Mealtimes and Milestones (5 page)

After tea, the amount of Enlive I was due to have was so much that a plan was made to give it to me in two feeds. I was going to be given the first part now and then attempt to eat a snack, and
then the night staff would feed me the second part – which would be even more if I didn’t manage to eat the snack.

Even after the first 750 ml I felt really sick; it doesn’t help that it is done quite quickly. After the second feed I felt so unbelievably ill. I explained to the member of staff that I
felt like I was going to be sick, but she offered no support or comfort. As soon as I was off observation I went upstairs to bed. I reached the toilets and just threw up. One of the young people
heard, and I asked her to go down and get a member of staff. They came up, but didn’t do much. I tried to explain that it wasn’t forced, but she didn’t seem convinced. I’m
going to sleep crying because my frustration is so huge, but I’m not going to go and get a staff member, I don’t trust them and it seems pointless anyway.

Wednesday 22 August

I had therapy today.
¹⁸
We mainly talked about my future because I was worried about it. One thing that I think triggered my worry
was that the GCSE results are coming out tomorrow, and this for me brought out a lot of feelings around education. Would this illness ruin my chances of gaining all ten of my GCSEs next year? Would
my school ask me to drop some? If they did, how would I feel? To be honest, I would be absolutely devastated. I feel so embarrassed that people don’t think that I can cope. I would be letting
myself and my family down. I have actually been thinking about my GCSEs since I was 11, and now they are just around the corner, but I am stuck in a hospital battling a mental illness and really
struggling to see the point of living.

Thursday 23 August

The GCSE results came out today, and it was really strange because they weren’t even my results but I was nervous. I just kept thinking about what I will get, and
how anorexia will affect my results next year.

The two young people in the group who had taken GCSEs this year got amazing results. One got 10 A*s, and the other 5 A*s and 5 As. I guess I feel jealous, because I’ll never be able to
gain such great grades. What I did find interesting, though, was that the young person who got 10 A*s said that she had worked and worked for those exams, to get what she thought would be a really
solid start in life, but in actual fact it hardly meant anything to her, because now she realized how much she had sacrificed her health for them. She forgot about her body and neglected it, and
the things that mattered to her now were the small ones.

This was really mind-opening for me. I need to realize that life isn’t measured by exam results – and perhaps I should stop thinking so far ahead, and just set small goals, like
eating a meal, or not crying more than twice a day: just small things, but things that will hopefully give me a larger sense of achievement.

In my core team meeting it was agreed that my uncle and aunt could visit this weekend, which is a bank holiday. Also, the plan for how my tube is managed was changed. Up to now I’ve been
getting ten minutes to make up the calories in Enlive after missing a meal or snacks; from now on I will have the chance to make up the missed calories in food at eight o’clock every evening.
If I don’t manage it then, it will be fed through the tube the next morning. The idea is to try to ‘wean’ me off the tube.

Friday 24 August

The new plan for my tube came into practice today. I needed to eat two pieces of toast and a snack to get up to date. I just couldn’t do it, though.

‘Why do you want to come off it? . . . It is symbolizing success . . . you are being a really good anorexic, and I am really proud of you for that.’

So I went to bed knowing I would be fed first thing in the morning.

Saturday 25 August

Mum and I went out to the local town when I had my visit. We went shopping and I picked up a top, but I couldn’t fit into it. I found this hard, because I
wasn’t quite sure what to do with the fact that I couldn’t get into it.

‘They did this to you.’

It brought home to me that I have put on weight, and I find this hard to absorb.

Monday 27 August

My uncle and aunt came today. It was great to see them and gave me a real confidence boost. We went bowling in the afternoon and had great fun. I didn’t win, but I
was surprised that I didn’t take that out on myself, because I would usually take that as meaning I am a failure, even if it was just for fun, but I didn’t, and it felt so liberating
not to be pressured by my negative thoughts.

Tuesday 28 August

We went back to Willen Lake today. We went on an orienteering course of 4 km. As soon as we were told this I thought about exercise, and it is still something very much at
the forefront of my mind, because it is something that I have struggled with in the past. I was worried whether it would affect my weight.

We walked for about an hour and a half, and at the end I was so completely exhausted. My legs ached and I hardly knew how to move. I found this hard to deal with because it made me think about
how much anorexia has taken away from me. I might have been exercising excessively before, but it meant at least that I had reached a certain level of fitness, and now not to have any of that made
me really sad. I used to run 10 km, but now I couldn’t even walk 4 km.

In the evening one of the other young people had a tube passed, and all my feelings just came rushing back. I feel sorry for her, but also jealous. I want to be the most ill. Even though having
a tube passed is a horrific experience, I am proud of it. I am obeying my voice, and some day it will reward me for that – it told me so.

Wednesday 29 August

In therapy we got talking about what achieving and what being the best actually means. In my life I have always striven to be the best, and where has it actually got me? I
have turned my determination into something negative. I have used it to try and become the best anorexic. We wondered why I needed to drive myself to achieve so much. I guess it’s because it
is a way in which people can commend me, which I feel I need so that I can gain a confidence boost, because I can’t find that self-belief. I need other people to appreciate me and my
achievements because at the moment I am unable to appreciate myself and value myself for who I am.

Thursday 30 August

The issue about my tube, and when it would be coming out, has been around quite a lot. I had to go for a meeting with my case manager after tea. She said that I should
have a think about it before I went in.

When she asked me what I’d been thinking, I said, ‘I think the whole “three day” thing is good, because once you manage to do this, it proves that you are ready to have
it out, but for me, it just seems that it could go on for ever because as soon as I get to the third day I panic and stop eating. Maybe something like a set date would be more helpful, say Monday
or Tuesday.’

‘Well, how about tomorrow?’

There was then one of those very long, awkward silences.

I’m not ready to have it out. I don’t want it to come out. It has become a part of me within less than three weeks. How could I say that, though? That I want another weekend of
people outside looking at me, curious about what is wrong with me? I desperately want to disappear and become invisible – but I also want people to notice me, as I haven’t got anything
they can remember me by, only my tube. I tried a bit to explain this, but actually I don’t want to because I am afraid that they might take it out even sooner. We came to the agreement,
though, that it would come out on Monday morning, whether I was eating or not eating.

Saturday 1 September

I rearranged my morning snacks so that it would allow time for me to go with Mum and Dad to Covent Garden in London and meet up with some friends there. It was really
great, the healthy side of me realized that this was normal, and wanted to have a normal life, but I also wanted to have a tube in for the rest of my life. I can never escape this confusion.

On the way back a man offered me his seat on the Underground, I expect probably because of my tube. I didn’t really think much about it at the time, except that he was a very generous man.
However, in the car afterwards Dad said that it had brought a tear to his eye. I was quite shocked by this because although I was very, very grateful to the man who gave up his seat, I don’t
realize or understand how much my dad cares for me, and thinks about me. It doesn’t make sense. I’m a person who has obviously caused him so much despondency, sorrow and frustration.
Why should he care for me? I just don’t get it. I am trying to think of reasons but I can’t. All I hear is:

‘You are a failure, everyone hates you. Your dad is just pretending to like you. He is deceiving you.’

I am sure that this isn’t true, but I can’t think of any reasons why it isn’t true, so I just have to believe the voice.

Sunday 2 September

I am really anxious about my tube coming out tomorrow, and I talked to my key worker about it. I am worried that I won’t be able to cope, and that it will have to go
back in. I also wanted to know whether it was going to be taken out before or after breakfast. I want it to be taken out after breakfast, because I think that I am going to find it really hard, so
it will make it even harder to then be expected to eat a bowl of cereal. She agreed, and said that my request would be passed on.

I guess I’m so worried because I know that, as the voice keeps telling me,

‘It IS going back in.’

I’m not ready. I’m not going to eat. I want to keep my tube. It’s how I identify myself as a person.

Monday 3 September

I sat down at the breakfast table, but then one of the nurses came to get me. I assumed that she was just going to confirm that my tube was coming out after breakfast, but
she just said that it was coming out now. It ran through my mind to say something, but I was too scared.

Pulling it out was a lot quicker than putting it in, but no less uncomfortable. She said, ‘Well, at least you have got your nostril back!’

I got up and smiled, but underneath I was crying a river, it was like a rainstorm was brewing up inside me, I could feel it all coming together.

I sat back down and my riverbank broke. I wasn’t sure what to do with everything.

I feel that it was quite insensitive to take it out, because one of the reasons that I have become ill is because when I’m upset or angry, I take it out on food. I am also confused why my
request hadn’t been handed over, because as I predicted I found it hard. The voice just took over:

‘You’re a failure because you don’t look thin. You’re not ill enough – just being in an in-patient hospital isn’t enough. Having the tube gives you a
status symbol, it tells people that you’re not managing and that you are an anorexic – now, THAT is something to be proud of and hold on to. Keep going, my friend.’

I do have another voice saying that I don’t want to be ill, but it is nothing like as powerful, and I have given up trying to fight the negative one. Every day is such pure labour; it is
like a thousand wars going on in my head each day.

I didn’t manage any breakfast.

I am finding it so hard being off the tube. I am managing food, but I can’t let myself drink. I feel like a swinging pendulum. The more I swing to the recovering side, the more the force
pulls me back to the anorexic side. Therefore if I remain in the middle, I stay totally neutral and satisfy both voices. To me eating but not drinking seems like the perfect solution, I will be
like a peacekeeper between the two sides.

Tuesday 4 September

It was the first day of school today at the hospital.
¹⁹
I went through with my key teacher
²⁰
how my timetable would be set out, and where I would do my extra subjects for GSCE (Geography, French, German and Latin). I was pleased because I’ve been really frightened
that they might make me drop a subject.

In the third session of the day we were set some temporary maths to do, just until some work was sent through from my school. I suddenly felt really pressured again. I want to stay on top of my
work because that is what I judge myself by, but I also know that my health comes first, whether it’s positive or negative. The right balance seems blurred in my mind.

That evening during tea a nurse came in. I still hadn’t drunk any fluids, and it had been two days now. I knew what she was going to do, and I really didn’t want it to happen. She
supported my head again because I was crying and kept moving it away. The tube came closer and closer to me, and was slowly pushed in.

It is corrupting me. It is my enemy but also my lifeline. It is unpleasant and sore, but offers my body fundamental nutrients to stay alive. It is a snake squeezing all the hope out of me and
restricting me, forcing me down a disconsolate path from which I can’t escape. I blame myself for everything.

Thursday 6 September

In my core team meeting I asked for consent to see either a friend or my grandparents this weekend. Although it would be less awkward seeing my grandparents with my tube,
I think it will be more motivating to see a friend from school because it is them I am really missing. It was agreed, and because it was such a positive meeting I even managed half a glass of water
at snacks.

I had family therapy in the evening. We discussed why I find it hard to talk to my parents about things. We wondered if it is because we are quite a jovial family, which therefore makes it hard
for me to say if I’m feeling low for fear that I will bring down everyone else’s moods too, and if I do that then I feel guilt-ridden and totally accountable for the unhappy mood. It
was helpful for me to see that I can be sad, and that my parents will be able to cope with that – they are mature adults. Although I don’t think that I’ll be able to put this into
practice.

Friday 7 September

I spoke to my parents, but it was too late to arrange for a friend to come this weekend. I found this quite hard, because I had really built up my hopes, and I really
believe that this is the motivation that I need to come off the tube permanently.