There is a knock at the door of the Van Gogh room. A head does not wait to pop in.
Good, I see you have unpacked. Time for orientation now.
Admission begins, sickeningly cold and impersonal. I am swept into a current of intake forms, vitals, inventory, insurance. Down to business as soon as finances are cleared. The white coats unfold: the primary care physician, the psychiatrist, a nurse. Then follow the suits: the psychologist, the nutritionist, and the first of a stream of look-alike staff members I would come to know only as Direct Care.
Meal plan, treatment plan, rules of the house. Session plan, towels and sheets, rules of the game.
I sign a form that states that I am here voluntarily. Then about twenty more: no drugs, no alcohol, no smoking on the premises, even when out on the porch. My legal rights, my patient rights, the conditions for any release of medical information to family.
Then a few more morbid ones I choose not to take seriously: That I will not burn myself, cut or harm myself or others. That I will hand all sharp objects to staff. That I will not kill myself.
I sign, deliberately offhandedly, one form after the next, trying not to understand what they mean: that this nightmare is real. But at the very last form, I freeze:
The document states that I will lose all my rights—to object, to refuse, to leave—if the institution or Matthias believe I am not of sound mind, or at risk.
Lose all my rights. Not of sound mind. Not burn, cut, or kill myself. No time: Direct Care snatches the last form out of my hands.
Now the schedule:
My days will begin at 5:30 A.M., in a blue flower-print robe she gives me.
You can wear it however you want,
the lady explains.
Flap at the back or front.
Flap at the back says hospital, I think. Flap at the front then, like a spa.
Once vitals and weights are taken,
she says,
you can change back into your clothes. You can also go back to sleep.
Like I could do that in a place like this, I snort. Like I could do that at all.
Breakfast is at eight, downstairs in community space, where I will have to stay all day. Within the premises, and well within view of the nurse’s station and Direct Care. Midmorning and late-evening snacks are served there too; I should sign up for those each day. All other meals will be served in the house next door. Menus for those are planned on Thursday.
No outside food, no food outside those times. The cook plates and wraps every meal. I am to eat every dish set in front of me within a specific time: thirty minutes for breakfast and snacks, forty-five for lunch and dinner. Failure to complete the meal means drinking a nutritional supplement. Failing that is a refusal. Three refusals means a feeding tube, and she assures me I do not want one of those.
Forty-eight hours in and pending good behavior, you can go on the morning walk.
It will be led by a member of staff to ensure a leisurely pace. If it is raining, the walk will be postponed to the following day. No other exercise or time outdoors. I pray for a month of sunny days.
All the bathrooms are locked, and outside those, there are no mirrors on the walls. We must all ask for permission every time we have to go. Direct Care will then pull out her keys, their humiliating jingle announcing loud and clear to everyone else that I need to empty my bladder.
Some of the girls’ bathroom use itself has to be monitored; they cannot go or flush alone. A precautionary rule against purging, cutting, or attempts at suicide. But I am not bulimic, and at least so far, have not expressed interest in self-harm. I am therefore graciously informed that I may use the bathroom alone. I will, however, have to report how much fluid I drink throughout the day. But that is only temporary and, if my kidneys behave, she says, that rule will be revoked in a week.
Whenever I am not eating I will be in session, individual or group. The therapist will see me three times a week, the nutritionist twice, the psychiatrist once. No phones or other electronics during programming hours; no distractions from eating and fixing the mess I have made in my body and brain.
Oh, and one more thing,
she says.
A note on terminology.
Certain words and phrases are inappropriate here. She calls them triggering. No talk of food or exercise, no mention of weight or calories. My disease is not to be mentioned by name; a vague eating disorder is fine. If I am sad and want to die, I should say I am struggling. If I want to run away, throw myself under a bus, then I am having an urge. If I feel fat or worthless or ugly, I have body image issues. These verbal gymnastics are to be applied at all times and to every subject.
I should, she insists, always communicate my thoughts and feelings freely. Staff is here to validate those and redirect my behaviors,
and by the end of treatment, you will be cured of ano—your eating disorder.
Direct Care wraps up orientation with a sympathetic, condescending smile. The professionally appropriate, if slightly distracted, smile of a time-clock employee. She has given this speech hundreds of times to hundreds of girls just like me. Her mind is already on other things. Mine remains frozen in place.