The following is a letter from my mom to the head doctor of our insurance company:
I have just returned from a day at the Pediatric Intensive Care Unit at North Shore University Hospital in Manhasset. My daughter, Sara Romeo-White, was transferred there on Monday evening, 3/15, after a suicide attempt. This was her second attempt to end her life. The first was two years ago, both were by overdose of prescription medications, prescribed to treat her mental illness.
Sara has bipolar disorder, anxiety and attention deficit disorder and has been in treatment for these conditions for more than four years now. She is despondent about not getting help for her compulsive eating disorder and severe obesity. At age 18, she is now close to 300 pounds. She has become increasingly depressed, withdrawn and filled with self-hate.
Since December, we have been desperately trying to get her into a comprehensive treatment facility capable of handling BOTH her psychiatric and medical problems. It was clear to us, her parents, and her health care providers (psychiatrist, pediatrician, therapist and nutritionist) that she needs long-term intensive, interdisciplinary and residential intervention or she would be in danger of another suicide attempt. We were right.
Sara has been accepted into Chestnut Children's Hospital in Virginia, which is the only facility with the reputation for being able to handle the complexities of her case. Your insurance company denied this request for approval and subsequent internal appeal.
So today I am standing by her bed in an ICU.
Your company had no plan for her except to state that services could be accessed on an outpatient basis and that outpatient treatment for obesity could be coordinated with psychiatric services.
We had to enlist the assistance of Senator *****'s office to get your physician who oversaw her appeal process to respond to the calls from Sara's primary care provider, Dr. Mazur. When Dr. Mazur asked your physician to give suggestions as to where we might access appropriate care for Sara she didn't know. A consideration for gastric bypass surgery was made which is absurd as Sara does not qualify for such as an uncontrolled eating disorder is a contradiction for this surgery.
I fully believe that my daughter is being discriminated against because she is mentally ill and obese. Both of these conditions are stigmatizing in our society, and our system of medical care reimbursement has mirrored this. I also fully believe that with adequate care, my daughter has a great chance of being a well-functioning adult, able to fulfill her dreams and goals.
Without such help, she will be in need of expensive, lifelong, medical and psychiatric care. She is at a critical juncture developmentally, and not enabling her to get the treatment she needs is unconscionable.
I am asking you to personally look into this matter. It is of urgent concern. I prefer not to feel compelled to go to the media to solve this problem, however, I will not stand by while my daughter's life is at risk
My future slipped further away from me every time a new denial letter arrived. The constant back and forth of it all quite literally sucked the life out of me and I couldn't take it anymore. My faith had been rocked too much. I had lost hope and I just wanted it to be over.
Standing in my kitchen over a container of cold leftover pasta I made the decision that if I was going to give in and binge again it would be for the last time. I grabbed a fork, dumped an entire bottle of parmesan cheese into the bowl and cried as I shoveled every last bit of it into my mouth. The noodles were hard and rubbery and the cheese was gritty and left me with an aftertaste of plastic. The fact that this was my chosen last meal just goes to show the sense of despair I felt in that moment. Nothing mattered, not taste, not the future, not life. If I was going to do this I needed to feel as numb as possible.
I stumbled back to my bedroom, drunk on food, and grabbed a bottle of Trazadone, a sleeping pill given to me because my brain refused to shut off from the anxiety this experience had caused. Back in the kitchen I poured most of the pills onto the table, next to the empty bowl of pasta. Two by two I swallowed them shutting my brain off and letting my hand-to-mouth coordination take over. Some pills were cut in half, the dose I was instructed to take, and for some reason I decided to leave them and put the lid back on. I walked back to my room and hid the bottle. Filled with fear, regret, and disbelief of what I had just done, I climbed into my bed got under the covers, closed my eyes and waited.
I couldn't sleep. Something wasn't right and when I could feel my mind fighting my body from falling asleep, I began to panic. I knew in that moment it didn’t work, I wasn't going to die, and when my parents found out what I had done I was going to be sent to yet another psych ward, instead of the hospital I so desperately needed to be in. I tried to hold back my vomit and convince myself that I could just sleep it off, I'd just wake up in the morning and act like nothing had happened. My dad would never know. My body, in an effort to save itself, vetoed my plan and I projectile vomited three times before I could make it to the bathroom.
I lay sweating and crying on my bathroom floor before finally making the decision to get help. Somehow I had my cellphone with me and so I called my dad, who was upstairs sleeping in his bedroom. It was by far the hardest phone call I have ever and will ever have to make. The pain I put him through is unbearable to think about. The same pain I had already put my mom through only a couple of years before. I had once again attempted to murder their first child. A child who they loved with the whole of their beings. A silly creative little girl filled with these quirky intense emotions and I tried to rip her away from them. My dad who has the biggest heart of anyone I know was completely broken when I told him what I had done. I could feel the thud of him running down the stairs. Knowing that he was both hoping to get to me faster and dreading what he was about to see. When he appeared in the bathroom door I looked up to see him already crying. "I made a mistake", I muttered through tears, snot, and vomit. He knelt down on the floor his whole body shaking as he hugged me and called 911.
The ambulance showed up with the cops, because suicide is illegal and despite the fact that one is in a completely incomprehensible state, they are required to ask you why you committed the crime. This is the last question you want to be answering when you’re a nearly three hundred pound half naked teenager laying in a self inflicted pool of her own vomit. Part of me just wanted to scream “Look at me! Do you really have to ask?” but I mustered some short “Things are just really messed up” answer before four EMT’s struggled to lift me onto a stretcher and wheeled me out of the house.
After hours of throwing up in the ER of Huntington Hospital my doctor on duty confirmed I would need to be monitored more closely and transferred me into the ICU of North Shore hospital in Manhasset. The last time I had tried to kill myself I got sent immediately into Five North, Huntington Hospital's psych ward, whose claim to fame is having once held a certain Long Island Lolita, as a patient. I knew immediately that if they needed to transfer me someplace else something had to be seriously wrong. It turned out that those pills I left in the bottle had saved my life. If I had taken even half of a pill more I would have died. For the next week I lived in a hospital bed attached to an IV drip and a heart monitor while different nurses sat by me making sure I didn’t try and hurt myself, told me how lucky I was to be alive, and asked why such a pretty young lady would want to end her life.
While they waited for my vitals to stabilize my parents and doctors worked to figure out what they were going to do with me. Since I was already in the process of trying to get into treatment, they decided that instead of sending me back to a psych ward, they would send me to a short term eating disorder unit in a hospital upstate. A place where we had to shower in front of each other and the towels and hospital gowns weren't even big enough to cover half of me. Where they couldn’t take my blood pressure because they didn’t have a sleeve big enough to fit my arm and where I would be a constant reminder of all the fears my seventy pound anorexic and bulimic peers obsessed about daily. It was my very own purgatory.
I lived there for almost two weeks while my parents and team continued to fight to find some immediate ground with my insurance company. Chestnut still wasn’t an option. Apparently nearly dying still wasn’t enough to convince them that I was sick enough to be admitted. After what felt like forever they finally came to a compromise; The Warner Hospital, an all woman comprehensive eating disorder treatment center in Florida. It would provide me the treatment I needed, but for a shorter term than Chestnut. I knew little to nothing about the place, but my parents seemed happy and at this point I had no other choice but to agree to it and so I did.