“I want to start by letting all of you know that we’re a team and Edwina’s health is our number one priority.” Dr. Sunil seemed to be directing his communication to the large monitor screen where Joel’s parents had joined on a live feed from California and Winnie’s parents had joined them from Michigan. “These are my colleagues, Dr. Gundry, and Dr. Nardi. If you don’t mind, I’d like each of you to introduce yourselves and tell the team how you’re related to Edwina. Mr. Anderson, would you go first?” Dr. Sunil turned to Joel.
“I’m Joel Anderson, Edwina’s husband.” Joel turned to his brother-in-law.
“I’m Marshall LaFleur, Winnie’s older brother.” Marshall looked up at the screen, passing the floor to his parents.
“My name is Warren LaFleur, and this is my wife, Teri.”
“I’m Edwina’s mother,” Teri said, her voice cracking at the end. Joel wasn’t sure if Teri was truly worried or a good actress.
“And I’m Winnie’s younger brother, Gage.”
“Nice to meet you, folks,” Dr. Sunil said and then directed his attention to Joel’s parents. “And you must be the Andersons?”
“Yes, I’m Joel’s father Dean, and this is my wife Lynnette, and our daughter, Emilie.”
“Thank you all for joining us,” Dr. Sunil said. “I’m going to turn the time over to our dietician, Dr. Gundry and then Dr. Nardi, our psychiatrist.”
“Good morning, folks,” Dr. Gundry said, standing and mostly addressing the parents on the monitor. Joel would be connecting with the dietician every day and this was good to have the woman explaining things to his in-laws, so he didn’t have to. “I’m going to be focused on getting Edwina through the process of refeeding and then transitioning back to real food.”
“Are you finally going to convince her to eat some meat?” Teri interrupted.
Dr. Gundry looked down at her clipboard. “I was under the impression Edwina was a vegetarian.”
“She is,” Joel grumbled, glaring at his mother-in-law. “Dr. Gundry, I hope you’ll forgive the interruption. Continue, please.”
“Thank you, Mr. Anderson.” Dr. Gundry nodded politely. “As I was saying, refeeding takes time and right now we’re really focused on acute crisis stabilization and returning her body to health. Edwina won’t be allowed to leave the hospital until her heart is stable enough for her to go home and receive treatment as an outpatient or to enter an inpatient residential facility.”
“That’s where I come in,” Dr. Nardi said, raising his hand. “After the medical stabilization program, we’ll design a psychiatric program focused on coping skills, relaxation, and addressing the eating disorder thoughts while she’s still in an inpatient setting.”
“You need to keep her in the hospital in order to teach her coping mechanisms?” Joel’s dad asked.
“In a psychiatric setting we’ll have support groups, individual therapy, and an entire treatment program dedicated to working on some of the possible antecedents to the eating disorder.”
“I don’t know what you mean by that,” Gage said. “What the heck’s an anti-seed-something or another?”
“An antecedent would be a root cause of the disorder,” Dr. Nardi explained. “Something in her past that caused her to have unrealistic thoughts about food.”
“Are you implying this is our fault?” Teri asked, her incredulous tone showing guilt rather than disbelief.
Joel almost laughed out loud. He wanted to answer her but instead he glanced at Marshall and they both rolled their eyes.
“That’s not what we’re saying at all, Mrs. LeFleur,” Dr Nardi said. “Although things may come up in therapy that show events from her youth that have a direct correlation if not blatant causation. There are several different points in time when these problems are likely to emerge. Junior year of high school, for example, tends to be a very vulnerable point in a teenager’s life. Between college preparation, a difficult load of classes, separation anxiety while transitioning from a child to an adult, etc. There are a lot of risk factors during that time.”
Teri lifted her chin in response. She pursed her lips, and pulled her gaze away in defiance.
“Within the next few days, we’ll be transferring Edwina upstairs to the psychiatry and behavioral medicine unit,” Dr. Nardi continued. “That's our inpatient psychiatry unit. She’ll have intensive management not only from a medical standpoint but also from a behavioral and emotional standpoint. An eating disorder is a medical problem, but there is also a big component of the mind. This disordered relationship between the patient and food is something that is rooted in a patient's psyche.”
“I have a question”—Joel’s mom interrupted—“Once she’s stable and can leave the hospital, then what?”
“With a condition as extreme as hers, we strongly recommend an inpatient residential facility,” Dr. Nardi said. “For now, we have her admitted directly to a medical bed because she needs the special monitoring that’s only available in a medical unit.”
“Does she have to remain in New York City for the next phase of treatment?” Joel’s mom asked. Her eyes were alight, and Joel considered what she was up to. Puzzle pieces fell into place in Joel’s mind before the doctor even answered.
“She’s welcome to go to any inpatient residential facility,” Dr. Nardi said.
“What if they were to come here… to California?” his mom said. “We have one of those facilities about a mile from our home.”
“If she’s going to leave New York she should come home to her own mother,” Teri butted in. Joel wanted to say something like, over my dead body, but didn’t think that would be a good phrase to use when his wife is literally clinging to life.
“You’re coming up on winter in Michigan,” Joel’s mom said. “In California, Winnie could walk on the beach and watch the sunset over the ocean. What could be a more relaxing environment to encourage recovery?”
Teri couldn’t argue with that. None of them could.
Joel’s heart raced with excitement at the prospect.
“That’s not a bad idea,” Joel’s dad said, nodding in contemplation. “We still have their honeymoon suite available.”
“They are not on their honeymoon,” Teri snapped.
“Well, they should be,” his dad said. “They haven’t even been married a full year, and half of that year they’ve either been apart or sick.”
“I agree,” Winnie’s father said. “California sounds like a great place for them to go.”
Dr. Nardi interjected. “Let’s see what Edwina thinks before we all make decisions on her behalf.”
“Sounds like we’re on the right track with planning,” Dr. Sunil said. “For the next few days let’s focus on getting her stabilized enough to leave the hospital. Between now and then we’ll ask Edwina to decide where she’d like to go.”
They wrapped up the meeting a minute later and Joel felt a sense of optimism for the first time in days. This could work. They would get through this. If only he could talk Winnie into leaving New York City.