Chapter 23: Never The Best: Chapter 23

Missy was on Pearl watch. We were taking turns: Aunt Hattie, Missy, and me.

I felt like a gigantic asshole whenever I saw Pearl, wondering how she’d gone through this alone when I’d ripped her life apart, and later, when she’d first been diagnosed with anorexia after her heart stopped. She thought she was weak? A failure? I didn’t think so! In my book, anyone who got through what she had on her own was the strongest motherfucker out there.

To help Pearl, I knew I needed to better understand her condition. Since I couldn’t talk to her therapist about her, which was unethical and impossible, I found someone who could teach me to be a better caregiver.

Aunt Hattie suggested I talk with her friend, a therapist, Dr. Monica Ryan. We were meeting at The Sentient Bean near Forsyth Park for coffee and a free education session.

I used to frequent the Bean often when I was younger. It was a Savannah staple on a cobblestone street, cozy and unassuming. It was populated with locals, college students, and the occasional out-of-towner who stumbled upon it while looking for a decent cup of Joe.

The wooden tables were scratched but polished, evidently both lived-in and loved. I chose a table by the window, where the scent of coffee mingled with the faint tang of magnolia blossoms drifting in from the park despite the summer heat that killed pretty much anything green in sight.

Dr. Monica Ryan walked in right on time.

She had the kind of presence that instantly put you at ease, and her warmth and demeanor were inviting. Yet it was clear there was a sharp intelligence beneath her friendly exterior. Her salt-and-pepper curls framed her face, softening the sharpness of her eyes. She wore a neatly pressed teal linen blouse—a surprise, given Savannah’s humidity, which had most people surrendering to wrinkles by midday.

‘Rhett,’ she greeted warmly as she set her leather bag on a chair.

I rose, shook hands with her, and gestured for her to sit across from me. Once she was settled, she told me, ‘I have to admit, I was a little surprised when Hattie said you wanted to talk, but not as a client. She made it sound important.’

‘It is,’ I admitted. ‘Thanks for making time.’

A server came by to take our orders—an iced tea for me and a cappuccino for her. Dr. Ryan adjusted her chair, folding her hands on the table and tilting her head slightly as she studied me. ‘Alright,’ she said with a small smile. ‘Tell me what’s on your mind.’

I wasn’t used to feeling helpless. It wasn’t in my nature. But watching Pearl slip into a world I didn’t fully understand left me feeling raw and desperate.

“I have a friend,” I began. “She was diagnosed with anorexia nervosa about a decade ago. A week ago, she relapsed. I want to make sure I’m taking care of her the right way—that what I do actually helps and doesn’t hurt her, whether that’s now or in the long run.”

“Does she have a therapist?”

“Yeah, but she refused to talk to him until last night. I’ve set up an appointment for her later today.”

She arched an eyebrow. “You set up an appointment?”

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 I was Pearl’s friend but also the 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 be insulting, 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’s not 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 feels safe, 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 keeping her 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.

Dr. Ryan reached across the table, placing her hand lightly over mine. ‘I know it’s terrifying. But Pearl is getting professional mental health help. That’s very important. I recommend including a dietitian and maybe even a doctor on her care team to monitor her physical health. You can be her support system, but you can’t be her entire recovery plan.’

‘She’s finally talking to a therapist, which is a relief. Next step, I hope she’ll let me take her to her doctor.’

“Understand this,” Dr. Ryan cautioned. “When she pushes back, it’s not personal. Resistance is part of the illness.’

‘Thank you,’ I said quietly, meeting her steady gaze. ‘I don’t want to screw this up.’

‘You won’t,’ Dr. Ryan assured me with a small smile. ‘You care, Rhett. That’s half the battle right there. But this is a marathon, not a sprint, and that means you’re going to have to pace yourself. But the fact that you’re asking these questions, that you’re trying to understand, says a lot about the kind of support you are for her.’

“I can’t thank you enough, Dr. Ryan.”

She studied me thoughtfully. “How are you doing? Taking care of someone like this is not easy. Are you giving yourself time to take care of yourself?”

I blinked. “I’m fine. It’s Pearl who is⁠—”

“Let me put it this way: always put your oxygen mask on first, then the child’s. If you’re not healthy, you can’t take care of Pearl.”

She wasn’t wrong. “What do you suggest I do?”

“I’m glad you asked.” She dug into her bag and pulled out a business card, sliding it across the table. “Here is someone I think you should speak with. He’s an excellent therapist.”

“Why not you?” I asked, genuinely curious. Talking to her felt easy and natural, like she already understood the weight of everything I was carrying.

She smiled kindly, folding her hands in front of her. “I’m afraid I simply don’t have the bandwidth to take on new clients right now.”

“Are you saying that you’re too busy to take on Aunt Hattie’s favorite nephew as a patient?” I teased.

“Exactly,” she replied cheekily.

“Thanks, Dr. Ryan,” I said, picking up the card. “I’ll reach out.”

“I want you to know that you’re doing a lot better than you give yourself credit for. I’m very impressed with your dedication to your friend, and I believe she is going to come through this, and so are you, stronger than before.”

When we were ready to part ways, Dr. Ryan gave me a reassuring pat on the shoulder.

‘Oh, Rhett,’ she threw over her back as she walked away. “Tell Hattie she owes me a bottle of Krug for this.’

I laughed, the sound feeling almost foreign. Damn, but Dr. Ryan was right; I hadn’t been taking care of myself. I was tired and cranky. Confused and belligerent. Yeah, I needed help myself.