Wintergirls by Laurie Halse Anderson
On my daughter’s first Thanksgiving in 2006, I ate a cold slab of turkey with stuffing from a box and gelatinous cranberry sauce from a can. The year before, my husband roasted an organic turkey to perfection. I cooked my mom’s cornbread dressing recipe, truly a labor of love. My father-in-law contributed his homemade cranberry sauce.
Why the difference? I was a patient on a Eating Disorders Unit in a local hospital. I didn’t have food issues. My issue — extreme anxiety overtook me following the birth of my daughter in early October.
The Sunday before Thanksgiving, I called my brother at 6 a.m. His groggy voice answered the phone, “Hello.” I blurted out, “I need to go to the hospital.” Still half asleep he asked, “Why?” My response jolted him awake, “I want to be murdered.” The anxiety had morphed into intrusive thoughts. I was terrified I might hurt my daughter. I didn’t want to be the next Andrea Yates.
After hours of waiting and the intervention of one angry sister-in-law, I was admitted to the hospital. As a medical resident at Duke, she knew the system. They were waiting for my health insurance to agree to pay. She assured them we would pay for a night’s stay out-of-pocket if necessary.
The general crisis ward was full. The attending physician had a choice; the chaos of the psychotic floor or the relative peace on the Eating Disorders Unit. His decision forever changed Thanksgiving for me.
I’ve since learned my first experience was typical for admission to any psychiatric facility. . . shoe laces removed, bag searched, sharp objects taken away. Afterwards, I was shown my room and introduced to my 17-year-old roommate. This reinforced a bias. I thought eating disorders were an adolescent girl thing. They aren’t. The patients on the unit were women ages 17 – 53 and a 23-year-old man.
Next, restroom procedures were explained. This isn’t typically done on a crisis psychiatric ward. However, on an eating disorder unit the restrooms in each room are locked. When I had to use the restroom, I walked down the hall or pushed the nurse call button. A nurse would come as quickly as they could to unlock the door. Sometimes all the nurses were helping others; they couldn’t run down the hall immediately. Unlike the patients suffering anorexia nervosa and bulimia, I wasn’t monitored. I didn’t have to place a toilet hat under the toilet lid so my outtake could be measured. Thank goodness. I was suffering from c difficile, an intestinal issue. Being watched would have embarrassed me.
Life on an eating disorder unit is regimented. Meals and snacks are eaten at regular intervals. I ate alone in the day room. The other patients ate together in a small room. After meals and snacks, they joined me in the day room for post-meal observation. A time when patients are observed so they don’t give in to urges to purge or exercise. This time provides patients with distraction and support during the very difficult period of having to endure the feeling of being full. Anxiety is usually high during and after meals. Supervision, observation and support are essential to help patients get through this tough period.
On Thanksgiving, the patients’ compassion touched me. They were adamant. I shouldn’t eat Thanksgiving dinner alone. The nurses agreed. I entered their dining room; a room with no windows and bright fluorescent lights. The sign on the wall said “No Hoodies, No Pockets Allowed.”
Anorexia Nervosa and Bulimia Nervosa have commonalities with what I was experiencing. Obsessive thoughts about food plague these patients. Obsessive thoughts about other things plagued me. I obsessed about the ratio of baby formula to water; making certain to level the scoop with a knife. The scariest thoughts started with the fear I would drop my daughter. Right before I was hospitalized, I panicked every time I saw a plastic bag. The warnings about keeping babies away from them filled my brain. I feared I might forget and put her in one.
Every fourth Thursday in November, I give thanks, Once appropriate care was received, I improved quickly. The journey for those hospitalized for eating disorders is long. Not only do they suffer mentally, their body is shutting down physically. As a nurse told me last year, working on an inpatient eating disorders unit is hard. There are success stories; but often you see the same people again and again. Each time they arrive, they are a little worse than the last time.
As we remember those less fortunate this week, remember those struggling with an eating disorder. A holiday that revolves completely around food is one of their worst days of the year.
So why did I state at the beginning of this post Wintergirls by Laurie Halse Anderson haunted me? The teenage character in the book suffers from anorexia nervosa and also cuts herself. I’ve met her. She was my roommate.
If you suspect a friend or family member is struggling with an eating disorder, you can help. According to Cynthia Bulik, PhD, FAED, director of the UNC Center of Excellence for Eating Disorders, “It’s harder for family members to raise concerns to a loved one about an eating disorder than about smoking, drinking, drugs, or depression. I always tell friends and relatives that it is so worth pushing past their hesitation knowing that they might save a life. Be compassionate, but firm. Have resources at your fingertips.”
To learn more about anorexia nervosa and bulimia nervosa and how to get help for those suffering check out the links to the resources below.