At a quarter to five the night nurse rapped on my bedroom door, and then she flipped the light switch on and off until my eyes fluttered open. I padded after her in my slippers to the scale in the corner of the nurses’ station, then gulped the meal-replacement shake required when my weight didn’t match the target gain for the day. A few hours later at breakfast, I studied the other women as we sat three to a table in the dining hall. The bulimic ones still had a little color in their cheeks, but the anorexic women, like Claire and Sadie, looked like ghosts. They had a certain pallor about them that makeup couldn’t hide and drowned their skeletal frames in long sleeves and pants a size too big. Counselors circulated through the dining hall eyeing us while we ate, checking our trays before we threw them away and writing down everything that we’d left uneaten. Despite the close observation, Claire still toyed with her food, tearing pieces of bread into little bits and lining up peas and bits of carrot in a row before piercing them one by one with a single tine of her fork.

In the afternoon I dutifully filled out the menu worksheets for the next day, adding up my calories. My meal plan required thirty-five hundred a day, so I chose the foods with the highest caloric density—two chocolate milks, a piece of cherry pie, six packets of half-and-half in my coffee. After all, the jig was up. There was no use resisting the program and risking a longer stay. I was always the first one done with the worksheet, and this reinforced my belief that I was an easier case than the other women. They were clearly damaged, while I was just going through a rough patch. I ignored the fact that we cut the same figure. At five feet eleven inches tall, I weighed only ninety-six pounds. A few weeks before, just after spring break, the doctor at my college health clinic had told me I had no choice but to sign up for a stint at the Renfrew Center, a residential treatment center for women with eating disorders.

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Once I was finished with my worksheet, I met with my therapist, Rebecca, in her office in the heart of the manor house. The walls were hung with small abstract paintings in brown and orange, each carefully framed. I guessed they were from former patients, but I didn’t dare comment on them for fear that she’d think I was reading something into them.

“I was reflecting on our conversation a few days ago, and I have some questions for you,” Rebecca said, pulling out her legal pad. She probed at the story I’d told her: how I’d walked away from my parents’ Pentecostal church when I was fifteen years old, driving a wedge between me and my deeply religious family that only got worse when my parents learned I‘d fallen in love with my best friend, Sophie—something they saw as an abomination. Getting a scholarship to a college hundreds of miles from southern Maryland was a hard-won victory, but I only made it to Easter of my freshman year before ending up at Renfrew.

After a while Rebecca something about how I’d overcome a lot of obstacles to make it to college, and I must have felt proud of that. I realized I was shaking my head.

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“You look angry,” she said.

I shook my head again and kept my eyes on my lap, trying to ignore the burning sensation in my sinuses. Actually I was furious. But I wasn’t going to give her the pleasure of knowing that. Rebecca lived in a world orthogonal to mine. She had pearls in her ears and an expensive haircut. Her parents probably owned some hundred-year-old stone house in Connecticut and vacationed in Martha’s Vineyard for two weeks every summer. She grew up in the same world she still lived in now, listening to rock music and believing in evolution without ever feeling guilty about it. She’d never had to make a choice between the past and the future.

“What are you thinking about?”

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My eyes rested on an ugly mud-colored painting in a gold-edged frame, and I found myself telling Rebecca about a time that I was looking through the old steamer trunk at the end of my mother’s bed and found a list she’d written out of what her life was like before and after she’d met the Lord. One side chronicled all her insecurities: her stuttering, her anxiety, her loneliness. On the other side were the names of her children, her status as a wife and mother, and the many ways she ministered to others through the church. Even her handwriting changed when she listed her blessings, becoming fuller and more confident.

I said that I understood how my mother, having found the key to fulfillment in her life, would want to give that experience to everyone she met. She was a shy woman, not comfortable talking to strangers, but whenever she saw someone begging for food, she’d make her way over to them and offer a hand, speak to them quietly, slip them a few dollars. And then she’d start talking to them about Jesus and what he had done for her, and what he could do for them. She wanted strangers to know God’s love, so how much more did she want that for her own daughter?

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I told Rebecca that before I walked away from the church, my family and I used to look in the same direction, toward the same sun. We believed there was one God and we were his children. There were those on the margins—my aunt who smoked cigarettes and the people who attended the mosque up the street. But there was no one who would actually deny God. Such a thing would be unheard of. And then somewhere along the line I slipped outside of the circle, and there was no future there. That was why I couldn’t gather up the energy to focus on my classes, to eat enough to keep myself going. I was already outside of the only world that mattered, and I didn’t know what to move toward.

A few days later I stood in line for my midday dose of clonazepam—for anxiety—and paroxetine—for depression—and then shuffled to the eastern side of the manor house for the residents’ support group. Jill, the social work intern, facilitated the session. She had fat ringlets of blond hair with dark roots and a singsong voice she used to thank us for minor contributions to the discussion.

I settled myself in my chair and looked over at the women in the circle next to me: Sadie, who lived in a mini-mansion in Georgetown with her politico parents. Ava, whose little sisters ran to her room to embrace her every time they came to visit. Maggie from Appalachia, so embarrassed of her thick accent that she hardly spoke. Claire, one of the walking ghosts, fresh out of the hospital where she’d had a feeding tube put in.

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I knew one of the reasons these women didn’t eat was because they weren’t that invested in themselves or their survival. They had high standards for themselves and they never managed to meet them. When things went wrong, they turned their pain and frustration around on themselves, so that to the rest of the world they still appeared whole and content, even though on the inside they were slowly deconstructing.

But looking at those women in the circle that day, I had no judgment at all for them, even though I had so much for myself. They were doing the best they could to keep body and soul together. They were wrestling with a sadness that had grown so big and all-encompassing that it had swallowed them up.

I had a sudden desire to tell them my story, to lay it all out on the table and let them tell me what was what. I wanted to ask them if I had been wrong to leave the church, to abandon my family and move to New England for college. I wanted to hear what the other women would say, what they’d think of me. I didn’t trust Jill or my therapist—they were far too high-functioning to shed any light on my own situation, but if the other women could understand why I’d left home and forgive me for it, then maybe they were right.

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I tried to speak, but I couldn’t stop crying. Jill was used to a few tears, not a fit of hysteria. She stuttered, and that was when Claire got up out of her chair and stooped over me, pressing my wet cheek against her dry, sweet-smelling one. Then Sadie got up. And Ava. They took turns holding me and telling me that it was going to be okay. Jill rose uncertainly, but she didn’t get up. Instead she narrated what was going on, saying “That’s nice, now Sadie is hugging Jessica. She’s saying, it’s okay.”

Then Ava’s voice cut through Jill’s ramblings. I’d dismissed Ava early on as as a sorority girl, but with great confidence, she disregarded the tacit agreement among the residents that we’d speak as little as possible during group therapy. Instead she started talking about how she’d come home for spring break and eavesdropped on her little sisters as they played dress-up. The girls primped in front of the mirror, sucking in their tiny bellies and mimicking Ava’s voice—or maybe their mother’s—saying “I look like a whale! I need to go for a run!” Ava said that their high, girlish voices had haunted her over the next few days, and she started watching her sisters closer as they refused dessert and filled up on salad.

Ava said she approached her mother and father a few days later as they sat around the dining room table, knocking back some wine after dinner. She explained that she was sick and they needed to find her a place where she could get better. She couldn’t do it on her own. And then she ended up here. It took everything she had to drink those chalky shakes in the morning and watch the fat creep back onto her waist. But she knew that if she didn’t get better—for herself and for her sisters—she couldn’t forgive herself.

“It’s been nineteen days,” Ava said, and smiled that same languid smile I used to see on people when they’d just come back from the altar.

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There was a buzz of validation. Thank you, Ava. Our faces were flushed; we were in a state of deep attention. Ava looked up at me and raised her chin. Something had settled in her eyes. It was my turn now. I nodded and sat up straighter, then I started talking. I began with my mother, who loved us fiercely in her gentle way. My father, deeply wounded from his own difficult childhood, whose spiraling rage sometimes got the best of him. I told them about the first time I spoke in tongues, when the Holy Ghost poured out of me and I felt like I was caught up in a fever-dream. I told them about how climbing into Sophie’s embrace felt like coming home. I told them how hard I worked to get into college, how I’d nagged my parents to catch up on their taxes so I could apply for financial aid, how excited I was when I got the letter about my scholarship, and how my heart broke open when my father told me my mother still thought I’d come back home one day. But I wouldn’t. I was headed somewhere else, somewhere far from my family and my hometown, far from my childhood faith. I just didn’t know where it was, or how to get there. And I couldn’t forgive myself for leaving in the first place, for walking away from my family when I had been so deeply loved.

The air in the room buzzed with energy. It didn’t feel like a conference room in a residential treatment center—despite the linoleum and the grey walls and the fluorescent lighting, despite the self-esteem posters taped to the wall. It felt like one of those holy places that people climb mountains or cross deserts to get to, just so they could return to their lives entirely different. The kind of place that could heal the broken parts of you, if you could just suck up the courage to ask for help. When I finished talking I looked around at those women’s faces, calm and smiling. Their gaze on mine felt like a benediction. In the long moments before Jill broke up the circle and ran through her list of announcements, those women’s eyes rested on mine, and I felt forgiven.