One morning this past September, Kiarra Boulware boarded the 26 bus to Baltimore’s Bon Secours Hospital, where she would seek help for the most urgent problem in her life: the 200-some excess pounds she carried on her 5-foot-2-inch frame.
To Kiarra, the weight sometimes felt like a great burden, and at other times like just another fact of life. She had survived a childhood marred by death, drugs, and violence. She had recently gained control over her addiction to alcohol, which, last summer, had brought her to a residential recovery center in the city’s Sandtown neighborhood, made famous by the Freddie Gray protests in 2015. But she still struggled with binge eating—so much so that she would eat entire plates of quesadillas or mozzarella sticks in minutes.
As the bus rattled past rowhouses and corner stores, Kiarra told me she hadn’t yet received the Cpap breathing machine she needed for her sleep apnea. The extra fat seemed to constrict her airways while she slept, and a sleep study had shown that she stopped breathing 40 times an hour. She remembered one doctor saying, “I’m scared you’re going to die in your sleep.” In the haze of alcoholism, she’d never followed up on the test. Now doctors at Bon Secours were trying to order the machine for her, but insurance hurdles had gotten in the way.