Rebecca J. Lester - Famished: Eating Disorders and Failed Care in America

I ease my aching, anorexic eleven-year-old body down into the softest chair in the common area I can find. It smells vaguely of urine and cigarette smokeI bet Kevin was here before me. I glance up to see him shuffling around the perimeter of the ward, muttering quietly to himself as his slippers make a swish, swish noise on the tile floor.

I situate the IV stand next to me. It holds a bag of Sustical, liquid nutrition that supposedly tastes like chocolate. I cant actually taste it, though, because it is being delivered directly to my stomach through the long tube that snakes down from the bag, up through my nose, and down the back of my throat. It is my first meal with the tube in, and I sit there watching the brown liquid drop, drop, drop slowly into the tube, petrified. So many calories! So many calories, oh my god. What had they said, eight hundred per bag? Eight hundred? Thats more than I used to eat in an entire day, and now theyre pumping it into me for one meal. And I cannot do anything about it.

Oh, I fought getting the tube, believe me. I fought with everything I had.

For about a week I had been hiding food under my napkin during meals so I wouldnt have to eat it. Id also been water loading before morning weigh-ins, chugging Shasta can after Shasta can filled with water that I hid under my bed. I knew those things were against the rules. But never in my wildest dreams did I ever think they would shove a tube down my throat to feed me. Id never even heard of such a thing until that morning, when the doctor and five staff members came into my room.

Why are there so many people here? my thoughts screamed in my head as they entered, and I felt immediately apprehensive. The doctor walked toward me with a plastic package containing something medical under her arm. She explained to me that my weight was dangerously low and I would die if I didnt bring it up. I had heard all of this before. It scared me, but not nearly as much as calories and gaining weight did. I was prepared to try harder, though, no matter how terrified I was. I felt awful for deceiving the staffI knew they were just trying to help me, and I definitely didnt want them to feel angry at me. I wasnt trying to lie to themit wasnt about them at all. I hated lying. But I was terrified of food and eating the way a person with agoraphobia is terrified of going outside, or a person with claustrophobia is afraid of enclosed spaces. The deception wasnt about anything except pure animal survival.

The doctor opened the package and pulled out a long plastic tube that was bigger than an IV line. She explained that it was a nasogastric (NG) tube and told me what they were about to do with it.

Wait, youre going to do what? I blurted out, beginning to feel actual fear now. What if I promise to eat my full meal plan from now on? I can sit near a staff member and show you guys everything on my tray so you know Im not hiding anything. My words came faster and faster, my voice rising in pitch. Someone can watch me take every bite! I know it was wrong to hide food. Im sorry! Im really sorry! I wont do it again, I promise! I promise!! But the staff members began arranging themselves around me.

At this point, I freaked out. I completely panicked. I began sobbing, pleading, wailing, promising to do anything that they wanted me to as long as they didnt put that tube in me. Please! I begged. Please, Ill do anything! Please dont! Please dont!

The staff people moved in closer. My panic spiked higher. Stop! Please STOP! Two staff members grabbed my arms. Two others took hold of my legs. Someone grabbed my head. I fought like hell, desperately flailing my bony limbs and twisting my sunken body to try to get away. But one anorexic eleven-year-old girl is no match for five grown adults. Still, I thrashed with all my might, begging the whole time for mercy.

Susan, one of the nurses I liked the best, was pinning my right arm to my body and trying to hold my torso still as the doctor approached with the tube. I saw that Susan had tears streaming down her face, even as she held me immobile. The doctor stood before me with the tube. You will have to cooperate with this next part, she cautioned. If you dont, theres a chance the tube could go into your lungs instead of your stomach. We are going to put it in. You can either cooperate with me here, or we can take you to a seclusion room and put you in restraints and do it there. Its your choice.

I had never felt so utterly broken in my entire life. I had no choice but to let them shove that tube into me, giving them access to my very insides, where they could do as they wished. Finally, all the fight left me, and I became limp and compliant.

Having an NG tube placed is extremely uncomfortable. The tube is flexible, but not that flexible. It was inserted up my nose and then curved down the back of my throat, and the doctor had me drink water to help it go into the right spot and not end up in a lung. After it was in, they used a syringe to suction up some liquid; when they saw stomach acid in the tube, they knew it was in the right place.

They fastened the free end of the tube to my right cheek with medical tape. My cheeks were still wet with tears, and the edges of the tape curled up, tickling me uncomfortably as the adhesive pulled away from my skin. No one seemed to notice. You can rest now, the doctor said. Youll have your first meal in about an hour.