Here is the proposal I wrote to my therapist. I’ve “edited” it a bit to keep names out of it.
June 7, 2010
As you know, Dr. K was alarmed about what I weighed today, so she called Dr. P immediately, and then Dr. P called you immediately and left a message or something, and then she called me immediately and left a totally inappropriate message on my machine (as anyone could have been in my apartment at the time–maintenance men as well as management personnel are frequently in my apartment even when I am not home, with or without my prior knowledge) stating that I was at an unhealthy weight and malnourished, and should go to the ED hospital immediately. She left the ED hospital number, with instructions to call them. I was at the library all day, and then went to my knitting group, and returned home after 8pm. I picked up the message then.
I refuse to go to the ED hospital. My decision is final. What they do there is cruel and unusual punishment and an assault on my body. It is an assault worse than what the Seroquel did to me and an assault worse than having broken my leg in 1999 and an assault worse than having been raped, and I have been raped more than once. Like rape, it is a physical assault, but because I have an eating disorder, it is, like rape, also a mental and emotional assault. I choose to not undergo this horrific trauma again.
I choose not to be treated like a child. I choose not to be in a prison-like environment. I choose not to have my rights taken away from me. I choose not to have my privacy taken away from me. I choose not to have every bodily function monitored by authorities. I choose not to be constantly watched. I choose to have access to my belongings and not have them taken away from me. I choose freedom.
What is the difference between the ED hospital and being on the outside, then, given that I plan to eat? Even if I did go to the ED hospital, I would definitely refuse the tube. So all they would do would be to feed me. So eat there, or eat at home? Honestly, which is better? Which makes more logical sense?
Going to the ED hospital would totally ruin all the progress I have made here at home. I have added prunes, ham, bacon, veggie burgers, All-Bran cereal, green pepper, minute white rice, quick brown rice, low fat cottage cheese, celery, mushrooms, radishes, garlic-flavored olive oil, walnuts, and scallions. In addition, as of tonight (June 7, 2010) I have purchased, and plan to eat, wheat germ, sunflower seeds, thick rolled oats (I plan to eat oatmeal tomorrow before I see you), hulled (whole) barley, Kashi pilaf, creamy broccoli soup, Ak-Mak crackers, split pea soup, bananas, and cheddar cheese. That is, I have added 25 new foods! Many of these I am storing in my refrigerator, and they will go bad if I end up in the ED hospital. This is no trivial matter. Think of what spoiling all this good food will mean to me! I have created new recipes of my own using the foods I have purchased in quantities that I can tolerate. I season my food to my liking. I actually cook foods that I like. I sit at my table and eat. This is something new. I used to eat standing up, if I ate at all. I do my dishes every night, also something new. I used to not have dishes to do. I keep my kitchen clean. Surely, an interruption in my new-found routine will ruin all this progress I’ve made.
The ED hospital will ruin my progress because the place breaks my spirit. The ED hospital makes me want to restrict. The ED hospital makes me want to lose all the weight they make me gain, and more. The ED hospital, because of their strict rules, makes me want to break out and rebel against them. I refuse to give in. I refuse to sign myself in this time. I refuse the tube. I refuse to eat their horrible, unhealthy, institutional, badly cooked food. The ED hospital is for children. Indeed, most of their patients are children, and the unit is designed for them. I refuse to go there.
I hope that you are convinced by what I am writing here that my going to The ED hospital is a poor choice, especially now of all times. I hope you can convince Dr. P and Dr. K likewise. I know Dr. P will be very stubborn about this. I know my lab work may have irregularities, and I will have to deal with some consequence of this, but I’m sure whatever needs doing can be done outpatient. Perhaps nothing will be wrong after all. I hope that you and Dr. P and Dr. K will agree to continue working with me. I’m sure you will.
Eating is eating, after all, and it’s better and easier done in freedom, in one’s own environment, in a natural environment, not forced upon one, don’t you think? That is just like the concept behind low-residency colleges: that one is writing at home throughout one’s schooling, which is no different from one’s life after graduation. That is why graduates of low-residency schools are more likely to keep on writing than those in regular MFA programs. See what I mean? It is more natural to learn to eat at home.
Furthermore, there are a lot of girls at the ED hospital who have given up on themselves, who have accepted the fact that they are going to die. I honestly can say that I feel this myself. The ED hospital will not help me with this. Those girls rub off on me too much. Almost all of them are into the routine. Many are repeat offenders. I have already told you that you are a very good therapist for me who can help me out of this. In a way, both the maddening phone call from Dr. P and the actual writing of this proposal are helping me to want to live again.
So, what do you say? Will you work with me? Or will you give up on me?