October 27, 2000
When a producer from the public television program NOVA asked Susan Willard if part of an upcoming documentary about eating disorders could be filmed at the inpatient unit of the Eating Disorders Program at DePaul-Tulane, she wasn't sure if she should say yes.
"I was ambivalent, to put it mildly," Willard said. She directs the Eating Disorders Program with the help of psychiatrist George Daul Jr. and also is an associate professor of both psychiatry and pediatrics at the medical school, as well an alumna of Newcomb College and the Tulane School of Social Work. She received the Newcomb College Alumna of the Year Award in 1997 for her contributions to the field of eating disorders.
"I would never, ever do anything to jeopardize the care of a patient," Willard said. The patients are mostly women and teen age girls with eating disorders so severe that without hospitalization their lives would be in danger.
Willard was concerned that allowing a television crew onto the unit could be intrusive, a potential betrayal of the patients' confidence and an interference with treatment. But the patients felt otherwise, as she found out when she talked to them about it.
"They actually thought if I said 'no,' I would be depriving them of an experience that they wanted," she said. "They were so excited. They thought it would be really great for them to publicly own their illness, to say, 'I have this illness, I hate it, I don't want it anymore and you people out there don't want it either.' They thought it would be therapeutic, and talked about how good they would feel about themselves for possibly helping others. They couldn't think of a down side."
Producer Larkin McPhee understood Willard's concerns. "I know it's very hard to open your doors to a camera crew," McPhee said. "I think Susan and I knew we could trust each other, which was critical."
The crew filmed just about everything that went on in the unit, including group therapy, body image therapy and mealtimes. Any lingering doubts that Willard might have had about allowing the crew on the unit were laid to rest by the sensitivity McPhee showed toward the patients.
"One day they were filming a therapy group and one of the patients got into talking about a very, very abusive experience in her life," Willard said. "It was extremely personal, but the second the patient entered into that conversation, Larkin signaled to the crew, and the camera went off, the sound went off. Everything went off, and the therapy went on."
McPhee was surprised by how emotionally draining the experience was. "I wasn't prepared for how difficult it would be in terms of the trouble the patients are in," she said. "Many of them have very sad stories, and I was really made very sad listening to them."
The crew focused on a 14-year-old girl with anorexia nervosa who was entering the hospital at the same time they arrived. They returned six weeks later to film her as she prepared to return home. The girl's story ends on a hopeful note, as does the film.
"I don't think these illnesses are as baffling and mysterious as we've been led to believe," McPhee said. "Overall, the show is hopeful because I show how these patients can get well."
The program at DePaul-Tulane was originally recommended to McPhee by one of the directors of the Harvard Eating Disorders Center. The DePaul-Tulane program, which was founded by Willard at the Tulane University Medical Center in 1982, is highly regarded in the field partly because it pioneered a multidisciplinary approach to the treatment of eating disorders. From the beginning, each patient has received attention from a number of different specialists, including an individual therapist, a family therapist, a nutritionist and a physician.
"There are not many eating disorders clinics that have a multidisciplinary team of people who are all in the same place treating outpatients and inpatients," Willard said. "We feel that it takes a team of people to do this kind of work well."
The program's stellar reputation is one of the reasons there is always a waiting list to get in. Once in, patients can stay from several weeks to several months-long enough for them to not only reach a normal body weight but also to demonstrate that they can maintain it. In addition to the inpatient unit, the program encompasses an outpatient clinic and a partial hospitalization program that helps patients make the transition from inpatient to outpatient.
"There are many programs in the country that are much larger than ours," Willard said. "But I have always felt that a small, intimate unit, where the staff and the patients know each other very well, would produce an environment that is warm, supportive and nurturing. I do believe we have that here." The whole country will have a chance to see the program's good work for themselves when the NOVA program "Dying to be Thin," which is narrated by Susan Sarandon, premiers Dec. 12.
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