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looked about my size, and bright-colored things like blocks, pegs, and crayons. On the other side of the room, a door and two windows looked out on a playground.

      A different lady, dressed exactly like Sister Mary Joseph, greeted us. Her black shoes with black laces peeked out from under her dress. This new lady smiled and talked with my mother and aunt, but I wasn’t listening. Instead, I looked around at the things in the room, wondering what they all were. There were no other people around, just the four of us. The room echoed a little as the three women talked.

      After a while, my mother announced, “It’s time for us to go, Anne Marie. Be a good girl now.”

      “No, don’t leave me,” I cried.

      “We’ll be back real soon, Anna Banana,” said Margie. “On Friday. I love you.”

      I cried while my mother and Margie walked out the door then watched as they walked through the playground. Margie turned around and waved. My mother didn’t turn back. I thought I’d never see them again.

      “There now, Anne Marie, it will be okay,” reassured the nun as she picked me up. “No need to cry. You’ll have fun here at Rosary. Tomorrow you’ll start school and meet the other children who will be here for you to play with.”

      I should have been used to institutional life by that time. Throw my things into a duffle bag on Sunday afternoons and say, “C’mon, Ma and Margie, gotta get to Rosary on time.” But, being four years old, I wasn’t quite up to being a trooper about this leaving home stuff. I’d certainly had a lot of practice at it in my short life, though.

      My mother later told me that I began my semi-incarceration at three months of age. I lived at the first group home Sunday afternoon through Thursday night and at my mother and aunt’s apartment for the rest of the week. The facility’s owner devised shortcuts to handle the dozen or so babies in her charge. Toddlers and older babies sat on potty chairs while they ate—to accomplish two functions at one time. Diapers were changed once a day. Babies were fed in their cribs with bottles propped on their chests. Crying babies were left alone.

      By the time I was eight months old, I had a diaper rash severe enough for Margie to bring me to the family doctor despite the five-dollar charge—about a quarter of my mother’s weekly salary. Later in medical school, I shuddered when I saw pictures of bacterial skin infections that developed in severe diaper rashes, as I remembered Margie describing the raw, red area stretching from my upper legs to my waist, covering front, back, and sides. It would have been swollen and oozing a yellow liquid with areas of bleeding and peeling skin. After the doctor examined me, he told my mother to take me out of that home.

      Years later, when my mother told me her side of this story, she talked about the difficulty of finding childcare in a time and place where women were expected to stay home with their babies. “That doctor made my life hell,” she said.

      Now as a doctor myself, I can see the influence this man had on me. Some people become physicians to follow a family tradition or because they aspire to wealth and status. A few enter the medical profession in gratitude for excellent treatment through an injury or illness. I chose medicine in part because I wanted to save people—similar to how my childhood doctor rescued me from neglect. My research extends this desire to the general public; if I can discover whether diet changes, weight loss, or exercise reduces risk for cancer or other illness, then hopefully some people will be saved from suffering.

      Within a month, my mother sent me to a home for physically and mentally handicapped children near Boston. Teresa Burns took care of babies and children with diverse conditions, such as polio, rheumatic heart disease, water on the brain, cerebral palsy, brain injury, and Down syndrome. In the 1950s, many of these children had life expectancies of only months or years. Their parents could not, or would not, care for them.

      I’m not sure how I managed to get admitted to her facility. Maybe our doctor pulled some strings, saying I needed special treatment for the skin infection from my diaper rash. I certainly fit the criteria of having parents who did not want to take care of me. Full of love and warmth, Teresa was as wide as she was tall, her body as soft as a feather pillow. To this day I love the comfort of being hugged by a chubby woman. This helps as an obesity physician and researcher, as I’ve never thought of obese patients as ugly, but rather as people with a health condition. I stayed with Teresa until I was three years old. For the following year, Margie babysat me on weekdays while my mother worked. The comfort and joy I experienced with Margie during this period made the move to Rosary Academy even more wrenching.

      Rosary was my third institutional home. It was as if I was a repeat offender. Go to an institution, do your time, get a short reprieve at home, commit a crime against your mother, face more time. My mother would often slap my face when I cried, or was sick, or wet the bed, or if she didn’t like the way I looked at her. I tried to be a good girl so she wouldn’t hit me or send me away, but it was difficult to know exactly what I was supposed to do to make her happy.

      Many of my memories of Rosary are hazy with its Gothic-like settings of dark hallways, classrooms, dormitory bedrooms, and bathrooms. Other memories are crystal clear like it’s happening to me right now in such bright light that I can see details without my bifocals.

      The Rosary boarders slept in one large dormitory room. The beds were arranged by age with the youngest girl’s (mine) closest to the bathroom and the oldest girl’s on the other side of the room. The room’s windows were close to the ceiling. No one could see in or out.

      That first night, I lay awake, unable to sleep. I clutched Ruthie tight against my chest and curled myself into a ball while the hated new doll sat on the cabinet by my bed. I wore my favorite pajamas, pink with little dark pink roses on the yoke’s ruffle. My head lay on my bunny pillow toy, the one with the big floppy ears and a pink pocket in the back. Margie had shown me how to put my pajamas into the pocket in the morning so they’d stay neat during the day. Although my sleeping things were with me, I didn’t have Margie and I didn’t have my own bed. I wanted to be at home so Margie could read me a Peter Rabbit story, rub my back, tuck me in, and give me a Kleenex to put under my pillow.

      As I lay in bed, listening to the sounds of the other girls sleeping, I couldn’t understand why my mother and aunt didn’t want me to stay at home with them. I decided that I needed to try harder to be a good girl so that my mother would love me, then all three of us could live together.

      At some point during the night, I fell asleep because I woke to the sound of ringing. Through a brain fog, I saw Sister Mary Joseph, moving a small bell up and down as she walked between the rows of beds.

      “Time to get up, Anne Marie,” she said over my head.

      I sat up, confused. Girls were going in and out of the bathroom, toothbrushes in hand. Others were slowly dressing by their beds, their backs to the room. All wore identical cotton undershirts, underpants, and full slips; those further dressed had donned blue uniforms.

      “You’ll want to visit the bathroom first,” Sister Mary Joseph explained.

      I inched out of bed and stood up. Sister Mary Joseph took my hand and walked me over to the bathroom. The other girls giggled but stood aside as she led me into the long room with its row of six sinks opposite a row of toilet stalls. She told me to go into a stall and shut the door behind me. I could see her feet under the door, waiting. When I emerged, she led me to a sink and showed me how to mix hot and cold water in the sink so I wouldn’t burn myself. There were no bathtubs here; the bathing room was down the hall. Back at my bed, she told me to find some clothes in my cabinet, get changed, and fold and store my pajamas. While I was doing this, she told one of the older girls to make my bed. Sulking, the girl did as told. I noticed she didn’t make it smooth and neat the way Margie always did, but I didn’t complain.

      “Hurry, Anne Marie,”

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