3 weeks ago, I relocated to New York for 10 weeks. Cue the bright lights and big city vibes – the food, the shopping, Broadway!!!!
Hmmm… not quite.
Instead, I’ve been living in the Eating Disorder Unit at the New York State Psychiatric Institute in Washington Heights. And, while there are some similarities – constant observation and strict house rules – this is a far cry from the Big Brother House.
The journey of how I got here is far less interesting than the daily life in the unit. Suffice to say that I relapsed again and found myself at an extremely low BMI, which put me at great risk of sudden cardiac arrest. When the doctor first informed me of this fact, I downplayed the risks. “Not me,” I said. “My body is beyond resilient. I’ve never once wound up in the hospital so no stress…”
It was only when my EKG revealed a dangerously low heart rate that I conceded that she could be right. I was playing a game of Russian Roulette with my heart and the risk seemed too big to bear.
An interesting fact about sudden cardiac arrest in anorexia patients is that there are no precursors to indicate if you heart is about to give out. It happens suddenly, without warning, and without a rewind button. The heart stops, often in your sleep, and it is game over.
The NY program is considered to be one of the best programs available – at least in terms of medically-monitored weight restoration. Oh yes, the process of gaining weight can actually kill you if not closely monitored. Your vitals are monitored daily and blood is drawn frequently to monitor the body’s reaction to all the extra calories being ingested.
Before arriving, I dubbed it “food jail”—a place with strict rules and privileges you must earn each day, only to lose them for not finishing 100% of your meals and snacks. You start at 1,800 calories and quickly move up to 3,000, plus two Ensure beverages. Leave just one bite uneaten and you’re restricted to the unit the next day. No substitutions. No exceptions.
Days begin at 6:30 every morning with weights and vitals. Breakfast is at 8 and kicks off a full daily of eating. 1-hour of close observation occurs after every meal and snack. During this time, you cannot go to your room or go to the bathroom unaccompanied. Fresh air breaks of 30 minutes are possible if the weather isn’t too hot, cold or rainy – and IF you ate everything the day before.
As I write this, I’m grounded to the unit all weekend for refusing cottage cheese at breakfast yesterday—a decision I made after two traumatic encounters with that polarizing food. Everything is clearly explained beforehand, so there are no surprises. You make informed decisions and accept the consequences.
Because it is a psychiatric unit, string and sharp objects are kept under lock and key and can only be used under observation. Shaving and flossing your teeth has to be done under observation, and staff checks are done every 15 minutes, around the clock, when you are in your room.
Phones are handed in at the door and electronics are limited to certain hours of the day to ensure you attend groups and do the work required to recover – including sitting with your thoughts and feelings.
In exchange for following these rules, you are surrounded by an amazingly kind and supportive team of doctors, nurses and aides who give it their all to give you what you need to recover. A range of groups – from body image and self esteem to cognitive behaviour therapy – are peppered throughout the week to help break up your days and, most importantly, help you gain insights and add tools to your toolbox, flanked by people who are on a similar journey of recovery and truly know firsthand what you are talking about when you share your thoughts and challenges. You also get to speak to a psychiatrist every day, with at least 2 full sessions in a given week. Activities and outings are also organized to bring a bit of extra joy and fun. And of course, a host of games, art supplies, puzzles, books, etc are at your disposal throughout.
This is far from the food jail I had in mind driving here. From the warmth of the staff to the truly amazing co-hort of patients I spend my days with, this is a place where beautiful things can happen. And, if you look beyond the rules that are in place for your well-being, you see that you are left with a lot of agency about your treatment and your preferences.
3 weeks down…many more to go.
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