Following on from the introductory post on my experiences in hospital, I want to share where I spent most of my time.
At the front of the ward is a locked section, well, a locked section within an already locked secure ward! This section has it’s own little common area with three single bedrooms, a seclusion room, shower and toilet. This area is where the most acutely ill patients are kept. Often they are extremely violent. This is where I ended up for many of my admissions, after earning myself a reputation of a serial absconder, and of being unmanageable due to purging, exercising, hoarding food, self harming and overdoses, etc.
All this is enclosed by shatter proof, soundproof glass. It’s called the HDU (High Dependancy Unit) but I call it the Goldfish Bowl. Because you are on show to the whole world, every undignified played out soundlessly for the whole ward to see. And you can bang on the glass and yell for hours if you care to – nobody will take any notice of you. In there, you cease to be a human being. You become the worst of the worst, not even fit to mix with the rest of the patients in a psych ward.
Often these other patients are scary. They get loud and violent. They will come into your room. Sometimes the nurses will lock you in your own room to make sure you are safe. They are often psychotic, and will scream and rant and rage and throw the heavy foam furniture about like bits of paper. Because they are terminally short staffed, these patients cease to be dangerous at exactly 11pm each night, often before, and don’t become dangerous again until 7am the next morning. You are all locked up by yourselves for those hours – a very scary prospect for me, and strictly against rules but what can they do, three staff, often on their second and sometimes third consecutive shift, to look after 25 patients overnight – it’s impossible. For this reason, being constantly on Constant Obs in later years was a relief – it meant a staff member sat with me 24 hours a day and I felt safer in that way, at least, even though it wasn’t nice being constantly watched.
It was not a nice place to be. In there, you lose everything. The protocol is you can’t have any of your belongings, you wear hospital pyjamas only, to prevent hiding any weapons or having anything that can be used to hurt yourself in anyway.
You can’t have anything to help you pass the time. Books might be thrown, might be used to light a fire. Ditto writing paper. Pens and pencils are out. You can’t have anything to brush your hair or clean your teeth. You can’t use soap to wash your hands, and the water in the toilet is often turned off. It’s locked anyway. You can’t have a cup or water bottle of any kind, there is no tap to drink from anyway.
Your room is stripped bare except for your bed and you aren’t allowed many bedclothes in case they are used to hide things. There is always a nurse in there with you, and hourly you and your belongings are searched.
At meal times, you eat off polystyrene plates, off your lap. Food goes cold quickly, and just doesn’t taste good off polystyrene. You eat with a single soup spoon that’s carefully guarded. It’s messy, especially if it’s something needing to be cut. They tried plastic cutlery, but that’s too dangerous.
For an eating disorders patient, meals are already fraught. Once you get yourself locked up in the HDU, you will wish you were out there again, on table. Your meals will never arrive as they were ordered by the dietician leading to anxiety attacks and attacks from staff who think you somehow caused the wrong meal to come up, or accusations of being a nusicance because you asked for the correct meal because you are TRYING. And then, you will find yourself at meal and snack times, being forgotten, because your nurse has taken the rest of the ED patients to the table and again forgotten that one of hers is in the HDU. You will fight with yourself over whether to let it go – and chance being accused of not trying – or to remind them and be accused of being selfish, because everyone is busy. If you decide to remind them, the process with take at least half an hour, as nothing can be done without consultation from YOUR nurse who is now out of comission for at least the next hour and a half (meal and supervision afterwards) so this necessitates a lot of back and forth and negotiation and mostly a feeling of ”why do I even bother”.
The toilet is locked, of course, as is the shower. If you want to go, you have to ask permission. This is a process that also takes a lot of time and getting permission from your always hard to find nurse. Then, you’ll have the nurse watch you, with the door so wide open that the whole ward can often see you do your stuff. Because of how unwell the other patients are, it will often be smeared with stuff. The toilet itself is a stainless steel, seat-less, jail-issue thing that will always be filthy, even though the cleaner comes in several times a day.
You can’t keep this place clean, because the patients are just that unwell and have utterly zero cares about hygiene. In later years, it ceased to matter so much, because I was often restrained in my bed to stop me pulling out the picc line through which I was fed, and being spoon fed and toileted there (also such a loss of dignity). I was so unable to cease my purging that I was, for months at a time over several admissions, purging from that restrained state – vomiting on myself, the bed and the floor, to the disgust of everyone, and I stank, my room stank. Life stank.
During the months I was locked in the HDU at a time, I felt I became less and less of anything at all. My life was reduced to bare white walls, nothing out the window but the bare walls of the next building and the sky, if you were lucky, I bit of the huge tree that was outside. (I stared at that tree constantly, as if I could somehow wish myself out of there and into it’s branches.)
I forgot what made Fiona who she was. Forgot what she liked, forgot what she didn’t like. Forgot what it was like to be passionate or have interests. Forgot that there was indeed a life beyond all this. More than forgot – stopped believing in it. And if this was what my life was, then I wasn’t interested in fighting for it. All I wanted was to be free from this prison – both the hospital prison, and the prison of my mind and body. When I was on restraints, I’d dissociate a lot, just to ‘not be there’. I began to believe that I’d never left, that I’d been there for one long, never ending period of time, and that the ‘world out there’ was actually just a dream that I kept waking up from.
I had to earn my way out of the HDU and back on the program and apart from the last two admissions when I offered to put on weight and voluntary went in – I never made it out. I would try my hardest, I’d even achieve every goal they set for me (they used to come out of ward rounds and say to me, “If you achieve x, y and z, we will take you out of the HDU onto the general ward.” I would MORE than achieve x, y and z, only to have them then say “you are doing SO WELL that we think it would be risky to shake anything up – we want to keep things just the same, so we are NOT going to let you out of the HDU at all. ” It happened every time and in the end I became so discouraged I didn’t care any more. Being in there just made me feel like a caged animal and confirmed to me that I wasn’t worthy as a human being. It was punishment and I felt I deserved it.
I fought them so hard. I always found it such a war in hospital, between me, the ED and them. I always hoped that just being in there would allow me to let go of the ED and work with them – but it was always a huge battle to get to that place. I’m not proud of the ways I found to sabotage myself, which led to me being locked in the HDU as a matter of the norm.. I wish that I was just able to let go and let them help me. But the ED got angrier – like a savage beast prodded and poked, and life followed, leading to a classic catch 22 situation – they wanted me to act like a human being but treated me like a caged beast; I wanted to be treated like a human being but acted like the beast.
A huge part of my motivation when I was finally able to fight for myself was just to get out of there. I didn’t feel any different about myself, and I didn’t have any less of the ED screaming at me that I deserved to die. I just couldn’t bear it in that hell. It truly was, to me, like I had been jailed for comitting a crime, was being punished for already punishing myself. So I’d finally realise I couldn’t fight them – and just do it long enough to get the hell out of there as early as possible. As I was a long term patient, I never had any maitenance phrase. I would get to my weight, and bang, out the door same day. I’d hit the big wide world with still no idea or practice on how to keep myself safe and well. I’d also be manic, coming cold turkey off the sedatives they kept me quiet with, and overwhelmed because the world would hit me like the volume was suddenly turned up full bore after silence for so long. I look back and wish they’d actually made me slow down during those times and properly transition between complete imprisonment and the wide open world.
Just thinking of that place gives me the horrors. I never want to go back again. It’s good motivation to stay out (not that it helped me all those years I was in and out of there). I just wonder – if there was more understanding of eating disorders and the power they have over people, would this have happened to me? I wasn’t doing anything that I did/didn’t do to be ‘bad’, and I already hated myself that much – punishment on top of the punishment I already put myself through was the last thing I needed. Having this sort of treatment reinforced that there was no hope for me of ever being a decent member of society.
It also exacerbated the PTSD. Having to gain weight would bring my sleeping mind back to life, and I’d be engulfed in the flashbacks and nightmares I’d been trying to block out. I’d wake up in this little prison, finding myself trapped – tied to the bed in my reality now, feeling powerless and alone. I always emerged from these admissions more broken than I went in.
It’s not only myself or others with eating disorders that this post is about – it’s the other people locked in HDUs like this one. Where did people with a mental illness cease to be human beings who are sick, and become less-than beings to be locked away and submitted to such a horrible experience? It really isn’t right at all.