Page 67 of Never the Best

I sighed and then explained the situation. Pearl was in no condition to handle logistics, and I was adamant that she didn’t have to because she had me.

“Can you give me some insight into your relationship with the patient? Is she just a friend? A girlfriend?”

The server came with our drinks and the check. I dropped my credit card immediately, and she pulled out a card reader. We finished the transaction, giving me time to think about how to tell Dr. Ryan that IwasPearl’s friend butalsothe monster who had changed her life when she was young.

“This is confidential, I assume.”

“Rhett,” Dr. Ryan admonished.

I raised a hand and nodded. “Sorry. I don’t mean to beinsulting, but let me explain what happened, and maybe that’ll help you understand why I’m so jumpy.”

She listened silently, her face blank of all emotions, occasionally sipping from her drink. She didn’t take notes, just nodded and made small, assenting sounds.

I started from the beginning, telling her about sleeping with Pearl and how she’d overheard me. Dr. Ryan wasn’t judgmental—she radiated calm curiosity, asking the occasional question to dig deeper and understand more. She didn’t rush or interrupt; she simply let me pour everything out.

“Are you having sex with her now?”

I shook my head. “But we’re sleeping together…that’s all.”

She looked at her coffee and then at me.

“Can you help me?” I pleaded.

Dr. Ryan nodded compassionately. "Anorexia is a complex illness. It’s not about eating—it’s about control, fear, and the stories people tell themselves about their worth. Supporting someone who’s relapsed is incredibly hard, especially when you’re close to them."

I took a deep breath, the memory of finding her in the cottage still fresh, still painful. "She’s not eating. Barely drinking. She’s…shut down. She lets me help her take a few bites of food, but even that feels like it’s killing her. She’s so tired, so fragile. She has nightmares. I hold her when she sleeps. She lets me."

"First," she said after a moment, "you need to understand that you can’t fix this for her. I know that’snot what you want to hear, but it’s the truth. Anorexia is deeply rooted. It’s about the beliefs Pearl has about herself, her body, and her value. Those beliefs don’t disappear overnight, and you can’t reason them out of her. Recovery is a process, and it’s one she has to want for herself."

“She does. I know she does. She was doing so well until what happened with Josie. I’m to blame. I started this, and now Josie went after her because of me. I keep hurting the woman I love.”

Dr. Ryan smiled at me. “When you were teenagers, yes, you triggered her, and what you did was inexcusable, certainly, but that was then. You’ve grown, and so has she. Josie’s actions are not on you, only on Josie. The thing is, Rhett, if you were the monster you claimed to be, you wouldn’t have spent a decade wanting to apologize to Pearl, and finally doing it in a way that, regardless of what she says, she has accepted. A monster would have rationalized it as teenage behavior and moved on. You didn’t do that. Give yourself credit for that.”

It was hard to do so when I could see the damage it had done to Pearl.

“Pearl’s problem started long before you came into the picture. It sounds like her mother pressured her about her weight, and from what you said, her brother ridiculed her, as did children in school. All these factors coalesced for Pearl.”

I nodded slowly. "Will she get better?”

"Of course, if she gets help, which she has been and is," Dr. Ryan confirmed. "You can support her the way you already are by being present, creating a space where she feelssafe, where she knows she’s not being judged or pressured. People with anorexia often feel an overwhelming sense of guilt or shame—about their eating, their appearance, and even about burdening the people who care about them. If you approach her with frustration, it will push her further into that shame."

I swallowed hard, the knot in my chest tightening. "I’m patient with her. I promise. No matter what, I stay calm."

"I know," she said gently, "but, Rhett, what you’re doing is more than patience; you’ve shown her that you’re there for the long haul, no matter how slow her progress is."

I stared at the condensation on my glass of iced tea. "What you’re saying is that I’m doing a lot of the right things?”

“Absolutely,” she affirmed.

“What else?"

Dr. Ryan leaned back, her eyes thoughtful. "Don’t make food the focus of your interactions. Talk to her about things she enjoys, things that remind her of who she is outside of her illness. Anorexia has a way of consuming someone’s identity—Pearl might need help remembering who she is beyond it."

I nodded, thinking back to the moments when I’d seen glimpses of the Pearl I’d once known—the way her eyes lit up when she talked about books, the sharp wit that surfaced when she felt comfortable.

"And when it comes to meals," Dr. Ryan continued, "don’t push too hard. Offer, but don’t force. If she can’t eat, don’t make her feel worse about it. Instead, focus on keepingher hydrated. Dehydration is a serious risk during a relapse, especially if she’s been avoiding fluids as well as food. Encourage her to drink water, tea, broth—anything she can tolerate."

"That’s what scares me the most," I admitted. "The physical toll. What if something happens to her heart again?" Her heart had stopped for one hundred and ninety seconds once—she’d almost died.

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