Who knows why I had to watch it? I had, after all, lived it.
Actually, I hadn’t. By in my years as a nurse, I had seen a lot of bulimics and anorectics; as well, I had worked on the eating disorder unit at University of Wisconsin Hospital.
And the documentary Thin, by Lauren Greenfield, brought it all back, from the moment I saw the first wraith wrapped in her blanket coming down the hall. Nor does Greenfield hold back—at times it’s unbearable, almost too painful. A fifteen-year old girl is confronted in group therapy, and breaks down shrieking, “I just want to be thin!” Another patient is kicked out of the institution, and has to call her mother, who spits out her rage at the staff. You can hear the desperation behind the fury, and it’s well justified: the patient later killed herself.
And it made me remember: this is nursing in which you never really know what you’re doing. Can you believe the patient when she breaks down and swears she really, really wants to get better? Should you trust your gut, which is telling you, “nah, bullshit?” And what’s better—to tell the truth, and say, “I don’t believe you?” Or do you say nothing at all?
The really dangerous nurses were the ones who thought they knew what they were doing. For them, it was simple—believe the least of what the patient says, set limits, and then follow up with consequences. On psych wards, that often meant seclusion or restraints; sadly, there were times when I thought the staff had egged the patient on.
In the film, Greenfield captures the uncertainty and the anguish of the staff, as they struggle to understand what’s going on on their ward, who the players are, and what to do about the situation.
One of the most telling moments of the film is the patient who sketches a life-size outline of what she thinks she looks like—she produces a chubby figure. The art therapist the puts the patient against the sketch are draws the patient. But that’s not enough to convince the patient—who then writes “fat,” “chubby,” and a host of other epitaphs on different parts of the sketch. At the end, she writes, “help me.”
There’s the frustration of the insurance running out—the patient is nowhere near ready, you know you’ll see her again. At least, you hope you’ll see her again—if not, she’ll be dead.
There are the relatives, who are almost more anguished than the patients. The patients, after all, are very often in denial, but mothers know perfectly well how sick their kids are. One patient reports her boyfriend saying, “I want to be with you for the rest of my life, but the way you’re going, I’m gonna bury you in five years.”
It’s possible—the mortality rate is between 10% and 20%.
To make the documentary, Greenfield spent six months living in the facility.
It’s a remarkable achievement.
