I want to be proud of you, she’d said. She said the starving was the most confusing thing I’d ever done.

I showed Tilly a college ID from that year. Her breath came out in a long sigh. “You can see it in your face,” she said. “You look sad.”

“I don’t even know why I still keep this in my wallet.”

“You don’t?” she said. “I think you do.”

Telling her these stories, the old fear returned—the fear that nothing would ever feel as good as that pride had felt. One day on the subway, during the worst of it, I caught a glimpse of myself in the darkened glass: a pair of ghoul eyes peering sideways above my cheekbones. I watched the other people on that car—the old man with his violin, the woman with a slouching baby, and thought there was no way a stranger could see me without thinking, She’s given up on something. All of them were coming up with stories about what made me look the way I did. I switched positions and clutched the pole from another angle, this way they could see me from all sides, the stick of my profile and the protrusions of my shoulders.

When we broke into sunlight on the other side of the river, pushed up from our underwater tunnel, I lost my own face in the darkened glass. I looked around at the strangers, and none of them was looking at me. They’d been looking before, hadn’t they? Maybe I’m going crazy? Could I be going crazy? Nobody was looking; there was only my sick useless need for them to see. I raised my hands to cover my face oh my God and then the subway lurched and my hip banged into the seat and I clutched the hard plastic for balance.

“You better sit down,” the old man said.

“I’m sorry,” I said. “I’m sorry.”

He was only a stranger. And there I was, crying harder, still standing. He shook his head and handed me a pack of tissues and shuffled off at the next stop, the hospital that specialized in ears and mouths and throats. What kind of help did he need? Back then I hadn’t even wondered.

One time I saw a thin girl, even thinner than I was, fall to her knees in the bathroom of our dorm. Her legs were twitching. She had broomstraw hair and the glassy startled eyes of an animal smoked out of its burrow. She was splashing water on her face, and then her knees just buckled. I thought, This is where it ends up. The body forgets how to stand.

I’d fallen in bathrooms of my own, several of them. Once I flushed a toilet at Revere Beach and woke up in a puddle of wet sand and urine. Blackouts took the moments of my life and hid them from my sight. I thought: This is being sick. This is wanting it. Years later, finding Lucy on the floor, I remembered the chill of piss and concrete on my skin. I saw her fluttering fingers and thought, This isn’t wanting anything. This is dying.