'We cried with him and over him'

'Lying in that hospital bed, he reminded me of the awful famine pictures that you see, with the hips and legs loosely attached…

'Lying in that hospital bed, he reminded me of the awful famine pictures that you see, with the hips and legs loosely attached to a torso. There was fear in his eyes because of the voices in his head. This was part of the anorexia," said Maura* on looking at the motionless and emaciated skeleton that was their 11-year- old son.

The intense sadness of the memory filtered into her voice. "We cried 26 times a day as we watched him go down. We cried between ourselves. We cried with him and over him.

"As the good parent that I saw myself as, I thought that I could deal with this and get it sorted. Get him to pull himself together' and start eating. I'd have had pre-conceived notions then about what type of person gets this sort of disease. Obviously this only happened to other families' children. Suddenly, there we were living with it in our own home."

Liam is the eldest of our three children. "It's not that I had two brats and a perfect child, but he was in so many ways - a 'good' child.

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He was the "neat one". never one to mess up the place. He was obsessed with the idea of being 'the best'.

With girls and anorexia, it's usually something like Britney which acts as a trigger. With boys, it's more likely to be sports. Liam was in fifth class at time and very interested in athletics. He'd decided to loose "flab" and he started cutting down his food. That's when the over-exercising began too. In only a few months, as he became visibly emaciated. "I went up and down to the GP a few times , but really she had very little advice to offer. Over a few months, our lives began to evolve around mealtime. We were at our wits end. The 'softly softly', followed by the 'tough-love'/'you're going to eat' approach didn't work. I felt so bad and that somehow or somewhere, we had done something wrong."

When Maura and Kevin sought help, they discovered there was none to be had. Maura recalled, "There I was with a dying child on my hands and nobody would see him. They said there was no bed - not even in that emergency situation. Child psychiatry has no beds in that hospital. We finally got him in when we threatened to put him in an ambulance and abandon him there.

"Fortunately for us, we had private cover and we were able to have our child seen quickly. But the whole thing was all wrong. The health services need to get their act together in relation to having a specific unit, with staff who are properly trained in the treatment of this disease."

Maura spoke of the impact on her two younger children. "Liam was in Crumlin for months and a lot of that was during the holiday period. It was very difficult for all of us. It's not over yet by any means."

Oddly enough, having come through this part of the journey, Liam has become fearless. He puts this down to the "awfulness" of Crumlin hospital.

"He went away recently with a friend on his own. I had said 'if you get lonely or homesick, you can come home'. He said, 'Don't worry about me. I suffered Crumlin'."

If he sees Crumlin on a road sign he freezes. Not because people wanted to treat him badly, but because of the lack of a specialised unit for the treatment of children with anorexia. "At his age and level of intelligence, he was subjected to Barney movies all day, every day for weeks, and ever-changing nurses who didn't seem to have any expertise in this area."

The way the feeding was handled was unbelievable, she said. "Breakfast would arrive and they'd be told 'there'll be sausages, beans and waffles for dinner'. For an anorexic to contemplate that prospect, is like a nightmare.

"One day I tried to speak to a nurse about a problem. She said dismissively, 'You have to realise that we have sick children to attend to here'. This kind of summed up the attitude in there."

Maura and her husband Kevin stressed that they acknowledge the excellence of the hospital's reputation in treating children with serious physical illnesses.

Our Lady's Hospital for Sick Children, Crumlin has said a proposal for the development of the psychosomatic unit was submitted to the Eastern Regional Health Authority in January 2004 to address the current shortfall in facilities. This would provide integrated medical and psychiatric care for children and adolescents, but approval has not yet been granted, a spokeswoman said.

She added: "Research and experience in other centres shows that the most important part of the management of these children includes the milieu in which they are cared for. By the milieu is meant the general philosophy of the unit, the structured programme of the day, the use of group dynamics to bring about improvement, and the use of the relationship between staff and patients as part of the treatment.

"Such a environment is extremely difficult to achieve for one child on a busy ward. We continue to press this matter to ensure that the needs of these vulnerable patients and their families are addressed," she said.

* The names of the people in this case history have been changed to protect the anonymity of the family.