Note: To protect her privacy, the student referenced throughout the article wished to be anonymous. In the article, she is referred to by the pseudonym “Annie” or by her pronouns.
Trigger Warning: Mentions of suicide and eating disorders.
“Everyone in my life…including the [resident] Deans, were telling me ‘You need to go get help,’ but the barriers to doing so were so egregious that I was going to be locked out of school. I’m not gonna be able to come back. And what am I gonna do? How am I going to find a job? I can’t do this.”
Annie, reaching a new low point in her health and well-being, made the decision to pursue medical leave from Harvard. However, she was faced with an ultimatum: if she wanted to take a medical leave of absence, she would have to complete treatment and a mandated six-month work requirement before she could return. Or, she could stay.
“I wanted to be at school. I loved school. School had always been so fun and exciting for me. I’m my most myself when I’m in a classroom… Harvard was the last thing I had. If I didn’t have Harvard, I didn’t have anything.”
The “Voluntary Leaves of Absence” section of the Harvard Student Handbook contains no record of the six-month, full-time work mandate that Harvard enforces if students pursue medical leave. Only after Annie began conversations with her Dean was she told that the leave policy required students to complete this work mandate.
Because Annie was at the midpoint of her Spring semester, completing treatment and working for six months would force her to miss the following Fall semester. “There’s no way I’m going to take off the Fall semester,” Annie thought. “If I have to work through six months, I might as well push through the end of the semester…there were only six weeks left. I can do six weeks. I don’t want to work. I don’t want to have to petition the ad board to come back.”
Annie felt both discouraged by the work requirement that would be placed on her and completely unsure of its purpose. Moreover, there was nothing comforting about petitioning the Ad Board. Instead of a means of seeking help, petitioning felt like a daunting barrier—diplomatic and detached. “It was so impersonal…I was just navigating the system. No one was walking me through it. No one was helping me, telling me what [were] the pros and cons.” Instead, Annie chose to fight through the rest of the semester and avoid the intimidating and laborious process altogether.
So, Annie begged her parents and called her treatment facility, planning to remain at Harvard until her exams concluded. “[My parents] will forever blame themselves for this to this day [for allowing me to stay]. They said it’s the worst thing they’ve ever done.”
Annie’s freshman fall took place in 2021, a time when the world was readjusting from the COVID-19 pandemic. This change, on top of Annie’s struggle with an eating disorder, made attending Harvard a challenge. “It was my first time being back in school for a really long time…Because of COVID, I never really had the opportunity of slowly becoming independent. It all sort of happened at once.”
Harvard’s campus represents not only a bubble, but a pressure cooker: a place where the best of the best students, athletes, musicians, and leaders converge and compete. The need to balance perfect academics with impressive extracurriculars and bustling social lives consumes many students and can be crippling. “Harvard is one of those places where if you’re not doing something, you’re doing something wrong. If you’re relaxing… there’s something else you should be doing,” Annie said.
Her eating disorder progressed rapidly as a means to cope with the stress of school and her self-imposed pressure. She began to withdraw socially, basing the entirety of her self-worth on how effectively she was spending her time. In an overwhelming and uncontrollable world, she “compensated by restricting.”
By Thanksgiving of her freshman year, Annie’s eating disorder had progressed to a noticeable state.
“[My mom] was like, ‘Alright, this is bad. You have to get this under control. You [have] to go to the doctor,’” Annie said.
When Annie returned to Harvard after Thanksgiving break, she met with a doctor from Harvard University Health Services (HUHS) who noted her rapid weight loss but did not ask or mention any concern about an eating disorder. “I’d lost 25 pounds in three months. The doctor [said], ‘You really need to gain weight,’ but…no one knew my medical history or my history of an eating disorder. No one asked.”
“It was really just ‘You’ve lost weight, you should try to eat a little bit more.’ I [told them], ‘Sure, I can do that. That’s not a problem.’ But, I couldn’t. I would try, and I just couldn’t,” she explained. After her appointment, there was no follow-up from HUHS regarding her weight loss or state of being.
Annie, prompted by her parents, decided to seek out counseling. However, accessing support through CAMHS, Harvard’s Counseling and Mental Health Service, was not on the table. “I knew CAMHS only did eight sessions … It felt like a big bureaucratic process. There’s something about wanting to do it not involved with Harvard and wanting it to be an extended period of time.” Annie’s concerns about CAMHS guided her to opt for a Cambridge-based therapist and former CAMHS employee.
Still, Annie remained connected to Harvard’s services. Her therapist connected her with a nutritionist and scheduled weekly weigh-ins for her through a doctor at HUHS. Returning from Thanksgiving break and with a support system at school, Annie’s parents felt more comfortable with her going back. Yet, Annie’s weight loss continued to progress. Despite her obvious declining condition, no members of the HUHS team seriously intervened.
“The doctors saw that I was not doing well. The nutritionist must have known I was taking pictures of food I was not actually eating. The therapist knew I wasn’t doing well.” By the spring, Annie’s health was rapidly declining. “I had a conversation with someone and I couldn’t even formulate a response…my brain was literally shutting down,” she explained.
Realizing that her mind’s functions were declining represented a turning point for Annie. “I had those moments throughout the year, where my hair started falling out, I lost my period, I stopped wanting to see people, and I felt super fatigued. But this moment, when my brain wasn’t working … My brain has always been the most important to me [and] the way I identified myself, almost to a fault.” She immediately enrolled in a treatment center and was ready to petition the Administrative Board to obtain permission to go on medical leave.
However, instead of being warmly greeted by an accommodating and accessible process, Annie was faced with the hidden work mandate and the unfavorable truth behind the situation. “My nutritionist and my therapist both really wanted me to take this time off … The reality of it was not what I wanted. It was like, ‘This is the way it is, you’re in a bureaucracy.’” This ultimately contributed to her decision to stay at Harvard.
In those last six weeks, Annie’s health was in the worst state it had ever been. “I caught the norovirus [and] ended up in an emergency room. They said, ‘This is really bad, you should be in treatment for an eating disorder.’ [I said], ‘Yeah, I know, I’m going in two weeks. I’m just finishing finals.” Upon turning in her final essay, her mom arrived at campus and drove her to treatment.
“I had my first meal at treatment … With Anorexia, if you haven’t eaten food in a long time, your body completely freaks out.” Her blood sugar dropped to an extreme low. She had a seizure. Her heart rate was in the low 30s. “[The staff] at the treatment center [was] like forget anorexia, forget eating disorder treatment, you need to go to the ICU. So, they forced me to leave treatment, and I went to Children’s National Hospital in DC.”
“My brain was not functioning … This was the night I almost died. I vaguely remember [them] calling the code blue. I didn’t know that I was gonna live, and I very easily could have died. It was like I didn’t exist.”
Annie had a team of 12 doctors and remained in the hospital for a month. “Do I refuse food and decide to die?” she asked herself. “I just didn’t think I could get any better. This is the closest to death I’ll ever be. [I almost] just died. Getting back is too far. There’s nothing left.”
While in the hospital, Annie received her report card from the Spring semester. “I like to say that I sacrificed my life for my grades because I ended up getting a 4.0 that semester…This epitomized the lengths I was willing to go to. There was a 4.0 on a piece of paper, and I almost died because of it. In what world is that okay? There’s nothing that justifies that.”
Due to her fear of Harvard’s medical leave policy, Annie’s decision to push through six more weeks for exams now seemed pointless. “I remember sitting there, looking at my grades, just [thinking], ‘nothing has changed.’ And, I almost died. What could have happened? Imagine if I had died but that had been left in my place. That’s nothing. That’s a piece of paper. That’s a print.”
After a summer of treatment, Annie wanted to return to campus for her sophomore year, but after conversations with her parents, mentors, and doctors, she was convinced not to rush back to Harvard.
Instead, she began to pursue the prospect of taking academic leave to continue treatment and partake in two prestigious fellowships. Yet, in stark contrast to her experience seeking medical leave, the attitudes of her Freshman-year Yard Dean and the larger Harvard community were much more encouraging.
After she explained her desire to take an academic leave to explore opportunities beyond Harvard, Annie learned that she would not be required to petition the Ad Board or work full-time. “It’s very easy. It happens all the time, don’t worry about it at all. We look forward to seeing you when you get back,” the Dean told her. Instead of petitioning, she only needed to write two sentences on the academic opportunities she desired to pursue in her year off. “It was so different from my other experience. They seemed to really, really encourage it.”
This disparity in treatment from the Harvard community between her decision to pursue academic and medical leave was obvious to Annie. While a medical leave of absence is often treated with shame and disapproval, her request for an academic break was encouraged, admired, and unquestioned. She recognized that the situations were different, considering her medical leave of absence was attempted mid-semester. However, the difference in accessibility and required terms was extreme. “You don’t have to work if it’s an academic leave. I don’t have to [prove anything]. No one has any questions.”
After taking the Fall semester off, Annie still felt pressure to return for the Spring semester, to jump back into her life at Harvard and the world she left behind. But, bravely, she chose to take the Spring semester off to continue treatment, pursue her academic interests, and find herself. “[People] said to me, ‘What’s the rush?’ This was the first time I really had the choice, [and] everyone was very surprised when I ultimately said, ‘I’m going to take this extra semester off.’”
Annie spent her first month off meditating, walking, and reading. She found a job within a diabetes organization where her passion for medicine grew. Her next few months were spent working, traveling, spending time with friends, and practicing independence. “My life got so amazing. I was ecstatic with every day that passed … I felt like I was like a kid again, growing up and experiencing everything for the first time, because I really felt like I was.”
“The things that were so, so hard for me a year ago, I don’t even think about anymore. It’s just incredible when you look at everyone around you and realize how much—without even doing any extracurriculars, without even doing well in classes— how much is on all of our plates. Just living, just existing here at Harvard is the biggest task of all, and requires so much of us and so much energy.”
After her leave, Annie came back with a newfound appreciation for not only Harvard but also for her life. “I never took for granted that I was at Harvard, but I took for granted that I was getting an education. I never take that for granted here [now]. Just every little freedom that I have and I just want to soak all of it up.”
Annie recognized that her healing began when she was not under the stipulations of Harvard’s medical leave requirements. Perhaps she could have started this process earlier if she was not confronted with work mandates and barriers. “It ended up being obviously the best thing that ever happened to me. Upsets are setups, which I often like to say. But I needed that year, and it has forever changed my trajectory.”
Layla Chaaraoui ’26 (laylachaaraoui@college.harvard.edu) and Julia Torrey ’27 (juliatorrey@college.harvard.edu) write News for the Independent.