Since She’s Been Gone

Sagit Schwartz (Crooked Lane Books, 2024)

Time is devious, the way it silently accumulates before bearing down all at once, writes psychotherapist turned author Sagit Schwartz in her upcoming debut novel. And in Since She’s Been Gone, the past and present collide in unexpected ways.

Aged 15, after the shocking death of her mother in a hit and run accident, Beatrice ‘Beans’ Bennett developed anorexia nervosa. She spent some time in a treatment facility and recovered. Years later, Beans trained as a clinical psychologist.

But Beans’s life takes an unexpected turn when a mysterious new client arrives at her office and tells her that her mother is still alive — and in danger. She even has her mother’s unique charm bracelet to prove it. Forced to reassess her whole life, Beans is determined to discover the truth, and sets out on a mission to find her mother, perhaps even to save her.

Beans is a sparky, gutsy heroine and a determined truth-seeker, but her single-mindedness trips her up. In her desperate desire to find her mother, she starts to neglect her eating. The way that the eating disorder insidiously gets its claws in again while Beans is preoccupied with looking for her perhaps-not-dead-after-all mother, is deftly crafted. It’s only a matter of time before the cunning, sleeping giant, anorexia, or ED as Beans calls him, begins to wake up.

In recovery, it’s said that we have the clock, proudly counting and tracking the days, months, and years since we last restricted—while ED has the time. All the time in the world to wait for a crack, an opening, however long it might take, to pounce again 

Set in LA and New York, the book follows a dual timeline. In the present, we follow Beans as she discovers that her mother may in some way be connected to a powerful Sackler-esque family. The family own the giant pharmaceutical company largely responsible for the national opioid epidemic, and will seemingly stop at nothing to protect their secrets.

In the past timeline, we learn about Beans’s experience of anorexia, and her time in a treatment centre, 26 years previously. Beans’s experience of the illness is not sugar-coated. The competitiveness of anorexia is explored in a realistic way as Beans and her fellow patients jostle to be the best at anorexia — in other words the most starved. Anorexia is a strange illness, and the author depicts the tricks it plays on the mind with accuracy. But a word of caution: several food-avoidance and purging methods are described, some of which even took me by surprise. The author has responsibly added a warning about this content at the start of the book, and I would urge anyone who has anorexia or is in recovery to tread lightly.

Since She’s Been Gone also offers much high-quality information about anorexia in general, which is interspersed throughout the book. The author has done a lot of research and does not rely on old tropes about the illness, as so often happens when anorexia is explored in fiction. For example, Beans talks about her ill-fated pregnancy, years earlier, and how the nausea made eating difficult. I started losing weight, which triggered ED, which I thought I’d put behind me over a decade prior. She explains that genetics underpin anorexia and not everyone develops it when they lose weight, but some do. For those of us who are biologically vulnerable like myself experiencing any energy deficit, whatever the root cause is… presents a relapse risk.

There is also a mention of hypermetabolism in recovery as well as a description of anosognosia — a topic many know little about but one that everyone who is treating anorexia patients should understand:

Anosognosia is one of the defining features of anorexia—the medical term for when a patient is unable to understand that they are sick, stemming from anatomical changes to the brain due to starvation. It’s incredibly problematic because, without an awareness that one is sick, the patient has no desire to get better, which makes the disease confounding and difficult to treat.

Schwartz also writes that anorexia nervosa is now considered a metabolic psychiatric disorder, although I’d argue that many working in the field haven’t caught up with that description yet. And she even touches on the controversial diagnosis of atypical anorexia — Atypical anorexia is, in fact, not atypical at all — and that eating disorders affect people of all shapes and sizes, all genders, all races, and from all socioeconomic backgrounds.

So a huge round of applause for all of that!

It’s admirable that Schwartz has packed so much solid knowledge of the illness into this book, although I wonder if, for the lay reader, so many informative asides might distract from the story a little. I hope not because with this book Schwartz does a lot to redress the balance of how anorexia is represented in books and on film. There have, let’s face it, been a huge amount of bad takes over the years which have only served to reinforce the public’s misunderstanding of this illness, from literature like Siri Hustvedt’s What I Loved to screen depictions of the illness like To the Bone.

This is a good debut novel which I gobbled down eagerly, keen to know what twists and turns were coming next. And, most importantly, would Beans be reunited with her mother? No spoilers here, but I will say that the book ends on a hopeful note. Anorexia may have the time, patiently waiting in the wings for a moment of vulnerability. What happens next is not a foregone conclusion.