I felt  vulnerable and unsure. But it was agonizingly clear to me that the brand of “help” he had been offering with great confidence for nearly ten years was not working, and my body had run out of time. Insight is of no use to a corpse.

     On the third try, I found  the person who helped me change my life.

      Her first piece of advice was practical: she suggested that I attend Twelve Step meetings (in my case, Alcoholics Anonymous, which may sound odd at first but really isn’t. Anorexia is, after all, an addiction.) She believed that the group support I would receive as an adjunct to therapy would be of help to me. She was right. I went to a  meeting every day . I became less and less isolated. I met people who understood what addiction is, and how to fight it. I found people whom I could call at 3:A.M. if I was frantically fighting the urge to vomit and needed help immediately. And I was finally in treatment with a psychiatrist who actually helped me change my behavior and gave me the emotional support I needed.

     Eight months later, my psychiatrist gave me a prescription for an anti-depressant medication which she thought might help me . Within four weeks, the remnants of bulimia, which I had not been able to fully control on my own no matter how hard I tried, vanished. After ten years with an analyst who told me I  failed because I wasn’t trying hard enough, this was absolutely astounding. A life-threatening symptom which I couldn’t imagine being free of for even one day was gone.

     I was fortunate; I had  a psychiatrist willing to try anything to help me help myself. Not everyone responds to medication. I was lucky; I did. It isn’t an “answer”. It helped me in a very specific way with one particular symptom, and it is only one of many options and tools toward finding the help you need.

     I  always wanted to get well. But that was not enough. During the years I spent in psychoanalysis I lost things which can never be replaced. Bone mass, dental health, but above all, time—time during which I could have been helped. It was not a lack of will or a character flaw which made it so difficult for me to alter my behavior. Anorexia, with all its various symptoms, is not something to be ashamed of. It’s not something to be proud of. It isn’t anybody’s  “fault”. It’s an illness—a life-threatening illness—and it’s treatable.

     Finding help is possible. It requires  enormous effort, persistence, and hard, unpleasant work. A sense of humor helps immensely. It is never easy. But it is worth it.

     During the past nine years I have built a life beyond anything I could ever have imagined. I have a wonderful, funny, supportive husband. I live in an apartment I love. With multiple rooms! It even has a beautiful view, though the dark alleyway I saw from our last apartment was just as thrilling to me because I was alive to see it. I’ve continued to write and publish dozens of books for children. I survived being pregnant—which I never thought I could do, physically or emotionally—and in 1996 gave birth to a healthy baby girl, the light of my life. She sings and dances. She is stubborn and funny and smart. She has tantrums. She laughs. She makes us laugh. She’s happy. Both of my parents are alive and well and able to enjoy their granddaughter. I have friends whom I love who love me back. For all of these things I am grateful every single day.

    It doesn’t all go away. The problems. The struggle against anorexia. It’s much, much better, but there is room for improvement. That’s O.K. I have a full, interesting, and frequently wonderful life. Even if I have to struggle forever, I’m in the black.

     I have many people to whom I will be eternally grateful. I thank my family and friends for putting up with me, for always believing in me no matter how bad things looked. I thank my physician, whose stubborn refusal to give up on me pulled me through a very dark time. I thank all the people I met through A.A., who gave me hope and courage when I needed it most. I thank  my psychiatrist’s colleague who specializes in cognitive behavior therapy  for his humor, his help, and his caring. Most of all I thank my psychiatrist, whose imagination, skill, wisdom, pragmatic guidance and loving support helped make my life worth living. She has given me something that can not be weighed, measured, or priced. She has given me my afterword.