Just flipping EAT!!!

How many of us generally have a problem with that? Just eating? Actually, more than one might think; a lot of geriatric patients have no appetite. A lot of cancer patients feel appallingly awful (plus the fact that a lot of cancer meds cause taste changes.) People in dialysis sometimes have to choke down their food because they feel too lousy to eat.

It's often frustrating. We know the patient needs to eat. How can they ever get better without enough energy and protein? How can the cancer patient keep up their strength when lean body mass (muscle!) is slipping away on them, yet all meat tastes like metal? We try all kinds of weird things to make it work. For cancer patients alone, I've seen and tried cold food only (less smell), white food only (it was the only thing that didn't trigger vomiting for this guy), endless amounts of hot cereal, ice cream and popsicles (comfort food from when she was a kid), and dry food (toast, rice krispie squares, that sort of thing.) What works for one person is completely way off for someone else. It can be so aggravating when every method you've ever tried JUST DOESN'T WORK.

The frustration with this is nothing, NOTHING compared to an eating disorder. Eating disorders are just...ridiculous. Not in a 'haha, that's so funny' way, but in a 'I don't freaking know what to do' way.

It seems like this should be straightforward. You need to eat. You KNOW you need to eat. Everyone's bending over backwards to help you eat. You get to eat whatever you want! WHAT'S THE FREAKING PROBLEM?

It is simply that, for whatever reason, you can't.

It's hard for us to understand. What do you mean, 'can't'? The swallow reflex is there. Your GI tract is still intact, which is more than can be said for a lot of those cancer patients. All systems go, yeah? But you can't. I'm not just talking about anorexia nervosa - the stereotypical disorder which is essentially when someone starves themselves to be thin. I have learned there are other reasons to intentionally or unintentionally starve yourself. Sometimes, the patient may not even be doing it on purpose. Which begs the question: what the #%&@ do you do with someone who is maybe subconsciously intentionally restricting?

I was venting to boyfriend one day about how frustrated I was that we couldn't 'prove it' either way. Why prove it? he wondered. It's not court. Good point. It's really not about proof either way - it doesn't really matter in the context of our job. But to not know, is this person or aren't they trying to restrict/control their intakes, is a huge mind warp. How can you work with them, help them to eat, if you don't know if they're working with you or against you? And where do you start, if you don't know if they just need a high calorie diet plan or a psychiatric assessment? Where do you even start?

I read an amazing book called Brave Girl Eating. It's the story of a young girl who has a brutal battle with anorexia nervosa as told from her mother's point of view. The way she describes it, 'every bite she took was like jumping off of a cliff.' (You can see a preview at Excerpts from Brave Girl Eating. A really good but intense read.) It made it feel more real to know the mother herself didn't/doesn't understand. And yet, she MAKES herself think along the same wavelengths as her daughter, so she can premeditate what she's going to need and when.

Most of us can't even come close to fathoming the twisting and turning of a brain that isn't working the way it should. I am especially bad at this sort of thing. For example, I have a really hard time understanding depression. Some of my good friends have had long-standing issues with this, but it's only because I KNOW better, not because I understand, that I don't say 'Go pet a kitten and eat some ice cream and get over it!' So not helpful, right? But I've never been depressed, I can't imagine waking up feeling like the world was crumpling around me and not knowing it would get better. Even when I graduated university and was finding myself unprepared for the real world, I got up earlier so I could spend more time looking for jobs rather than struggling to get out of bed. I've got a very bouncy and happy personality - ask boyfriend, your average storm blows over in a couple of hours. If something doesn't work out, I can always find an alternative. If I've had a bad day, a cookie makes everything sunshine and daisies. I've had many a comment about bottling whatever my chemical make-up is, because it's awesome. I can't seem understand why everyone isn't like that. Just get up! What's the big deal? Everyone knows, that is NOT how this works. The same goes with an eating disorder. For most people, there's a simple solution. Too skinny? Eat more. Eating too much? Stop! It doesn't work that way for anyone suffering from an eating disorder or disordered eating. It's like telling a depressed person 'Just cheer up.'

I don't have any amazing insights into this. I still don't really know what to do in this sort of situation, really. I used to think I might be interested in eating disorders one day, due to my fascination with psych and neurological disorders. Still might, but I'm thinking I'd better work on empathy and patience a bit before jumping into the whirlpool that is disordered eating.