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The System and I

by Mira Sunwon Goldstein

My name is Mira Sunwon Goldstein. I’m 17 years old. I love cats and the color purple. I run for fun along the beach. I sing in the shower, I listen to records, I go to museums to sketch. I take pictures with my friends, I shop online, I have an affinity for misunderstood loners in movies.

My name is Mira Sunwon Goldstein and two years ago, I lived in the hospital for nine months.

Before I was hospitalized, I didn’t know what the inside of an ambulance looked like, much less seven. I used to think you receive care at one hospital, not nine in one year. I didn’t know what bone density tests were, or EKGs, or orthostatics.

I did not used to know how an IV felt, or a feeding tube when it was inserted up your nose and into your stomach. I didn’t know the pain you felt when your liver was on the brink of failure.

I used to think I knew pain.

I don’t know what to think anymore.

The night of February 12th, 2019, I walked out into a blizzard at night and didn’t come home. I spent hours out in the cold, snow crystallizing in my hair. I sang to myself and shivered, saw a bus and took it to nowhere in particular.

At last, I came to a CVS, lit up and warm inside. There, I stole a bottle of Extra Strength Tylenol and took it with hot water from the sink in the staff bathroom. I sat down in the store, and I was okay. Until I wasn’t.

Pill shards came up, burning my throat and my nose. My vomit was red. I called my mom. She called the police. A store worker locked me in the bathroom where I had previously overdosed until the police came.

I was strapped onto a stretcher, bundled up because I was shaking. Other customers crowded around it anxiously. I was freezing, but the doctors said it was shock. I vaguely remember asking the EMTs if they could turn the ambulance siren off.

We pulled up to C________ Hospital. I was told to drink activated charcoal and given an IV. I walked to the bathroom to pee out the fluids until I couldn’t stand anymore.

That night was blurry and unfocused. My stomach hurt. I was completely indifferent to life itself. I wanted the pain to dissipate; I wanted to go to sleep.

Hours later, I was transferred to B_____ M______ Center because the doctors thought I needed a liver transplant. I didn’t. I fell asleep in my bed at the pediatric ICU. The next morning, the pain went away. I watched TV and drank vegetable broth and went on walks with women who bathed me in bed with washcloths.

My liver began making proteins again. After three days, I didn’t need the IV anymore. Doctors began talking about psych hospitals I could go to. There weren’t many that would accept me because of my dual diagnosis - suicidal ideation and an eating disorder. Later I realized this meant there weren’t enough hospitals equipped to restrain and tube.

The doctors said there weren’t any good options. I said I would stay in the ICU. My parents pulled a few strings and found me a bed at the adolescent unit at F________'s. I came in on a long weekend, so I didn’t meet my social worker or psychiatrist until Tuesday.

For two weeks, I cried every night. I couldn’t bring myself to swallow pills. My eating got worse, and the self harm started up again. I paced the halls, foolishly waiting for somebody to ask if I was okay.

The doctors weren’t happy. I was losing weight. They threatened to send me to an inpatient eating disorder facility. I was put on bathroom restrictions and ordered to count out loud to staff while I was using the toilet.

My panic attacks came back, but worse. I would scream because my brain told me I couldn’t breathe. At first, the staff gave me cold washcloths. Then they grew frustrated. They stopped coming when they heard my screams.

The doctors didn’t know how to help. My therapist stopped meeting with me. I didn’t know how to help myself. Scars now covered my whole hands. I couldn’t stand without the world spinning around me. My body began growing fine hairs to keep me warm.

Then one day my team met with me. I had to go to an eating disorder center after this, they said. I told them that the one eating disorder center I had been to made my eating worse. It made me more suicidal. They told me that it was my eating disorder talking. I said I could do better if they gave me a chance. They said no.

They had given up. As soon as I began to struggle, they gave up.

I had given up a long time ago. I flipped my desk, hid behind my bed. Staff came. They grabbed me by my arms and dragged me down the hall kicking. Locked me in a small room to the back of the unit.

I was in disbelief. Locking me by myself, especially while I was emotionally dysregulated, was the most dangerous thing they could do.

It was my only seclusion. I banged on the door. Cried and begged them to let me out. They didn’t. I promised to go straight to bed, just please don’t leave me by myself. They watched from the Plexiglas in the door. I broke my skin with my nails. Wrote on the white walls of the room with my own blood.

They sighed. I took off my shirt and tied it around my neck so tightly that I passed out. They unlocked the door. My vitals were checked and they had me clean the walls. I went to bed.

In the morning, I stopped eating. I had done things I had never dreamed of doing. The floodgates opened. I was crazy, and F________'s had given up. Everything was the same. The tunnel in my brain narrowed. I had to get out. Even an eating disorder hospital would be better. I had to get out.

Days passed. I became dizzy and cold. I was riding the euphoria of starvation. My vital signs were taken, first lying, then sitting, then standing. They were called orthostatics.

A week went by. Finally, my psychiatrist came to talk to me. “Your ambulance is here,” she said. I asked if kids like me ever came back to F________'s after. “Not usually,” she said.

I rode in the ambulance once more, talked to the EMTs as they showed me pictures of their dogs on their phones. As they carried my stretcher into B______________’s ER, one of them looked at me and said “You’re so light! You weigh nothing!” I just smiled.

After a couple of hours, I got a bed on the medical unit called 7 ____. I met a security guard, who nicknamed me MG and taught me how to play Uno in stacks. As he left his shift, he took my hand in his and squeezed it. “Eat for me, MG,” he said.

The first day I did not. At lunchtime, I was tubed for the very first time. The nurses were gentle. I held my mother’s hand.

Then the next day, I ate lunch for the security guard. I was tubed breakfast and dinner. I wish that I could’ve said it was okay. That all the nurses were kind. Most were. I asked them if I could leave my room on a wheelchair ride. They said maybe if I ate more.

I was trying. My life became an endless cycle of eating or tubing. I memorized the TV programs. I used a dish to pee because I wasn’t allowed in the bathroom two hours after eating. Security guards watched me shower. My vital signs were taken every two hours.

Two weeks passed before I tried to run. I could barely walk, but adrenaline pushed me down three flights of stairs before I was caught by security. Two were stationed permanently inside my room.

The next day, I pulled out my tube. The nurses put it back in. My nose bled. I pulled it out again, and the clear plastic shone pink. They put it back it. They told me they would call security. I pulled it out again.

That was my first restraint, first out of dozens. Security guards filed into my room and I clawed at them as they pushed me into the bed. They held my every joint and told me it would be over if I stopped resisting. I screamed as the nurses forced my parents out of the room. The men strapped my wrists and ankles down to the bed. The nurses got a clean tube and put it in.

Only then did I stop screaming. I felt the cold plastic in my trachea and struggled for breath. I coughed and turned blue. I tried to say something, but all I could do was gag. I tried to signal I was choking, but my hands were tied down. Finally, the nurses took it out, and the clear tube shone pink with my blood.

I was crying. They apologized and offered me meds that I refused to take. I was shot with medicine.

The TV was still playing. I fell asleep strapped down.

When I woke up, my hands and legs were free, but the restraints were still tied to my bed. I begged my security guard to take them off. He said they would reconsider in a day. I slept in a bed with Velcro cuffs attached to it. I screamed for my parents at night. My wrists were rubbed raw.

How did hospitals become my prison? How much longer would I spend in this tiny white room? How many days until both my nostrils bruised and a tube wouldn’t fit in them?

I was restrained again and again and again. I pulled my tube out. Tried to run. Fought security guards. I wasn’t allowed to leave my room. My hospital curtains were taken down and black paper sealed my window. My legs hurt from laying in bed; I slept with compression cuffs to keep my blood circulation normal.

I stopped drawing and writing poetry. I folded a thousand papers and wished in every single crease for my discharge.

After three weeks, I was medically cleared. My vitals were okay. My weight was okay. But no facility had the means to treat me. Eating disorder hospitals couldn’t cope with my suicidality. They couldn’t restrain me. Psych hospitals couldn’t tube me, if necessary.

My parents and treatment team searched the country. My two options were U___ , or B____. They were both full.

Seven weeks passed. Seven weeks in my room. I missed the sky. I started praying to God. I folded crane after crane. They piled up in my room like a snowstorm of pattern and color.

After all those weeks in one hospital room, a spot at B____ opened. Nurses lined up in the halls and sent me off with bubbles. I scattered origami flowers down the hallways.

I had an intake meeting, and I had a panic attack. It was my first time out of one room in seven weeks. I was overstimulated, leaving that prison and safe haven.

I barricaded my room, I needed to be alone, I needed to breathe. The B____ staff didn’t know how to help me. They called for security. I was tied to a restraint bed. I screamed. Staff pushed me into the “Quiet Room”. Security left. Nurses shot me with medicine. Then they left me tied to the bed too. I was completely isolated and restricted. I hit my head against the guardrails, something I had only learned in hospitals.

A nurse turned off the lights in the room. I screamed louder, begging her to turn them back on. Begging them to let me go. I promised I would be safe.

“When you calm down,” she said.

“I’m calm,” I told her.

“When you stop crying, I’ll turn on the lights.”

I couldn’t. Couldn’t breathe, couldn’t stop crying. Couldn’t stop the feeling of hands all over me.

There was nowhere to go but down.

She waited for the tears to stop. Hours later, she let me go. It was my longest restraint. The day after, my room was stripped. My therapist forgot to meet with me for weeks. I only had a mattress and origami paper. My birthday came and went. I was fifteen.

Restraints weekly. I was the only kid who had them that often. And I wasn’t allowed to talk about it. How could I end the cycle that I started?

A cycle of trauma. I suffered trauma and wasn’t allowed to process it, to speak the word “restraint”. What happened was forgotten about until the next time security was called.

Sometimes, I knew those security guards from those 7 weeks before B____. They would stroke my head, my hand, and say hi. Those were always the fastest restraints. I would calm almost immediately. They were close to me, I had talked to them for hours. They were the ones that brought me tiny paper cranes from the chapel and made me laugh as I got tubed. They were the ones who let me do yoga, kindly averted their eyes as they watched me shower. One even bought me a book, “Be Brave Little One”.

These security guards made me brave. Calm. Okay. I was okay. I went outside for the first time in ten weeks. I wrote endless poetry about the air, the grass, the sky.

And then, after a week, I slipped up. Recovery is never linear. I cut and came to a staff member for support. She refused to talk to me. “I will once you get a hold of yourself,” she said. “Your crying is triggering everybody else.”

I was tired of support being conditional. Of being told “once you are calm”. “Once you stop crying”.

I pleaded with her to talk to me. I yelled. I didn’t know what else to do. “Act your age,” she told me.

I went at her. Got restrained. My room was once again bare and white. I still remember her face, hovering over me as I laid in restraints. “What did I ever do to you?” She hissed.

I got restrained three times that day, because the first time a security guard had tried to grip me and his hand accidentally grabbed my inner thighs instead. By the third time, I was shirtless and crying because I was trying to choke myself with my clothing. I slept off my tears.

It was fight, flight, or freeze. I tried flight, but in a hospital there’s nowhere to run to. Fight had wore me down. My life froze.

I had been at B____ for eight weeks, when the average was one to two. That meant a total of around five months, just at B______________'s. They discharged me to the highest level of care in my state, the long term hospital W________.

The recovery center was unlike any other hospital I had been to. The kids there stayed from anywhere from three months up to two years. Because it was long term, staff and kids got to know each other. There was a school there, with teachers for each subject. You were allowed outside if you asked. I received therapy for hours everyday.

Most of all, it was a fresh start that I so desperately needed. The new setting allowed me to break my endless cycle of restraints. I was able to talk about restraints freely with other patients and in groups. This allowed me to process the trauma my hospitalizations had induced. Mechanical restraints were not allowed there. There was no restraint bed, no seclusion room. Because it was the highest level of care, the program was different in that it was not desperate to prove itself. At B____ and F________’s, if I brought up human rights issues and feedback, it was brushed aside. They were desperate to keep up a reputation, whereas W________ didn’t have one.

Maybe it was because of this that I began to recover. But most of all, no matter how many times I screamed, people heard. I realized that I didn’t have to scream. I spoke and, for the most part, I was listened to.

My life began to move. Slowly at first, but I built up momentum. Like a child on a swing, I let go of the ground, the hands pushing me down. Some days, I felt I was flying.

There was not one moment that I was suddenly thrust into recovery. It happened gradually, without me even noticing. It was only months later that I looked back and realized I had not been running in place.

Some days I went to school, other days I did not. Some days I witnessed a mirage of flashbacks, in my dreams and in waking moments. Some days I starved, other days I listened to my body. I wrote and talked to friends. I cried for hours in therapy. Cut. Wrote on my hands instead. Did yoga, started a blog. Had panic attacks. Went outside to sunbathe in the wet grass. Everything was not the same. Not everyone cared and not everyone understood. Those who didn’t told me to “just eat” or that “I was a trigger”. But others did and they mattered.

They would hold my hope for me until I could carry it myself. They told me they were proud of me no matter what.

And at first I thought, how could you be? Proud of a girl who used to rely on tube feeds? Spit at staff and got masked as security guards held her down? Who screams even though it doesn’t do anything? Who hurts others?

Because I hurt myself. I saw the way it hurt the people who cared about me and I did it anyways. But somewhere along the line, people saw something in me. They saw my ability to recover. They believed in me.

The EMTs, nurses, doctors who worked to save my life saw something worth saving. The security guards saw a life worth living and that was why they couldn’t bear to look at me as I screamed.

I am Mira Sunwon Goldstein, and I am somebody. When people ignored my struggle, they turned their heads away from a suffering girl.

They must have been scared of me, because they couldn’t lose a girl to herself. But their cold, desensitized manner killed part of that girl. The nature loving, Birkenstocks wearing, flowers in her hair girl. The cat obsessed bookworm. The girl who won the Most Smiley superlative in the depths of her depression.

Now I was trying to rebuild her. Break her free from the system that so many others are slaves to. The system that locked me in the “Quiet Room”. Forbade the word “restraint” but not the actual thing. Kept me waiting, forbidden to leave my bed for seven weeks and took the outside away from me for ten.

I was living in pain. I was told, again and again by experts and ignorant people, that my pain wasn’t valid. That I made it up. That my pain was my fault.

To stop crying, to calm down, to be patient. Because maybe then restraints wouldn’t be necessary.

Were they ever necessary? Maybe. But they didn’t have to be. Not if I had been offered compassion first. Been told that it was okay to suffer, because everybody does.

The hand stroking my forehead even as another held me down made all the difference. Imagine what your two hands could do.

Recovery gave me so many firsts I never thought I would get to experience again. First day out of bed, out of a wheelchair. First paper crane, ukulele song.

First day outside in ten weeks. First time back at Starbucks, the library. First shower alone, steam furling off my skin in waves. First day home, night spent in my own bed.

And lasts, they come and go and you never know it. I didn’t know when I got my last tube that it would be my last. My last restraint. My last day in the hospital.

Sometimes, a part of me grieves. Because I lost so much of myself. Because I left hospitals with so much more trauma than I came with. I grieve for the children who have only experienced a semblance of my story, and for those who have experienced far more.

Grieving allows me to heal, and healing allows me to act.

Why are so many children in hospitals for short-term but continue to get re-hospitalized in years to come? Stabilization units such as F_________’s or B____ are not the answer. Insurance is not the answer; insurance is a reason why inpatient hospitalizations kick out kids who aren’t ready to leave. The care so many receive at these inpatient units is not trauma informed. Think about it: If someone tried to kill you, wouldn’t you be traumatized? If someone cut you, starved you? Why is it so different if you do that to yourself? You still suffer trauma, trauma that needs to be addressed and treated with compassion, and healing from trauma is a long-term process. I am sick of hospitals treating the symptoms instead of the illness itself. Most hospitals restrain a child for self-harm instead of educating them on coping skills to fight their urges to self harm. They are eager to tube before even mentioning body dysmorphia. Stabilization only works for some. Recovery works for all.

This was not for nothing. I am alive because my story speaks for all those that can’t.

As a society, we need to question the system. Why are so many children struggling with mental illness? Why is it the most deadly fight?

Why are there so few treatment centers available for those with a comprehensive case? What is the ethicality behind seclusions and mechanical restraints?

Why is the hospital system better to kids who struggle less, or at least pretend to be okay? Shouldn’t it be expected for kids to be suffering if they are in the hospital?

When a child is suffering, the question is not: Why is the child failing the system? We should be asking ourselves: Why is the system failing this child?

The system. We put our faith in it because we have to believe in something. We have to believe that society has it right. I’m asking you to believe in the survivors instead.

The system changed me. Now I am fighting to change the system.

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