Editor’s note: This piece contains discussion of the symptoms and treatment of eating disorders.
Towards the end of last year I ended up in hospital. I want to write, I ended up in hospital again, but it was different this time – for the first time, it was an inpatient stay, instead of the day programs I’ve always checked in to instead. Day programs have always been a sensible option for me: they usually run over two or three, occasionally four, days in each week, and so rarely required me to step away entirely from my (freelance, casual) work – I’ve always been a ‘highly functional’ anorexic – and they’re also easier to access, because their size is not constrained by the number of beds available on the ward, unfailingly too few.
But I know too that day programs always felt safer to me, because they felt limited and delineated in the changes they could demand: because they tend to run from the mid-morning until the early afternoon, beginning with a morning snack and ending just after afternoon tea, the control I was asked to relinquish, each time, was only partial, leaving breakfast, dinner, and supper still under my small command, weekends still mine to do with what I would. I also never thought I was sick enough, medically compromised enough, frighteningly thin enough, for an inpatient hospital stay, mostly because I never went to hospital when I most needed to, when I was at my lowest weight. And because I hadn’t done it then, doing it later seemed like both a failure, and a waste.
The shock, when I finally entered the hospital, was immediate and awful. I was shown into my room, leaving my bags behind to be searched for contraband – scissors, cigarette lighters, artificial sweeteners, or any kind of food – and it was tiny and beige, the single bed, with its white, waffle-weave blanket cordoned off from another, exactly the same, by a sickly-green curtain on a plastic rail. The coat hangers had no hooks, but were built into the wardrobe, evenly spaced along a rail that automatically collapsed if too much weight was brought to bear upon it. Alex, who had driven me there, sat beside me on the bed – there was no chair – and I said to him, blankly, I didn’t expect it to look so much like a hospital.
I never thought I was sick enough, frighteningly thin enough, for an inpatient hospital stay, mostly because I never went to hospital when I most needed to.
Almost immediately, I was given a laminated menu from which I had to choose my evening meal. There were three options, none of which I thought I could manage, and when I tried to explain this to the nurse, a beautiful, cropped-haired woman with a nose ring and an eyebrow that seemed almost permanently cocked, she kindly but firmly said that regardless, I had to choose, and so I closed my eyes and pointed. I felt painfully alert, all the more so because the other patients seemed relaxed, even resigned, into their routine – they filed together into the group room, into a line outside the nurses’ station, to the row of chairs beneath the medication window, they gathered their jumpers before heading downstairs to the dining room, all so seemingly conditioned and unthinking that I had to ask each time what was happening; no-one ever thought to explain.
But more than this, the shock was visual. The hospital that I was finally admitted to was only really willing to take me because it is run by a renegade, a psychiatrist who set up the place in order to treat the patients who fall through the cracks – there are many, and they are veritable chasms – in the systems in place elsewhere. People who are too thin to be accepted into other programs, with directors unwilling to gamble on the medical risk that the critically underweight pose (these people are usually told to gain some weight and then come back, as if that were a simple thing to do). People who have multiple and complicated diagnoses or behaviours, such as self-harming as well as self-starvation, or PTSD as well as bulimia. And people like me, who have medical conditions underpinning their eating disorders, which make regular, unrestricted eating of full-sized and varied meals far more difficult, and possibly even unattainable.
What this meant, though, was that the other men and women on my ward were often visibly, viscerally unwell – some with bandages up their arms, some confined to wheelchairs to prevent their hearts from giving out, some so thin I couldn’t help, at first, to stare. I’d never, in all my years in treatment, seen someone this unwell. To my shame, it was days before I could speak to them properly, days before I could even see the thinnest among them as properly human.
One of the things, I think now, that first felt so fractured about my time within the hospital was that the landscape around me was so different, decidedly suburban, broader and flatter and more quiet than the space in which I now live. My window, once I was moved into a room that had one, overlooked something that may have been a canal, a creek, or a storm-water drain – a thin trickle of water through a steep concrete ditch – and a dry-grassed park backed onto by red-bricked and boxy apartment buildings.
One of the things that first felt so fractured about my time within the hospital was that the landscape around me was so different.
Eventually, once I’d been deemed no risk to myself or others, I was allowed to leave the grounds to walk here for fifteen minutes in the afternoon, the dried leaves of casuarinas and bottlebrush seeds catching in my sandals. The place was beautiful, in its own way, tranquil and languorous and filled with birdsong, but I missed the press of buildings near my home, the way they cram up close together, overspilling with wetter, fatter foliage – ivy, frangipani, tibouchina, silky oak. I missed the press of people, of cyclists, of dogs tangled up outside supermarkets, clothes shops and cafés. I felt alien here, and so alone.
The hospital was its own bubble – and set up deliberately to be so – but what this meant was that there were patterns of conversation, routine jokes and repetitions that became the fabric of the days there. I started drinking instant coffee, perhaps because everyone around me was constantly sucking it back, and then I started liking it (I drink it still). I learnt how to wrap the cuff of the blood-pressure monitor, twice daily, around my own bicep, and which buttons to press to make it inflate – although not how to read the numbers it displayed. My heart stopped hammering in my chest at snack times when I put the same things on my plate: a kiwifruit in the morning, a box of sultanas in the afternoon, three Jatz and a pre-packaged square of cheddar cheese at 8pm.
I joined in on the in-jokes, most of which involved comparing the levels of bloating that our changed hospital diets had induced in all of our bodies (I’ve never heard so many and such consistent jokes about constipation and farting in my life, despite growing up with a brother and a toilet-humoured father). One evening, when my friend Laura visited, I lifted up my shirt to show her my distended stomach and she just looked at me, puzzled and silent, and it was only then that I realised how odd a thing this was to do. We adopted each other’s patterns of speech: you’re a good egg, and, oh, what fresh hell is this, the refrain whenever we were served something that was difficult or just plain disgusting. These things were what we needed to feel slightly less uncomfortable, to feel a little bit connected, to survive.
These things were what we needed to feel slightly less uncomfortable, to feel a little bit connected, to survive.
There was a dark side to this too because we couldn’t help, at times, but copy the habitual ways that the others ate – separating trail mix into its component pieces on our plates, or slicing apples into impossible piles of translucent wafers, eating ridiculously slowly every time. In all the other hospitals I’ve been to, these kinds of rituals, called ‘safety behaviours’, were not permitted at the table, but this hospital was more lenient, more pragmatic, in its approach. We don’t mind how you get the food in, the dietitian, a wonderfully kind woman, said, as long as you get it in.
But I started feeling guilty and somehow greedy because my breakfast, one piece of toast (either undercooked or burnt, and more often than not stone-cold) and one glass of full-cream milk, didn’t take me anywhere near thirty minutes to complete, and I’d sit at the table with my empty plate and glass in front of me, awkward and ashamed.
On the day that I left the hospital I left early, so that I could arrive in Petersham, just up the road from where Alex lives, in time for breakfast, one of our shared rituals. I ordered coffee, real coffee, sweet-bitter and smooth, the cup a deep, mineral grey. Toasted sourdough, bread that was chewy and seedy, not wet and white; I held my handbag on my lap, because it still felt so novel, so pleasurable to be carrying it around. (Coffee I had known I’d miss; carrying a handbag, far less so.) Later, I unpacked my clothes, vacuumed my bedroom, watered the pots of cherry tomatoes growing in my small backyard. I’d missed my home, the habits I have that shape it and are shaped by it, the small delights it gives me across the day. I felt collected, grounded. And I thought, I must remember this, in the coming months, as my habits and routines become once more invisible because of their ordinariness, their everyday repetition. I must remember how they help me, hold me. I walked along King Street, just to feel it on my skin.
An extended version of this piece appears in The World Was Whole (Giramondo Publishing), available now at Readings.