Walking the “Thin” Line
To gain control, I had to give it upThe New Physician
As I stare out the window of the Lincoln Town Car, I knead the rock in my hand hoping it will provide me with courage. Once again, fear rips through my body, not unlike six weeks earlier when this same car dropped me off at the Renfrew Center, a residential eating disorder treatment facility in Coconut Creek, Florida. But before, I was petrified of what Renfrew would be like, and I was embarrassed that I couldn’t recover from anorexia nervosa on my own.
Committing myself to a treatment facility was the hardest thing I have ever done and, conversely, the best thing I have ever done for myself. Even the act of admitting I had an eating disorder was easier because I erroneously believed that if I confessed to being anorexic, I could maintain control. What I failed to realize was I had lost control long ago. The eating disorder had taken over my life. It isolated me from my friends and family, it forced me to lie, and it jeopardized my future.
My anorexic behaviors began during my first year of medical school when I felt as if my life was spinning out of control. I could not memorize all the material that was being thrown at me. All those obsessive-compulsive study habits I had so meticulously perfected during my undergraduate years were not helping, but instead were hindering me. Inevitably, my evenings would end with me on the floor in tears surrounded by review books.
Consumed with studying, I opted out of social events. And embarrassed that I didn’t know more of the material, I refused to study with others, which resulted in feeling isolated and depressed. The only time I allotted for myself was the hour I spent at the gym, swearing not to gain the “freshman 15” like I did during my first year of college. Ultimately that one hour would evolve into two and then three hours, as exercise became my escape from my insecurities about becoming a skilled and compassionate physician.
I watched helplessly as my relationship fell apart, partially due to the stresses of two first-year medical students attempting to maintain a long-distance bond, and partially due to my inability to share my vulnerabilities.
Although I did survive the first year academically, I had lost 20 pounds, and I did not feel prepared to handle the additional pressures of the second year. Anorexia was my warning flare, signaling to others I needed assistance since I was ashamed and afraid to ask for it myself. When two of my classmates approached me with concern about my weight loss, I was relieved to finally have help, but I was not prepared for the battle I would face in the recovery process.
Thus began a four-year roller coaster ride in outpatient treatment with some of the best physicians, nutritionists and therapists. Their support enabled me to go back and complete my second year of medical school along with USMLE Step 1, but it was not enough to prevent me from relapsing. Renfrew was my last resort.
At Renfrew, I surrendered physical control of my world. My mornings began with a 5:30 wake-up call for weights and vitals. All meals were eaten as a group and were supervised to ensure they were completed.
Group therapy occupied the majority of the day, and attendance was taken at each session. Curling irons, nail files, scissors or anything that might be used to hurt oneself (an estimated half of those with eating disorders also self-harm) had to be checked out from the office. There were surprise room inspections for nonpermitted items, such as gum or anything containing alcohol—even hairspray or perfume. The one 8-ounce Styrofoam cup of coffee we were allowed after each meal was no replacement for my venti latte. I was miserable, but I refused to show how difficult it was for me.
It wasn’t until my third week I was at Renfrew that I finally broke down. And that was when the healing process really began. I began to realize that my treatment team was tremendously knowledgeable and highly proficient in helping people recover from eating disorders. With their guidance and support, I learned to surrender all control—only then could I rebuild my life on a stronger, more flexible foundation.
People often ask me if life at Renfrew was really like it was portrayed in the HBO documentary “Thin.” But I compare my experience more with “Indiana Jones and the Last Crusade.” I barely avoided being crushed by many boulders. I felt as if the ground beneath me was crumbling. I had to have faith that if I stepped off the ledge, a bridge would appear beneath my feet. Like Indy, I was in pursuit of the Holy Grail, except mine was not the fountain of youth; it was my recovery from anorexia. To get there, I had to ask for support from my friends and family, I had to face many of my fears, and I had to have faith that recovery was possible when at times it seemed as if there were far too many obstacles in my path.
Now, as I sit in the Town Car, a nervous excitement pulses through my veins. This is my opportunity to utilize the coping skills I had practiced and refined within the safe and nurturing environment of Renfrew. Now I have to do it on my own.
Before leaving, I had shared with the counselors my anxieties and concerns about what my fellow classmates and supervising physicians would think of me having been in a treatment facility. One simply replied, “If it were easy to recover, then places like Renfrew wouldn’t exist. Seeking help is not something you should be ashamed of; it is something you should be proud of.”
In the palm of my hand is a rock with two stick figures painted on it, and the word “connect.” It was a gift to me from my movement therapist during the “healing garden” ritual—a weekly custom in which each new arrival picks a rock from the basket, and departing patients hand off their own inspirational rocks.
My challenge now is to break down the fake façade I created to mask my insecurities, and to accept my imperfections along with my talents. To use my newfound voice, and not the anorexia, to ask for support.
Brooks Broderick is a fifth-year M.D./ Ph.D. candidate at the University of Virginia School of Medicine.