Hungry (30 page)

Ned and I flew away, guilty yet grateful for a long, cramped trip through eight or nine time zones, sealed away from any news.

It came soon enough. Lisa called the ED day program near our house, but she sounded so bad that the intake person told her to have someone take her to the emergency room or they would send an ambulance. Lisa was admitted to the psychiatric ward at Stanford Hospital. It was a place that we had joked about, in a previous lifetime. Years earlier, when we knew the place only vaguely, we’d called it SMI, Stanford Mental Institute, as if you had to be very smart to go there. Big joke. Now my daughter was attending SMI.

My sister flew down from Seattle to stay at our house, and then Ned’s sister came from San Diego. Also there were Scott, Jake, our nephew and his wife, and my cousin Peggy, who had helped Lisa through the prom. We met my mom in Istanbul, where the cruise would start. She offered to fly home. If anybody flew home it should have been us. We felt like assholes, but we got on the ship.

We checked our email and called home. Elaine was making dinner for a full house, then they’d go to the hospital and visit Lisa. She told us Lisa seemed about the same. Doctors said it could take a while to find the right medication.

We had warned our friends that our stopover in Paris was doubtful, but when we changed our flight, the soonest we could get home was the following day. Part of us desperately needed to be with Lisa, our child. Part of us was incredibly relieved to have one glorious day in Paris with wonderful friends.

 

lisa:
When I got home from Arizona, I immediately resumed my old habits. I tried to restrict my food and to exercise as much as possible, and I lost five pounds fairly quickly. With my parents gone on their trip around Europe and Scott at work, I was alone all day with my disease. To fill my loneliness I binged and purged. I’d been home a week when Scott found me in the garage covered in cake crumbs. He took me to the emergency room, and I was admitted to the psych ward. It was our second trip to the ER. Two days earlier I had been on the phone with the intake coordinator at El Camino Hospital’s day program for eating disorders, the place I had turned down when I chose residential treatment. This woman feared for my safety and urged me to admit myself overnight. We went to the ER but the thought of being in a hospital with patients who were severely mentally unstable was too much. I promised to take better care of myself. But every time Scott went to work and I was alone, I would binge and purge until I coughed up blood. I went into the garage freezer to chow down a chocolate cake, and as I was leaving to purge, Scott came home. He looked at me, and I looked at him and said, “I just want to die.” His only response was “Okay, get your stuff. Let’s go.” And I knew we were going back to the ER and this time I had to stay. In the car I told him I didn’t know how I was going to do it but I planned on ending my life, that I had nothing to live for, and that I promised to leave a note. He snapped, “Well, that’s great, that’s fucking great!” I did not blame him for his anger.

We returned to the Stanford ER and they had to place me in the lookout room, a place for suicidal patients that had a security guard at the door. I was allowed to have one visitor at a time. The guard sat and read as I lay on the bed staring at the blank walls. He told me I looked too young and innocent to be this sad, and he prayed that I would get better. We talked for a little while about activities I used to like and my boyfriend, and then he brought me a magazine. I told him I was only twenty-two and wanted to die. He said there are too many people in the world who would be distraught if I died. I wanted to believe him.

After hours of waiting I was brought upstairs in a wheelchair. A nurse asked me routine questions and made sure I would not hurt myself. She took my vitals including weight (ninety-eight pounds), and we put together a standard schedule and treatment plan. My aunt had flown in to take care of me and to her surprise ended up sitting with me in a hospital room. From my room in the psychiatric wing, located right by the entrance to the ER, we heard sirens and saw panic. My room was also located next to the nurses’ station, making it nearly impossible to sleep at night. They gave me earplugs. I covered my eyes with my blanket, but every hour or so a nurse came in to check on me and shined a flashlight in my face. Most of the night, I followed the slow tick of my clock. Early in the morning a lab attendant came in to draw blood, finding it difficult to locate my veins as I squirmed. An hour later a nurse came in to take my blood pressure, heart rate, and weight. We started a weight curve with where I was and where I needed to be. My doctor explained they hoped to see a steady incline. I always went down. Unlike inpatient treatment centers for eating disorders, the hospital let me know my weight each day. I wanted it to go down.

Meals were at 8:00 a.m., noon, and 6:00 p.m. I had extreme difficulty choosing items on the menu, but my dietitian, Johanna, patiently sat with me as we tried to figure it out. I just wanted fruit and nonfat yogurt. The hospital did not have nonfat yogurt and she said I couldn’t have it anyway because I needed to gain weight. She required me to have soymilk with each meal to get more calcium, in addition to calcium supplements. Many meals I ate mainly vegetables or just the chicken off my salad. Unlike at the treatment center, no one watched me eat. I circled how much I ate on my menus so Johanna could monitor my weight and caloric intake. She said they hoped I was getting at least eighteen hundred calories a day, but I wasn’t—not even close. One of the interns, Jennifer, often sat with me at breakfast and asked me why I wasn’t eating. I told her it all looked like binge food to me and she asked me why it was a binge food, and I said, “It just is.” I wouldn’t let myself have french toast, scrambled eggs, or potatoes. Most days I had oatmeal, a banana, and cholesterol-free eggs. They kept opening Ensure shakes. Johanna explained that I was not getting nearly enough calories and needed the Ensure shakes. But I saw them as a one-way ticket to fat land.

In the hospital I felt no relief and no healing. I felt like a helpless mental patient when in reality I was incredibly sick, lonely, exhausted, confused, scared, and longing for someone to talk to. The doctors barely had any time to listen to my thoughts and feelings nor did it seem they even cared when they did lend an ear for two seconds here and there.

 

sheila:
Our nephew had set up a hospital meeting for Ned and me the day we got home from Europe. Seeing Lisa in a hospital gown, disheveled, hardly speaking, we could only say to ourselves, “She’ll get better.” We agreed to the suggestion of a new medication, and thus began the torture familiar to patients with mental illness and their families. The medication may not work, or may have terrible side effects, but in any case it’ll be at least a few weeks before you know. Meanwhile, Lisa was having delusions and decided she wanted to leave the hospital. She was put on a seventy-two-hour-hold.

In California, a person who is demonstrably a danger to herself or others, or gravely ill, can be held involuntarily for three days if authorized by a physician or police officer. The patient has the right to contest the hold. One afternoon I got a call from the patients’ rights advocate, who reported that Lisa had filed a petition to overturn her involuntary hospitalization. The advocate said the mediator who considered these petitions would decide based on Lisa’s ability to feed, clothe, and care for herself. Then she asked me, “Does she have a place to go?”

I stumbled. “What if I say no?”

“Then it’s highly unlikely the mediator will approve her petition.”

I said no.

My own daughter could not come home. I woke up at night and each morning, sure I’d dreamed all of this. No? It’s real? The walls of our bedroom were still pale yellow, the trim white, and Lisa was still in the hospital. I knew I wasn’t going back to sleep, but if I didn’t get out of bed, maybe nothing bad would happen. Or it would happen without my participation. I could stay in bed and not answer the phone until I became like the Jennifer Connelly character in the movie
House of Sand and Fog
. She stops paying the bills, stops taking care of everything, and holes up in the house that is no longer hers. Like Lisa, she has no other place to go.

When did these cotton sheets turned to lead? I couldn’t move. Sweating, I waited for a sign, something to tell me it really would be better if I got out of bed, but on that day, like day before, there was no sign.

The only shopping we did was for food, and Ned did most of that. If we went to a movie and ran into someone we knew, we’d stonewall. Well-meaning questions struck me as judgmental. I didn’t want to hear about other people’s children, or that a friend of a friend’s child had trouble with eating disorders and they could get the name of the place she went for treatment. My left ear ached from being plastered to the phone. Sometimes I would remind myself to use my right ear, but if I had to write something down, that didn’t work. I stopped answering the phone or returning calls for several weeks.

Ned and I scrabbled around for words that would sound like improvement. “Yes, she is a little better today.” “She has a lot more energy today.” Or, “Not as good as yesterday, but you know, two steps forward, one step back.” We said “better” so many times, it became an anvil chorus in my head. “Better better better better better better,” like the end of “Hey Jude.”

The psych ward is on the second floor, near where the maternity ward was when I had Lisa. The last time we were in this hospital, Lisa was eighteen months old, having tubes put into her ears so she wouldn’t get so many infections. The other child in the room had leukemia. We felt very lucky.

Stairs are quickest, but the stairwell often smells of urine. The elevator is for wheelchairs. The escalator is the best way. It feels like a department store. You can forget for thirty seconds that you’re not on the way to the lingerie section.

One week after Lisa was admitted, I arrived for the midday visiting hours to find that visiting hours were now only 6:30 p.m. to 8:30 p.m., and that surely we had been informed. Maybe we had.

Lisa was so thin, she often used a wheelchair, and she was threatened with tube-feeding if she didn’t gain a few ounces. Roommates and other patients came and went. One of them, a graduate student, came back to visit and told Lisa she looked better. “When people tell me that, it makes me feel worse,” Lisa told her.

It also seemed to make Lisa feel worse when other patients commented on what a nice family she had, coming to see her every day, how lucky she was to have parents who obviously loved her.

At the time, Lisa took this to mean that, with support like us, being sick must be her own fault. She interpreted any encouraging comments as, “This isn’t cancer, Lisa. Stop feeling sorry for yourself!”

Doctors said they wanted her to stay until she was well enough not to come back. Her diagnosis, in addition to anorexia and bulimia, was major depression with psychotic features. Not that the TV was talking to her. Psychotic features were defined as “excessive worries that don’t respond to assurances, or fixed false beliefs.” One recurrent theme was that she was committing insurance fraud, being in the hospital when she shouldn’t be there, and that the police would be coming to arrest her. Later, her therapist explained the logic of this, because in Lisa’s mind she wasn’t sick enough to be hospitalized. Another psychotic feature was: “Holds self to impossible standard.” She was convinced she was the worst patient ever. “I’m not following my treatment program” and “I messed up,” she repeated without end.

After six weeks, we were suddenly informed that Lisa was being discharged in a few days. What? She could hardly walk and was still hauntingly thin. We only knew that if at all possible, she had to get out of the hospital. The department’s helpful social worker lined up an interview with the director of La Casa, a residential treatment facility in the community since 1979. Only eight to twelve people live there at any one time. It reminded me of a great old house in Berkeley I used to live in, cozy living room with overstuffed couches, a big dining table, young adults milling around. La Casa had therapists, medical supervision, house meetings, and chores, including cooking dinner, and an offsite day program to work on reentry skills. Ned and I were thrilled to learn such a program existed, and that Lisa could leave the hospital and be safe there. Previously, our knowledge of halfway houses was as charities or mentions in a crime report: Someone from a halfway house was beaten up while walking downtown.

Lisa stayed two nights at La Casa, but her medications made her tremble uncontrollably, and then she got so scared that she called 911 and told the dispatcher, “I think I just killed myself.” She was having what doctors called a dissociative episode, a sort of out-of-body panic attack. Sirens blaring, the police came and took her, handcuffed, back to the emergency room.

When I was allowed in, there was a security guard posted at her room but the handcuffs had been removed. Because of the suicide threat, a security guard would be there the whole time. Lisa was more cogent, though, and even smiled when I arrived. A real smile, appropriately sorrowful. She talked about “goofing up” this time—not her whole life, not “I’m the worst person in the world.” Could something have clicked? For a few hours Lisa shared a room with a severely anorexic young woman, immersed in her laptop and being extremely snotty to her mother. She knew the staff, and she displayed deep knowledge about eating disorders, electrolyte imbalance, and irregular pulse. She repeatedly mentioned her potassium levels. Lisa and I were able to watch this display at a remove, which gave me hope, even though Lisa was back in the hospital. Scott came to the ER, but only one of us could visit at a time. Their relationship was unraveling. Embarrassed, Lisa wanted him to go home. Ned and Jake were away for the weekend, using the Portland tickets and hotel that Ned had canceled for Lisa’s emergency in June, but I wasn’t left alone. My cousin Peggy came to the hospital with her sweet Labrador retriever.