Today’s ABC Radio National Essay

Hospital is Another Country

My 83-year-old mother is in hospital. I sat in the front seat of the ambulance, Mum’s handbag and a pair of slippers in my lap. This is it, I thought. This is the day it will happen. This is the day my mother will die.

What did we talk about when I saw her yesterday? Did we argue? Oh yeah, she’d told me to make sure I wore a greeny-browny silk scarf to the gig I was doing that night, and I’d suggested back that she stop telling me how to dress given I was over fifty now. Then she’d said that at my age I should always wear a nice scarf because your neck will always give you away no matter how well you take care of yourself.

The ambulance driver tried making conversation with me but all I could hear was the other ambo in the back with Mum.

‘Can you hear me love?’ he asks her.

‘Does she speak English?’ he asks me.

‘Yes. Very well.’ I tell him. ‘Her English is better than mine. She corrects my grammar and she reads voraciously and she was an English teacher and she’s very smart and independent and…’

It must have been her Italian surname.

‘We’re taking you to the hospital now love. Your daughter’s here.’

‘Mum? I’ve got your bag.’ Like she cares about her bag.

I’d expected to sit in the back of the ambulance with her. You know, holding her hand reassuringly. But they don’t let you do that in real life apparently. So I’m sitting up front and the driver is asking me something again but I can’t make out what she’s saying.

This is one bumpy, noisy and fast ride. I realize I’ve brought the wrong slippers; these ones ‘have had it’ she reckons.

When I’d gone to Mum’s yesterday to pick her up for our daily walk in the Botanic Gardens she’d said she felt too tired to walk. I’d tried to cajole her into getting dressed. Sometimes one of us is too tired or too low so one usually convinces the other to snap out of it.

‘Everything always feels better after a walk,’ I’d said to her yesterday. ‘Come on, the blossoms out. Get off your bum.’

I spend the next 12 hours with Mum in the Emergency department of a large regional hospital. At one point, about 3 hours into the wait for triage, she and two other elderly lady-ducks are all lined up on their trolleys against the wall in the corridor like, well, ducks, all flying high with delirium.

Mum tells me to put a clean singlet on my sister who’d be in her late 40s, if she were still alive that is. I offer some water to another woman, who takes the paper cup in her paper-white hand and calls me Patrick.

My mother is staring up at me and I have never seen this expression in her eyes before; startled, unrecognizing, blazing.

‘Does she know who I am?’ I ask the ambo who’s been waiting with me all this time.

‘Love?’ he almost shouts at her. But then it’s so noisy in Emergency – all the beeping and buzzing, talking and dashing about that maybe she just couldn’t hear me earlier when I’d been holding her hand and stroking her feathery silver hair.

‘Love? Do you know who this is?’ he’s ushering to me to come closer now. Mum appears to nod and tries to speak but nothing comes out.

My friend is with me and she stays a long time. She must have followed the ambulance in the car but I hadn’t really noticed her until now.

Eventually we get moving. Mum is wheeled into a small area behind a blue curtain and it’s hard to stay close to her because so many people are around her now asking questions, speaking about things I don’t understand.

She has a temperature of 105 and is muttering all kinds of crazy stuff. Every so often she tries to leap off the trolley, so I hold her, steady her, cradle her in my arms to prevent her falling off the narrow wheelie bed and onto the hospital floor, ripping at all the tubes and leads.

During the course of the night I drink cups of tea and eat white bread sandwiches from those plastic triangle shaped boxes. I wander the ward and over-hear all sorts of things that ought be private. Sick people, exposed people, doctors, nurses, cleaners, families, friends, we are all here: compressed humanity up close and personal.

Hospital is another country and I have been living the hospital life for the past twenty-two days now. But although I am l beginning to learn the language and to eat the food of my new country, I will never be accepted as a local. I will always be that middle-aged daughter who comes to see her sick mum every day, asks too many questions and doesn’t stop tidying up and rearranging her bedding and flowers.

She’s like her mother isn’t she, I imagine the nursing staff saying, she really speaks her mind and is so bossy.

On good days Mum and I talk and gossip and on bad days she just lies there quietly furious and shocked with her recent and uncharacteristic decent into indignity and powerlessness. Handing over is not in Mum’s DNA, neither is being cared for.

This large regional public hospital never stops. It seethes and functions like one massive sighing, grieving, struggling, sucking, weeping, eating and purging single organism.

The hospital is under staffed, there are not enough beds, the food is awful, the air is too warm, the nurses are efficient, their use of language often more pre-school teacher than medical professional, the doctors are either inexperienced and tentative or less entertaining versions of Doc Martin. Although some are so wonderful and kind you can’t help falling in love with them just a little bit. Everyone is this place is run off their feet and working like dogs.

In her recent Quarterly Essay, ‘Dear Life: On caring for the elderly’, writer and Dr. Karen Hitchcock observes: ‘All general medical departments are under enormous pressure to treat and discharge patients as soon as possible. They have such a large number of patients that extending each patient’s stay by even a single day would cause emergency departments to choke up. However, elderly patients are complex and time is needed to offer them the care they need, to talk to them about their wishes, listen to their experiences of their illnesses, and together forge ways to make their lives bearable. To do well, patients need to eat, move and remain mentally active in hospital – three things the hospital environment specifically hinders’.

Mum is being discharged next week, they say, and will be able to go back to her home. But it remains unclear how will she be changed and how she will re-adapt. She is scared stiff. So am I.

Today she talked her head off about politics and our recent change of leadership.

‘You watch’, she said. ‘Shorten will step up now. You just wait and see.’

Then she demanded I take her credit card and go pay her rates, wash her nighties, and buy myself a decent set of saucepans and a new greeny-browny Italian silk scarf.

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Confessions of a Middle-Aged Binge Eater – The Australian Women’s Weekly February 2015

I’ve just eaten a litre of vanilla ice cream, a packet of chocolate biscuits, a frozen cheesecake and seven dried figs in less than forty minutes.

But what’s triggered this lack of control, this most recent escape into such short-lived anaesthesia? Well, my laptop suddenly gobbled up the two thousand words I’d just written for this article and emotional eating has been a big part of my life for the past 35 years. Given this article’s subject matter, though, I’m more amused than ashamed; an emotion that usually engulfs me halfway though and directly following a binge, and that most likely sent me fleeing to food in the first place. There is something particularly abject about chomping down into a frozen Sarah Lee past its use-by date.

BED (Binge Eating Disorder), the most common of eating disorders in Australia and more prevalent than Anorexia Nervosa, Bulimia Nervosa, affects almost as many men as it does women of all shapes and sizes, incomes and ethnicities, and its occurrence in the over-forties-demographic has doubled in the past decade. Most people still assume this kind of crazy eating is for teenage girls or celebrities, whose every visible rib, baby bump and puckered thigh are exploited for all they’re worth and for all of us ordinary peeps to perve at.

But I’m not a celebrity or a mid-lifer in denial of the ageing process and seeking love and acceptance from a vanilla slice. I’m an educated, middle-aged, middle-class-feminist. So why can’t I stop eating compulsively and start relating to food like a ‘normal’ person.

In her book Midlife Eating Disorder, Cynthia M. Bulik, Ph.D., points out how recently BED in older people has been acknowledged as a serious illness and that “in the medical field, typecasting eating disorders as teen disorders poses dangerous challenges for adult women and men seeking care.”

My love-hate-but-mostly-hate relationship with food started when I was a teenager and my girlfriends and I would loll about at school talking diets, food, fat and calories and how great it would be if only we were perfect. None of us was over-weight but that’s not the point. I was already hiding food from Mum, shoplifting Tim Tams and not eating in front of boys. When I left home at eighteen to go to University I lived in a share-house and survived on take-away kebabs and jam doughnuts one of my housemates routinely brought home from working at his dad’s doughnut van at the Vic Market. I’d binge and starve, eat and fast, diet and exercise and in between it all, and if I had the time and energy, go to university and waitress at a local café.

It was around this time and after a ten-day fast of cappuccinos and menthol cigarettes that I attended my first therapy session and the physiologist gave me a little book called “Fat is a Feminist Issue” by Susie Orbach. Orbach’s take on the female body and self-esteem issues from a feminist perspective was a revelation and that she suggested giving up dieting, and eating what I liked and when I wanted, was welcome relief.

For a time. I binge when in extremis – extremely bored, sad, pathetic, in-love, self-hating, procrastinating, anxious, frightened, rejected, drunk, happy, sexually frustrated … I binge when my twelve-year-old son is asleep. I eat in bed while I’m reading. I consume calories like the Cookie Monster when I’m watching television and I can devour the pantry while on the phone, as long as the other person does most of the talking.

I fret I am not a good role model for my son, that I am projecting onto him my own disordered thinking and that he has inherited the same binge-eating schema. Sometimes I’m grateful I don’t have a live-in partner because my BED is plain embarrassing and I’m too old and self-aware to be so out of control and focussed on food when there’s still so much else to do like trying to keep kids out of barbed wire enclosures for one thing.

Maybe it’s because of my disorder I don’t live with a significant other. Or maybe I don’t want one and I keep a hold of my ‘issues’ as a form of self-sabotage. ‘Partners and children suffer when adult women and men are afflicted’, writes Bulik. ‘The cost of treatment renders families destitute and destroys relationships. Intimacy is crushed by body image concerns. Trust in relationships is shattered as women and men desperately try to hide their illness from others’.

I dissemble around my relationship with food. I cancel social occasions and work commitments. I hide at home. I make pretend excuses as to why I’m not eating at a dinner party because on the way there I’d actually stopped off at a 7-Eleven and gobbled up enough junk food for an end-of-season footy bash. It’s hard navigating intimate relationships at any time let alone when an eating disorder can dictate how you feel and think about your body. And by extension, how you feel about someone else touching it, looking at it and planning on enjoying it.

I love to cook for friends and family but how can I do this when I’m ‘in the food’ as the OA (Overeaters Anonymous) 12-Steppers would say. ‘In the food’ means being in the zone that is the binger’s private’s hell. In 2012, BED was added to the DSM-5 (The Diagnostic and Statistical Manual of Mental Disorders) and now has its own set of criteria as distinct from the other more widely known eating disorders. According to the DSM-5 to be diagnosed as having Binge Eating Disorder is characterized by: “Recurring episodes of eating significantly more food in a short period of time than most people would eat under similar circumstances, with episodes marked by feelings of lack of control.”

Some days I wake up with a major food hangover and the nausea, fatigue, anxiety, fuzzy thinking, irritable bowl syndrome and depression are debilitating. Living with an eating disorder when you’re a grown-up with kids, a mortgage, an 82-year-old mother who knows you inside out, and a job, is both harder to hide because of all the responsibility but often easier to get away with too. If I want to drive to the shop, come home and consume a $50 fix in my bedroom I can. I do. BED can be an expensive habit.

My BED has waxed and waned over the years. For weeks and months, I’d be fine, in control, my illness manageable, and then wham! One emotional trigger and I’m off again and gorging. When my sister died four years ago my BED was triggered big time and I also took up running. A lot. In fact I couldn’t stop moving. I began training for the half-marathon. My grief had turned my life onto high flame and I was in psychic-free-fall and as I fell I began to drink and to take Valium to help me sleep. Within six months I had become a bingeing, alcoholic, grief-stricken, drug addicted, promiscuous, marathon runner.

These days I still run but far less obsessively, drink only occasionally because the alcohol can trigger a binge, and listen to book readings on a podcast instead of downing Valium to get me to sleep at night. Food is the “good girl’s drug” as Sunny Seagold describes in her book “How to Stop Using Food to Control your Feelings”. I’ve used benzodiazepines, alcohol and tobacco occasionally but food remains my drug of choice.

The grief is still there, that will never go away, and when I do have sex, I make it free of mind-altering substances as possible. It’s sexier that way Obesity and eating disorders are a capitalistic dream but we are forever blaming the individual instead of the food and those who are financially invested in our consuming it. “Because who should be shamed are the food companies that are producing foodstuffs that aren’t even food,” writes Susie Orbach. “Who should be shamed are the corporate structures not the individuals.”

When the man with whom I was having a relationship decided – around the same time I was retrenched from my long-term tertiary teaching position early this year – that it was easier to pay me to go away for a week to a health retreat than to commit to me, I was thrown into a bubble of boundary controls and extreme sports. I stopped bingeing and gave myself over wholeheartedly to the control of a suite of clean-living life-coaches and organic chefs, naturopaths and flower readers. I felt great after that week at detox-boot-camp but it’s impossible to maintain that kind of regime in one’s own environment.

After three weeks at home, with my relationship in disarray and my finances too, I began to retreat back into the food and the whole awful cycle began again. BED does not just screw with your brain it can stuff up your body too. Bulik again: “Some, but not all, of the complications associated with BED are secondary to obesity, such as Type 2 diabetes, gallstone, high blood pressure, stroke, digestive problems and high cholesterol.”

Going through menopause has also contributed to my renewed ‘enthusiasm’ for bingeing. While my hormones rage and I do too, I use food as company when I’m not up to any other kind. But it’s the regular exercise, the healthy eating, in between the less frequent binges these days, and the therapy that has all kept me from going completely nuts.

And being honest. Writing and talking about my condition has been a way to cope, although my mother is appalled I would go public yet again with another of my lamentations. I used to hide food from Mum and my illness from everyone else but no more hiding.

As the analyst Winnicott said, “It is a joy to be hidden but disaster not to be found.”    

Published in ‘The Big Issue’ Sept 26

Still Waters…

 

Walking with her mother, Elly Varrenti reflects upon family and loss.

 

I wait for my mother in our usual place at the Botanical Gardens. There’s a lake and ducks, a kids’ playground, oaks and elms.

 

My 82-year-old mother and I meet most mornings for a half-hour walk. She usually sets the pace, although sometimes we do get out of sync. Once I was so excited telling her about my latest relationship disaster our walking got faster and faster.

 

“Can you believe he actually said that, Mum? I mean can you believe it?”

“Slow down! I’ll have a heart attack if we keep up this pace. He’s not worth losing your mother over, is he?”

 

And there was that time we had to stop walking altogether because we were laughing about those pictures of Treasurer Joe Hockey sucking on a fat cigar shortly before he announced the budget cuts.

 

“Come on,” she said. “Hurry up before it rains.”

 

This morning I watch as Mum manoeuvres her small silver car up to the curb, and when she gets out I notice she is wearing a new brown felt hat.

 

“Very becoming, Mum.”

“Got it from Vinnies. You should go there. Stop wasting your money.”

“They got any nice jumpers?” My 12-year-old son is as tall as I am now.

“They’ve got everything. Good quality, too.

“Okay. I’ll go today.”

“The leaves are all wet on this path,” Mum says. “I can’t afford to fall over again.”

“You can hold on to my arm if that helps,” I suggest.

“No, thanks. I’m not a complete geriatric yet.”

 

My mother doesn’t like me writing about her because she always comes across as tough and pragmatic.

 

“I feel things, too, you know. Just because I don’t talk about everything.”

 

I routinely defend my right to tell the truth as I see it, and she remains suspicious of my need to share.

 

“It’s indecent the way your generation just lets it all hang out,” she says.

 

I’m just fiercely grateful she’s still around to talk books and politics, cooking and kids, and to argue about all the rest of it.

 

These days I watch her rearing her late-daughter’s five-year-old son, and I can sense in my mother’s small body the quiet agony of grief. It’s not toughness I see, but long-learned self-protectiveness. For people like Mum, exposing one’s vulnerability, asking for help, is not so easily done.

***

My sister took her own life four years ago.

Took her own life. Somehow it doesn’t sound as shocking as ‘suicide’.

There were those who suggested Mum have my sister’s baby fostered. “Never!” Mum said. “I’ll look after him. It’s not a choice.”

 

Mine is a political family legacy. Single-minded commitment goes way back. Both my parents were ‘Persons of Interest’ to ASIO during the 1950s, and Mum’s Italian migrant parents were dogged if not disorganised anti-fascists.

My sister, fired with the same Bolshie gene, was an activist from her early teens. Later on, during her medical training, she pursued life with the sharp and scary focus of a revolutionary, travelling and volunteering in Chile, Nicaragua and, later, East Timor.

 

Her son has his father’s eyes, his grandmother’s empathy and his mother’s mischievous intellect. And her mouth. He definitely has my sister’s mouth.

 

On weekends my nephew stays with his dad, an Iraqi Kurd who spent five years in detention before my sister managed to help get him out. He is now an Australian citizen and has little to do with his countrymen. The post-traumatic stress disorder has made sure he is not very sociable. He is politely suspicious of the world and has never missed a weekend with his son. Not once in four years.

 

Mental illness is not like in the movies. It’s not like in The United States of Tara or Girl, Interrupted or Silver Linings Playbook. In real life, severe mental illness is not fun or zany or interesting or sexy.

 

In real life, my mother cared for her deteriorating daughter without conditions or limitations. I did what I could, responded to the calls at all hours and was at her hospital bed after her first two attempts. But, mostly, I watched on helplessly as Mum did battle for her gifted, troubled daughter.

 

I hated how much our lives had become all about my sister’s illness. I hated her illness. I did not fulfil my role of the unconditionally supportive big sister. I tried, but often I failed. I missed her. I wanted her back the way she used to be.

***

“How long have we been walking?” I ask Mum.

“It hasn’t even been 20 minutes yet.”

“The lake looks beautiful, doesn’t it?” I say. “All misty.”

“It does. Like from a children’s fairytale.”

 

It’s my mother’s patience, her gentle guidance and a teacher’s attention to the minutiae of her grandson’s development that strikes me when I am with them. She can’t play ball with him, but she can read and talk to him and she can fret about his monkish diet of rice, cucumber and mandarins. She can painstakingly connect the lines from one generation to the next.

 

Since her daughter’s death, my mother has changed. Everything is different now. Mum hates getting old and is worried about what will happen to her grandson when she dies.

“I just want to hang in there until he’s seven. Like the Jesuits say, give me the child until he is seven et cetera.”

 

In that small child we see all that we have lost, but all that we have found, too. And it is beautiful. My late sister’s child is beautiful.

 

“We’ve walked for half an hour, Mum. You want to go have coffee or something?”

“Not yet,” she says. “Let’s go around the lake just one more time.”

 

 

Screen Time Scream Time

 

 

 

Those mental health experts are at it again and considering adding “video game addiction and internet addiction” to the next edition of the globally recognized, ever-expanding Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

 

But while most people associate addiction with substances, like drugs or alcohol, we all recognize addictive behavior when we see it.

 

Last week my 10-and-a-half-year-old son went on a detox camp. Except the camp was inside our house and he wasn’t detoxing from substance abuse; my boy was ‘coming down off computer’. Cold Turkey.

 

There was to be no computer access for a week and it would be the same deal at his father’s next week, and maybe the week after that depending on how it all went.

 

Things had just got so out of control for us. I was at my wit’s end and so was my son, he just didn’t know it. Screen time had become scream time.

 

He’d hang out for his next ‘fix’ while I’d be madly improvising strategies to keep him off the screen. And if he was temporarily distracted from his primary passion and hanging out with a friend – one who wasn’t on line, that is- or swimming, or biking, or reading or Lego, then the cycle of nagging and begging – Mum? Just 20 minutes? I promise I’ll get off when you tell me to. Pleeeeease – would ease off for a bit.

 

Then once back on the computer he’d be immediately in ‘the zone’ and ‘uncontactable’ again, his dopamine-infused cheeks reddening with pleasure, his body tensing as the game’s stakes soared, his little fingers tapping away with the speed and accuracy of an A+ secretarial graduate.

 

The lure of a fantasy world made him instantly happy. Did his virtual life make him feel better than his real one?  Was he sad and angry about other stuff in his life and finding refuge the best way he knew how? As social studies professor Sherry Turkle suggests ‘modern technology has become like a phantom limb.’

 

There are 6 other kids in class at his new school – 5 boys and a girl – who are all on this one server. They get on-line together. It’s a virtual club, a stationary bike-meet; hide and seek without the huffing and puffing.

 

Is this his generation’s version of hanging out on the phone to the best friend every night, having just spent the whole day at school together? The script is similar.

 

Get off that phone and go and do your homework!

Just 10 more minutes?

Get off now! I’ve already asked you 20 times.

Just 5 more minutes, okay. It’s really important. I’m in the middle of something.

Go outside and get some fresh air for God’s sake or I’ll throw the bloody thing out the window!

 

When I’d eventually manage to get my son off the computer after repeated warnings, countdowns and alarm bells, he’d invariably get angry, distressed, disorientated and aggressive. And then the begging and bargaining would start up all over again.

 

Have our children forgotten how to play? Do our children not get that it’s okay to be bored or idle? Or have we all lost our capacity for ‘solitude that energizes and restores’, to invoke Turkle again? Surely downtime, unstructured-time, technology-absent time is good? And what’s wrong with being bored anyway? Have I let this happen to him? Am I a bad mother? Do we both need help?

 

There will be those parents who know all too well what it looks like when you remove your child’s screen. But there will also be those of you who have never succumbed to the lure of technology and to you I say, Congratulations. How do you do it? To those of you who have embraced our brave new world, bravely, but have found a way not to have it ambush your home life, to you I say, Good on you. How do you do it?

 

In the overall scheme of things technology-addictive-behavior is a fairly recent parenting issue.  I’ve read the studies about what computers may or may not be doing to our children’s executive functioning, their social development and real -world perception. I heard the recent talkback on this program about computers and kids. And I felt, in turn, reassured, confused and terrified.

 

I too am a fast-moving object in our increasingly complex culture of distraction. I too love my phone and my computer. God knows I have just started a blog!

 

But these are our kids and we need to model reasonable and contained behavior around technology – for their sakes and for the sake of something like a cohesive home life.

 

The computer thing had got so bad that I had begun to feel ambivalent about my son’s returning after time at his dad’s. I was more than ambivalent I dreaded it. I mean, I’d miss him like a severed arm but it was a relief too.  Respite from the insanity, from the on-going stress. The computer was ruining our lives.

 

So last week’s detox was bad. There were tantrums and breakages, tears and arguments, recriminations and accusations. I felt hopeless, ashamed, angry but stony-determined.  I felt sorry for my boy, too but I did not surrender.

 

There is much contention around the notion of computer gaming as a form of addiction because addiction suggests that only if the substance is removed altogether the addict may begin to recover. Not so. Compulsive over-eating is a form of addictive behavior and you’re not expected to give up food altogether in order to get abstinent. So too with technology, it’s all about balance isn’t it? Isn’t it?

 

At the end of that first technology-free week and on the cusp of calling his father to come over and get him – forever! – I suggested we go play pool at our local pub.

 

We used to do this once a week when we first moved to the country three years ago. Initially my suggestion rendered him mute with rage and misery but eventually we went. We played pool for 2 hours together. We ate chicken curry together. We shared a massive piece of apple pie and ice cream together. We laughed. He had a go at the way I held the cue. We danced to dumb music. We both pretended we had not been to hell and back.

 

Later that night, we chatted about all kinds of stuff and he went to sleep at a respectable time for a boy his age. (He’s been getting to sleep later and later recently.) He was back.  My boy was back.