The night before I was supposed to go to EDAM felt like I was preparing for jail. They had sent over a packet with information about what to pack and what to expect once admitted. I remember sitting at the counter with my mom, both equally horrified at what we were reading.
The list of forbidden items to pack was miles long, with everything from chewing gum to slippers to sweatshirts with sleeves that went past your wrists. Upon arriving, it said, all of your items would be confiscated and examined. Anything that you were allowed to keep would then be locked up in a cabinet, which you would have access to twice a day when you were changing in and out of pajamas. You couldn't even keep a toothbrush out.
You would have a CNA in your room 24 hours a day. You couldn't move farther than from your bed to the chair next to it without the CNA's permission. Your bathroom door would be kept locked, and if you needed to use it the CNA was required to stand in the doorway and watch you. You couldn't use the bathroom for an entire hour after mealtimes, a big problem for people like me with pea-sized bladders. Every meal was timed: 30 minutes for snacks and 45 for breakfast, lunch, and dinner. You could have nothing at the table with you. Blankets and jackets were forbidden while eating and your sleeves had to be rolled up past your elbows; another problem as many people who are underweight tend to be extremely sensitive to the cold. You were limited to one glass of water during the night, and you'd be woken up at 5 A.M. each morning to be weighed. You could go back to bed if you wanted, but if you chose to sleep you sacrificed your only opportunity to shower for the day.
I understood the idea behind a lot of the rules. Since EDAM was primarily formed to treat patients with eating disorders, these rules were in place to help prevent some of the behavior that comes along with their illness. However, by treating patients like prisoners, it gives the feeling that they did something wrong and that treatment is a punishment. Reading all of these rules that night, I was beyond terrified. I was the kind of kid who never got in trouble at school, who would come home sobbing when a teacher would reprimand the whole class and require hours of convincing from my parents that they probably weren't mad at me. I knew I was constantly going to be stressed out about doing something wrong or getting in trouble, and the restrictive policies were certainly going to make me feel even more uncomfortable than in a normal hospital setting.
At this point, I was having major second thoughts about my decision. Maybe, maybe I would be able to bear it if my parents could be with me, but I just couldn't even imagine being stuck there all alone. My mom tried to stay positive, suggesting maybe it wouldn't be as bad as it sounded, but I could tell she was shocked by the nature of some of these policies as she read them off to my dad. Ever the optimist, he suggested, "maybe since you don't have the mental side of things, they'll make exceptions for you," but clearly EDAM had had this request before. Plastered all over the packet was disclaimers that these were their policies no matter why a patient was there.
The next morning, I walked between my parents through the parking garage and up to the hospital entrance, clutching a Mickey Mouse stuffed animal like a five-year-old kid. By now, I had given up on feeling angry or resentful, instead I was just scared to the point of numbness. Two CNAs were waiting at the entrance with a wheelchair, and I was immediately made to sit as they took my suitcase (and my Mickey stuffed animal) from me. One of the nurses rolled me into the elevator, leaving my parents behind. They were hoping to be let into the unit during the admissions process so they could talk to my treatment team and know what was going on, but since it was outside of visiting hours, we weren't sure if they'd be allowed and I didn't know when I would see them again.
The CNA barely spoke to me, besides telling me to undress and change into a hospital gown. She poked and prodded at me, taking vitals and tests, without ever telling me what she was doing. I had no idea what was going on, I didn't even know if I was supposed to be sitting or standing or lying down, but I remember being so nervous that I was going to do the wrong thing and be scolded. Then it was time for me to be weighed, but I would have to use the bathroom first. I sat there with the CNA staring at me for ten minutes, but I just couldn't do it. If you've never had the experience before, having someone watch you try to go to the bathroom is quite possibly one of the most degrading things imaginable. "Can I just try again later?" I asked. She begrudgingly agreed, but only because the heater in the room I was in was broken so she was going to have to delay the rest of her checklist until I was moved into another room.
There were so many people coming and going that day, I don't remember much about the sequence of events. But I do remember, with every new person that came in, it felt like more bad news was being piled on. Soon after arriving, it was my morning snack time, and they brought a banana and a cup of the most sickly sweet fruit punch I'd ever tasted. I hadn't been briefed on the mealtime rules yet, so when I removed a small piece of the banana that was black and mushy, I was told I'd be reported as non-compliant for that mealtime for trying to hide food. Not completing meals was, apparently, the best way to delay your discharge. I quickly ate the mushy part, but it was too late. I gulped down the fruit punch as well, trying my best to not taste it.
I later learned, which I still think is one of the most ironically stupid policies ever, that I wasn't required to complete the drinks sent with meals. Despite that I was at a center for malnutrition and eating disorders, the hospital as a whole was on a mission to promote healthier eating, so only diet and sugar free drinks were allowed in the hospital, including at EDAM. The fruit punch and subsequent cups of soda, lemonade, and hot chocolate that I'd be brought were all calorie free and therefore optional.
Eventually, my parents were allowed in my room so that they could meet the providers. I was relieved to see them, I was already ready to go home. The doctor came in, and the first thing we asked about was all the tests we had been told needed to be done to check for underlying conditions. We were promptly told they were going to wait a couple of weeks and see what kind of progress I was making before they ran any tests.
What?! First of all, that was basically the whole reason I agreed to come to the hospital in the first place! And second, I was counting on being out of there in seven days. If they were going to wait two weeks before even starting to do any tests, was I ever going to get out?
We continued down our list of questions, and with each one I more and more wanted to jump in the car and go home. Worst of all, even though the admissions team had assured me that I'd be able to finish the semester while at EDAM, the doctor was adamant that I couldn't. With only one week left of the school semester and one week of finals, my professors had agreed to let me continue virtually. But the doctor kept lecturing to my parents that school could wait, even though all three of us continuously told her that I was the one who wanted to be able to continue. It was going to be far more stressful for me to have to declare incompletes in all of my classes and worry about finishing them the next semester than to do the last few tests and assignments which I had already been preparing for.
The dietitian came in next. She was kinder, but had some equally disappointing things to say. She gave me a menu for the next day and explained what to expect: she'd come in every 1-2 days and I'd have a few minutes to look over a menu and choose between four options for the next couple days' meals, plus selecting snacks from a specified category based on calorie content. If I couldn't choose in time, if we had to skip an appointment for any reason, or if they were out of something I'd ordered, she'd make the selections for me. There was a list of condiments that I could choose from if I wanted, but as part of the hospital's healthy eating initiative, I could only have one packet of salt per day and the list was full of sugar-free and low sodium substitutes. (Quick P.S.A: sugar-free jelly is one of the grossest inventions ever. No matter who you are, you deserve better, just splurge for the real thing!) No changes could be made to the meal plan, no matter what. Even when, a few days later I was writhing in the most miserable stomach pain and nausea I'd ever experienced and asked if the chocolate milk that was supposed to be coming could be switched with apple juice, the answer was an emphatic, "absolutely not." And, she told me, they kept their patients on a low-fiber diet, which meant no vegetables and practically no fresh fruit.
"No vegetables?" I remember my mom asking. The low-fiber part made sense, but I was the person who as a kid would literally throw fits on vacations if I went more than a day without fresh fruits and vegetables. So zero vegetables for at least a week seemed a little extreme. She conceded that sometimes there would be a chance to add a slice of tomato and piece of lettuce to a grilled cheese sandwich, or that a stir-fry might come with a few pieces of pepper and corn, but for the most part I could expect none. Then, she handed me the snack list. I was relieved to see some recognizable foods: Goldfish crackers, Clif Bars, vanilla wafers. I was even more relieved when I found out that, although it wasn't on the list, ice cream (which I liked even more than carrots and celery) was another option.
If I wouldn't have been so miserable, I could have laughed at the irony: my entire life doctors had been constantly saying to eat less junk food and more fruits and vegetables, and now I was sitting in a hospital where they were limiting me to a single leaf of lettuce but I could order six cups of ice cream in one day, if I wanted. My younger self never would have believed that an actual doctor could say such things.
After the dietitian came the social worker, whose main job was to help patients with discharge planning. Of course, the very first thing I wanted to know was when I was getting out of there. She couldn't give me any kind of estimate, but based on that it was only Monday and she said the next time she'd come in was probably Friday or the following Monday, it was looking like longer than a week.
More providers kept coming and going, some much friendlier than others, and suddenly it was time for my parents to leave me. It might sound dramatic, but I remember feeling absolutely trapped and helpless the moment they left. It was even more shell-shocking than when they left me at college for the first time. I was completely alone, there was no one there to stand up for me or protect me, and I couldn't get out.
I am hesitant to talk about this, because I know so many people have had experiences so much worse than what I went through. The truth, I understand, is that I was lucky to be in that hospital getting the treatment I needed from people who had my best interest at heart. I continued to lose weight the first couple of days I was there, my liver enzymes didn't stabilize until long after I was discharged, and my blood sugar was consistently so low that I had bruises on every finger from having to be pricked every couple of hours. I was definitely sicker than I felt, and since I couldn't find alternative treatment, I don't know if I would have been okay if I hadn't gone to the hospital. I am sure some people have had great experiences at EDAM or similar hospital settings. I believe that their work has probably saved a lot of lives. That being said, my experience at EDAM felt truly traumatic for me. Even now, I have many sleepless nights filled with nightmares of being left at the hospital. I have never felt so alone, hopeless, and invalidated as I did in the two weeks I was there. I don't say that to fault anyone there or to seem like I'm throwing a pity party for myself, it is just an accurate representation of my interpretation of the experience.
I think the worst part of my hospital stay was how incredibly inhuman I felt. I realize that the policies at a place like EDAM are put in place to protect patients from eating disorder behaviors. But I can't understand how stripping a person of every basic sense of dignity is a productive step towards mental rehabilitation. I had one CNA who ripped open a bag of Sun Chips I had finished so that she could turn it inside out and make me lick the salt crumbs from the bottom of the bag like a dog. Apologies for the TMI, but I was so miserably constipated that they were threatening to give me a suppository, and when I wanted to try to use the bathroom while my CNA was on her lunch break, the nurse who came in stood in the doorway for a couple of minutes before yelling at me that she didn't have time for this, she had other patients, and I needed to be done. When the CNAs switched shifts, they'd report to each other about me as if I wasn't in the room, revealing private things such as that I was crying while on the phone with my parents or calling me difficult because I was up most of the night, unable to fall asleep.
Before I was admitted, I generally enjoyed eating. But at the hospital, eating became a chore. Mealtimes felt like punishments. Meals were scheduled and timed to the second. If you didn't finish eating in time, even by a few bites, you'd be given a nutrition supplement to drink and be written up for non-compliance. If it was deemed you were too reliant on the nutrition supplement, you would have to get a feeding tube. In some instances, like the time I was supposed to get rice pilaf but instead got a plate of plain rice and a cup full of vegetable oil, I just couldn't eat everything that was brought. At first, the time limits were manageable, but when meals got to the point of being four slices of toast, a cup of yogurt, and two bowls of nuts and dried fruit, my heart would be racing with nerves as I tried to finish in time.
It was shocking how much my relationship with food changed in the short time I was there. It took a long time after I got home to not be repulsed by eating, even the foods that used to be my favorite. A favorite story in my family is one day, gummy bears were on the menu as a side option for the next day's lunch. I've always been a huge sweets lover, and I excitedly texted my family after the dietitian left that I was going to get candy the next day! Twenty-four hours later my parents got a call they probably never could have expected: me in tears crying that I never wanted to see another gummy candy in my life. After completing my gigantic sandwich and pudding cup I only had a few minutes to finish the entire half cup of bears. I had already taken the nutrition supplement once that morning when my CNA deemed that there was too much peanut butter residue left on my plate and I'd either have to lick it or drink the supplement, so I was determined to finish. I have never been so nauseous; I didn't move for the next two hours and I begged my sister to switch places with me when she came during visiting hours. I seriously thought I'd explode if I had to put anything else in my mouth that day. (For anyone who's concerned, I have since mostly recovered from my gummy candy aversion, but the texture of generic gummy bears still makes me sick).
Of course, some of the discomfort was a necessary side effect of weight gain, it wouldn't have made a difference if I was at home implementing a meal plan on my own. By the time I was discharged, I was on a diet of 3,000 calories a day: an extremely volumptuous amount of food for someone who's barely 5 feet tall to tolerate! Nevertheless, the stress and the punishment feeling of eating while at EDAM certainly didn't help. I remember saying on a few occasions after being discharged that it almost felt like I developed an eating disorder at EDAM; after I left I despised eating and was completely unable to feel hunger or find food appetizing to the point that just deciding what flavor granola bar I wanted to eat was paralyzing.
One of the proponents of EDAM's treatment model was to keep as much information as possible disclosed from the patient. The idea was that patients wouldn't have anxiety over whether they were gaining weight, how many calories they were consuming, etc. But the level of secrecy was frustrating for my whole family. We understood that they couldn't talk numbers in front of me, but couldn't they at least share some information to my parents? We found out after several days that I had continued to lose weight for the first few days of my stay, which seemed like something my parents should have been kept updated on. We continued to ask about the testing that was supposed to be done, and the doctor kept putting off the question until she finally admitted that they were never planning on running the tests as long as I started to gain weight. The drastic weight loss I had experienced over the last month must have been due to extreme hypermetabolism, probably exacerbated by the fact that I was trying to eat even more than I had been. While this partially made sense, as I certainly wasn't aware that I needed to eat 3,000 calories a day to be gaining weight, we felt deceived, and to this day wonder if there were things missed by them never doing any of the tests.
They also started secretly adding calorie supplements to my food. For days, I was being served cups of yogurt with liquid-y foam in them. I assumed the yogurt was spoiled, but I couldn't send it back. Constipation was no longer a problem as each time I ate one of these I'd have horrible digestive issues for hours. I finally worked up the courage to ask the dietitian and found out they'd been adding a substance to the yogurt that was basically just oil. No wonder I was feeling so terrible, my stomach has always been extremely sensitive to lipids. I appreciated the effort to add calories without increasing volume, but it was moot if it only made me more miserable.
The worst part of the secrecy, though, was the indefiniteness of my stay. They kept saying there were certain markers I'd need to reach before I could be discharged, but no one would tell me or my parents what those markers were or how close I was. Prior to coming in the admissions team had estimated a week or less. When the doctor who started EDAM came in to introduce himself he told me to expect a stay of six weeks, minimum. I was freaking out; I felt completely trapped with no end in sight. When it got to be the first weekend and all of the providers were leaving for the weekend; they hadn't done any testing and it seemed like all they were doing for me was bringing me food, which we were capable of following a meal plan at home, we pushed and pushed as to if I really needed to stay. The doctor responded that I absolutely could not go home, but she couldn't give a straight answer as to why. The feeling of stuck-ness was really incomparable to anything I've ever experienced in my life, but I felt completely hopeless. It was akin to how I imagine princesses in fairytales feel when they're locked away in towers; there is an ominous indefiniteness to if they're ever going to be saved. Even writing about it now makes me want to cry, I remember so intently the never-ending feeling of desperation. As I said earlier, I acknowledge that a lot of people have gone through much worse things, and I'm 100% aware that I'm being over-dramatic. Even though I hated being in that hospital, there was no reason to be desperate. I wasn't in danger, nothing horrible was going to happen. But right or wrong, I felt desperate, and my goal is to share what the experience was like from my perspective.
Not every aspect of my time at EDAM was terrible. Some of the providers were friendly and empathetic. Because I didn't have the mental aspects of an eating disorder, the social worker and psychologist advocated for me to have more freedom and were able to negotiate some small concessions during my last couple days there, such as that I could be monitored via a camera rather than having a CNA in my room at night since I was unable to sleep. A child life specialist came in one time and brought Christmas decorations that a good samaritan had donated, which I greatly appreciated making my dreary room feel more festive. A couple of the CNAs were particularly nice; one of them would even come by my room to check in on her breaks when she was assigned to other patients. My parents made sure that at least one of them could come during visiting hours each day, even though they were extremely busy. Some of my friends made themselves available to talk on the phone when I was alone, and one of them who had experienced multiple hospitalizations herself checked in with me almost every day and arranged for a big basket of movies, stuffed animals, and activity books to be sent to me. Aunts, uncles, and cousins would send GIFs and videos to cheer me up on hard days.
I greatly appreciated the kindness and thoughtfulness of all of these people. I don't think they realized how much of an impact a simple "How are you" could have when I felt so alone. But still, even though I had only been in there a short time, the hospital was definitely starting to take a huge mental toll on me. I’m not even sure how to put into words how I was feeling, the best way I can describe it was a sort of numb, out-of-body experience. I didn’t feel like myself at all. I felt like a caged animal, like a shell with no soul. I would watch my favorite Christmas movies and be unable to laugh, or play games with my parents when they came to visit and be completely incapable of enjoying it, even though I wanted to. I was so anxious that I was constantly trembling. Some days I legitimately didn’t think I’d be able to finish my meals because my hands were shaking too much to hold a fork or spoon. Thank goodness I was able to stay in school, because the only way I made it through the sleepless nights was by staying up and studying all night for my finals so I’d have something to distract myself with.
To make matters worse, I felt an insurmountable amount of guilt for being in the hospital in the first place. I was gaining weight, which means that I could have been capable of gaining weight on my own. Of course, before I got there, I had no idea it took 3,000 calories a day to get there. Even though I had done plenty of research on weight gain, I had never even heard the term weight restoration before, so I really had believed I was trying my best. But I should have done more. I had failed, I had let everyone down, I ruined Christmas, I left Ashley stranded in L.A. by herself, I had racked up tons of medical bills, I had added piles and piles of stress to my parents' already terribly stressful lives, I even made us cancel the family vacation everyone had been looking forward to for months. I was so angry and ashamed at myself for ending up in this position, I couldn't have blamed anyone in my family if they resented me forever.
The last week I was in the hospital, I would call my parents every night, sobbing and begging them to come get me. We all could concede that the treatment was nothing like we were expecting, and they had promised me that they would get me out and we’d figure something else out if that was the case. But now they didn’t know how to figure something else out, and these teary phone calls would always end with threats of, “Fine, if you really need to then go check yourself out, but then you’ll be going against medical advice and USC certainly won’t let you come back.” I hated this argument, but it was effective. As much as I longed to get out, I wanted to go back to normal life as soon as possible, and being prohibited from returning to school certainly didn’t fit into that vision.
Here is where I need to defend my parents for a second. But first, let me start by saying that I hate admitting that other people are right. I can be extremely stubborn, I get that from my dad (sorry, Dad! I'm about to say nice things about you!) This whole journey has been a gigantic push-and-pull between my brain and my heart. Logically, I understood that there was nothing my parents could do to get me out. They wanted me home as much as I wanted to be home, but if the doctors wouldn't release me, there wasn't much they could do. As angry as the threat of not being able to go back to school made me, USC had already essentially kicked me out once, so the risk of them not allowing me to return was prevalent. More than anything, though, I know that every decision my parents have made has been out of love, that they are as terrified as I am of something terrible happening, that it felt like making a wrong decision could truly cost me my life. But when you're in the thick of things, sometimes the emotional side wins. The emotional side can't see that in the big picture you're trying to save your life, because it doesn't know how it's going to survive another night on its own. The emotional side feels abandoned and betrayed every time your parents walk out the hospital doors without you because it wants them to save you and protect you, and being left feels the opposite. All this to say, I hope that it is clear that a lot of the things I've said and the decisions I've made (and continue to make) throughout my recovery have been fueled by my heart, not by my brain. I acknowledge that, and it doesn't make it right, but the truth is that this has been an extremely emotionally taxing process, and at times emotions speak volumes louder than logic. So as you continue to read, I just want it to be clear that my writing will at times reflect how I was feeling in the moment, and there will be times when I very irrationally disagree with some of their very rational arguments. But, if it comes across that my parents were being stern or inconsiderate, that is simply a reflection of how it felt at the time and not their actual intentions.
EDAM wouldn't discharge me until I had a plan for once I was released, and we were running into the same problems as before I went to the hospital. No one would take me on as a patient; my weight was still too low that it was difficult to find an outpatient treatment team. Adding to the challenges, it was December, which meant our insurance was about to change, and since I was planning on going back to Los Angeles the next month, we really wanted to find someone with a virtual option so I wouldn't have to change treatment teams. We did find a few people willing to speak with us, but the rigidity of the hospital's schedule made scheduling meetings with them a challenge, so the process seemed never ending. Finally, though, we found a dietitian willing to work with me, and coordinated bi-weekly check ins with my primary care physician. After twelve days, the social worker came into my room to share the news: I would be discharged tomorrow! I've never felt such relief, tomorrow could not come fast enough.
The rest of the day was filled with providers coming and going, trying to prepare me for my sudden discharge. None of them believed I was going to succeed once I left, I could tell. Each one made comments about me coming back as if it was almost a certainty. But I would show them! I was going to go home and spend the next few weeks doing nothing but watching Christmas movies, baking, and eating. I'd be able to gain weight no problem, I'd prove everyone wrong, and I'd be back to health in no time!
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