A Letter to Kimmy: Would you be saved today?

It has been 15 years since we talked, and now this is the only way I can talk at you, not with you.

I also know how much you would hate not being able to argue back. See? You should have taken better care of yourself. (Imagine me wagging my finger.)

It was August 25, 1995, when I called the Royal Oak police and asked them to do a wellness check on you, my then-34-year-old stepdaughter. That’s when we learned you had died, apparently from a brain bleed that resulted from a fall at home - a fall that resulted from the escalating wave of seizures brought on by the toxic combination of alcoholism and bulimia. The end of our conversation.

I taught myself web design a year later, in order to post the Kimmy site on the first anniversary of your death. I wanted to tell the story of your life to warn others of the dangers of pouring alcohol on top of an eating disorder.

In 1995, there were only 100,000 personal sites on the web. In that pre-Google era, you found the Kimmy site by going to Yahoo’s directory and looking under the letter B for Bucqueroux. Back then, we were just learning about the problem. The Kimmy site and Something Fishy were some of the only resources online about eating disorders.

Put alcohol+bulimia into Google today, and the search engine generates 9,740,000 entries. Yet the question that haunts me is whether a young woman like you would stand a better chance of survival today.

More awareness - not enough answers

Sifting through the first of those more than nine million Google entries on alcoholism and bulimia shows that we are doing a better job of talking about and studying the problem. But we still have no concrete answers about how best to treat this dual diagnosis. The web offers sufferers information and opportunities to share their stories and ask questions in forums, but is that enough?

There are an estimated 10 million American women with eating disorders. And as many as a million men and boys are suffering as well.

Women with serious eating disorders exhibit the highest death rate of any mental illness second only to depression. Studies show 18% to 20% of women with serious eating disorders will be dead after 20 years. With treatment, the rate falls to 2%.

So the answer seems simple - get treated.

Yet making that happen isn’t easy. Many sufferers will literally fight to the death to avoid facing their problems. And even those who do may find it hard to find good care that they can afford.

As anyone who has watched Dr. Drew Pinsky’s “Celebrity Rehab” understands, dealing with people overwhelmed with self-destructive behaviors takes enormous patience and tolerance. At first, I was repelled by watching people hell-bent on killing themselves. I felt the same anger and frustration that I experienced in trying to persuade you to get help, Kim. But then I began to understand and then accept that denial is inextricably wound into the disease itself.

Alcoholism and bulimia are both diseases of denial. Studies show alcoholics suffer higher rates of bulimia, while other studies confirm that bulimics suffer higher rates of alcoholism. The combination of both kills quicker.

Less than a month before your death, you ended up in the emergency room because of a fall from a seizure. Even though testing showed your blood alcohol level high was enough to render most people unconscious, you refused to admit you had been drinking. And the self-hate associated with your bulimia kept you from admitting that to your doctors as well, though they knew.

Would today’s online support groups have helped you cut through the denial? Something Fishy still tops the list in most search engines because it’s online forum focuses on the positive. It even deals with the underlying issue that young men are socialized to reject full-figured females as sexually unacceptable.

If that resource had been available to you, Kimmy, would it have helped? Or was the well of your self-loathing so deep that nothing could touch it?

Worrisome as well is that alongside the therapeutic forums are the “pro-ana” (pro-anorexia) websites that offer tips on how to do all the wrong things.

Solutions must include changing the culture

Now, 15 years later, I am increasingly aware of the fact that eating disorders and alcoholism are not only individual but societal problems. We must always keep trying to save people one by one, but we should not ignore the need to fight back against corporations who profit from exploiting our insecurities and those whose bottom line remains blacker if they deny us help.

We still live in a culture where eight out of 10 women are dissatisfied with their bodies. That is no better now than it was when you were struggling.

Yes, there are positive efforts. The National Organization for Women sponsors Love Your Body Day. The Dove folks have that marvelous series of commercials with full-figured women.

But before we get misty-eyed about the great work Dove is doing, remember that it is owned by Unilever, the same corporation that hawks Axe, which uses the same old and tired stereotypes - the ones that still work.

The advertising industry is still built on bombarding us with images that tell us that scarecrow skinny is the ideal.

We often dismiss these problems as the by-products of “affluenza.” How awful that you starve yourself in the midst of all this abundance. How terrible that you drink yourself to death when the world is your oyster.

But isn’t that just a fancy way of blaming victims who are drowning in the toxic soup of media images that tell women they are unworthy? And we still call binge drinking “partying” as if it were fun.

Hardest of all is to talk money. The fact is, treating such disorders is expensive, and insurance companies fight tooth-and-nail to avoid any burden. I remember the weekend when we finally intervened and forced you into treatment here at St. Lawrence. But your husband’s insurance balked at paying for in-patient treatment, so you opted for day treatment back home in Royal Oak. Then that program kicked you out a week later for failing the Breathalyzer. If you had still been treated in a hospital with no access to alcohol, would you have been saved?

It stuns me to think you would soon be turning 50. What kind of woman would you be now? Would you be happy? Or was your death actually self-inflicted as a way to end the pain of not loving yourself?

In many ways, I have even more questions now than I did then. Bottom line for me is that I still cry on occasion thinking about all you have missed. I warned you that life is not a dress rehearsal. And, looking around, I am not so sure we could save you even if we all had a second chance.

But all I can say with certainty is that I still miss you, kid. I am sorry that I did not have the right answers to save you then. So all I can do now is push back against a culture that keeps hurting others.