"Right Now, As You Read This"
The first time I was ever treated for an eating disorder, in a medical unit at my local children’s hospital, I cried through a nutritional supplement and couldn’t finish it. Twenty minutes later, a nurse snaked a nasogastric feeding tube down my nose and into my stomach for the first time. I cried, begged, and pleaded; I told them I would eat. I was held down. The nurse left the room crying, and later told me: “I had to. It’s protocol.” I was thirteen.
Quickly, I learned to eat and drink mechanically out of fear of being held down and forcibly fed. There was something indescribably out of control, helpless, and terrifying about watching the Ensure (feeding supplement), inch up the tube and there was nothing I could do to stop it. When I was transferred to the medical psychiatric unit for the first time, at the age of fourteen, there was a level of desensitization to the procedure. I knew exactly what to expect –– measure, mark, lube, insert, feed. The procedure was clinical and cold, nurses did what they were expected to and few engaged with me. There was never any debriefing afterwards. More alarmingly, part of the protocol for those with eating disorders was to have the adolescent sit in front of each meal and snack no matter what. Male counselors dragged me kicking and screaming to the dining room to sit and stare at food that I knew I wouldn’t eat anyways.
The meal-time protocol for those with eating disorders was that you would have 30 minutes to eat each main meal, and 15 minutes to eat every snack. If you didn’t finish everything (and I mean every last bite –– they would have you scrape your plate), you were given a nutritional supplement and given 15 minutes to drink that. If you didn’t drink that, you were tubed. The tube was dropped, you were fed with a syringe, and then the tube was removed. I cried through every supplement, and eventually got to the point where I was force-fed six times a day. Each time, with a new tube inserted. This was a “deterrent” to refusal to consume orally. I was having tubes placed six times a day for months at a time.
There was no refusing it –– the times that I did, I was strapped down to a board (called a restraint board) and had a tube shoved down my nose and throat while in a supine position. In the evenings, when I struggled with exercising or vomiting (a medical symptom of my eating disorder, not bulimia), they would tube feed me again to make up for the calories lost, sometimes adding a 6th or 7th tube insertion that day.
There were times that force-feeding caused me to bleed. My nasal cavities swelled so badly from having such frequent insertions and removals that they had to try and pass a baby-sized tube. It exploded because it was so small that the Ensure was too thick to go through it. They prescribed me a medication to reduce the swelling in my nose, and didn’t record it on my discharge summary of medications. This went on, on and off, from the ages of fourteen to eighteen-years-old, until I finally aged out of the children’s hospital system and could refuse treatment.
The trauma that I endured while institutionalized didn’t end there. In that same hospital, I was given a PRN medication prior to every meal and snack (a benzodiazepine, six times a day). I felt like a ghost every day, and those four years of my life feel incredibly foggy because of how highly drugged I was. If I didn’t take my medication orally, they would threaten to inject it.
I watched my friends go through the same kinds of trauma. I saw so many children, (yes, children) get told that they “did this to themselves.” I watched people with chronic pain (including myself) get diagnosed with “Somatic Symptom Disorder,” and told that they were looking for negative attention. I watched teenages lose their minds from excessive ECT (electroconvulsive therapy). I watched restraints happen to my friends for hours and hours (longer than the law allows for restraint in children to be used). I watched children try to kill themselves because of the abuse they endured in hospitals. I watched myself get forced into family-based treatment even though the hospital knew that I was living in an abusive home. I had mits (padded restraints that velcro around your hands) put on me and left on me for hours and hours because I engaged in OCD behaviors like picking at my skin or pulling out my hair.
When I was nineteen and went to get eating disorder treatment after I went sharply downhill medically, and required tube feeding to maintain my life, they could not pass a tube on the left side because of how much physical damage the hospital caused. At the new treatment center, I was medically and psychiatrically neglected to the point of almost dying on the unit. I lost a significant amount of weight while in the hospital and my vitals became worse and worse to the point of having a hard time even standing. The unit was grossly understaffed, and staff members would just walk by me as I self-harmed or exercised (to the point of bruises on my spine). Nurses forgot to give me feeds. I was given the minimum amount of nutrition in order to barely survive. Two counselors consistently advocated for me and essentially single-handedly forced staff members to adhere to my treatment plan.
This hospital was negligent regardless of their good intentions. They stood by and watched as a nineteen-year-old girl almost succeeded at starving herself to death. My therapist recently told me: “These treatment centers don’t seem to care until someone dies under their care.” That could have been me. And yet, I still don’t believe that they would have changed anything.
The terrifying part about my story with psychiatric trauma is that this is not a unique story. There are so many children and adolescents (and adults!) experiencing what I went through, right now, as you read this.
I don’t have faith in treatment centers. I do not believe that they work. I do not believe that they have people’s best interests at heart. I do not believe they care. I believe that treatment centers are widely run as businesses. They are huge corporations that are damaging our children and making long-term consumers of carceral care, because it pays out. The mental health system doesn’t care about us.