Mealtimes and Milestones

by Barter, Constance

  I was cross with her for taking me, but also relieved because my anorexia told me I was being recognized as a ‘good anorexic’. Finally I had something to identify myself by. I continued to refuse all nourishment, despite endless support from my parents and the hospital staff, until the point came when they had to act: I was delirious and my heart was beginning to slow down.

  Refusing water was my ultimate weapon. They even gave me a little medicine measuring cup, and tried to make me drink a sip an hour. But I couldn’t do it. I just couldn’t.

  ‘It will make you fat … don’t do it … they’re trying to trick you.’

  I stayed there for a week with a drip in my arm. Then I was transferred to a specialized eating disorders unit for adolescents.

  I remember being so scared while driving to the unit, but I didn’t cry. I didn’t have the strength to cry.

  At the unit I joined around fifteen other young people from all over the country, all of whom were also in-patients. I tried to think about it as like the first day of a new school term. The difference was that this time I didn’t know how long the term would be. Would I be there for weeks, months or years?

  Going into hospital as an in-patient, although it was such a gruelling experience, helped me to break this defensive anorexic shell and re-emerge as a more confident person – to realize that I am who I am, and I don’t have to compare myself with anyone.

  I was admitted on Tuesday 17 July 2007 and I was there for seven months. This is the diary that I wrote, starting in August.

  THE DIARY

  Thursday 9 August 2007 to

  Thursday 14 February 2008

  Thursday 9 August

  Weighing today. I really hate it. I just get so anxious. Have I put on weight? Have I lost weight?

  In the past I have usually had about two good weeks followed by three or four bad days. This pattern has almost become a habit, but where have the bad days gone? Shouldn’t they have come by now? I suppose I might be getting better! But how come? I’m not ready to get better. I still need to get thin. I can’t accept this, I can’t. The voice told me, and planned that I wasn’t going to eat. It told me that if I put on weight, that could be my excuse to starve myself again. It told me not to worry if I had put on weight this time, because I will soon be able to lose it again. It told me – so I have to believe it.

  I went down, undressed, got on the scales and waited for the three numbers to come up. Yes, I had only put on a tiny amount, but it felt enough to blame myself for.

  Breakfast was put in front of me.

  ‘No, don’t give in, you mustn’t. Do NOT put it in your mouth.’

  I kept telling myself this over and over again. Then I figured there was no point in not eating but still drinking, it didn’t have enough impact for me, I had to not drink either. I was so tempted the whole time, but I just kept saying to myself that it was for the best.

  For the morning activity someone came in to teach us drama. But to be honest I wasn’t really concentrating, I was preoccupied with thinking about food and water.

  Snacks.2 Resisting my snacks felt so good, because they looked really nice. I pulled them closer to myself to make it look like I was trying, but I wasn’t going to have any.

  At lunch I got to the stage of cutting the smallest piece of broccoli off. I got it halfway to my mouth, but then stopped …

  ‘DON’T GIVE IN!’ it shouted at me.

  I had a core team3 meeting today. My key worker4 brought up my eating today, and asked what was going on. God, I really wish she hadn’t. I just want to forget about it and get out of here. When they asked me how they could help me, I just didn’t know. I have wound myself up so deeply. I have dug such a big hole and there doesn’t seem to be a ladder around to get myself out, and I don’t really want to find that ladder. I’d planned to gain some self-confidence today through not eating, but now anorexia had taken over, and I wasn’t in control any more. It isn’t up to me, I just have to obey my illness.

  I only managed a few sips of water at afternoon snacks. I was feeling so trapped. Anorexia had taken control, and I didn’t know how to get out. I was so hungry, but it just kept telling me:

  ‘This is a good thing. Keep going. Never give in. Hunger is your friend; it means that you are losing weight.’

  It took a lot of encouragement from staff just to make me take those few sips. Afterwards I felt terrible. Everything had just become out of proportion.

  Afterwards, I had a meeting with two senior members of staff. They explained very bluntly that they would have to pass a tube5 if I carried on not eating or drinking. This put me in such a big mess, I was so confused about what to do, I had so many thoughts and feelings:

  ‘You want the tube because it gets the message across, it means you are ill.’

  ‘What? … No you don’t, it’s painful and unnecessary, you don’t need to go down that road.’

  ‘Just eat, Constance, you can do this, you are hungry and thirsty.’

  All these thoughts were running through my head and I just didn’t know which one to choose. I had already taken the decision to let anorexia take control, and that clearly was the wrong decision, but then again, it was making me thin so that is the best thing that has ever happened to me.

  In my core team they decided to let me have a phone call with a friend, but I couldn’t get through, so I had to leave a message. I just said that it would be great to talk to her and catch up if she wanted to give me a call back. I was quite nervous, because part of me was really ashamed of being in hospital and I didn’t want my friends to feel burdened with my feelings.

  I only managed six sips of water at tea. By now I was feeling really weak when I stood up and I really wanted to give in, but I knew that I couldn’t. I felt guilty too, because the staff were giving me so much support, and were really encouraging me, and I could see how it was affecting the rest of the young people.

  My friend rang me back after tea. It was really good to speak to her and just to hear a friend’s voice. For thirteen minutes I felt healthy, and that I could recover. It gave me real motivation – but just as quickly as the motivation came, it went when she hung up the phone.

  I had a session with my key worker this evening, and I shared some things which were really close to me. I just don’t see the point of living any more. I feel worthless. I’m not any good at anything. I find it so hard to want to put anything inside me like food and water because I am no good. I don’t deserve it. I’m nothing, so it is easier and better to have nothing inside me. My key worker asked me to think of three good things about me, but I can’t think of any.

  I had the same conversation with my mum in my phone call.6 She said that she had quite broad shoulders, but I think that it was hard for her to hear that her daughter just wants to die. So much of this illness is behind closed doors. I bet most people can’t imagine what it is like to feel this way. Imagine if my friends at school knew the real truth – that their friend is in a state of mind where she can’t see a way out. The voice keeps telling me that death is the only option. I have reached rock bottom, and I can’t see any hope. I am super-glued into a hole.

  I was obviously quite distressed about my phone call, so it didn’t help that I had to go straight into evening snacks afterwards. I walked into the dining room and just burst into tears. I didn’t know how to cope. When I’m upset or confused my first combat reaction is just to starve myself.

  I’m going to bed early so I can just get to sleep and forget the day, and drift away. If only it could be a reality.

  Friday 10 August

  I woke up this morning in a new frame of mind. I was going to do this, beat anorexia and not have a tube. This unfortunately went as soon as breakfast was put in front of me. My confidence and strong will were shattered once again by anorexia. It had blown things totally out of proportion. I had a few sips but this seemed like a gallon of water. I guess this is how it takes control and is so deadly because it makes you believe that you are
having more than you actually are.

  During team games my key worker called me inside. I knew from the minute she called my name that it was either about having a naso-gastric tube inserted now, or discussing when it would be put in. She had spoken to my parents, and they had given permission for a tube to be passed. I am so cross because I don’t want to live any more, I just want to starve myself to death, I don’t see why I am still here. It would be better if I wasn’t here because I am such a burden on everyone.

  ‘You’re nothing, a total waste of space.’

  What is the point of my life any more?

  She had also spoken to the nurses and they had taken the decision to pass a tube at 10.45 a.m., unless I could eat all of my morning snacks.

  I burst into tears again at snacks. My key worker walked down the hall with me into the dining room and sat down next to me. Even more thoughts were running through my head – not running, these were sprinting. I wanted the tube, I didn’t want the tube, eat – I was starving – don’t you just want to die, don’t give in and end your life, you are never going to recover, but they won’t let you do that. HELP!! . . .

  When 10.45 a.m. came, I had managed a bite of my snacks. The nurse then walked in, and because I had made a start the decision was made to let me have until 11 a.m., but then they would tube me. I just cried and cried. I felt like all the emotions that I had felt over the last few days were just coming up in buckets and buckets of tears. I was totally helpless, I couldn’t help myself, and I couldn’t accept help – anorexia wouldn’t let me. They gave me the last option which was to drink my snack in Enlive,7 but I just couldn’t . . .

  They basically had to drag me out of the dining room. I had to sit down on the treatment room bed. This was it. I was having the thing I least wanted, but also what my anorexia most wished for.

  One member of staff took the tube and measured it against my body to see roughly where my stomach was. While my key worker held my hand, she told me that she would push it up my nose, and then it would go down the back of my throat and then into my stomach. She moved the tube nearer and nearer my nose. I moved away, so she had to support my head. I was crying and groaning, but through my tears I begged her not to do it. ‘Let me die, I’m worthless.’ This wasn’t my anorexia saying this, though . . . this was me now.

  I thought about what my friends would be doing at that moment. Having fun at school, laughing with friends, enjoying life – and here I was, having a tube inserted into my stomach.

  To make it smoother going down they suggest that you take a gulp of water, so when it goes down the water opens up the passages. I didn’t want to have it, but I had it anyway just to try and make it more comfortable. She pushed the tube up my nose and then said the word ‘gulp’. I swallowed the water and the stiff tube went down with it. It was awful. For one thing, I didn’t want to live, and two, it was like I could actually feel the tube going down inside me and moving. She then taped the rest to the side of my face and round the back of my ear.

  It was then time for my first feed via an NG tube. They syringed up the Enlive, attached it to my tube and then pushed it down. I could actually feel my stomach filling up but nothing was entering my mouth. I felt really light-headed and I vomited. They got me to do breathing exercises to try to calm me down. It helped a bit but I still hated the sensation, and I wondered how long I would have to go through this for.

  I ate some lunch, but it was really uncomfortable with the tube in my throat. It feels like when you don’t chew a large piece of food enough, and you can feel it go down your throat. You keep swallowing and eventually it moves down and you can’t feel it any more, but the tube doesn’t move, and it stays there.

  In Friday Group8 one of the things talked about was the low mood, which was partly because of people not eating. I feel like all the young people are really mad with me, and that I have caused the entire low mood. One of the young people actually directed a question at me.

  ‘I wonder how it feels for Constance hearing this?’

  There was a long silence where I wondered whether to respond.

  ‘Yeah, it is quite hard, because when people talk about the non-eating, that is basically me, so I just feel like I take all of the responsibility, and I’m so sorry that I have affected you all so much.’

  There was another long silence, then another young person responded.

  ‘It’s just hard when other people don’t eat, because none of us want to, but sometimes you just have to.’

  The conversation then moved on. I just feel so guilty though. I don’t want to affect other people, but I also don’t want to eat.

  For the rest of the day I just had to keep thinking that the more I ate normally the less I had to have through my tube. It was such a struggle, with every snack and every meal. One of the staff members was lovely and offered loads of support as she could see that I was finding it really hard. She asked me why, but I just kept crying and saying that I didn’t see why people were being so supportive, when all I wanted to do was end my life. She kept reiterating that I DID deserve to live, and I DID deserve food, and I DID mean something to many people. I tried to believe this but I just couldn’t, it was too hard, and a complete lie to me. It’s all a lie.

  Saturday 11 August

  My parents arrived at 10 a.m. for their visit today.9 I had to get my tube re-stuck on as the tape wasn’t sticky any more, so they were waiting in reception for me. When I opened the door I found it really awkward. I knew that they were slightly anxious about seeing me in case I was angry with them for giving permission to pass the NG tube. To be honest, I am a bit, but I was just so glad to see them. Whenever something painful has happened to me before Mum has always been there holding my hand, but this time she hadn’t been there, which makes me feel even more lonely.

  When I left them to go into morning snacks, instead of having a green snack, I changed it for a blue and a red;10 this was more manageable for me, because it enabled me to have smaller mouthfuls. For me, it is more about the portion size, and not the calories, but while I have been here I seem to have developed an obsession with calories, because here everything is so calorie controlled – it’s hard to avoid getting caught up in it. I guess I didn’t count them before because there wasn’t any real option at school to know the calorific amount in the food; I just went on portion size, as that was much easier to reduce.

  I’ve tried different methods to disguise food for myself while I’ve been in the unit, to try to make myself think I’m eating less than I am, so I won’t get distressed about it. One thing I do is wrap food up in other types of food. I did this at snacks this morning. I put pieces of chocolate inside a dried apricot. I guess I was trying to trick my mind into thinking I was having less than I actually was. I finished my snack, but my guilty feelings just became too great. I walked out of the dining room and shut myself in the toilet. I couldn’t believe I had been so stupid as to give in.

  ‘You’re a failure. You’ve betrayed me.’

  I didn’t deserve to eat food. So much for wanting to end my life; I had just got as far as possible away from doing that.

  ‘You stupid, stupid girl, you deserve to die, you’re nothing, nothing.’

  The voice kept on and on at me.

  I tried to compose myself as I went back to join my parents, but one of the nurses had seen that I had been crying and called me back and asked if I wanted to talk. We sat down, and I just felt all of the emotions come back up again. I didn’t know what to do but cry. I possess so much self-hatred. I just want all these pressuring thoughts to disappear, and I want to be able to eat some food, even a snack, without feeling the need to commit suicide afterwards. Is that really so much to ask for? My parents had seen me talking to the nurse so when I went back Mum opened her arms out to me and gave me a big hug. I burst into tears again. I am fed up of this illness, I just want it to leave me alone, I want Mum to click her fingers and it all to go away, but it is never going to be that simple, and the road o
f recovery that lies ahead of me is very long, very hard and very frightening if I choose to take it, and I am scared of embarking on it.

  Mum and Dad left at 5.45 p.m I was incredibly sad that they were leaving but also glad because they are quite ‘lovey-dovey’ parents, and because I am so self-conscious about my body I don’t really feel comfortable with hugs, so I always get cross, but I don’t feel strong enough to say that to them in case they become cross with me. I would rather have a swift exit than a ten-minute goodbye. I want to exert independence, and I don’t appreciate that much affection, especially when I want to die anyway. I know I should be able to accept affection, but I just find it too hard.

  I ate about a third of my tea, but then I had to wait for my feed by tube, which just increased my anxieties. It was so much today, I was really down on calories. I cried the whole time that the nurse was feeding me. I know that this isn’t what I want in my life. I just want to escape and never return.

  I got a text from one of my friends tonight and it said:

  TEXT MESSAGE:

  Babe. There is always a tunnel out. ALWAYS. You have just got to wait until you find it – Which will be very soon. Everything will seem better soon. Keep the faith babe. xxx

  I just found that so inspirational, and I was really proud to be friends with someone so supportive, and things like that give me glimmers of hope, which I really need right now.

  Sunday 12 August

  I really wanted to go to church this morning. I just find it really helpful. It gives me an hour of peace. I find prayer very beneficial, and I believe that if you believe enough, God will answer your prayers. I used to go to church a lot with my dad when I was younger, but then I stopped. But since I’ve been ill, I’ve been praying a lot more, before I go to sleep.

  You have to be up to date,11 though, to go to church, and that is what got me through breakfast. I just had to give myself a chance to show myself that I did deserve to live. At the end of breakfast I still didn’t think that I deserved my life, but at least I had managed a meal.