Chapter Text
Dennis is ten years old when he realizes he can simply not eat.
He’s one of many, too many, in a house that always feels a size too small. The walls crowd in around the table when they eat. Everything’s a contest: for their parents’ attention, for a seat that isn’t splintered, for the last slice of pizza. Dennis, the youngest of the siblings, is left in the dust more times than he can count.
The realization happens by accident.
That evening, Dennis is late. He’s been helping the neighbor fix a sagging fence, staying out until the air turns cool and the nails glint in the dusk. By the time he slips back inside, the family’s nearly finished eating. His mother sets a plate in front of him - a few limp pieces of broccoli, a thumb of chicken, and the heel of bread slicked with butter.
“Sorry, sweetie,” she says, stacking plates with one hand, brushing hair from her face with the other. To Dennis she’s still beautiful, though her skin is worn by years of sun and strain. She married young and had babies younger. She isn’t forty yet, but life has already made her look it. “We couldn’t wait. You know how your father is.”
“That’s okay,” Dennis says.
She smiles, ruffles his hair, and turns back to the sink. Water runs. His brothers are in the next room, shouting over each other. His father’s voice cuts through with a sharp knock it off that echoes down the hallway. Dennis can imagine his father sitting in that old gingham armchair, its patched arm split again at the seam with a beer in his hand shouting at his siblings.
Dennis looks down at the plate.
He’s hungry. But also, he isn’t strangely. Maybe because he was sitting at the table by himself, not elbowing someone to get to the bread. It’s like all his urgency is gone.
The thought comes to him quietly;
What if I just don’t?
He picks up his fork. Puts it down. The broccoli looks dull and wet, a cold green stare that gazes up at him. His stomach aches. His arms are sore. He’s tired, bone tired from a day of patching fences. He really should eat.
He doesn’t.
He sits there until the water stops running, until his father starts shouting about someone breaking a lamp and throwing a ball in the house. Then Dennis stands and scrapes the food into the trash. At once the guilt hits him like a slap. They’re not supposed to waste food on their shoestring budget. His hand hovers over the garbage, ready to dig it out, but then his mother appears in the doorway.
“Oh, you’re done! Will you take the trash out, dear?”
He nods, the words caught somewhere behind his teeth. He ties the bag shut and carries it outside. The plastic is warm against his fingers.
That night in the top bunk, surrounded by the steady breathing of his brothers, his stomach growls. At first it’s unbearable. There’s a sharp and hollow pain that is gnawing from the inside out. He almost gets up to go to the kitchen. But then something changes. The ache softens. The hunger turns strange, almost light.
He feels untethered.
Weightless.
And for the first time all day, it feels good.
Really good.
It’s not about weight; he comes to realize.
It’s about control.
It’s the most cliché, overused reason on earth. But it’s true.
He doesn’t spend hours in front of the mirror, pinching at the soft parts of himself or cataloguing imperfections. The mirror means nothing. What matters is the ledger.
He writes down everything - every crumb, every sip, every accidental bite when he’s not paying attention. He learns the language of food like scripture: grams, calories, ratios, conversions. He knows what happens once it crosses his tongue; starch into glucose, glucose into glycogen, glycogen burned down to carbon dioxide and water. He knows that fat stores what sugar cannot, that protein feeds the body’s slow repair. He gets a library card and spends hours in the reference section. He learns about metabolism, insulin spikes, and basal rates. He learns how to outsmart them all.
He likes the math of it. The logic of it. The perfect order where input meets output and nothing slips through. He likes that his body can be charted and reduced to figures in a notebook.
His mom sees him jotting down the chemical formulas in his notebook one day, the one he carries everywhere. She never finished high school- she’d gotten pregnant at 16 and dropped out her junior year.
“What are you doing?” she asks him, a basket of laundry that needed to be folded balanced on her hip.
“Chemical equations,” he tells her. “This is how the body turns glucose into glycogen.”
“Wow,” and for the first time in a long time, she sounds impressed in him. “You know bunny, I think you could be a doctor. That’s a lot of science right there.”
The hallow, gnawing hunger in his stomach squirms and transforms at her praise. He feels proud.
Dennis cannot control the noise of his brothers, or his father’s temper, or the way the house always feels one argument away from breaking. But he can control this.
He can choose when to eat.
and when to stop.
It builds slowly, like a hum beneath the skin.
Dennis doesn’t plan it. It just happens. Sort of like the same way some kids start collecting baseball cards or stones with streaks of quartz. His collection is numbers. Columns of them. Calories, grams, minutes spent walking to school. A record of a body being managed and tamed and balanced.
By twelve, he knows how to make hunger invisible. He eats at the table with everyone. Just small bites at a time and chewed carefully and he’s praised for being “such a good eater.” He packs lunches for school but gives half away. At dinner, he cuts his food into smaller and smaller pieces, moving them around until the plate looks convincingly touched.
No one notices. Or maybe they do, but the noise of the house covers it. There’s always someone crying or shouting or slamming a door. There’s always something more urgent than Dennis being quiet.
He likes it that way.
Hunger becomes a kind of friend. Dennis is a little odd, he knows. He’s not the most popular guy at Broken Bow Middle School. He has a few friends, but none of them are quite like hunger. It’s reliable. It’s something he can carry with him when everything else feels out of his reach. The ache in his stomach is clean and simple. It asks nothing of him except endurance. It gives him something no one else can: proof that he can choose what happens to his own body.
Sometimes, late at night, he lies awake and counts his ribs under the blanket, not out of vanity, but curiosity. It’s like checking the work of an experiment. And when he counts them all over and over it’s a small, private success.
Then in the morning, when his mother sets out breakfast - eggs hissing in the pan, toast gone golden - he smiles, says he’s not hungry yet, and means it.
The feeling is still there, light and steady. And it feels like power.
By the time Dennis turns fifteen, control isn’t a habit anymore. It’s a rhythm. A compulsion, almost.
He’s taller now, all elbows and legs, a boy stretched too thin by time. His brothers have grown louder and the house smaller. His father drinks more, his mother works longer. Bills are piling up with big red stamps on them.
Dennis has learned how to disappear in plain sight.
At school, he’s unremarkable. Quiet. Polite. Teachers call him “dependable,” which really means forgettable. He keeps his head down and his grades perfect.
The cafeteria is a kind of theater with everyone watching each other and pretending not to. He learns tricks: how to break a sandwich apart and toss half away without anyone noticing, how to sip water until the hunger ebbs and flows like a tide.
He takes up running. First for the torture that is called gym class and then later for himself. There’s something pure about the slap of sneakers on asphalt and the ache spreading like fire through his legs.
Dennis is even talked into joining the cross-country team. His guidance counselor says it’ll look good on college applications. He even gets third place in the state competition. But he doesn’t run to win. He runs to empty out. Each mile is a subtraction he can add to his ledger.
He tells himself it’s science, and that it works because he understands it better than anyone else. He charts his progress: heart rate, weight, intake, hours slept. His notebooks fill up with data and equations. He’s looking for the math to balance.
But balance never comes.
He starts skipping meals entirely. Not because he means to, but because the thought of eating feels heavy. Hunger becomes the background music of his life.
His mother comments sometimes. She says he’s “thinning out,” and offers him seconds. He smiles and shakes his head. His father doesn’t notice. Or maybe he does and doesn’t care.
By then, Dennis has already learned the secret truth:
If you can master the body, you can silence the rest.
By the time Dennis starts medical school, hunger has become less a feeling than a philosophy.
He studies metabolism now in lecture halls instead of the back of the public library. Glucose pathways, lipid oxidation, endocrine feedback loops. It’s honestly kind of incredible. The language he once whispered to himself in notebooks has become the currency of his world. He can recite it all without looking: how ATP fuels muscle contractions, how leptin and ghrelin battle over appetite, how the body is never still, always burning, breaking, and building.
The knowledge thrills him.
The science validates what he already knows. That the body is a system and can be obedient if you learn the rules. It’s all ratios and exchanges of energy. Hunger, he learns, isn’t just emptiness. It’s chemistry. It’s electricity and impulse. It’s something you can master.
Medical school suits him. It rewards endurance. He learns to live on caffeine and the satisfaction of not needing what everyone else seems to crave. Around him, classmates joke about surviving on vending-machine snacks and Red Bull. He laughs with them, but he’s proud that he doesn’t need even that.
He doesn’t eat because he can choose not to.
The body is supposed to demand. To insist. To scream.
His doesn’t. Not anymore.
He feels powerful in the way surgeons must feel, holding a beating heart and knowing it will obey their hands.
Sometimes after a long day in the cadaver lab he’ll stand under the shower until the water runs cold, mapping each bone and tendon beneath his skin. In awe of the human body.
He keeps a small notebook still, though now it looks more professional with neat handwriting, and labeled columns.
Dennis calls it data, but it’s something holier.
Sometimes, when Dennis walks the halls of PTMC late at night, he thinks about the time he was homeless.
He doesn’t call it that - not even to himself. He calls it “the in-between,” as if it were just another rotation. But he remembers the exact feel of it: the thin blanket, the damp concrete under his back, the wind that cut through his jacket like glass.
It was during his last year of med school, the semester after his father died and he couldn’t bear to call his mother. His loans had been delayed. His part-time job had fallen through. He told no one. He couldn’t. What would he have said? That he could memorize the Krebs cycle but not keep a roof over his head?
So, he lived in his car for three months. A faded blue sedan that had 200,000 miles on it with one door that didn’t open from the outside and a heater that coughed more than it warmed. He parked near the river where the streetlights didn’t reach, where no one would notice him curled in the back seat with his coat pulled to his chin.
He studied by flashlight, his anatomy flashcards balanced on his knees. He rationed everything. Every apple, every granola bar, every cup of gas-station coffee was a calculation. Intake and output. Energy and conservation.
It should have felt humiliating. But mostly it felt familiar.
Sometimes he’d wake before dawn, the windows fogged, his breath hanging in the cold air. The city would be silent, just a low hum of traffic somewhere distant. He’d sit there, feeling the ache in his stomach and the tightness in his chest, and think: This is control. This is freedom.
He doesn’t tell anyone at PTMC. He doesn’t tell anyone about the abandoned wing he’d found after his car finally broke down and he was desperate. Only Trinity knows, and just barely
When his coworkers talk about resilience, he nods. When they joke about being “starving med students,” he smiles.
But every time he walks past a patient tray, the smell of food makes something deep in him tighten. Not in hunger, exactly, but in memory.
He knows what it’s like to live on the edge of the body’s patience. To live small and to need nothing.
And part of him still believes that’s what makes him good at being a doctor.
The patient’s name is Thomas. Sixty-eight. Late-stage pancreatic cancer.
Dennis meets him on a Thursday morning the third week in at PTMC during his internal medicine rotation. The sky outside the ward is a dull gray, the kind that makes everything inside feel more fluorescent. Thomas is thin in a way that’s different from Dennis’s kind of thin. Not controlled, but consumed. His body has turned against him, feeding on itself cell by cell.
He’s propped up in bed, a plastic tray untouched beside him. The oatmeal has gone cold, congealed at the edges.
“You the new doc?” Thomas asks, voice rough as sandpaper.
“Student doctor,” Dennis says, forcing a smile. “Just checking in on you.”
Thomas grins faintly. “You don’t look old enough to know what you’re doing.”
“Most days I’m not sure I do.”
They both laugh, but the sound feels thin in the hospital room. Dennis checks vitals, asks questions, and writes notes. When Thomas turns away to cough, Dennis sees the tremor in his hands.
“Can’t keep food down,” Thomas mutters. “Body don’t want it anymore.”
Dennis looks at the untouched tray. “We can try something lighter.”
Thomas shakes his head. “It’s not about the food. It’s about knowing it won’t matter.”
Dennis nods, pen stilling in his hand. There’s something in the man’s tone he can’t quite place. It’s almost a kind of peace Dennis doesn’t know how to name.
When he leaves the room, the smell of cold oatmeal lingers on his gloves. He scrubs his hands twice, harder than necessary, watching the pink bloom under his skin.
That night, he can’t stop thinking about Thomas’s words as he settles into the old hospital bed.
It’s not about the food.
It echoes in him like an answer to a question he didn’t know he’d asked.
He dreams of the hunger that makes him feel powerful. And then of Thomas, a body hollowed and not by choice.
The next morning, Thomas is worse. His wife sits by the bed, spooning broth toward his lips. He can’t swallow. It dribbles down his chin, and she wipes it away gently, her hand shaking.
Later, in the stairwell, he leans against the cold tile and realizes he hasn’t eaten in almost two days. His hands are trembling. He tells himself it’s the lack of sleep or stress. But it’s more than that. He can feel it.
For the first time, hunger doesn’t feel clean.
It feels cruel.
Dennis is pretty sure he can go on forever like this.
Running on caffeine and adrenaline is something they all do. Even Dr. King, with her meditation apps and lectures on the importance of a full eight hours of sleep.
The world blurs at the edges, but he tells himself it’s fine - he’s fine. He’s efficient. People keep patting him on the back and telling him he’s doing a good job. He can do this forever.
Until he wakes up on the floor of the ER.
There’s a sharp smell of antiseptic and copper in the air. His cheek sticks to the tile. The fluorescent lights burn through his eyelids.
“Dennis.”
Robby’s voice cuts through the ringing in his ears. It’s low and threaded with something like panic. When Dennis blinks, Robby is crouched beside him, hoodie half-off, his face pale.
“You passed out,” Robby says quietly. “When was the last time you ate?”
Dennis opens his mouth. Nothing comes out. His pulse pounds in his temples quickly. He can feel his heartbeat in his throat. It’s too loud.
Fuck.
So much for balance.