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Hannah Brown: In the Eating Disorder Unit

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The Parliamentary and Health Service Ombudsman found last month that Averil Hart, who had anorexia nervosa and died in December 2012, was failed by ‘every NHS organisation that should have cared for her’. ‘Sadly these failures, and her family’s subsequent fight to get answers,’ the PHSO report says, ‘are not unique.’

In October 2009 I went to see my GP to ask for help with my anorexia. A few months earlier, I’d completed 30 sessions of therapy, and improved; but with great humiliation and anxiety, I had to admit that it hadn’t been enough, and things were getting worse. The advice was not encouraging. Since I’d already been given the treatment available in my borough, and my weight was only just within the ‘anorexic range’ (below a body mass index of 17), I was told I’d be better off registering with a university GP with access to better mental health services.

Reminded of the endless assessments to nowhere of previous years, being made to feel like I wasn’t thin enough, or wasn’t crazy enough, or was too crazy, or wasn’t consistent enough in my craziness, I resolved instead to keep fighting on my own. A few months later, even more ashamed, I was at the university GP. I had lost more than a stone. In April 2010 I was admitted to a daycare programme, but I was already falling downhill faster than I could clamber up, and after a few weeks my doctor referred me for inpatient care, warning me that it would be a long wait.

The hospital I was referred to had (and still has) 20 inpatient anorexia beds. Thanks to NHS ‘restructuring’, these serve five London boroughs, as well as parts of Essex and occasionally elsewhere in the country. When I was treated, only two beds at a time could be allocated to male patients. A patient had died the year before I was admitted; another died shortly after being discharged while I was still being treated there; and a third ex-patient, a close friend, killed himself two years ago.

Weeks before I was admitted, I was told that my heart and kidneys were at risk of failure. I was ordered to stay in bed as much as possible, to avoid walking or taking stairs, but at the same time I had to make it to two appointments a week at two separate hospitals, one for blood tests and one to be weighed and checked up on. One week at a weigh-in, I was told that I had been at the top of the waiting list, but the person below me had lost weight, so I had been moved down. When a blood test suggested my organs were failing, I was told to go to A&E and ask to be admitted. I was kept on the acute ward for a couple of days, where I was vaguely monitored and then allowed to discharge myself. By that time I had lost everything – my job, my degree, my relationship, all facets of my ‘normal life’ – and become suicidal.

By the time I arrived at the eating disorders unit in August 2010, my BMI had dropped below 12, indicating ‘serious risk of death’. My memories of the first few days are hazy, but I know that for much of the time there was no doctor on site. I refused to eat or to drink the squash offered to me, and was told that I couldn’t have water because there was no dietician present ‘to prescribe it’. I became delirious, and blood tests confirmed that I was in kidney failure. I was taken by ambulance to a different hospital, where the exasperated A&E doctor, confused as to why I had been brought there if I was already in hospital, tried to discharge me, despite my nurse escort explaining that they didn’t have the equipment to care for me on the EDU. Another doctor intervened and admitted me for the night. The following day my heart and kidneys failed. My blood sugar was below 1mmol/L, and I was clinically dead for eight minutes.

I spent three weeks in critical care. For a while I wasn’t expected to survive. My sister was called home from a holiday to say goodbye to me. I am lucky not to be permanently physically disabled. I spent a further five weeks immobile on a cardiology ward which had recently experienced dramatic staffing cuts, and often had to wait for hours for help with basic care. On one occasion, my mattress deflated, leaving me with the metal bed jutting into my back. It was only when a friend showed up for a visit and found me in tears, trying to pull myself off the bed, that it was dealt with. One nurse refused to help me turn over, telling me I had done this to myself. Another, after accidentally bursting my

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