Fragile

by Nikki Grahame

  Our neighbours just hated us because of all the screaming and shouting. They kept complaining about the noise but they were the least of our worries. It was a house so full of anger that nothing would keep us quiet.

  I was angry at Mum, angry at Natalie and angry at myself. Some days I would hit my stomach again and again, screaming, ‘I’m so fat. I hate myself.’

  All the time my weight was dropping perilously low.

  I was still attending outpatient appointments at Collingham, but even they were unsure how to save me. Whatever good work they did while I was in there was all undone immediately I returned home.

  By the start of October my weight was down to 29 kilos (4 stone 8 lb). I’d lost 9 kilos (1 stone 6 lb) in just four months. I was sullen, spiteful, having temper tantrums and rowing with everyone. I was vomiting up food soon after meals, and even several hours later if I felt the need.

  Mum says the haunted, troubled look had taken over my face again and she gave up the fight herself – she couldn’t see anything left that she could do to help. Then, one morning at the start of October, she told me we were going to an appointment at Great Ormond Street Hospital for Sick Children in central London. Great Ormond Street is a general hospital, I thought. This will be a walk in the park! I was so angry inside and so full of pain that I wasn’t bothered what happened to me next. It couldn’t be any worse than the present.

  On 16 October 1995 Mum, Tony and I trooped up to the Mildred Creak Unit at Great Ormond Street, which specialised in psychiatric and eating disorders. When we walked in, it looked more like a youth hostel than a hospital – it was really cosy with posters on the walls and lots of armchairs. A group of kids were sitting around having their afternoon snack and chatting.

  The nurse took me into a side room before guiding Mum and Tony down a corridor away from me. She returned a few minutes later with a glass of lemon squash and a couple of biscuits.

  ‘I’ve brought you this for your afternoon snack, Nikki,’ she said.

  I took one glance, smirked at her and replied, ‘No thanks, I’m going home soon.’

  How wrong I was – it was to be almost three years of pain, sadness, anger and loneliness before I properly returned home once more.

  CHAPTER 11

  DEATH PACT

  I’d been at Great Ormond Street Hospital for about a week when Nina arrived. Tall and super-skinny, with dark-brown hair which fell either side of her angular face in long plaits, she looked amazing.

  She was dressed really grungily in brown corduroy trousers and a Radiohead T-shirt. She was so severely anorexic and so cool. I was desperately jealous. Nina was the first anorexic I had ever met and to finally find someone else who felt and thought like I did was incredible. In the four years I’d spent at the Maudsley, Hillingdon and Collingham, I’d always been the only anorexic. That had just made me feel even more of an outsider.

  So meeting Nina was fantastic. She was like me, but better, because she was skinnier. Nina was 12, just a year younger than me, and we became best friends instantly. We thought we’d be soul mates for life. The staff put us in the same room and that first night we stayed up talking for hours, sharing our secret thoughts and dreams. It was

  obvious to us that we both had the same problem, although we didn’t really discuss it then or later.

  It was just as well I found a friend, though, because the rest of the kids on that ward were, quite frankly, nuts. They weren’t anorexic but they were some of the most seriously messed-up kids in Britain at the time. What I didn’t realise then was that I too probably qualified as seriously messed-up. But all I could see was myself surrounded by total oddballs. Sometimes it was funny the way people behaved but other times it was just horribly scary.

  At one end of the ward there was a girl called Isobel who spent every day propped up in a big wheelchair. She was very pretty but she didn’t speak or communicate with the outside world at all. She needed to be fed through a nasal tube, was incontinent and had to be carried or pushed in a wheelchair everywhere she went.

  But the incredible thing was that there was nothing physically wrong with her. Nothing! What she had was a psychiatric problem called Pervasive Refusal Syndrome, in which kids just shut their body down and go back to being babies. When her parents came to visit she would lie there and scream and scream. Isobel was at Great Ormond Street for two and a half years, then one day, all of a sudden, she started talking and walking. She returned home and went back to school. It was unbelievable.

  Then there were a couple of kids at the Mildred Creak Unit with Attention-Deficit Hyperactivity Disorder (ADHD) – to me they just seemed incredibly naughty and would run up and down the corridor screaming and shouting at all times of the day and night.

  Then there was a great big fat boy called Jonathan who we used to call Pugsley after the character in The Addams Family. He used to lie in bed all day and the nurses would have to bring his food to him because he claimed he couldn’t move. They even had to wheel him into the schoolroom.

  And there was another boy called Shane. He had this weird thing going on in his head where he claimed he couldn’t see or walk. I used to fight with him all the time. I could tell he was a liar and couldn’t see why everyone made such a fuss about him. When I saw him crawling past my room for a wee, I’d follow him down to the toilets, then look under the door and see him standing up for a pee. I knew I was right.

  Honestly, these kids were nuts and sometimes when they were having fits or tantrums it was terrifying. I’d come from a pretty ordinary middle-class home in a nice area with nice friends and there I was in a scene like something in a horror film. Often I felt Nina and I were the only sane ones in there. Although looking back, we probably had a lot of problems ourselves.

  At first they only gave me portions I was happy about, so I pretty much ate what was served up to me. My first dinner there, the day I arrived, was spaghetti hoops (a Great Ormond Street speciality), mashed potato (another of their favourites), one sausage and for pudding a fruit salad. So, although that was a lot more than I’d been eating recently, it was still bearable.

  After dinner, one of the nurses searched my bags for laxatives, which some anorexics use to flush food through the body, and razor blades, in case I was thinking of killing myself.

  Breakfast the next morning was OK too – one Weetabix, a piece of toast and a cup of tea.

  I felt I was doing really well and told myself I was fine again now. They should let me home in two days, I thought. But if they don’t, I’ll start refusing things. What I didn’t realise at first was that they were just warming me up with small portions and there was no question of them letting me home for quite some time. When I saw how wrong I was I began to refuse food.

  All of the kids in the unit would sit around the dining table together, watched by a nurse. There would be Isobel with her drip feed and Pugsley Boy Jonathan, whose bed had to be wheeled right up to the table. Every mealtime would be the same. ‘Come on, you need to make a start, Nikki,’ the nurse would say over and over. But I’d just carry on sitting there, staring miserably at my plate and shaking my head.

  I’d eat on Mondays because afterwards I’d be allowed down to Radio GOSH, the hospital’s station. But other days I just wasn’t interested.

  The policy at Great Ormond Street was that I had to stay at the table until I had eaten everything on my plate. I wasn’t allowed into the schoolroom or day room until it had all gone.

  If, after a couple of hours, I was still refusing to eat, everything left would get carried over to the next meal. So if I refused a snack, later on I’d have to have lunch and a snack. And if I refused lunch as well, that evening they would give me dinner, lunch and a snack.

  If it got to bedtime and I still hadn’t eaten anything, I’d got away with it – and I did. But then they’d threaten me that if I did the same the following day I would be tube-fed. So I’d go a few days eating a bit more before refusing again. It was a case of staying one step ahead of
being ‘tubed’ for as long as possible.

  Nina and I were equally obsessive about food and our conversations went round and round. ‘What do you think will be for lunch?’ ‘What will they make us eat for dinner?’ ‘How many calories do you think were in that casserole?’ ‘How many sit-ups will it take to work off that cheese sandwich?’

  But there was one big difference between us – Nina was cooperating with the nurses. She would beg for smaller portions and say things like, ‘Please don’t make me eat this,’ but in the end she would give in. Great Ormond Street was her first admission and she was still compliant and polite, like I’d been at the Maudsley.

  But my time there and at Hillingdon had made me fearless and far harder to control. I’d watched kids have screaming fits and rages and learned from them. I was well on my way to becoming a psycho child myself.

  After being kept away from my family for the best part of four years, I really wasn’t sure where I belonged any more. I’d been drugged up and dragged face to face with the horrors of mental illness and I felt deeply damaged by it. I was going into fits and tantrums more and more often and crying a lot of the time. My mind was utterly tormented. And although my anorexia had begun with a desperation to be skinny, now it was almost as much about beating the system as about being thin. It was Me against Them.

  One afternoon Mum took me down to the hospital shop to buy a helium balloon for my collection. I was standing in the aisle waiting for her to pay when I saw a plastic bottle of paracetamol pills. I wasn’t even thinking about what I was doing, or why, when my hand instinctively reached out, picked them up and slipped them in my jeans’ pocket.

  I might have been only 13 but I knew exactly what taking the contents of that little bottle could do and it felt very possible. After Mum had left for the day I called Nina over to my bed and turned out my pockets.

  ‘Where did you get them?’ Nina asked, staring at the bottle of pills and immediately realising the seriousness of the situation.

  ‘I nicked them downstairs and I’m keeping them,’ I replied. ‘I’ll put them in the second drawer of the cabinet between our beds in case either one of us ever really needs them. For if things ever get too bad.’

  ‘OK,’ Nina whispered. ‘It’s our secret. But we’ve got to promise that whichever of us needs to take them will tell the other one first.’

  ‘Pact,’ I replied solemnly.

  ‘Pact,’ repeated Nina.

  We should have been little girls making pacts no more serious than about which boys we fancied. But it was too late for that. We had already been propelled into a hideous other world far removed from childhood.

  I was still eating as little as I could get away with and was weak and listless. One day, Nina and I were allowed to go to nearby Covent Garden as a treat but I had to be taken there in a wheelchair because I couldn’t afford to use up any energy by walking. When we got there I bought a Baileys-flavoured Haagen-Dazs ice cream and ate the lot – it was fantastic. But the guilt I felt afterwards was overwhelming and I didn’t eat a thing the next day.

  After I’d been at the unit a month the doctors called a meeting with Mum and Dad because they were concerned I hadn’t really gained any weight since my admission. Dasha Nicholls, the registrar, said to Mum, ‘Things aren’t getting any better, Mrs Grahame. We might have to think about tube feeding.’

  When Mum told me what they were proposing I felt sick. I hadn’t forgotten the tube feeding at Hillingdon and exactly how painful and disgusting it had been. But worse still, I knew it meant I’d have no control over how much I was eating. But even though that threat was there I still refused to eat. I knew I couldn’t cope with the guilt I’d suffer if I gave in to their food.

  One morning I saw a nurse approach my bed pushing a trolley. On the trolley was a long tube. I knew exactly what this meant – they were going to tube-feed me through my nose.

  Dr Bryan Lask, my specialist doctor, came over and talked me through it. Dr Lask is a professor of child psychiatry and one of the leading experts in his field but he always talked to me as an equal. I really liked and respected him, so I listened.

  In the end I agreed to be tube-fed so long as I was allowed to follow a 1,000-calorie-a-day diet. That’s about half what a girl of my age should have been eating but I think Dr Lask hoped to be able to increase the amount later and felt that in the meantime anything was better than nothing at that point.

  The deal was I would eat normally during the day but whatever I didn’t eat in proper food would be made up for at night through the nasal tube. For instance, if I ate 100 calories of crackers at lunchtime and another 100 calories of fish at dinner, they’d give me the remaining 800 calories by tube during the night.

  It was a metre-long tube made of pure silk, which meant it was much softer and less painful to push into me than the hosepipe-like one they favoured at Hillingdon. A vanilla-flavoured milky liquid containing calories, fibre, protein, fat and vitamins called Ensure was pumped through the tube and down into my stomach.

  After a couple of weeks my weight stabilised and Dr Lask wanted to increase my daily intake to 1,500 calories. I went schizo. I felt I’d been betrayed and was furious. ‘There’s no fucking way you’re doing it!’ I screamed at the nurse as she tried to fit up a larger bag of milk feed.

  I went on yelling and throwing my body around until Dr Lask had to be called. Finally we agreed he could increase the calories by 100 every other day.

  But the day it hit 1,800 I went mad again. As soon as the nurse inserted my tube that night I ripped it straight out and tore it in half. The pain as the tube came shooting up my throat and down my nose was hideous. But I didn’t care. It was a victory to me.

  I was raging. A second nurse came and had to hold me down while they inserted another tube. But again as soon as she stepped away I pulled it out with one sweep of my arm and threw it across the room. That happened again and again until I’d destroyed six tubes. One of the nurses told me later that each tube cost £45. On top of everything else I was costing the NHS a fortune – but I couldn’t have cared less.

  For weeks I would rip out up to six tubes a day. I did it so often I became anaesthetised to the pain. Even now my nose still clicks because of the damage I did by pulling those tubes out so roughly.

  Sometimes six male nurses would hold me down, trying to keep my arms from the tube, as it was connected to the feed bag and pump. I was like a mad thing. Screaming, kicking, punching them, pulling their hair and scratching their faces to get them off me so I could grab hold of that hateful tube before it started poisoning me with calories.

  I was obsessed with keeping that tube away from my body. On different occasions I punched a couple of nurses quite hard and spat in the registrar’s face. Another time Nicky Harris, the ward sister, had to sit on me to hold me down because I was demented with anger.

  By now I was little more than a bag of bones but my desperation to stop them from feeding me gave me an inner strength. And I would never give up. It was like I was being driven by some demon to claw and punch and spit – anything to win.

  In the end the nurses got sick of fighting with me time and time again and one morning as I started screaming and lashing out, I suddenly felt a sharp prick in my bum. The sensation of drowsiness I’d known at Hillingdon soon surged over me and within a minute I was lying there unable to fight any longer. It was Diazepam, a sedative and muscle-relaxant which basically just knocks you out.

  That became the norm. They didn’t have the staff to spare six nurses to hold me down six times a day as they tried to feed me – there were another nine kids on the ward who needed looking after too. A ‘chemical cosh’ was both quicker and more cost-effective, I guess.

  In addition to the emergency Diazepam jabs, I was already on a daily cocktail of other drugs designed to knock the fight out of me and make me compliant. I was on Thioridazine, a tranquilliser, Amitriptyline, an anti-depressant, and Chlorpromazine, an anti-psychotic drug which was supposed to re
duce my anxiety.

  I went from being a real live wire, always slightly hyper and ready for a fight, to a total zombie. I was 13 years old and one of the living dead. My eyes were glazed, my expression blank and inside my mind it was like stumbling through a deep fog. It was like living my entire life buried under a huge pile of blankets, warm and comfy but suffocating too. I knew things were going on around me but every noise was muffled, every sight fuzzy and every sensation dulled.

  I’d fall asleep in classes or halfway through a sentence when Mum came to visit. I couldn’t concentrate on anything.

  At first I tried to fight the drugs by drinking litres of black coffee but then the nurses worked out what I was doing and limited me to one cup a day.

  Whenever the drugs wore off, though, I’d become even more angry than before. I was like a wild animal who’d broken out of its cage and wanted revenge knowing that it would soon be recaptured. I’d hit myself and the nurses, claw and spit. Often I’d go up to the playground on the roof, where there was an area for kids to shout and let off steam. I’d scream for hour after hour until patients all over Great Ormond Street Hospital could hear me.

  Even in my most docile state, I never totally gave in to the system. At every opportunity I would turn off the machine next to my bed which pumped the milk feed into my nasal tube. The milk feed dangled next to my bed in a bag connected to a machine, but I soon worked out how the machine worked. I would press a button at night to see exactly how many millilitres had gone through and how many were left to go, then lie awake for as long as I could manage to watch those calories flooding my body.

  Sometimes I switched off the machine but that was only ever a brief victory as the nurses would soon spot what I’d done.

  A craftier trick was to unscrew the connector which linked my nasal tube to the bag of Ensure liquid, then let the milky fluid drip from the tube on to my mattress. Sometimes I’d lie all night in a soaking-wet mattress that stank of vanilla-flavoured milk. But even that was preferable to having it go inside me.