Today is a day of appointments. This morning I have a scan of my ovaries. An, ahem, ‘internal’ scan. Two weeks ago my GP told me there was a large lump on my right ovary, after I saw her for acute stomach cramping. I have been more anxious than I wanted to admit, and actually, thought that perhaps I would have an explanation for why my mood is so low, why I want to sleep all the time, and even if it needed surgery, it might be a cure. The internal scan took place in a dimly lit room where a sensitive NHS worker explained to me in detail what would happen. I smiled and listened, nodding. She showed me the ‘probe’ they would use and told me that although it looked terrifying, it wouldn’t hurt. I nearly exploded by having to repress the quip, “You’ve never been in an Ann Summers shop, have you?”. And it began. Turns out my ovaries are fine. In fact they are, ‘really nice’. So no chopping or keyhole incisions. And probably the stomach cramps are the fibroids she found and the low mood and exhaustion are just depression and, well, life as we know it.
And this afternoon, family therapy. How we whoop with excitement as it approaches. To be fair, the CAMHS team are lovely. They support each and every one of us and there are no blame theories, no digging up every family skeleton, scrutinising it as the possible cause. The medicine L needs is food, they say, and the therapy is designed to support her taking the medicine and support us in administering it. Her weight has again gone down. Today it is 49.2. 7 stone 10. 16.8 BMI. Those are the figures – the reality isn’t as neat or ordered as this sounds. I explain how she doesn’t hear the seriousness of her situation. How she hadn’t heard the therapist saying that readmission was likely and imminent. I wonder if that is anasognia, the inability to grasp the reality of her situation. The psychiatrist tells me this is even more worrying, and how her capacity to get better is being reduced.
We go through the possible causes. C thinks she is getting ill in solidarity with The Boyfriend. I don’t. I think her boyfriend”s illness is a convenient excuse for anorexia to tell her not to eat. I believe her weight gain is because we allowed her control, hoping that her new life would spur her to move on. And K says something so wise it takes my breath away. Perhaps it is because she is so happy that she is losing weight, because eating and gaining weight brings her down. She says it in a far more hesitant teenager way, but it is such an insight. Because despite everything I’ve learned, I still haven’t got my head around the fact that losing weight makes her happy. And as she loses, she needs to lose more. And more.
The team listen to all our views and write them up. Then they invite L to comment on what she could change. I feel some frustration and then I get it. As her psychiatrist makes clear that a readmission referral should be made next week, as they agree her ability to make choices is impossible, the field of options narrow. To two. Eat now. Or readmission. That’s it. No easy fix. Just eat, or give up sixth form, her job and seeing The Boyfriend. Fine by me, because her health is everything. But for her? She can’t see it though. We are all just people, speaking words, on the outside if her brain, while on the inside, Ed whispers that it’s fine. We’ve been here before. We can get through this. Just hang on. At the end, we are all clear. L must eat and gain weight. Her psychiatrist is sceptical and thinks the readmission process should be commenced. But we agree on a review date of a week next Monday. We leave, perfectly clear about what will happen next.
Except that is, for L. We get home and I make her a snack. We sit on the sofa and she eats it. K and I make jokes about lard deliveries. K goes off and, with L wrapped around me, I tell her I will get up and make breakfast. She starts to do the very thing we said we wouldn’t do. To negotiate. To ask me if we could start slowly. I say No. Bizarrely she then says that the team said she needed to stabilise. They didn’t. She tells me she doesn’t need to gain weight. She does. It is as if a demon has possessed her. She weeps and begs. “Please, Mum, please, just please, I physically can’t do this, it will kill me. It’s too much. It will hurt me and harm me. Please, just please.” Her tears soak into my top and her shoulder shake. She pleads and sobs. And each time, I must say No. All of my instincts to tell her it’s ok, that I won’t make her do this is must be suppressed. As her mother, I must be immune to her distress. I must turn my heart to stone to make her brain healthy again. I must cause her pain to make her well. I can no longer be her mother in the way I understand it. I have to be her gaoler, her feeder and her carer, without seeming to care.
But at least I have allies. Our team at CAMHS have been heroic in guiding us to this place, while caring for each and every one of us. At the end of the session, M, her psychiatrist, says, I know you can do this. I hope we can prove her right.