Cheryl Chandler doesn't remember her response to a viral video of her daughter being thrown out of a hospital on a cold night in Baltimore. A friend told her she screamed.
"I realized it was Rebecca," Chandler said. "I couldn't make my hands work to call someone."
For viewers, the January video of 22-year-old Rebecca Hall getting tossed out of the University of Maryland Medical Center wearing little more than a hospital gown was a troubling example of "patient dumping." For Rebecca's mother, however, it escalated an emergency - one she had lived through many times as her daughter's mental health worsened.
Rebecca's life can be measured in hospital stays and 911 calls. Chandler said she pleaded with hospital staff to commit Rebecca, but pleas went unheeded. Privacy laws prevent caregivers from giving information or confirming whether patients were treated. Rebecca is mentally ill, but she is a mentally ill adult.
Chandler was in West Virginia when she saw the video. She called the hospital, explaining she wasn't a reporter, but the hospital tried to give her the email of a spokesperson responding to news media inquiries.
Next, she tried the Baltimore Police Department. An officer said Rebecca had gone to a homeless shelter. The shelter wouldn't tell Chandler if she was there, so she asked if an officer could check. The officer said the shelter wasn't in his district and told her to call 911. Chandler explained she was out of state but did as instructed, and the operator sent her back to Baltimore police.
After additional calls and hours of worry, police confirmed that Rebecca was at the shelter. The next day, her family took her to another hospital, where she stayed until late March. She was sent back to her mother's home for about two weeks, then ended up in another hospital this month, Chandler said, suffering from flashbacks from her time in Baltimore.
The latest hospitalization comes after much struggle. In the months before the viral video, Chandler had embraced a new strategy for helping Rebecca: not helping her.
"If I'm there, they're more inclined to not do anything," she said of Rebecca's encounters with hospitals and law enforcement. "If I'm there, they are less likely to do their job."
Rebecca wasn't like her fraternal twin sister, and wasn't like other children, her mother said. She was quiet. She seemed to live in her own world. At Christmas, if she and her twin got dolls, Rebecca was more inclined to play with the box. One time, she twirled around the house for hours, captivated by a plastic hanger.
"It was concerning that there could be a cognitive issue," Chandler said.
When Rebecca was 4 years old, she was diagnosed with Asperger's syndrome, an autism spectrum disorder. Still, for more than a decade, she thrived. She was held back three times in school, but attended the same school with her twin and had access to special education classes.
"Being a twin, you always have a best friend," said Rosslyn Taylor, Rebecca's twin. "She was always my best friend. We was always close when we were younger."
But in the ninth grade, when Rebecca was 16, she began showing signs of depression and aggression. There were fights at school and suspensions. One day, though her teacher knew she couldn't be asked questions in class, a substitute called on her - and a student called her "retarded." This led to a melee during which the teacher got hit, and Rebecca was exiled to an external education program.
Around this time, Rebecca got another diagnosis: bipolar disorder with traits of schizoaffective disorder. Her behavior changed, too.
She would wander from the house. She would accuse family members of plotting to kill her, or talk about her upcoming trip to Mars or explain that she had died and come back to life. When her oldest sister got pregnant, Rebecca became infatuated with her belly, and her sister would wake up to find Rebecca standing over her.
"When Rebecca is psychotic, she can be kind of scary," Chandler said. "She was in need of a more secure, intense program. She needs someone with her."
As children, Rosslyn shared a bedroom with Rebecca, and the twins had private jokes and secrets. They would have long conversations about their future, about whom they would marry. They planned to start families at the same time.
"I love her even more, but our relationship has been very difficult because it's something you can't control," Rosslyn said.
After her diagnosis, Rebecca began taking medication and, for a few years, did well. She lived in a group home for the mentally ill in Charles County, Maryland, called Pathways, where she had her own apartment filled with stuffed animals and her artwork. She was working toward her GED and, for a time, had a job at Target as a cashier. She went to her mother's home on weekends and for holidays.
In 2016, things started to fall apart.
"Rebecca realized she was an adult," her mother said. "But she has the mentality of a preteen . . . . She wanted to be more like someone her age."
Rebecca started making her own decisions, but they weren't good ones. She started drinking and smoking marijuana. She dated other residents of Pathways. She stopped taking her medication, leading to more manic episodes and violent, paranoid behavior, her mother said. Once fastidious about her appearance, she stopped bathing and caring for her hair.
Such behavior wasn't only out of character, her mother said, but it put Rebecca out of compliance with Pathways. After a few second chances, she was kicked out of the program on Christmas Eve 2016, weeks after walking her twin sister down the aisle at her wedding.
Pathways Executive Director Gerry McGloin said he couldn't acknowledge whether a particular person received services, but said Pathways works as an advocate for patients, and sometimes patients and families don't agree on what's best. He said Pathways can only do so much for people with mental illness who refuse its services.
"They may decide to reject that help," McGloin said. "And you're trying to coax them back into care, but you may not be successful even then."
For Chandler, bringing Rebecca back home was a challenge. On disability herself, she had to arrange full-time care for her grown child at her Charles County home.
"I packed up her room, put it in a UHaul and brought it up to my house," Chandler said. "When the new year came, we started looking for services."
If Chandler took Rebecca to a hospital during a manic episode, explaining that her daughter needed help, the hospital staff could ask Rebecca whether she promised to take her medication. If she agreed, she wouldn't get admitted. After all, there was nothing physically wrong with her.
Chandler couldn't understand it. Nurses would listen to Rebecca talk about extraterrestrial travel and insist there was nothing they could do for her.
Because of privacy laws, she couldn't get basic information about her daughter, and was only able to get legal guardianship in March.
"The whole situation was like Homer's 'Odyssey,' " she said.
Before she stopped taking her medication in 2016, Rebecca was hospitalized twice, her mother said. After she stopped, she went to the emergency room or was hospitalized about 10 times, and her mother called the police on her three times.
Police were as unwilling to intervene as the hospitals, Chandler said. Twice, they refused to take Rebecca to the emergency room. A third time, they took her to the hospital only after she tried to attack a police officer. It seemed like an endless cycle.
"If you don't let me coordinate care for her, she's going to end up homeless on the street," she told a caregiver.
The last time Chandler saw her daughter before she turned up bloodied and half-naked outside UMMC was in October. A private case-management company called after one of Rebecca's hospitalizations and asked Chandler to pick her up. Rebecca was manic, saying the staff wanted to rape and kill her. As Chandler drove her home, Rebecca kept raving.
To end the conflict, Chandler dropped her daughter off at a police station, where some officers were familiar with her situation.
Two weeks went by. In November, Chandler and Rosslyn, who was in town from Texas, got a call from Rebecca. She was in a group home, she said, but wouldn't tell her family where. A woman who owned the group home also wouldn't reveal the name of the home or its location.
"She would tell me 'no,' she didn't want to tell me where she is," Rosslyn said of such calls with her sister. "She wasn't being malicious or anything. She was just in a mental state."
A few weeks went by. Rebecca's family didn't hear from her. Even when manic, Rebecca usually stayed in touch - particularly with her twin.
In the middle of November, Chandler got a call from the case-management company. Did she know where Rebecca was? Chandler didn't. Why didn't her case managers?
Chandler filed a missing persons report, even though she knew police couldn't make her daughter return home. She later traced her daughter's movements - or, at least, some of them. Only Rebecca knows the whole story.
Rebecca had gotten in touch with a former case manager who drove her to the Baltimore group home. Somehow, she ended up at Johns Hopkins Bayview Medical Center.
Her mother didn't try to visit.
"Rebecca can give consent and within a matter of minutes withdraw consent and there's nothing I can really do about that," Chandler said. "There's times I go to visit her in the hospital and I can't get on the floor."
The next time she saw her daughter, the world was seeing her, too. In a January video filmed by Imamu Baraka, a licensed counselor, Rebecca is seen being pushed out of the Baltimore hospital.
"So wait, y'all just going to leave this lady out here with no clothes on?" Baraka asks in the video.
What happened in the days before Rebecca arrived at UMMC isn't clear. Rebecca would later tell her mother someone at the group home confiscated her belongings and phone, and she wasn't permitted back into the home one night. At some point, she also went to the hospital to keep warm and "slept in tents with strangers," Chandler said.
Rebecca's plight was decried as a case of "patient dumping" - a hospital getting rid of people who, for financial or mental-health reasons, are difficult to treat. With few exceptions, the practice was outlawed in 1986.
But what looks immoral is not always illegal.
"There is certainly an ethical obligation to provide people with the best care available," said Sophie Terp, an assistant professor of emergency medicine at the University of Southern California who has studied patient dumping. "One would hope that hospitals would ensure patients be discharged to a safe environment. However, there are circumstances, at times, in emergency departments where people are sometimes discharged after their medical complaints and conditions have been stabilized in a way that is somewhat abrupt."
The hospital apologized, mounted an internal investigation and in March was cited by a federal regulator.
There are a lot of people to be called to account in how Rebecca was treated, Chandler said. There are hospitals, case managers and emergency responders who she says failed Rebecca. She has a lawyer and is contemplating a lawsuit against UMMC.
"Rebecca will be Rockefeller," she said.
Then there is social media's army of trolls. As much as Baraka's video helped Rebecca receive quality treatment, it also made her a target. People made fun of her appearance and called her a junkie.
And then there is Baraka. Chandler feuded with Baraka after he posted the video of Rebecca on a GoFundMe page, created in 2016, where he says he is raising $250,000 for "the John F. Kennedy Community Counseling Center." He says he plans to build the center in Baltimore to "serve the community as a teaching behavioral health center providing culturally sensitive counseling services," according to the page, which has raised $1,100 in about 18 months.
Baraka said he wasn't aware of a conflict with Chandler and pointed out that she thanked him for filming the video at a news conference in January. He also said he had planned to build the community center long before he filmed the video.
"I don't have a disagreement with them," he said. "If they have one with me, you have to ask them about that."
In the weeks since the viral video, Rebecca and her family have tried to heal.
"I have a lot of hate toward the people who dehumanized her, embarrassed her, hurt her," Rosslyn said. "I know Rebecca wouldn't want me to do that. She wouldn't want me to think that way. But it's hard to think that people didn't treat my sister like the beautiful human being she is."