Posted by Sunshine on February 10, 2005 at 21:06 [161.184.17.30]
More story. Heavy on discipline. Light on wettings. Read it if you like emotionally-focused stories.
* * *
Putting Julia in diapers for a few days turned out to be exactly what was needed. Her bathroom was locked, and the staff on the psychiatric unit were able to observe her much more closely at all times. They confirmed once and for all that she was not self-inducing vomiting to purge her food. With no access to a bathroom where she was alone, she was unable to purge, or throw out any food that she had smuggled off of her plate. This was a relief to the nurses.
Julia was shy about wearing the diapers, and during the days she wore them she spent most of the time in her room. She did venture out to watch a movie with the other patients in the day room, but she huddled in a corner and placed herself under blankets, presumably to hide what she was wearing under her clothes. When she needed to be changed, she would quietly asked a nurse for help getting cleaned up. Changes were done in her room, with the door closed, to protect her privacy. After a few days of this, Dr. Morgan allowed Julia bathroom privileges once again.
“Well, my dear,” he said cheerfully. “You’ve done very well without the use of a bathroom. The nurses tell me that you have been most cooperative. Are you ready to be a big girl again? I think we can try letting you in the bathroom now.”
She smiled up at him. “Thank you, Dr. Morgan,” she said gratefully.
He lifted an eyebrow, and said in a firm tone, “Now, don’t think this means you’re scot free, lassie. If there are any reports of you ditching food or purging in the bathroom, it’s back in diapers you’ll go. Do I make myself clear?”
Julia nodded. She saw he was waiting for a verbal response, so she said obediently, “Yes Dr. Morgan.”
He ruffled her hair gently. “That’s a good girl. And I think we’ll keep you in them at nighttime for now. It will prevent you from having your sleep disturbed by waking up wet, hmm?”
She blushed deeply at this, and dropped his gaze, but again nodded and agreed to still wear diapers at night.
Since Julia had been caught with food hidden in all the pockets of her clothes, a rule had been made that she must eat her meals wearing only a hospital gown. She looked pitifully thin and exposed in the short-sleeved gown, while all the other patients were dressed in sweat pants or jeans. She also had to be checked after each meal to make sure she hadn’t tried to hide any food under the gown, or used it to soak up her juice, milk, soup or Ensure. However, this wasn’t the end of the trouble they had with her.
The nurses Pat and Diane discussed the problem one afternoon as the prepared the patients’ tiny paper cups of medication. “Honestly,” said Pat in exasperation, “I’ve never seen a kid so sweet and cheerful with everyone and everything behave so terribly at her meals.”
Diane nodded in agreement, “That’s exactly it. She’s such a good little thing, and as polite as they come. ‘Please, Diane,’ ‘Thank you, Diane,’ she’ll say as I’m giving her pills, or a needle, or changing her sheets. You’d think she was a little angel. But at mealtimes…” Her face grew grim and she rolled her eyes and shook her head.
“Take yesterday for example,” said Pat, warming to her subject. “First of all, she kept trying to get up from the table. First to get a napkin, then to get some pepper, then to get a cup of water. I swear, the kid burns more calories preparing for the meals than she takes in. And she’s talking the whole time, making the other ones laugh, so of course it’s easy to relax and get distracted. Which is exactly what she wants. Finally, I say, ‘Julia, that’s enough. No more getting up, no more talking. You eat.’ She’s polite as you please, and says okay. Next thing I know she “accidentally” spills her juice. So I get her another juice and I notice all her rice is gone. So I’m thinking, oh, good girl, you’re almost done. She’s just got her beef stew left. So then I turn away to bring one of the other kids Ensure, and when I look back at Julia her plate is clean. So I check her and she hasn’t got it under her gown, so I’m thinking, okay, she finally ate, thank God. Right? And then guess what I find when she leaves?
Diane waited to hear, although knowing Julia, she had a pretty good guess.
“The little imp had smashed her rice underneath the table. It was stuck under there in big clumps. And you know where her beef stew ended up? The potted plant four feet away from the table. Honestly, I don’t even know how she got it in there. It was in a napkin. I guess she might have thrown it over when I wasn’t looking. Anyway, I’m at my wits end with the kid.”
Diane spoke quietly. “You know, Jason wants to tube feed her. He thinks she using up too much of the staff’s time and energy with all of this.”
Pat winced slightly. “I’d hate to see that. I mean, I get fed up with her tricks. But she can’t help it, she’s just sick, the poor thing. And she is making some progress, although it’s slow. Dr. Morgan would never approve of her being tube fed as long as she’s taking in anything by mouth.” She frowned, and glanced across the unit where Jason the resident was sitting on a chair, making notes. She hated the idea of him meddling with Dr. Morgan’s patients. Diane followed her eyes and guessed what she was thinking by the look on her face. She silently agreed.
Pat shook herself slightly, and then returned to the topic at hand. “In any case, I wish Julia would be more open about her feelings. There’s something very unnatural about the way she’s always so polite and smiling all the time. It’s not… healthy.”
* * *
Late that afternoon, the unit staff held a case conference about Julia. They agreed that her mealtimes were still too unrestricted. The single nurse assigned to meal supervision had to watch six girls at once. No matter how carefully she tried to watch Julia, there were always moments of distraction. Dr. Morgan sighed and shook his head.
“Well, we will have to put her on one-on-one supervision at meals. She’s going to hate it, but she’s given us no choice.” He felt sad for her, as he knew she was tormented by the food she had to take in. “Poor little lass,” he said quietly to himself, as he walked back to his office.
A small tray was set up in a corner of the unit away from the other eating disorder patients. At supper time, Julia was led to this table by Diane.
“Why are we going over here?” Julia asked with a puzzled look.
“This is where you’re going to eat meals from now on, kiddo,” said Diane calmly. Julia looked at the set up. A single chair in front of a small tray. A chair across from her, where a nurse could sit. No tablecloth, no plant, no other girls. Just a tray with her meal sitting on it. Nowhere to hide any food. And observation of her alone. Julia attempted a smile and sat down in the chair, but Diane noticed that her hands trembled as she picked up her silverware.
The meal was undeniably a large one. Her calories had been increased to 2800 per day, in an attempt to help her gain much-needed weight. Her supper tray held a large plate of spaghetti with meat sauce, a serving of milk, a serving of juice, a dish of peas, a cup of yogurt and a large bowl of chocolate pudding for dessert.
At first Julia began her normal rituals of unfolding her napkin, moving her food around on her tray, putting on salt and pepper and cutting her food. Every time she tried to get up from the table, Diane prevented her from doing so. Diane could see the strain beginning to show. Julia was trying to make polite small talk with her, but fear loomed large in her eyes. She began to take small, quick, nervous bites of the food. After half way through the meal, she put down her fork.
“I’m done,” she said stiffly.
“Sorry kiddo, I’m afraid not. You’ve still got half your supper left.”
Julia didn’t move. Diane saw Julia square her little jaw and cross her thin arms. She had never seen this look on the girl's face before.
“Julia, keep eating, please.”
Julia said nothing. She sat still and made no move to pick up her fork.
“If you won’t eat, I’ll have to help you,” said Diane firmly. She picked up Julia’s fork and prepared a bite of spaghetti. Julia’s mouth remained stubbornly closed.
* * *
Dr. Morgan sat at his desk and looked at the clock. It was 5:30pm. He had promised himself that he would get home early tonight, but it didn’t look as though it was going to happen. He still needed to write case notes on four patients and then check on his young charges before leaving for the evening. He sat back and stretched, preparing himself for the work ahead. Suddenly he heard a scream. He sat up straight in his chair and listened. Screams were not unusual on this unit, which was often filled with delusional young people. He waited to see if the person would settle down. However, the screams kept coming with increasing intensity. He walked rapidly out of his office to find the source of the disturbance.
Coming out onto the ward, he was shocked to see that the screams were Julia’s. She was such a frail, quiet girl. He would have never thought she had lungs like this. She was sitting with her legs drawn up in her chair, curled up into a little ball. Her eyes were closed and her hands covered her ears. She screamed wordlessly. The rest of the patients had stopped what they were doing, and were staring.
Diane was trying to pry her hands away from her ears and was talking to her loudly. “Julia, stop this. Stop it! You know better than this. Stop this right now and eat your dinner, or I’ll have to get Dr. Morgan.”
“Get him then, I don’t care! I don’t care!” cried Julia desperately. For days she had been bottling up her terror and rage at being forced to eat. All the frustration over the past few days had finally boiled over. She was frantic and hysterical with anger.
“I don’t care, I don’t care! I hate this! I hate it, I won’t do it!” she screamed.
“What’s all this, then?” said Dr. Morgan in a loud, stern voice. Julia looked up at him, furious.
“I’m not eating this!” she cried. She had never spoken to him in this tone before.
“You certainly are going to eat it young lady,” replied Dr. Morgan, in a raised voice.
“No!” she screamed in frustration.
“Julia, I am going to count to three, and when I get to three I want you to take a bite,” Dr. Morgan said authoritatively. “One… two…”
At this, Julia lost all control. Without thinking, she picked up her plate and hurled it to the floor. It landed with a satisfying crash, splattering her pasta over the tiles. Glaring up at Dr. Morgan defiantly, she did the same with her cup of milk, the juice and the pudding. Crash after crash rang through the unit. She threw her cutlery on the pile of food and broken dishes. With a final shove, she deliberately pushed over her tray, sending it clattering to the floor. Then there was silence, and she sat, her chest heaving, her chin set stubbornly, glaring at the doctor defiantly.
Dr. Morgan felt a strong surge of anger. This little girl had gone too far. He was a patient man, but he did not agree with letting patients misbehave. Psychiatry and therapy was all well and good, but he was wise enough to know when old-fashioned discipline was needed. He took Julia by the arm and pulled her up off the chair. Still holding her arm, he sat down himself. Then he swiftly and smoothly pulled her across his lap, facing downwards.
There were a few gasps and giggles from the other patients. They couldn’t believe it. Julia was about to get a classic child’s punishment.
Julia struggled to move, but he held her firmly over his knee. He was a rather tall man, and strong. A rail thin girl was no match for him. He began spanking her with swift, even strokes of his palm. Each of the smacks rang out in the quiet room. Julia had continued to scream as he pulled her over his lap. However, her screams turned to sobs as he meted out her humiliating punishment.
After spanking her, he stood up, and sat Julia back in her chair. He then knelt down in front of the chair in order to look her in the eye. He was no longer angry with her, as he watched her sobbing in frustration and embarrassment.
“Now,” he said firmly. “Are you going to eat your supper like a good girl?”
It was hard to make out Julia’s words through her sobs. But clearly, she was humbled and no longer defiant. She nodded. “Yes Dr. Morgan” she said in a choked voice.
“And what are you going to say to Diane?” he said in a quiet voice.
She looked up at Diane, who was standing nearby. “I’m , I’m sorry Diane. I shouldn’t have thrown my food on the floor. I’ll pick it up,” she said brokenly.
Diane nodded understandingly. “That’s alright Julia. I know you’re sorry.”
Dr. Morgan nodded with satisfaction, and rose to go. “All right then, that’s settled. You eat up, child, and I don’t want to see this kind of behaviour again.”
Julia stopped him from leaving by holding onto a corner of his suit jacket. He turned and looked down at her.
“Dr. Morgan?” she said in a small voice.
He knelt down again. “Yes lass. What is it?”
“I’m sorry. I don’t know why I did that. Do you… Do you hate me now?”
His heart melted as he looked into her earnest, fearful little face. “Now, now my dear, of course not.” He gave her a hug and smoothed her hair and he held her against him. “This was just a bit of temper, and it’s gone and forgotten. We all lose our temper sometimes. You’re still my good girl.”
Julia leaned against him and almost cried again with relief.
“You eat your dinner for Diane, and I’ll come in and see how you’re feeling before I go. Fair enough?”
Julia sighed tremulously and nodded. She again said the phrase that she had said so many times over the months she had been in his care.
She said it quietly and almost affectionately, as she watched him walk back to his office.
“Yes, Dr. Morgan.”