The Griz

Annie, my therapist, has moved on. The med student changeover occurred last week as their month-long stint on our unit drew to a close. I knew from the time I started seeing her that we would be having limited visits. I don’t think the knowledge of her imminent departure hindered our conversations in any way, and I tried to get as much out of our frequent meetings as I could.

What it comes down to is that, with this being a teaching hospital, there are a number of medical students making the rounds as they work in one area one month and another the next. I still have my residential therapist,                     Dr. VanHalen, who oversaw Annie’s work, sat in on a few sessions, and meets with me for a short one-on-one at least once a week. VanHalen is a very animated woman as far as her facial expressions and hand gestures go. Her short thinning hair, wide open eyes, and boisterous personality almost make it hard to take her seriously but “almost” is definitely the key word in that statement. Its not easy to forget just how much sway she holds over the unit and over our individual treatment teams. VanHalen is assuredly a key player and shes not going anywhere any time soon.

All in all though I think I lucked out when Annie left as far as adjusting to her replacement goes. Paul isn’t a medical student with a short month-long shelf life, he is a psych intern. He will be on the unit until December and actually specializes in the psychiatry field which means I wont have to readjust again to someone new at all during the rest of my stay.

Paul is of an indeterminable age. If I was forced to guess I would have to wager between 28 and 34. His longish but slicked back dark blonde hair reveals and only minor hairline recession and the neatly trimmed but full beard he sports only has a light amount of white just in the very front where it comes to a point. To me he sort of resembles a reformed hippie mountain man who decided to try it in the real world for a while. His big teeth and expressive nature-boy eyes don’t fail to reinforce the idea that he would be perfectly at ease camping or planting an herb garden. Before I knew his name I started referring to him as Grizzly Adams, meaning the term in the nicest of ways, and eventually shortened his nickname to “The Griz”.

Judging from the 3 half-hour sessions I have had with Paul so far I can definitely say that I really enjoy working with him. Our sessions are productive, enlightening, and I actually lose track of time talking with him. Hes easy-going with his laid-back stance during discussions and doesn’t inhibit his colorful vocabulary. The passion he has for his job truly shows almost like his acute interest in what I am saying is so real its leaking out his pores. He just loves what he does and is not at all afraid to show it. It makes it easy for me to be open with him.

In any case it feels good to look forward to the one-on-one time. Its comforting to know that I really will get something out of it. Headway – here I come!

Clickety clack

The scale clicks as one of the nurses moves the little weights around. It takes a minute to get it right. The final verdict has to be perfect, safe, and secure. There can not be room for error. It’s an important process and, after a few minutes, Tiffany emerges from the exam room and holds the door for me to take her place.

I rise from my sitting position on the hallway floor and get a couple of “good luck” comments from Amy, Elle, Benji, and Laura who are next in the queue. Today is the day that I am aiming to meet my 75% of ideal body weight goal. If I can do this I can move up to level three and assume all the privileges that come along with it. There is the ability to go on staff-accompanied outings to pretty much wherever they are willing to take us. There is the emergence of new activities on the schedule that I wasn’t eligible for below 75%. These include some of the more physical things like going to the gym for a game of badminton on Sunday, participating in the yoga group thats held twice a week, and going food shopping off the unit in preparation for coffee klatch. At 75% there is also the cooking group that is immediately followed by a lunch in which we dine on what we have cooked. There is now the Wednesday lunch group in where the unit’s dietician, Sally, takes a few of us out to lunch at one of the many nearby restaurants or delis. Then, at 75%, there is the group that has been my aim for a while now – Menu Planning.

Finally I will get to decide from, limited mind you, list of meal options for each week. I have been here long enough to go through the rotation and try everything they have to offer, for better or worse, and now I can have more say over the composition of the meals I am consuming. I consider this with a slight smile bringing light to my still sleepy 6 am face as I enter the exam room.

The heavy door closes behind me and i start to get undressed. Its just me and today’s nurse in there and she is busy updating and organizing the charts on her clipboard while I lay each article of clothing on the counter as it comes off. The room is not as chilly on my bare skin today and I am thankful for that. I am down to the one thing we get weighed in, my underwear, and she follows me into the tiny bathroom where the scale stands tall and intimidating. The authority this hunk of metal takes on is almost eerie; its extreme influence unnerving.

I am used to the nurses doing double and triple takes when they first see me undressed. At first glance it almost looks like I am still clothed due to all of my tattoos but this nurse has been through weights with me before. It’s not new to her. I step up onto the scale’s platform with determination, feeling the rough non-slip surface beneath my bare feet.  The nurse slides the bottom weight around, first to the 100 which proves too much, and then back down to the 50 pound mark. The upper, smaller weight takes a little longer to adjust, a bit more back and forth. I watch the needle on the side do it’s slow shimmy.

Finally, with one reassuring glance at the exact numbers, I get my answer. In the last 48 hours I have gained the one pound needed to hit my 75% goal. Its just the first of many accomplishments in this arena and I can’t wait to see what is behind the new doors it will open for me. I dress again and head back to my bedroom giving the others in the hallway a thumbs-up as I go.

Life Honey Pie

This was an assignment we had to do for the creative writing group we have once a week here. The objective was to pick a word, an emotion or a thing, that helps describe how we are feeling, want to feel, or don’t want to feel, and write recipe for it. Here is mine…

LIFE HONEY PIE

(Thats a sweet slice of life, Honey!)

1. Start with a pie plate that has patterned edges to give the pie rim some fun texture.

2. Lay the pre-prepared store-bought uncooked crust in the plate so that it forms to the dish. We use this because, with so many other activities to enjoy in the world there just isn’t enough time to make the dough from scratch.

3. As an added secret bonus sift some sweet powdered confectioner’s laughter over the empty crust before putting it in the oven to bake.

4. While the shell is baking you want to mix the filling in a medium-size bicycle helmet. (The helmet adds a hint of adventurous flair to the ingredients.)

Filling Ingredients:

• 1 cup sliced raspberries soaked in a sympathy marinade
• 1 cup blueberry amore puree
• 1 cup mandarin hope segments
• 1 tsp dry crushed irony
• 2 tbsp Karo family syrup
• 1/4 cup brown sugar friends
• 1 tsp fresh cream of the past
• 1 tbsp softened butter of the future

5. Once these have all been mixed pour them into the crust evenly. The crust  should be out of the oven and cooled for a minimum of 10 minutes by now.

6. Place pie back in the oven for another 15 minutes and relax with your favorite pastime and a mug of cocoa as the tantalizing pie scent drifts through your kitchen.

7. When the pie is done baking let it cool for a final half hour while you wander outside and admire the nature around your home.

8. Top your pie with whipped understanding and sprinkle equal parts cinnamon reality and spiced imagination generously over the cream.

9. Serve immediately on neon-colored plastic frisbee dishes with a small scoop of iced faith.

10. Lastly drizzle your desired amount of glistening, amber, sweet, sticky honey over it all and dig in!

Easy as pie in just 10 steps!

Compulsory

Amy is wisp of a girl. At the age of almost 18 she is smart, sweet, and fun to be around when she’s feeling social. Most of the time she seems to look out at the world as though she isn’t sure it’s a place she wants to be visible in. There are instances though, more and more frequently now, that her potential and her inner strength shine fervently in her large brown eyes. She has so much going for her and I can’t help but feel a confident hope for her future. She has only had her eating disorder for a year and a half and, if she’s able to beat it now, it won’t have stolen too much of her life. It won’t have stolen her light yet.

Today, after research group, she handed me a note. It read:

“…I’m sorry for what you saw, or didn’t see. I know that what I did was wrong, and I know I didn’t try to be better about it. I’m sorry that I let you down, and I can understand if that makes you think less of me. I mean, what do I know? I am just a 17-year-old who is fighting against everyone who wants me in a better position, but can’t see it. Please let me know if any of my actions have affected you in any way. You have been a big support to everyone here, including myself. I’m sorry for my lapse and please let me know if I can do something to change.”

Just before the group she had had a lapse in judgement and I had witnessed it. We are both on the same schedule for our twice daily Ensure shakes and, having been cued in by Benji that something was amiss, I was keeping my ears and eyes open while I worked on my crossword puzzle. After a few minutes, with a timid glance around, Amy stood and executed a swift maneuver that resulted in the disposing of her Ensure down the drain of the drinking fountain. She was so hesitant, so already full of remorse and yet, so taken by the insistence of her eating disorder.

From what Benji said this all started yesterday. he had been in my shoes as witness to action and had had a talk with Amy about it after the fact. When he related the story to me as we walked outside it was the air of sadness at Amy’s decision that relayed through his voice. Neither of us wanted to see the bright girl, who was quickly growing on us like a younger sister, turn down that road. Thats the strength of compulsion with eating disorders though. It didn’t matter that Amy was disappointed in herself or that she regretted what she did after the very first time she did it. The fact remained that she hadn’t been caught by any of the staff that first time. She had gotten away with it once and therefore the urge to do it again held strength enough to overrule any part of her that rued her actions.

This is the sickness of it. Its the pit the eating disorder seems to drag us into – this abyss that sucks us up entirely while letting us fall without reaching the bottom.

HOPE. All I can say is hope. With enough hope that falling just might turn to floating and I have every hope for Amy. Now we just have to see what she does. The rest is up to her.

At the table

For some reason we have been processing after meals a lot more recently. Its a basic exercise that really just involves the group of us sitting around the large dining room tables for a chat. After loading our more or less empty trays back into the trolley to be taken downstairs we kill the radio that livens up our mealtimes and settle back into our seats.

With this being an eating disorder treatment center it goes without saying that there will inevitably be some issues surrounding meals. In processing generally someone starts the group off, lately this job has fallen to Elle, and from there we go around the circle and discuss anything from the dining experience that might have been difficult for us. Usually any staff with us at that point remains pretty quiet and we do our best to offer each other support for our various issues.

Just because I have been tacking each meal with an ease and acceptance thats surprising even to me doesn’t mean that everyone else has such a relaxed time with it. Different meals have different components that create different amounts of anxiety in different people. For some of us its been so long since we have eaten in a natural social setting that we aren’t even sure what a “normal” way to eat certain things might be. Questions, like weather or not you would use a fork to eat a brownie and how many pieces one would usually cut a hamburger into before picking each one up and biting in, do come up. These quarries may seem silly to someone looking on but, to my peers, they are legitimate and the search for the answers is real. We just want to get back to a societal normality because our versions of table manner are so bizarrely skewed.

Elle, for instance, has problems touching her things. The idea of something being a finger food is not a concept that is easy for her to accept. Once she touches a food she gets the feeling that its crumbs, oil, or other remnants are all over her face and hands. In the beginning she wouldn’t pick up any of her meal with her hands. Now, after some time and a lot of encouragement, she still cuts things up a bit more than other people but she will pick up the pieces to eat. She has also been doing a great job fighting the urge to wash her hands of the imaginary debris the food has left after each bite.

Another one of the girls, Carrina, has issues with peanut butter. It’s a fear food of hers and she doesn’t want to be around it because it used to be the main thing she would binge on when she was back home. The other day she explained to some of us that, before she came to Columbia, she cleaned her room and dug up about a month’s accumulation of jar from its depth. She admitted that there were 26 cleaned out peanut butter jars that had been stashed in various spots. Here though she still has to face her fear. She doesn’t have to tackle the peanut butter issue everyday but she’s not allowed to avoid it either.

Other issues surrounding our meal table include things like cutting food into miniscule bites, putting salt on literally everything, the compulsion to eat things only in a certain order, or chew each bite a certain number of times. We are all trying though. Its hard but we are doing our best to overcome these things which can be so baffling to the average public.

Processing after meals helps all this and, although I don’t always have a whole lot to add myself and sometimes people say the same issues over and over, its good to help. As far as providing support goes we are a good little family. I’d be more than happy to have any of these girls on my side when and if I ever need that extra help.

The Confi-dance

It’s the last day of July and in about 48 hours it will have been three weeks since I left home. I’ve talked to Chris on the phone, through email, and via instant message more than once a day. My mom and I chat every few days by phone or computer. And I have kept in touch with the guys at work where everything seems to be running smoothly. I miss home, my job at the tattoo shop, my animals, my life…but not in the way that I’m homesick. I miss it all in the way that I am just so excited to return and have things be that much different in good ways, for me to be that much different because I’ll be healthy.

In my lifetime I have never truly believed that I really was deserving of a change like this. At the same time though I have never been so consciously proud of myself as I am each day with this. I have been proud of random acts, certain decisions, or pieces of artwork in the past but I’ve always been proud of the outcome and not specifically the person doing the deed. It’s almost like, in my mind, I just considered it a fluke that I happened to be the one doing those things. It’s truly different, and for me foreign, to actually have this belief in myself.

Thats not to say that I don’t feel the old pull of tension when I put myself in the place of something I have created. I’m not outwardly boastful about things and I try to keep an air of modesty when I talk to other people. Inwardly, though, I am much more conscious that I am the one who accomplished these goals. It didn’t happen by accident – it was me.

Sometimes my mind will try and tell me the same old refrains about how I don’t deserve to feel good about a deed. It tells me that I didn’t do it well enough, that I should have done more. It speaks to me about how everything I do now thats good is just another thing I owe the world for screwing up so bad in my past. Its like every good action is part of the penance I own for messing things up and hurting others years ago. But how long do I have to believe my every action is part of some cosmic repayment plan for my past? I’ve been told time and time again that I deserve to be happy but it wasn’t until now that I really believed that to be true to any extent.

Now it may not be a recognizable change outwardly but, inside, for once I feel truly good about myself. I’m walking a difficult road right now but I know that I am the one doing it. I am accomplishing things now that I truly believed I did not deserve to accomplish before…and it feels good. I know the potential for amazing new things is that much  more heightened because I am here now doing what I need to do for myself.

Now I just have to keep it up while thinking clearly about the next thing life throws my way. No matter what that may be.

The weight of progression

I am sitting in the dimly lit dining room where the tables have been pushed against the wall and yoga mats laid around the floor. Stress and coping group is rolling right along as the Friday afternoon sun leaks in through the slatted blinds. We do different things each week in this group but it’s mostly meditation and guided imagery oriented. If we aren’t into that sort of thing we have the option to read, journal, or do something else deemed suitably soothing quietly while the meditation tape plays in the background.

Elle is asleep with her Star Trek novel open in her lap on the couch next to me and I look up from my writing as her breathing becomes audible. On the other side of her, in a chair, Benji struggles to keep the comic book he’s reading from falling to the floor as his own eyes threaten to give in to the atmosphere of this makeshift sanctuary. The others lay on the mats more or less following the direction of the recorded voice that urges calming exercises between interludes of piano music and nature sounds. If proposed, I’d definitely place a wager that more than one of them is asleep as well.

Its one of the more stressful days due to some clashes between patients and staff earlier and the weekend weights taken this morning. The rule is that, once each of us enters the official weight gain phase of treatment, we have to gain a minimum of 3/4 of a pound each time the numbers are taken. Every Monday, Wednesday, and Friday are the stressful days as, at 6:30 am on the dot, we line up outside the exam room for the scale’s verdict. These days it’s a difficult balance that shakes everyone’s ease. It’s hard for most to watch the scale go up no matter what the amount is but, at the same time, we want that 3/4 difference because if we don’t make it we will be RTU until the next weights check.

RTU stands for “Restricted To Unit” and basically means that we are confined here no matter what our status level is. For me that would mean no fresh air breaks, which I value pretty darn highly due to it being the only outdoors life I have right now. For Elle, who is on level 3, to be RTU would mean the loss not only of fresh air breaks but also of any other outside privilege. At level 3 we have the eligibility to go on staff-accompanied outings to places outside the building. sometimes its to the store down the street for supplies. Sometimes its a trip out to eat with one of the staff members for practice. Then, occasionally, its doing something that involves delving deeper into the city like going clothes shopping or getting a haircut.

To have that freedom and then lose it, for any amount of time, can be a depression-inducing blow. RTU is meant to limit the amount of physical activity a person does so they can gain the intended amount of weight by the next official day. However, these days can be mood lowering on the other hand too because a lot of girls here are still terrified of the scale moving at all. They may be eating more but they are still giving their eating disorder sanctuary in their back pockets and letting it have its way from there.

Regardless of the confusion and sense of upheaval most of us feel regarding the weights vs. RTU issue, I believe they have a really good system here. They know what they are doing, as far as the program structure goes, and what a lot of it comes down to is acceptance. There is no other choice beyond that of accepting your body, accepting the weight gain, and accepting that you will have to live with your new self for at least 4 weeks once you are in the weight maintainance phase and doing a bulk of the research participation. I don’t know the exact numbers but, from what I’ve heard, Columbia has a higher long-term success rate than many other in-patient programs, and that’s some news I can definitely accept.

United diversity

The conversation with Benji and Cora had gotten me thinking. There is so much about this illness that so many people don’t understand, and the stigmas surrounding it don’t help in the least. Even I, before all of this, upon hearing the word anorexia would automatically jump to the image of popular highschool cheerleader just trying to get the guy. I have since learned that that ingrained mental picture is terribly wrong, but still the education of the public on the true nature of eating disorders remains at a minimum. There is so much more to it than the flimsy stereotypes and it took actually realizing that I was anorexic myself to actually understand that. Laura, who has been living with this for more than 10 years, frequently states that she wouldn’t wish and eating disorder on her worst enemy.

Diane is a good example of the diversity surrounding this. She is the new patient. Since her arrival yesterday she has done little more than sit with her head resting in her thin arms and her small frame bundled in multiple sweatshirts. Exhausted doesn’t even begin to describe how tired she looks, but it’s not a sleepy sort of tired. Diane is the perfect picture of being stretched too thin, taking on way too much in life. She looks so delicate – as though poking her with even just the tip of a finger would cause her bones to just separate and fall to the ground with a breath of dust that radiated relief.

At the age of 47 Diane is officially the oldest among us. We learn that she has 6 children ranging in age from 21 down to 8 and, looking at the differences between us, I almost can’t believe we have sons the same age. Topping off raising 6 kids she has spent her life going to school for nursing and working full-time as well as avid volunteer work in various areas. She is slightly shorter than my own 5’4″ stature and her husband’s shadow completely engulfed her when he accompanied her at check-in. With her gaze trained to the tiled floor her short blond highlighted hair falls forward hiding her face. Beneath her sweats and slippers she nervously fingers a string of pearls that hangs from her swan-like neck.

Tonight was the fifth meal since her arrival that she has joined us at the table for but she does little more than just that. The previous meals she at least ate a little, although it was a visible struggle for her, she would get about half down each time. Tonight though dinner was apparently out of the question. With her frail hand at her forehead to shade her eyes she didn’t raise her gaze or eat a single bite.

I had thought that having someone near my size come in and not eat would hinder my own progress because thats what happened at Remuda. Others not eating was a huge trigger for my own eating disorder tendencies to jump in. This time, though, it was different. The only thing that Diane not eating made me feel was a boost of determination. The conscious refrain of “I don’t want to end up like that” silently urged me on as I finished one of the biggest meals I have been faced to here to date.

Part of me was mad at her for not taking advantage of her situation here but maybe shes just still adjusting. Everyone comes in here with a different attitude towards recovery and there is plenty of potential for things to get better for her. We’ll just have to see how she does. Its all about time.

Fiends and fears

It was coffee time and Benji and I watched the clock tick away our allotted minutes until someone came to deem us ready to leave for the small upstairs cafe.

“I’m going to give them until 8:47 to get their act together before I start pestering them about leaving.” Benji was speaking of whichever one of the 3 staff members would be escorting us upstairs as his knee jumped in antsy anticipation. “We are running out of time!”

“I know, I know,” I said as I shuffled cards around in my computer solitaire game, “I don’t know why they put groups back to back with fresh air time when we are always running late in the mornings.”

“And its only the mornings!” Benji exclaimed, as he peered around the corner at the front desk for the umpteenth time. “All i ask for is my coffee in the mornings. Is that too much? It would be good to have more than 10 minutes to drink it in too. This standing around chatting like they are doing right now – this is crap!”

Just then Cora walked into the tiny day room. Cora was a larger woman, one of the nursing staff, who had a fluctuating attitude that she didn’t attempt to hide.  “What was going on with Elle at breakfast? What was the problem there?” She eyeballed the unkempt stack of magazines on the coffee table for a moment before looking from Benji to me and back again.

“Oh, she was just having some problems with the peanut butter. Its one of her fear foods.” Benji glanced past Cora at the front desk once more.

“She did a good job though. She ate it all in the end. It had just been causing some anxiety.” I added.

“I don’t understand. i just don’t get how someone could be scared of something like peanut butter.” Cora said with a gesture of her hands that displayed her giving up of comprehension. “In my house peanut butter is normal. The kids all eat it, everyone eats it no problem. Why would someone be scared of it…its just peanuts and sugar!”

Benji and I tripped over each others words as we both jumped in at once to try and explain the thought process behind “fear foods”. By the time we had sorted out who was going to say what though Cora had already turned and walked away. Benji looked at me.

“Well shes not known for her niceties.”

“I know,” I said, “but what I don’t understand is how someone who works on an eating disorder unit hasn’t had training in basic ED habits. Not only that but her walking away like she did just shows that shes not even going to try…”

“Coffee!” The call echoed around the room cutting our conversation short, that one word trumping all else.

REM

Oh the tricks our minds can play on us in dreamland…They do seem so real sometimes. Last night my subconscious played a haunting game over my field of sleepy vision as I snoozed beneath the white linen sheets. In the dream I was here, at Columbia, in New York as I am now. It started with me arriving and working out last-minute details of my stay as I got settled in. It played by the reality that I now feel in my waking hours and tried to pass itself off as a generally good dream. Quickly though it turned on me as my fears about this situation became apparent.

In the dream, after only a few weeks stay, I had to leave Columbia and go back home. I was terrified. There was no reason why I had to cut treatment short, I was just told that I had to go. Thats when it turned into a nightmare. Knowing I hadn’t been there long enough and terrified of just falling back into my old habits I headed home.

I’m not going to go into detail, because its evident what happened as a result of me leaving treatment early in the dream, but what does it mean? I can only assume that it’s a good thing that even my subconscious is scared to leave treatment. I hope that means my chances of continuing in recovery are that much better when I return home. It’s a tricky road to maneuver with lots of potholes. Here I am in an all new environment – new people, new schedule, new meal plan, everything. It causes how I eat and view food to stubbornly fall in with the agenda. It makes it easier to accept.

I’m not saying that once I am back in the environment that I know and love, the place I enjoy calling “home”, all my old habits will assuredly come back. I just know that there is, in fact, a very real possibility and recognizing that I am scared of it will allow me to figure out a defense. If I am better armed against the potential enemy rather than allowing my new-found joy of life leave me open for a sneak attack then that’s all the better. I will be prepared.