I tried to divert attention away from my body with large flowers pinned in my hair and baby-doll dresses. More than one person asked when the baby was due. Humiliation suffused me. My bookings were getting further apart, and I wondered if my looks had anything to do with it. My size had begun to rule my life and now threatened my livelihood. In this society weight is the elephant in the room, the great bulk that tips the scale, thus you plunge to the bottom while the lightweights float to the top. If it was true that my metabolism had been altered when my mother fed me to the wolves in the foster forest, how could I dial it back?
“We’d like you to consider being an ambassador for our international women’s empowerment campaign,” said a woman who identified herself as a public relations executive for Levi’s. “I read your book,” she continued in a chirpy voice. “It’s so compelling . . . and inspiring. We’re selecting young women who are leaders in nonprofit, fashion, and youth advocacy. Obviously you would represent the latter group.”
A few weeks later I was in Chicago, meeting with the firm and the other ambassadors—all of whom were slender to skinny women. Worse, we had to be fitted for jeans, which we would wear when representing the company. While I squeezed my now 240 pounds of blubber into one of only two pairs of jeans in the entire store that I could zip up, the other ladies fussed about which of the many styles accentuated their perky butts or nonexistent hips.
The executives tried to make me feel better, saying that Levi’s is for everyone’s shape. Still, I was mortified. I attended the TEDWomen Conference, where I felt like a whale next to my tiny and trendy teammates—most conspicuously on camera and during interviews. One of my responsibilities was to produce a short weekly video update for viewers and fans. Now, to my horror, cyberspace is filled with video evidence of me at my chunkiest. I just hoped that people would see beyond my size and listen to my social action message. Still, I was miserable.
On the way back from the conference, I caught a magazine headline: IS YOUR WEIGHT OVER? juxtaposed with a luscious fudge cake. I hated the way the media messed with women’s psyches by stimulating their yearning for a high-calorie fix while simultaneously dangling a remedy for the consequences. This time I was far more interested in a permanent solution than a sugar hit. I bought the magazine to read the article on the plane. After years of trying every diet, the writer had had LAP-BAND surgery and lost a hundred pounds, and even her diabetes was reversed.
I had heard about gastric bypass surgery, which is a permanent choice. It reduces stomach size to a tiny pouch, which makes it uncomfortable to overeat, and then reattaches that pouch to an area where food isn’t absorbed as easily. Since Erick and I were planning to have children, I worried that this might not be a safe option for a pregnancy; and I had also heard about the many people who overeat and stretch their pouch back out, leaving them right back where they started. The band, I read, is a different procedure. It cinches the stomach like a belt, creating a small pouch limiting the flow of food from the smaller section of the stomach above the band to the larger section below. One can have the band loosened or tightened in a quick in-office procedure, and the surgery is completely reversible. Driving home from the airport, I saw a billboard with before-and-after shots of an overweight, then slender woman. Again the words LAP-BAND jumped out at me. In the next weeks I caught references to LAP-BAND in a doctor’s office, in a full-page newspaper ad, and on television talk shows.
I handed my new husband, Erick, a brochure. “What do you think of this?”
“It seems a little drastic. You don’t want to have a risky surgery.”
“If I lose a hundred pounds, my risk of death goes down fifty percent.”
Erick’s face scrunched into a doubtful expression. “Death from what?”
“All the complications from being obese.”
“I think you need to get a lot more information.”
I started researching the surgery and joined an online support group. The more I heard, the more I thought that this could be a good solution for me. I believed that my cortisol levels were driving my hunger. When I had been deprived of food as a child, I became panicky, and that sensation had never left my body. With this surgery, overeating wouldn’t be an option, and it would be physically impossible for me to ingest as much as I craved. The cost, though, was prohibitive, and my insurance did not cover it. I had to set the idea aside.
Only a few weeks later, an ad in the newspaper caught my eye. “Hey, look at this!” I called to Erick. “It’s a contest for free LAP-BAND surgery.”
“What would you have to do?”
I chuckled. “Write an essay!”
There was a bit more to it. I had to attend an information seminar and then medically qualify with a certain BMI and have various comorbidities. My BMI was almost forty, with high blood pressure, shortness of breath, and swollen feet and ankles. The meeting room was filled with men and women who weighed much more than me. As they talked, I realized that—like them—I also had started limiting my social life, steered clear of mirrors and cameras, and avoided my family, because I either expected their criticism or saw it in their expressions.
Dr. Tiffany Jessee, the bariatric surgeon sponsoring the contest, asked the group, “How much can you eat at one sitting?”
“Five burgers and a half of a pie,” said a woman in a pink caftan.
“I usually eat the whole pie,” a man who straddled two seats added.
To myself I admitted that I could down two burgers, two foot-long sandwiches, or three packs of ramen noodles.
“This is all about taking control,” the doctor said, and went on to describe that they would select six winning essays—three by men and three by women. The finalists would be featured online, and then two winners would be chosen through social media votes.
As I’d hoped, my essay won me a spot as a finalist. I asked Gay if she would come when I was photographed for the web page and had a medical checkup. We had to watch a video about the procedure. I saw her flinch as the video spelled out the complications. “Mortality rate . . . one in two thousand . . . band slipping or eroding into the stomach . . . mechanical malfunction . . . infection, bleeding, pain.”
When the video ended, Gay said, “There are some scary complications, and you’ll have to change your eating style forever.”
“I’ll do what I have to do.”
The nurse answered Gay’s barrage of questions about traveling, problems while in another city, and having a baby.
“We loosen the band during pregnancy,” the nurse said to that question, “and tighten it afterward.”
In the elevator, I turned to Gay. “Doesn’t it sound like the right solution for me?”
Gay waited a long beat. Her penetrating stare put me on edge. “I wouldn’t do it.”
I gasped. I felt like I was falling off the cliff I had spent weeks climbing. “You are always hassling me about my weight, and now that I am willing to do something, you reject it. This option isn’t even remotely as dangerous or complicated as other types of surgeries.”
“Ash,” Gay said gently, “I didn’t say you shouldn’t do it, I just said that I wouldn’t. All those side effects—well, I couldn’t tolerate them. It’s your decision, because you are the one who will have to live with the result.”
I stopped short in the parking lot just as a car was coming too fast toward us. Gay pulled me back. “So it’s okay if I have the surgery?” I asked.
“First, you don’t need my permission or my approval, and I don’t want to give either, because I don’t want to take the responsibility if this doesn’t work. But Ash, I will support you completely and help you in any way I can.”
“Will you ask people to vote for me online?”
“Of course I will.”
I did not win the contest.
“You can’t win everything,” Erick said.
“Some of our friends refused to vote for me,” I fumed. One of Erick’s former band members said that if I just had more wi
llpower, I could lose the weight without expensive surgery.
“He probably voted for you anyway.” Erick always believed the best of everybody, while I was more cynical.
“Maybe we can figure out a way to pay for it in a few years.”
“Don’t worry, I love you just the way you are.”
Just after our first wedding anniversary, Dr. Jessee called. “I think there is a way I can do your surgery,” she said. She explained that she was using a new operative procedure, and it was going to be filmed for educational purposes. “I need a patient who won’t mind being on camera.”
I would be responsible for some of the hospital expenses but not her fee, the band itself, or the aftercare. The amount was now manageable, and so I agreed.
On the day of the surgery, one of the nurses prepping me said, “You are so smart to do this when you’re twenty-five, instead of waiting until you get debilitated by your weight.”
I smiled at the slender woman, who looked stylish even in her scrubs. “What do you think of Dr. Jessee?”
“Don’t worry, hon, she’s the best.” The nurse winked. “She did mine!”
My recovery was remarkably smooth, and I had far less pain than I had expected. Three weeks after the surgery Erick went with me to a conference in Nevada. “Are you up for a hike?” he asked, and was surprised that I agreed. Physically I was healing quickly—what took longer was adapting to a whole new approach toward food. Eating too much too quickly could cause me to vomit or experience a lump or pain in my chest. This would have been unpleasant in itself, but excessive vomiting can also cause the band to slip, requiring a surgical repair. This further inspired me to chew food more carefully and eat slowly so my meals could settle. It takes about twenty minutes from the time you start eating for the brain to signal your body that you are full. Just being forced to slow down resulted in my consuming less.
I also learned what foods I could tolerate. At an airport I grabbed my usual fast-food burger while running to a tight connection. I didn’t give a second thought to my band, and after a few bites I was terribly uncomfortable for the rest of the flight. I ultimately wasted most of the overpriced sandwich. A few weeks later Erick was joining me for a speech in Italy, and I told the doctor about my worries about the long flight and the tempting food. She loosened my band to make sure I didn’t have any problems overseas. Band adjustments are a painless office procedure where saline is either added or withdrawn from the band through a permanent port just under the skin in my belly. When I returned from our trip, I had the band tightened again.
“Everyone goes through a series of fills and extractions,” the nurse said. “Eventually we’ll find your ‘sweet spot’—that’s the point where you are consistently losing weight while feeling satisfied when you eat.”
When I figured out how often I had to eat and the right portion size, food was no longer the most important item on my plate. I didn’t have to think about what I could and couldn’t eat. I wasn’t deprived, and I barely missed the huge pasta dishes or heavy breads I’d once craved.
At my midyear checkup, Dr. Jessee’s staff was complimentary. “Look at you, girl!” the receptionist said.
She pointed to the scale. I closed my eyes. “You’re down almost fifty pounds!”
I was more than halfway to my goal, and it had been so easy. I was confident that the surgery had been the right choice for me.
9.
all about albert
Nothing you do for children is ever wasted.
—Garrison Keillor
The events that unfolded during the Daytona trip still bothered me. I felt terrible that Jasper was exposed to such an explosive environment. “Jasper was so humiliated by that caseworker,” Erick said. “How can we prevent any more problems like that?”
“Right now Jasper and Penelope are placed under kinship care status, which is basically foster care with a relative,” I explained. “All the same rules can apply. But in this instance I felt like we were being punished because the caseworker didn’t see him on time that month.”
“The rules are absurd!” Erick was furious. “He’s my relative, we are volunteers with the Guardian ad Litem program, we already had a background check, and have been fingerprinted. What more do they want?”
“If we had a foster care license, we could travel with them more easily, and if something happened to your aunt Liz, we could take over. Maybe we should get licensed. The foster classes are free, and it would give me another perspective for my studies and work.”
In a few months I would begin a master’s of social work program through the University of Southern California’s virtual academic center, attending live class in real time, interacting with the professors and students, and having supervised field instruction in my community. I could still take classes when I traveled by logging on from my laptop anywhere in the world, which was essential with my schedule. No local universities offered the same academic rigor and flexibility.
“Will you have time?” Erick asked.
“It’s only one evening a week, and the foster classes end before my semester starts. Besides, it’s not as if we’re going to become full-time foster parents.”
More than thirty people crowded into the orientation session. “I am thrilled to see so many of you stepping up to the plate to become foster parents in Pinellas County,” said Annabelle, the leader. “This marks our first class in a new era where foster parents will team with birth parents to protect their children and enable faster reunification.”
There was a buzz in the room. I wondered whether Luke and I might have been able to live with Lorraine again if she had had one of my better foster families helping her.
“Feel free to go if this isn’t the right fit for your family,” Annabelle said. Two couples left the room.
A few hands shot up. “What if we don’t want to have anything to do with the parents who had hurt the children in our care?” asked a Latina woman with hoop earrings.
“You will have our full support to determine the family’s strengths and needs.”
A woman in a suit and chunky heels stood up. “How soon after we get a baby could we adopt him or her?”
“Foster care is not a path to adoption,” the speaker said. “If that’s your goal, then this isn’t the right place for you.”
“But I heard—”
“Can foster parenting lead to adoption? Yes. Do we get babies? Tons of them, particularly right now with the pill mill crisis.”
Another hand shot up in the audience. “What’s a pill mill?” a gentleman wearing a bow tie asked.
“Some irresponsible doctors prescribe and sell narcotics from semilegal clinics. Right now we have an epidemic of addicted parents. More and more babies are born with drugs in their systems, and they go straight from the hospital into foster care.” She sighed. “In our area we have more babies than foster homes who will accept them. However, the vast majority are either going back to rehabilitated parents or their relatives. In the rare cases when a child has nobody or the parent does not complete a case plan, adoption is considered, and the foster parents have the right of first refusal. But if you go into foster parenting hoping to adopt every child, your heart will be broken many times over.”
Only six couples and two single women returned for the first official class. We were given a thick packet of forms to fill out at home. “The approval process is tiresome,” Annabelle said. “I’m sure you’ve read the headlines about bad foster homes, but we do everything possible to prevent this.”
Erick whispered to me, “Wait till she finds out that you were the child in some of those headlines.”
“Before we get into the nuts and bolts of the approval process, let me tell you about some current situations and see if you can wrap your minds around how you might help.” The group was riveted as Annabelle gave an example. “Two days ago we had a six-month-old baby come into care when the mother was arrested after a traffic accident. The baby was lying across the front se
at in a filthy diaper. She had a blanket, a pacifier, and nothing else—not even a bottle. The impaired mother had driven through a park and was stopped by a light pole.”
Annabelle made a passionate plea. “While there is always a huge need to house older kids—chiefly our teens—we are looking for families to consider taking care of babies and toddlers during this crisis until a possible relative can be found. We also need respite homes in case the regular foster parents have an emergency or go on vacation.”
Brian, a tall, lanky guy who looked to be about the same age as Erick said, “That’s definitely something we can do.” His wife, Beth, who had a beatific smile, nodded.
Annabelle pumped her fist. “Great! We’ll talk more about the details next week.”
On the way home I said, “Are you thinking what I’m thinking?”
We’d been together for so many years that we were already finishing each other’s sentences. “That we could do babies on a temporary basis too?” Erick asked.
“Neither of us has nine-to-five schedules. Besides, it would be good practice.”
“Are you really up for diapers and barf?” he asked.
“Can’t be worse than cleaning up after the pets.” We had three dogs, a cat, and a fish tank—and all required scooping, mopping, and scrubbing.
Plus, we had just bought our first house and had extra bedrooms. “We could put a crib in the smaller upstairs bedroom,” Erick said. He had a grin on his face that made me want to kiss him at the next traffic light.
By the time we attended the next class, we had started a notebook of lists. After class we had coffee with Brian and Beth.