A few days later, when she was no longer on the verge of death, Naomi announced she was going home – and the hospital responded by placing her on a 72-hour mental health hold. The clinicians then obtained what Colorado calls short-term certification, which required, by court order, that Naomi be detained and treated, in her case, until she reached what doctors determined was 80 percent of his “ideal body weight.” In Colorado, as in most states, a patient can be treated against her will if she suffers from mental illness and is deemed incapable of making informed decisions. That day, Naomi was transferred to a residential program at the Eating Recovery Center (ERC) in Denver.
“I’m so angry, I’m so angry,” Naomi said in another video message, her voice flat and impassive. “I was completely disrespected. “I was deceived.” Naomi could feel that her mind was diminished – it was too slow, too relaxed – but she found that she could think in straight lines. She could reason. So why did doctors say otherwise? By then, she had been in and out of hospitals, psychiatric wards, and eating disorder treatment programs, including CRT, more times than she could remember. Was it really that irrational of him to assume that trying the same treatment for the hundredth time would be futile?
When she was a teenager, Naomi believed that treatment programs could save her. She ate supervised meals and attended group therapy sessions where, among other things, patients discussed the origins and possible psychological functions of their eating disorders. Sometimes Naomi would talk about how she stopped eating because she thought it would make her a faster swimmer. Or the one about how she just wanted to be special, like her older brother was special because he was so smart. Other times, she told the story of the day her grandfather died and the whole family went out to eat. Naomi was outraged to see everyone feeding her body with something as carnal as food when they should have been overcome with grief. Years later, it was hard to tell if any of those origin stories mattered. With each hospitalization, Naomi gained weight. Each time, the extra weight seemed unbearable and she lost it shortly after discharge.
Over the years, Naomi struggled to “conform” to standard treatment. She refused to participate in the group sessions. Or she became disengaged during therapy, which she found childish and useless. She sometimes changed her IV lines because it was too horrible to watch those plastic bags full of liquid calories empty into her body. During some admissions, Naomi forced herself to gain weight in order to get out. Other times, she withdrew against medical advice. Later, Naomi began bingeing and purging. She would excuse herself after meals and go out into the yard to vomit into plastic bags that she would throw in the neighbor’s yard so no one would see her. She vomited and vomited until stomach acid burned the enamel off her teeth and she had to spend $22,000 to replace them.
Between treatment programs and emergency hospitalizations, Naomi, at 18, went to college. She wanted to study psychology, but all she could do was exercise for hours a day without eating almost anything, maybe an apple. During her senior year, she dropped out of school. Later, she found jobs that she loved — certified nursing assistant who performed health assessments at home, patient coordinator at a hospital — but they were often interrupted by yet another medical admission.