Not Down Or Out

It could be worse. I might not be laughing.

Tag: charity

I Can Hear You Now

One of the several lingering effects of chemotherapy appears to be tinnitus. Tinnitus is that ringing or buzzing in the ears that some suffer for various reasons. My tinnitus began back when I was in treatment for uterine cancer at the end of 2011 or beginning of 2012.

I did not have the benefit of a huge medical team as I went through treatment. I did not have medical insurance and relied on the county’s medical services. I remain so very grateful for the county’s care that I will state up front that tinnitus has seemed a small matter by comparison with cancer.

No one has ever explained to me what causes my tinnitus or how I might treat it. Ever since the enactment of what people call Obamacare, I have had insurance I pay for without receipt of subsidies. I pay for a gold plan because I know how expensive life-saving care is. But I seldom have used my bought-and-paid-for insurance because, after I pay the high premiums and the deductibles and co-pays, medical care remains very expensive. I have had a more expensive safety net, not an affordable source of ongoing healthcare.

So I have worked on acquiring my substitute for qualified healthcare. I read online sites and try to reason my way through conflicting, incomplete, sometimes advertiser-generated, and often anecdotal information. It has suggested that chemotherapy may have damaged the hairs in my ears that assist with hearing. That damage may have caused or contributed to causing my tinnitus. Do not take my word for it. It is a theory.

I take a Biotin supplement that includes Silica and Collagen. I know. Some will say supplements are unnecessary if your diet is nutritionally adequate. Overweight people often have nutritional excesses. There is no way to judge the purity and efficacy of supplements across the marketplace. What I know is that the hair on my head, my eyebrows, my eyelashes, even the unwelcome hairs on my chin, are all thriving. Just this week someone who has not seen me in years was asking what was with the hair. It is brown, shows very little silver for one who is 58, is thicker than ever, and it is wavy. Once again, I am relying on “sign reasoning” instead of double blind tests conducted by scientists.

Still my ears ring. Sometimes it is a din. Sometimes it is a buzz. I never work or relax in a silent place. Because the “sound” is distracting, I often play a radio, turn on the TV, or run a fan to mask it in part. Nevertheless, it is never absent.

A couple of weeks ago my mom and I traveled east by car from Chicago to visit family. We picked a day in which each of the states through which we passed experienced rain. I’m not talking about wet road conditions. I was thinking Ghostbusters (1984) rain. From its script:

Dr. Peter Venkman: Human sacrifice, dogs and cats living together… mass hysteria!

For most of the four to five hours it took to cross Ohio we had trouble seeing the taillights of the cars and trucks ahead of us. It goes without saying that there was road work. The big rigs traveling on the other side of the road were in what turned into a channel formed by cement walls on either side. The water collected. As they drove past our car they sent up waves of water that slapped the windshield. Mom and I flinched each time that happened.

Road conditions improved in Pennsylvania, but the weather did not. I kept going. We did not stop for lunch because neither one of us could handle the mad dash from the car to the service stop buildings.

I turned on the car’s radio from time to time, but we never did find a station with weather reports. I would let the radio roam through the few available stations and then shut the radio off. My mom was silent except for the occasional breath caught in fear and released with a sigh when the rain eased a bit in its ferocity or a truck moved a safe distance or the windshield wipers cleared our view for a moment. I was very conscious of my tinnitus during that long drive.

While we pressed on through Pennsylvania, I located a station that was broadcasting the daily rosary. Sponsored by the Knights of Columbus Bellevue Council #1400, someone led us through a rosary addressing the Sorrowful Mysteries. I left it on and we prayed along with the priest and the others present at the recording of the event.

Shortly after the rosary ended I shut the radio off. The rain slowed down. And the tinnitus stopped.

I started to cry because it was so quiet. I cannot explain how peaceful it felt to have the noise stop. I seldom complain about it. It’s not cancer, is it? I have handled many more scary situations. It is not painful. It is not employment discrimination. It is not isolating. It is part of the soundtrack of a busy life. There are a million other things that occupy my mind on most days. I cope with it. It bothers me most at the end of the day. I lie in bed and try to clear my mind. That is when it seems most loud. Sometimes I turn on a “sound machine” that plays crashing waves or a babbling brook or rain. But that is not silence. Most nights I turn on a fan and an air cleaner. But that is not silence.

I say my prayers of gratefulness for family and friends, health and hope, talents and opportunities. I fall asleep focusing on what I have and not what I need. I am blessed, not burdened in my earthly life. I still have the little scraps of paper on which I listed my blessings and my angels on October 6, 2011, when I could not sleep on the night before my hysterectomy. I know what they say.

I pray for the people I know and some I don’t. I pray every night for the souls of the departed. I spend a lot of nights focused on the special intentions of my mom, sister, brother, and their families. I pray for friends and students who face challenges, whether large or small. I pray every night for Mike Terrill and his family and so many other brave and kind people I have met here on WordPress during my cancer treatment and recovery. Somehow those prayers make my mind quiet even if I can still hear that ringing in my ears. But let’s be honest about my prayers–I’ve been doing most of the talking.

That’s why the trip through Pennsylvania was different. This was silence. I kept wiping my eyes because it was so wonder-full.

I did some more reading online and found some reports of tinnitus reduced or abated following fast descents. Maybe the mountainous roads of Pennsylvania helped. But, in the same way I put stock in my supplements, I am putting some stock in the possibility that prayer has found for me another way to silence the din.

The tinnitus has come back. In the week after it stopped, it faded in and out. It did not stop completely during the trip home, even though we passed through Pennsylvania’s mountains on a cloudy and dry day. It continues without change today.

My mom gave me a rosary recently. This past week the old friend who commented on my changed hairdo gave me a rosary she bought for me long ago in Medjugorje, the site of many unconfirmed miracles.

I pray, but I am not one who often says the rosary. I think that might be changing.

I am sending a check today to the Knights of Columbus of Bellevue, Pa. so that they can continue broadcasting the daily rosary. And, Lord, I am listening. Whether or not prayer will stop tinnitus, I cannot say. I can still hear the tinnitus, but I think I can hear something that will help me cope with it now, too. Lord, I think I can hear You now.

Checking In

Back at the hospital

This morning I went for my six-month exam. Other than fatigue from having survived a swift move, I have been feeling well. In late February/early March. the daily, serious pains associated with radiation cystitis abruptly stopped. In June I determined that the other side-effects of cystitis–distress and incontinence–were well behind me. I stopped taking the Oxybutynin that had been prescribed for me. My bladder and bowel seem to have healed from the effects of chemotherapy and radiation.

I have had several “clean” pelvic exams and tests for cancer cells. My last scan was June of 2012. It showed no signs of cancer. In October it will be twenty-four months since my hysterectomy. In December it will be twenty-four months since treatment ended. I was thinking there would be a scan and blood tests, but there were no tests today.

My oncology team wants me to undergo surgery to correct a pre-hysterectomy hernia. The surgeon who originally diagnosed my cancer was going to repair it as part of my hysterectomy, but he ended up having someone else perform the surgery. That doctor did not touch the hernia. But it was in the way of his reaching my lymph nodes. As a result, no lymph nodes were tested–which explains why my chemotherapy and radiation treatments were “adjuvant.” They addressed risks unknown. I learned that the scans also can be confounded by the hernia, and that my radiation was more extensive because of the state of my “habilis.”

Everything looks good right now, but, if cancer were to return, everyone would feel better if things got “tidied up.” There’s no question but that I would like to get this addressed as well–EXCEPT–I do not have health insurance, I do not have the money to pay for this surgery, I am about to start school and cannot imagine undergoing surgery during “school time,” and the very thought of checking in to the hospital after my December 2011 experience there is out of the question unless it would save my life.

I am returning this week to teaching at the law school that terminated me the day of my hysterectomy. The law school is facing declining enrollments and has decided to cut the compensation paid to adjuncts, like myself, by 40%. At the same time, it has increased class size by 25%. The school has conducted its own internal investigation of my case and has cleared everyone involved of any breaches of university policies.

I suppose that means that the school would support my termination a second time if I underwent surgery–even if my surgeon said, “You can return to work next week.” That’s what the surgeon said last time.

The EEOC is examining my case now. I would like to wait for the results of that investigation before chancing fate on the subject of job security. As if an adjunct has any job security.

The Affordable Care Act will go into effect this fall. I would like to wait to see whether I can afford insurance when the new exchanges open in my state. I might have new options for treatment at a hospital that does not scare me.

The doctors think the charity that covered so much of my post-surgical care would agree to pay for this surgery if I appealed to it. That will take some time.

The doctors want me to go now for a mammogram. My cancer was estrogen-related. Some breast cancers are estrogen-related. So, I’ll do that. My maternal aunt died after more than a decade of dealing with breast cancer, so I will have the test.

My weight had dropped somewhat. My blood pressure was much better. I’m only taking a water pill for that. The doctors put off until my next check-up an ultrasound of my legs that might rule out varicose veins as the reason for my sometimes swollen right leg. No one else reacted when I mentioned the possibility of lymphoedema–which means nothing. I know that it could be the reason for my swelling from reading the excellent blog http://lymphnodetransplant.wordpress.com/. Check it out if you have unexplained swelling after surgery or other treatment that might have affected your lymph nodes’ ability to function.

I am seeing a GP in late September. I see the P.A. for another gynecological check-up in October. I can investigate my insurance/charity/surgical options between now and my next oncology appointment in February 2014.

I am feeling relieved to have gotten through this check-up, but my definition of “relief” has changed from “phew” to a sort of uneasy reduction of the alarm level from orange to yellow.

Photocredit: ripsaw-defence.co.uk

Photocredit: ripsaw-defence.co.uk

A lot can happen in six months. And I have some checking to do before checking in again with my oncology team.

Voice Over

I needed to refill a prescription for a diuretic I am taking. Imagine taking a diuretic while taking a drug like Vesicare to keep my pipes from springing a leak. As in my own field of law, the medical profession seems intent upon engaging in inconsistent behaviors.

I called in the request for the refill last week. It takes three to five business days to get a refill. On Monday morning I woke at 5:00 a.m. and headed for the hospital. It was cold outdoors, but not as bad as it has been. My car’s thermostat read 28 degrees as I backed into the alley and proceeded to drive in the icy ruts left from the last good snow.

I got a good parking space and hunched down in my seat to wait until the elevators would open at 7:00 a.m. It soon became a bad space as someone parked an enormous SUV next to my Kia Soul. The other driver did not see me there. She wound down her window and bent my side view mirror in toward my car so she could open her door. Then she wriggled and shimmied her way out of that beast. She left even less room between the back ends of our vehicles. She used her coat to wipe the salt residue from my car as she squeezed her way out. Then she saw my reflection in my driver’s side mirror. I think she jumped a foot in the air, shrugged, and kept on going.

When I got out I had to appreciate the way she had parked. She had left plenty of room on the passenger side of her car and was about as close to my car as she could get and still exit. I had to hope that I would depart before her to make sure she did not clip me when she exited.

Fantus Clinic is across the street from the hospital. I waited for a few minutes in the hospital’s waiting area before making the crossing. The radiation patients had already gone downstairs so I missed Joyce. She has 18 more radiation sessions before surgery. I still say all of the time that she is 100% cancer free and has no signs of lymphedema. She, like me, has been working full-time through her treatments. Every time we talk I feel how strong she is.

There was a man in the corner with his coat over his head. Another man snored so loudly that I heard him from a great distance. Outside a man studied the discarded cigarette butts, found one, and lit it. That has to be the grossest thing I have seen in the grossest hospital that I have ever visited. Everyone there is sick with something. The sidewalk is covered with old butts and green chemicals used to melt ice. If there had been a machine in the vicinity I would have paid for a pack of cigarettes for him. It would have been the lesser of the two evils.

That sight made me want to go outside for fresh air and a short hike the rest of the way to the clinic. When I got there I pulled a number–B021. There are A numbers for people dropping off a prescription and B numbers for people picking up a prescription.

Someone had realigned the seats in the first floor waiting area. They usually are in parallel rows with space at each end for people to come around from either side. Now the seats go to the windows. A new row of seats faces the windows and blocks the waiting area off from the hall that separates the waiting area from the glass-protected clerks’ stations. There is a TV at one end of the waiting area. There are two sign boards that tell you a number called and the Window at which that number will be served.

Where are eight windows. Window 1 is where someone collects cash. Windows 2-6 are for drop-offs. Windows 7-8 are for pick-ups. The number dispensers are between Windows 6 and 7. All windows were closed.

The windows should open at 8:00 a.m. and remain open until 7:00 p.m. They opened at about 8:15 a.m. By that time there were close to fifty people waiting. The public address service that usually announces that A01 is now served at Window 5 (and then repeats the information in Spanish) was out of order.

There were four windows open. Two for drop-offs and one for pick-ups. The people in the drop-off windows would yell from behind glass, “A01 to Window 4.” Most people got the idea. And drop-offs are quick. It got confusing when someone wanted to call B numbers because the two women at Windows 7 and 8 kept forgetting to call the B. So people who missed the A calls started going to B windows and vice versa. Sometimes the numbers and windows got posted on the signboards–sometimes not.

Fox News was warning of a storm on Tuesday. There was an elderly African American woman with a walker. Everyone seemed to know her. People would arrive and go to kiss and hug her. She told them to call their mamas or visit their baby mamas. She told a few young men to get jobs and help support their families. She held court in the third row from the TV. That was close to Windows 6 and 7. It was too loud. No one could hear their numbers.

Window 1 opened for ten minutes then closed as the employee left for a coffee break. If you were picking up a prescription, then you went to Window 6 or 7, showed a valid picture I.D., signed a smart card machine with a stylus, and got a piece of paper. You took the paper to Window 1 and waited for the missing clerk’s return.

Then you paid for your prescription. The Window 1 clerk would stamp the paper and make it a receipt. You would go back to Window 7 or 8 and wait for a lull in new pick-up calls. You exchanged your receipt for your prescription and left.

That lasted for about a half hour. Then the pick-up clerks decided that the wrong people were coming to their windows. So one came out with a notepad. She called B numbers and checked your picture I.D. She wrote down your name. Then you went back to waiting. She would then call your name and you would go to Window 7. We were down to one clerk processing the pick-ups as the other clerk was collecting numbers and names.

The prescription area is by the clinic’s front door. Everyone was arriving and leaving by passing through this area. It is noisy and crowded. As the clerk from Window 8 announced, “You see it. We’re having some problems without a sound system. That’s right. We’re having some problems. Get over it.”

If it was hard to hear your number, it was harder to hear your name. The place was like a foreign airport. No one was called Smith or Jones. Half of the waiting patients were senior citizens who were “hard of hearing.” It was like being in a subway tunnel when a train is coming. Every time a name was called, others would announce it. There was movement as people tried to exit through the new choke points created by adding a row of chairs between the waiting area and the hallway. People kept getting in the wrong lines. People were waiting for Window 1 to reopen. The line at Window 1 had to bend and run along the hall wall so that people passing through could pass.

By the time I made it to Window 1, the absence of the missing clerk had caused some to give up. They had gone back to the waiting area to sit. I waited behind a man dressed for work on a construction site. He was tapping his toes. “She’s probably on a bathroom break,” he told me.

She returned with a cup of hot coffee from the coffee stand across the street at the hospital. She did not have a key so could not get back into the office. She went to stand in the line at Window 5 to ask the clerk to let her in.

Some of the waiting people had yet to figure out what was happening. Someone started mumbling about people cutting into line. They meant the clerk for Window 1.

It took two and half hours to pick up my prescription. It took another thirty minutes to get my car and exit the parking garage because someone got into the line of people waiting to pay to exit and then said she did not want to pay and leave. So the parking attendant had to come out of her booth and direct all of the rest of us to back up so the driver could back up and continue circling in search of a parking space. No one wanted to back up and there were about seven cars waiting. Most of us wanted to punish the confused driver at the head of the line.

The parking lot attendant had the sunniest of dispositions. She said, “Thank you for waiting, Miss. Today we are handing out the finest waits you’ll find in these parts. You may just want to re-enter to get a second wait while they last.” I paid for my parking and drove out into the street. The last thing on my mind was a longing for more fine waiting.

Bruised (Part III)

I still don't know who chews on the hospital's chairs.

I still don’t know who chews on the hospital’s chairs.

I proceeded to the CareLink charity office and waited in line for a number so that I could reapply for charity status. There were not as many people waiting at 10:30 a.m. on a Friday morning. I was number 469 and the office was serving number 458.

I took a seat inside the interior waiting room and tried to grade papers, but I had trouble concentrating. I just stared at the pages and ended up proofreading for typos instead of doing any serious reading.

There were many people waiting in the twenty-seven available chairs, but there were empty chairs, too. Some people were in a militant mood. There were two adult women in long dresses with their hair concealed by elaborate headscarves. They had not obtained a number at the desk out in the lobby and had waited for some time. They wanted someone to serve them without a number. No matter how many times they tried to get served without a white ticket, the staff declined to serve them. Sometimes voices rose. I believe one of them finally went outside to get a number.

There were many people with numbers on green tickets. They needed someone to approve a discount or fee waiver on their prescriptions. This was bothering some of them. You have to go to the pharmacy to claim your drug (a task that can take an hour, two, or three), get a sheet of paper that shows the fee for the prescription, take that to the CareLink office, wait for approval of the fee waiver, then go back to the pharmacy to collect your meds. Some people pick up prescriptions in the same building as the charity office (people being released from the hospital or dropping off first-time prescriptions). Some people have to cross the street to the Fantus Clinic. It was cold outdoors and the winds were punishing. Some of the folks waiting were on crutches, in wheelchairs, or carrying luggage.

Only one employee was on hand to approve these waivers. Sometimes other employees came out to approve enough waivers to keep the crowd’s size under control. Then they went back to their cubicles to handle people with previously set appointments and people like me with handwritten white “tickets.” My “ticket” was a red ink number on a piece of white paper the size of a fortune from a fortune cookie. I kept tucking it into safe places and it kept coming loose. I think it was an omen, but I tend to ignore them. One man was incredibly “antsy.” He kept getting up and inquiring whether he could be next. The answer was no. He sat in a chair in front of an empty cubicle, rose, knocked the chair over, righted it, sat down again, studied his smartphone, eavesdropped on the meeting taking place in the next cubicle, studied his watch, observed a woman wearing a long down coat, carrying a rolling suitcase, talking to herself, coughing without covering her mouth, until she began watching him.

As I sat there I observed the crowd. There were a husband and wife with three young children. They had number 468. They sat beside me. They entertained those kids, including an infant, and you hardly heard a peep from them. There was a beautiful woman waiting with a younger woman who might have been her daughter. The older woman had very long brown hair worn in a long ponytail bound periodically with bands. There was a bun wrapped around the top of the ponytail. She had wrapped a silver cord around the base of the bun. The back of her cinnamon-colored winter coat was decorated with black leather medallions to which some other decorations were affixed. It looked like a design from a palace in some Moorish country. There were tiny black stones decorating her collar, too. She wore reading glasses down low on her nose. Her skin was so fair that her freckles looked like pieces of bronze. She was very angry that the wait was so long. I could not make out her words, but she scolded folks regularly. She sometimes got up and escorted her companion out to the first waiting room. Then they returned and continued waiting.

A man in a motorized wheelchair wheeled alongside me at one point. He wore an immense white and black fur hat like a hunter might wear, if he bagged some Siberian white tiger. Because he came up to my side I got a good look at it and believe it might have been real. He also wore a mink jacket with a fur-lined hood. It looked velvet soft and was the most incredible shade of brown. He was a big man, very tall, and, of course, bundled up. He had a lovely smile and lively eyes. His voice was cocoa with whipped cream and a cherry on top warm as he patted my arm and said in a very loud voice, “I just have to say that I am loving your haircut.”

“Thank you.”

“It is just a pleasure to get to look at.” He looked around the room, “No one else seems to have taken hair as seriously as you have. This is one of the best times of my day, let me tell you!”

I thanked him again. He motored away and I saw that, hanging from the back of his chair was one of those yellow and reflective tape vests that road workers wear. It read: “Watch Me For Safety.”

Of course, he proceeded to go to one of the cubicles to demand service. It was so startling to have him publicly compliment my hair one minute and then go batsh*t crazy on some poor charity representative. I thought they were going to call security as things escalated, but a woman with a forceful cloak of authority told him that his needs required special handling and he would be served immediately if he would head immediately to Room 1317. He left as fast as his motorized wheelchair could take him and did not return. As he approached the heavy metal doors to the lobby waiting area, he lifted one foot and kicked the thing open. I think everyone flinched because those doors have no windows and open out so newcomers are always on the other side of them trying to figure out whether to pull or push. No one got hit.

At 10:40 a.m. we were up to number 464. That was incredible. Of course, people started taking lunch breaks. So it slowed down. But breaks appeared to be very short. At 11:10 a.m. staff called 466 and 467. At 11:15 a.m. someone called 468. I was next.

It took sometime for my number to be called. The charity’s staff seemed to be enjoying a Friday moment. As people started getting a tiny bit unruly the staff started repeating certain comments in soft voices and the message began to work its way to where I sat like a game of Telephone.

“He says he’s been waitin’.”

“She says she’s got things to do.”

“He’s got a job to get to.”

In the end I was called. Based on my current income, which is actually lower than it was back in 2011, I qualified for a 25% discount on hospital services. What hurt me was the DePaul did not pay me for my fall paralegal classes in the last payroll period of December. Then it did not pay me for the first payroll period in January. It arbitrarily decided to change the customary schedule for paying “contracts” with people who it treats as employees for payroll purposes and independent contractors when it feels like it. So the most recent pay stub I had showed me as earning much more in one payroll period than I ordinarily do. I also taught a 12-week class in 8 weeks for another school during January. That upped my monthly pay over what it usually is.

I felt really bad for some reason. It was like DePaul took another swing at me, when it really did not mean to do that. An employer’s arbitrary altering of a pay schedule to suit its purposes is a regular event for many adjuncts.

I probably should have waited for a February pay stub showing only the halved fee paid for teaching Transactional Drafting. But I was not trying to “work the system.” I will just keep working on getting a quote for insurance from someone and hope I can cover 75% of the cost of the three doctors’ appointments, five blood tests, and pap test I already have had since the last week of January. I have 30 days to appeal the determination. Maybe my pay stubs will better reflect my circumstances in that time.

In any case, I won’t be scheduling any operations for this year. I have experienced enough “tinkering” in the last fifteen months. I am resourceful and still have people to call and options to explore. And I am feeling much better than I did when this experience began. I am still grateful for the doctor who diagnosed me. I am grateful to the excellent hospital, doctors, and professional staff who operated on me. I value the thoughtful care given by my oncologist and feel lucky to have had her wise advice in making decisions that will affect me for the rest of my life. I think my oncology nurses and the phlebotomist who helped me through chemotherapy were excellent people. I owe an immense debt of gratitude to the two charities that covered so many elements of my medical care. I am grateful to my county, its hospital, and all the excellent people I have encountered there for having resources for people like me.

I have family, friends, and faith that things will turn out well. And I still have my sense of humor.

I remain Not Down or Out.

Serving Time

The clock moves at the same speed every moment of every day, but the hours can pass so slowly when you long to be some other place. Today I met with Dr. H and heard that my blood tests showed no abnormalities. My platelets should be between 169 and about 380. They were 196. That’s fine.

On Friday I will meet Dr. Y for my first gynecological examination in a year. Nothing terrifies me more. The last time a doctor examined me I screamed in agony. I assume that a great deal more healing has taken place since surgery and twenty-five days of radiation. Nevertheless, even as I sit at my desk typing this entry, my shoulders are tense. My hands feel cold. There is that tiny quake inside my body that could become a tremor and maybe a shake if I let myself feel it. Instead, I am clenching my teeth. I am curling my fingers into my palms to keep my hands from shaking. It will probably turn out fine. Women go through this every day.

Maybe that’s why it is making me so nervous. It is supposed to be easy. Nothing has been easy for some time. I may have powered through it, but it was not easy.

According to Dr. H, if Dr. Y is satisfied, then I do not need to return for another appointment until August. I like the sound of that.

She and Dr. Z examined my “rash.” It has not gone away. In fact, it has spread. They studied the blood results, but could only speculate as to why the patches have faded, but the expanse covered has widened. Dr. H called for a dermatology consult. The Dermatology Clinic agreed to fit me in today at 12:30 p.m.

I had already been at the hospital since 6:00 a.m., but I agreed to wait around until 12:30.

That’s right. I was huddled in my car this morning in the parking garage at 6:00. The 34 degree winds were gusting up to 50 miles per hour. I was reluctant to go inside and wait in a long line for the elevators to open. I hunched down in my seat and waited until 7:00 a.m. By that time the public parking lot was filled and people were halting beside my car to ask if I was leaving because they wanted my space.

When I got to the elevator bank the line of people waiting for an elevator wound all the way to the front doors of the building and back around in a huge horseshoe shape. I stood behind a senior citizen in his wheelchair. He had his medical file resting on his knees.

Only one of the three elevators at the east side of the building was in service. The elevator would open and the police would direct people into it. Someone would press B when everyone else was headed to the second floor specialty clinics. Everyone would ride downstairs. The pack would part resentfully to let the “deviant” depart. Then folks rode back to the first floor. The waiting crowd would surge forward and then be forced to halt because there was no room in the elevator. The doors would close and the elevator would proceed to the second floor. On its return, it would head for the basement so we could repeat the exercise.

A woman in her seventies cut into the line beside me and started to pass me. She looked fit and capable of waiting. I could have objected, but I did not have the energy to squabble when we were likely to end up in the same elevator anyway. She then made a move to pass the man in the wheelchair. Big mistake. Don’t ever make the mistake of thinking that the disabled are incapable. They just have less of some abilities and more of different abilities. The man in the wheelchair saw her out of the corner of his eye and he turned the wheels of his chair just a bit faster. He avoided riding up on the heels of the couple in front of him, but he made it impossible for the woman to cut in front of him unless she hitched a ride in his lap. She lengthened her stride and drew up alongside him and did the racer’s lean. You know what I mean. Her chin came forward. Her shoulders followed. She tucked her medical file under one arm and thrust her handbag forward.

Her intention was clear. If the next elevator appeared crowded, she would edge out the man in the wheelchair and leave him to wait for the next empty car.

I may not have felt like starting a “rumble,” but the man in the wheelchair had no reservations. As we waited for the next empty elevator, he pointed at the woman and said, “This is a line, lady, and you can’t cut into it.”

“Lady” is such a polite term, but not when it is used as the man in the wheelchair used it. There was a wealth of sneering anger in that one word. I felt it like a punch in the gut. The man in the chair might have been at the county hospital for his care, but his khaki pants had a crisp pleat down the front of each leg. His plaid shirt had starch in the collar and cuffs. He may have been in a wheelchair, but his shoes had the super thick soles you see when men walk a beat or stand in formation. The file in his lap was Army green and had papers that were organized rather than assembled. He spoke with authority, but, as I said at the outset, there was something else. It was darker and a little menacing.

I looked at the woman. She was equally determined to succeed. There is an inscrutable manner that some recent immigrants project. It is partly language differences. They may or may not speak English. They may or may not understand our cultural norms. This woman looked like she was pretending not to understand. She made no eye contact. Her eyes were on the prize.

As the elevator doors started to slide open she made her move. She darted forward, cutting past the wheelchair and the couple ahead of us. As she reached the elevator’s threshold a police officer crossed in front of her.

“Are you cutting in line?” The police officer was very tall. His uniform was very blue. His eyes were very dark, like the night when the moon is a tiny sliver in the sky.

The woman betrayed no emotion. None. She evinced the steely determination that will likely see her through whatever health threat she must now overcome.

The policeman looked at me. “Did this woman cut in line?”

Now everyone looked at me. The man in the wheelchair was right. She was cutting. But, I swear, he was giving me the same scathing sneer of distaste that he had directed a moment earlier at the other woman.

I shrugged. “Officer, I’m not sure when she joined this line.”

The man beside me was fuming, but both of us waited as she forged past the policeman. There was room for the wheelchair but no room for me. As the door shut in my face, the woman smiled. It was not a pleasant smile. I know. She thought I was weak. The man in the wheelchair was pissed off. He thought I was a bitch. Maybe I was a little more of one than the other.

I am betting that he was the first one out of the elevator on the second floor. If he could have, then he probably ran over the woman’s foot. I was better off waiting for the next elevator.

When I got to Clinic H there were other bad portents. It was 7:30. That’s right. It took 30 minutes to wait for and ride an elevator down one level and up two. I took a seat because my appointment was not until 9:15 a.m., and it is bad form to try to check in more than an hour in advance. The receptionist summoned me to her desk then told me I was checking in too early. I went back to my seat and graded papers for my drafting class at the law school.

When the nurse came out to test my vital statistics she could not manage to get my blood pressure. We tried three different cuffs, put it on two different parts of my arm, and let the machine take readings at least a dozen times. We finally tried another machine. By that time my blood pressure was slightly elevated.

That was a long way of telling why I ended up with time to try to renew my charity status at the hospital. I returned to Room 1290. That’s where I went on October 26th when I was told that I could not apply for renewal of my charity status unless I owed the hospital money. At that time I had one day left of eligibility so owed the hospital nothing.

I discovered that Room 1290 is now County Care’s office. County Care is part of the Obama Care plan. It is health insurance for people who cannot afford health insurance. Of course, you also have to have an income less than $15,000. There is a tremendous tax hit as you cross over from poverty to low income. Why would a person making less than $15,000 work even one more hour if the first thing she lost was health insurance?

I work way too hard to qualify for County Care even on what universities pay to adjunct professors. The receptionist sent me to CareLink in Room 1690. I waited in line with about 20 people to get a number that entitled me to wait to see someone. When I last had an appointment with these folks I was told I would not need an appointment to renew my coverage. Everything has changed since then.

I got number 317 when the number being served was 298. I watched the clock. It was only 10:30 a.m. I had two hours before the dermatology appointment. At noon CareLink was serving number 307. I left for my dermatology appointment. I thought there was a good chance I could return before 317. No such luck.

In the Dermatology Clinic there was a full house waiting. I sat behind a man, who was sleeping in his chair, and his transgendered sister. She was at least six feet tall, had a full head of orange hair that matched her orange fake nails, wore a push-up bra and three additional pieces of lacy lingerie layered one over the other, and sported a noticeable Adam’s apple. I envied her amazingly long legs that went up to the sky in leopard print leggings. I am pretty sure that she studied the various exercises of the Brazilian Butt Lift because you had to see it to believe how high her buns of steel were. She was still working on her voice. It was tough. It was Kathleen Turner after the Super Bowl and a sip of whiskey.

There was a man with a hospital mask and a plastic “cowl” that covered him from his neck to just above his glasses. It was more than a little reminiscent of those collars they put on dogs to keep them from biting their own wounds. This man showed up every place I did today. Apparently he let the door to Clinic G shut in the woman’s face and then said to her, “Get your own door, lady.”

The woman was incensed. “Who are you calling, ‘lady’?” she asked. “Are you talking to me, dog breath? Because let me tell you that I have a bigger set than you do and mine were cut off three years ago.”

This exchange woke the brother. He sat up and watched for a minute. Then he pulled his cap down lower and let his head sink inside the collar of his pea coat.

The woman was not done yet. “In these shoes I could raise my leg and still piss on your head, you shrub.”

The man looked dazed. He scurried away. The woman sashayed back to her seat and announced to no one in particular, “If he wants to treat me like I’m a man, then I’m still twice the man he’ll ever be.”

I saw five dermatologists today. Actually, one person was a med student. She introduced herself and shook my hand. Then she took my patient history very competently. We studied my rash and she informed me that it covered my sides and back now. I had not noticed.

She brought Dr. G. Dr. G brought in two more doctors. They studied my legs where the pattern of red dots was extensive. Dots ran from my ankles to the tops of my legs. The doctors took out a magnifying glass and all took a gander at the red spots up close and under bright light. “Just like cayenne pepper,” one doctor declared. They got on the computer and looked at my blood test results. “It looks like a reaction to the bladder medicine except that such an allergy would have stopped at your legs and flanks.” Everyone studied the profusion of red dots on my arms. They were unlike any of the other swashes of red dots because they collected in patches. There was a pattern like a petaled flower at the inside bend of my left arm. On my right arm it looked more like bruising. They poked and remarked upon the lack of swelling, “heads,” and other awful signs of allergy.

They left to get “the boss.” Dr. S came in and everyone studied me yet again.

It is a teaching hospital. I became a class problem. The doctor thought it ironic that he had only seen a condition like mine in other teachers.

He speculated that I may have an allergic reaction to my bladder medication. However, he thinks it could be hypergammaglobulinemia. Discovered by Waldenstrom–who also discovered macroglobulinemia. One should be careful to NEVER confuse the two. The former is an immunoproliferative disorder. Basically, it is possible that I have too much gamma globulin because I have too little of another type of immunity (antibody) in my blood. The one type of immunity is a paraprotein that is in excessive supply–IgM. It could be that I am too low in another immunity–IgA, IgE, or IgG. I guess these other immunities are sometimes referred to as B cells, T cells, and Natural killers (NK). The doctors would need a paraprotein count, and the test is expensive so will not be done at County. However, he described it as a nuisance condition. The spots will stay or go and may return throughout my life. He suggested that I give it another month to disappear. If it lingers, then I should return to the walk-in clinic after 3 p.m. on one of the several days of the week that the clinic is open.

He did not even want to make a note to my file of the possible condition because it has not been confirmed and because the other condition that Waldenstrom identified is a blood cancer, a leukemia. It is a very serious disease, and he said that practitioners will hear Waldenstrom and the rest will sound like the teacher in a Charlie Brown cartoon, “Wah, wah, wah, wah.” They will never appreciate how much less dire my condition is.

I agreed that I could deal with the nuisance.

It was too late for me to renew my charitable status. By the time I made it back to Room 1690 it was 2:30 p.m. and the staff was working with number 327. I was 10 people too late and will have to start over on another day. Maybe I can stay after my gynecological exam on Friday to pursue the charity status.

As I drove home after 8.5 hours of waiting for about 30 minutes of time with doctors I was struck by the similarity between this potential explanation of my current spotted look and my encounters with people waiting for elevators, care, or charity. They just have less of some abilities and more of different abilities. The man in the wheelchair could not walk, but he was steely in ways that keep him from getting run over. The woman in the Dermatology clinic may not have had enough anatomy to qualify any longer as a man, but she had balls of steel when confronted by a man who thought to put her down. I am not poor. I have plenty of education. I work very hard. But I have a history of cancer and not enough income to pay for health insurance. I don’t have enough of some essential immunity, but I have so much of another that it’s splashing all over my body in its outrageous excessiveness.

Sometimes we come up short and find balance by having way too much of something else.  Today the thing I really had too much of was time, so I spent as much of it as I could learning very little of any use to me.

Ironic-ing

Just an update on the week’s events: I drove to the hospital on Friday to start the process of refilling the prescription for my bladder medication. I needed to switch from the generic drug that has covered me in red splotches to the name drug. I took the latter for almost a year without any allergic reaction to it.

When I made it to the hospital the public parking lot was filled and the building was closed to additional cars. This is Stroger Hospital in Chicago–our immense, “new” county hospital. There’s no street parking in the area. The public can use only two floors of the structure. The rest is reserved for staff. There is a large, half empty parking lot right next to the multi-level structure that was closed. It stood more than half empty, but accepts no patients or visitors.

This is what happens when I do not get up at 5:30 a.m. to be there before the building opens at 7:00 a.m.

I could drive six blocks away and park in the Juvenile Justice Building’s far larger parking facility for a shuttle bus. But it was 9 degrees outside and the wind was blowing hard enough to have blown a window in my home open that morning.

I turned around and took my prescription to a Walgreen’s store. It was a risky decision. Some of the drugs that have been prescribed, including a previous bladder medication, cost $400/month. At the hospital I would pay a much lower price. I already had gone without the medication for five days and anticipated having to wait at least five days for the prescription to be filled. My principal side effect from five weeks of abdominal radiation is radiation cystitis. It is painful and causes incontinence. This drug that has brought relief and red splotches galore is the thing that gets me through my darkest days. It quells the spasms that can be very painful.

It was comical. No one at the Lincolnwood, Illinois drug store’s prescription counter greeted me for five minutes. I stood there, feeling like the clinic at the county hospital might have served me better. At the hospital I take a number and wait. At the drug store I was invisible. Eventually a pharmacist took the prescription and asked me to return in fifteen minutes. He said “fifteen minutes” like my waiting time might prove to be fifteen months. I took a seat and waited. Fifteen minutes seems like a short wait compared with three and five and seven hour waits at the hospital–except that, when I am at the hospital, I always know someone will serve me.

I went back to the counter after twenty minutes and waited. It took twelve more minutes for someone to help me. In that time no one acknowledged me. Others working in the pharmacy saw me and walked by. I was not the only person to receive such treatment. Another woman attempted to drop off her prescription. When no one came to assist her she left.

In time, the lone clerk operating the drive-through window finished handling a steady stream of customers. She assisted me. I walked away with a huge bag that contained my small bottle of pills (which turned out to look nothing like the two versions of the drug that I have taken previously).

So, this is one week when there was a win, loss, and a draw. My platelets turned out to be fine. They were not committing suicide, just collecting unattractively to signal dissatisfaction with my medicine. My quarterly check-up turned out to be a bust. The doctors and I never even had a moment in our fifteen minutes together to address my health concerns (I will get to see them again in another ten days or so). I faced inconvenience and frustration all week as I tried to fill a prescription for a drug that would address my principal side-effect of cancer treatment and put a stop to the spread of red splotches from my ankles to my hairline. The drug store only charged me $10 for my medicine. I was feeling like the rude service was an acceptable consequence of having been unable to even get into the hospital’s parking lot.

As I headed out of the drug store I stopped at the front register for about $15 of groceries. The woman who had walked away from the prescription counter without being served was there complaining. The cashier was determined to get the customer to wait to speak with the manager, but the customer left. I echoed her concerns and did stay to speak with the manager. He just apologized. It was not all that satisfying.

When I got home I realized that I had paid for my items, but the cashier (who seemed more intent on having me complain to her boss than I was) had never put my bag up on the counter. I had walked away without my few groceries. I never noticed because I already carried a big Walgreens bag. this means I “paid” $25.30 for the retail prescription I could have gotten for $5 if I had been less impatient and returned to the hospital again or taken a shuttle. Of course, it was not $400, like the drug I last bought retail, but it was five times as costly as if I had shown even more patience.

There’s a lesson here. I am certain of it. But–for the moment–I cannot figure out what it is.

 

Thank you for your Service

This morning I woke at 4:30 a.m. to prepare for my third trip to Stroger Hospital this week. Every day this week has been stressful due to the huge time commitment associated with even one trip to the hospital. Last year I had to be there five days a week for five weeks for radiation appointments. I certainly was feeling better about the process today than I did back then.

At a few minutes before seven in the morning I parked in the hospital’s lot. There were more than a dozen open spaces in the last row of the second floor. I hunkered down in my seat to grade papers because my appointment was not for a couple of hours. The weather turned cold yesterday evening. Thursday afternoon we hit a record high of 79 degrees. I could see my breath when I exhaled in the morning.

I wore what I will always think of as my cancer sweater. It’s gray, coat length, and heavy enough to keep the cold at bay for the walk from the car to the hospital building. It is not heavy enough to become a dead weight as I walk around the hospital trying to get things done.

As I marked a student’s contract I kept stopping to draw a long blonde hair from the sweater’s loose guage. I wore this sweater when my chin-length bob was falling from my scalp to my shoulders and from there to the floor.

It has been through the washer several times since then. I predict that I will reencounter my long lost locks for as long as I keep that sweater around. I have no plans to discard it. It served as a blanket during six long chemo sessions. It shrouded me in silence during tedious waits for appointments. I rolled it up and used it as a pillow once or twice.

The people who arrived after the hospital opened whizzed around the parking lot over and over as they despaired of ever finding a parking space. I could see an empty space several rows closer to the door than my parking space. It was unavailable because a pick-up truck had encroached on it. One by one drivers tried to fit into the narrow opening. Each gave up and returned to circling.

I went inside when my fingers started to feel the cold. I walked down the hallway to Room 1690 and waited in the line to check in for my appointment. The waiting area was nearly empty. There were five people waiting and the number being served was 151 when I got in line. It was 154 when I made it to the receptionist.

She looked at my paperwork. “You need to go back down the hall to Room 1290,” she said. “Go to the coffee shop and make two lefts.”

She handed me a piece of paper with my name and the time: 8:49 a.m. My appointment was scheduled for 10 a.m. It never pays to be late. Numbers come and go. People not present when called are passed over.

I walked back the way I had come and found Room 1290 in the area near the elevators where I once waited for permission to ride upstairs for doctor’s appointments. I walked into a waiting room. One woman sat in the three rows of chairs. She pointed to a reception desk. “Start there,” she said.

This room was unlike the waiting room at Room 1690. At that end of the hallway there are about fifty chairs in an open waiting area. Then there are about as many chairs in a second, enclosed waiting area. Every seat is filled in that second, enclosed waiting area.

I approached the receptionist. “Do you have a slip?” he asked.

I handed him my piece of paper.

“Have a seat.”

I sat down and went back to grading.

After awhile someone came to collect me. She pointed to one of two hallways leading from the waiting area. “Take a seat in booth three.”

I walked down the hall and sat down in a carrel. She used the other hallway and met me on the other side of her desk.

I explained that I had an appointment to “renew” my charitable status at the hospital.

“Did you bring everything we need for that review?” she asked.

“Yes.” I took out my driver’s license, original determination letter, birth certificate, marriage certificate, divorce certificate, pay stubs, and a current utility bill.  She studied them and her computer screen.

“You will have to return in January with these papers and up-to-date pay stubs and a current utility bill.”

I know I raised my eyebrows, but I was careful not to challenge. This is not the type of place that welcomes challenges.

“You don’t owe the hospital anything right now,” she explained. “You need to have your status reviewed when you receive uncovered service. I see your next appointment is in January. Come back then. You won’t need an appointment. You’ve been through that rigamarole aleady.”

She continued to study my papers. “I’m going to make copies of some of these documents so we won’t have to do that when you come back,” she said. “Wait here.”

Off she went.

I found myself recalling a time in my life when I could get irate about having to wait thirty minutes to see a doctor. Back when I charged $275/hour for my legal advice I sometimes wondered aloud with whom people thought they were dealing by dragging me away from my office, keeping me waiting, wasting my time. Those days are gone. I sincerely thanked the woman for her time, took my papers, and headed back out to my car.

This is what it means to be uninsured and diagnosed with cancer in America. You are grateful for the safety net and do not complain all that much about the difficulties. I am well aware that these inconveniences are minor when waiting means I can receive the care I need to live. The inconveniences hit me with much less pain than they do some others. I worry about the working poor with two jobs and no time off during the week. What about the people with young children? People sometimes wait on bus stops or on train platforms. They switch buses and trains. They walk long distances. They drag behind them their children or an aging relative. Sometimes they do not speak English. They may have to deal with foreign locations to obtain birth certificates or may be undocumented.

I already voted this week. I am not a big fan of the President. But I voted for him because I cannot write off the 47% of Americans that sometimes need the social services my past and current income taxes (and yours) have helped to make available. The people who rely on Social Security, Medicare, Medicaid, charity, and other programs are not faceless or nameless or useless. I understand that some in our society do not want to work so hard for the aid of others. I do understand that feeling. But do not imagine that here in uninsured America we are enjoying the fruits of others’ labors without being grateful. Please do not tell yourself that it is easier to be poor than it is to work. Please do not resent the fact that others are unemployed or underemployed or unemployable. Please do not fear us more than you fear finding yourself in need of assistance. Please don’t abandon the social compact.

We are a nation. The social compact that binds us together means that some are called to military service to protect our liberties. In times of war they have given their lives to protect this way of life. No one of us has ever given enough in thanks for their sacrifice. Some give their limbs, the right to bear or give life to children, their mental stability, or the quality of the remaining years of their lives. Nothing they receive financially for this service compensates for their suffering. Some are government servants. They toil each day on behalf of the public, most days without thanks or fanfare. When their service is done we sometimes complain about their pensions. Some serve in private endeavors such as charities. Their generosity is often anonymous. Some work and pay taxes. Some build businesses. Some work in them. All of us contribute. Maybe it has been awhile since anyone said thank you to you for your share of the national sacrifice. If that is the case, then let me rectify the oversight. Thank you for your service. It is sincerely appreciated.

 

 

My Car/My Cancer

I have been feeling very uncomfortable this week because of the overwhelming anger of some Americans over the Supreme Court’s decision to uphold the insurance mandate of the Obama care Program. I do not have health insurance. I currently am the recipient of charity to cover my extensive medical treatment for cancer. I am unable to afford insurance based on my health and other risk factors.

I insure my car because I must have car insurance. I also have a car loan and it is required that I have insurance to protect my lender’s collateral interest in the car. It’s sad that I can afford to insure my vehicle in case I injure myself or others while operating it, but I cannot insure myself. I am, after all, the most important asset that I possess.

I work for several educational institution employers, none of whom feel it necessary to offer me assistance in acquiring health insurance, even though I usually teach as many courses for them per semester as a full-time professor does. They get to choose my designation as full- or part-time and have chosen to categorize me as a part-time employee, often based on the amount of time required for administrative duties. They also pay a very low salary to their part-time faculty, much lower than they pay to full-time professors.  Some have estimated that close to 50% of higher education courses are taught by part-time faculty. http://www.usatoday.com/news/education/2008-12-03-part-time-professors_N.htm.

Much has been made of the fact that employers should not be required to insure their laborers, or even aid in the payment of their insurance premiums. It is a burden on small businesses to pay these costs. It makes it difficult for them to compete with other businesses if they must contribute to the employees’ insurance costs. That makes sense. Labor is an expense that employers seek to minimize, just like materials, utility expenses, administration and overhead costs.

I have read about how angry people are that they will be forced to buy insurance or pay a tax (some call it a penalty). None of the angry people who have written or spoken have announced that they do not want health insurance. Many of them are members of Congress–all of whom have health insurance made available to them and their families.  They can choose from approximately 300 plans, all of which offer immediate coverage with no limitations for pre-existing conditions. The government pays 72-75% of the expense. http://www.factcheck.org/2009/08/health-care-for-members-of-congress/. When I say that the government pays, I mean that my tax monies and yours pay those premiums.  So, it’s okay for tax money to be used to pay for insurance for some, but not others, to be insured.

It must be nice to work at a place that can afford such excellent coverage and so many choices. Of course, the government does not compete with the private sector so the cost of this coverage is not a burden to the government. It is a burden to the taxpayer. I may not be able to afford health insurance, but I pay taxes so that others may have health insurance.

I have no idea whether I will be able to afford health insurance in 2014. If the Obama care Program is still in effect, there will be no single-payer system like so many other countries offer. There will continue to be competition among insurance companies. The inclusion of people with few health risks in the group of insureds should lower the cost of insurance for some because the pool of insured people will include many who will have few claims due to their good health.

I suppose that the young and those in excellent health may resent the fact that they must have insurance in the future. I suppose that some of them are resentful already at the prospect. There are poll results that suggest women and youth oppose the program, even though they are expected by the program’s supporters to benefit from it. http://www.commentarymagazine.com/2012/03/26/opposition-to-obamacare-high-among-women-youth/. Yet I have not read a single news story or commentary written by a young person who would prefer that people like me die of cancer or be saved by charity to having me pay for health insurance. Indeed, the only opinion I read objected to the plan on grounds that it might encourage abortion. http://studentsforlife.org/2012/07/02/channeling-frustration-into-energy/. I can remember being young and not having health insurance. I often had insurance through my parents’ employer, my employer, or my ex-husband’s employer. But there were years when I did not. On more than one occasion I was sick and did not seek treatment. I often went without regular dental or eye care. I don’t recall thinking that it was my right as a free American to not buy insurance. I wished I could afford it then, too.

If I did resent the fact that my tax money paid for health insurance for children or pregnant women or senior citizens, I cannot recall it. I grew up in a conservative Republican home. I can remember thinking government was too big. But I never thought that people should die because I should be free of the burden of paying for their health care.

There are some signs that the public is willing to begin the process of implementing the Obama program:

According to a poll released this week by the non-partisan Kaiser Family Foundation, 56 percent of Americans believe opponents of the law should “stop trying to block its implementation.[“] Just 38 percent of Americans said opposition should continue. But that 38 percent is very well funded and speaks loudly.

http://www.seacoastonline.com/articles/20120708-OPINION-207080315. It seems to me that many Americans fear that the plan will prove expensive to the nation and many Americans fear that in this economy they are precariously close to becoming uninsured themselves. Loss of employment triggers rights to COBRA continuation coverage, but that coverage is expensive. http://www.dol.gov/ebsa/faqs/faq-consumer-cobra.html. It is not right that employers bear all of the costs of insuring their workers when they, too, face an insurance/medical system that cannot control costs no matter how many efforts are made to lower the cost of healthcare. As a nation, we need to work on modifying the delivery of medical services to all citizens to reduce the cost of keeping people healthy.

I paid taxes that paid for emergency care for starving people in foreign countries. I paid taxes for military intervention in matters involving disputes between other countries, sometimes for disputes between other countries and their own people. I paid taxes for education even though I never had any children of my own. I paid taxes to finance public transportation for people who could not afford to use it without government subsidies. I paid taxes for many programs that did not directly support me.  I thought that was my civic duty and that such sacrifices were part of the price of freedom.

I have paid taxes as an employee and as an employer, too. I have paid sales taxes on my consumption. I have paid capital gains taxes. I have paid penalties for accessing my pension funds early. I have paid penalties when I have let my meter run out.

Why is healthcare different from all of these other programs undertaken by government for the general welfare of the American people? It’s not. It may be for some the straw that breaks Uncle Sam’s back. Philosophically, many favor a smaller government. They have the political right to object to the plan. But the Congress has voted and they have lost. It is time that we explore what can be done to ensure that those who cannot afford to buy health insurance can afford it.

If some can pay to insure their cars despite the fact that they have never caused a car accident so that those who do cause them can afford to buy insurance if they own cars, then someone else now in excellent health can pay health insurance premiums so that others who need healthcare and could not otherwise afford it can afford to buy health insurance. It does not make sense to say that driving a car is a privilege but living is not and so warrants less protection and less responsibility. I could argue that insurance for cars makes more sense than insurance for cancer because driving a car is risky and being diagnosed with cancer is not, but I am not unintelligent, simply uninsured.

Thank You, Cook County!

On Monday I was standing in line to apply for CareLink, Cook County’s program for helping people with their medical bills when they are uninsured. It was six thirty and the line wrapped outside of the waiting area into the hospital lobby. My bladder was on a forty-five minute time clock. We waited with our birth certificates, pay stubs and miscellaneous other documents. There was a number on a screen that said the office left off serving applicant 863. The line was so long that I was uncertain how many people were ahead of me. I leaned against the chapel’s outer wall as the clock moved slowly and more people joined the line. I was perspiring. My knees were sore. I wanted to lock them for stability but then felt a little faint. So I leaned. The wall was my friend.

At 7:00 a.m., a manager came out and announced how she wanted to manage us. She would send people who had appointments in to an interior waiting room with yellow slips bearing numbers like those you get when you wait at the grocery store’s deli counter. They had to show their documents to her to reassure her that they were prepared. All of us took out papers to hold in our hands.

People without appointments, like me, would also show her our documents. If we were not ready, she would offer us an appointment for a future date. The next appointment was in May! It was March. As I waited I learned I needed utility bills to verify my address. I had none on me. I decided to wait and make an appointment if necessary. If by some miracle my papers passed muster, then I might get a white slip bearing a number from 864-910. That was how many walk-ins could be taken that day.

I finally made it to the start of the line. I pointed out the omitted utility bills. The woman with the master sergeant voice stared at me. I was one of few people there who looked like me–bald with baby fine hair growing in the wake of chemotherapy. She ushered me to the window where someone was handing out white slips. I was number 903.

I took a seat in the waiting room. Others were not so lucky. I saw many turned away that morning. The atmosphere was tense.  When people were turned away because there were no more white slips the line had wrapped its way down the hall toward the emergency room. Many left rather than wait to arrange an appointment. There were many who needed translation assistance. Those with English language skills tried to explain what was happening in Spanish and other languages. The manager’s impatience was not directed entirely at the people in line. She was LOUD and irritated with her co-workers, too. People spoke quietly so as not to let the many speak over the one with power.

It must be tough to turn away so many, but her authority was unquestioned. I never considered arguing with her if she dismissed me.

There were several young men sleeping on their backpacks in the waiting room. They appeared to have been discharged by the ER during the night. All had fair hair, ruddy coloring, and scraggly facial hair. One had bare legs that were lobster red and swollen. Another young man wore the hospital band. He looked fine to me and the man with the red legs looked in need of care. You never know, do you? The rest of us took seats around them. People were soft-spoken, respectful, patient. Several had bad coughs and others offered them lozenges, as if all of us might fare badly if they were disruptive, and not because we wanted to help. Those who were alone were silent. Those who were in the company of others spoke in hushed tones even after the manager went inside to begin evaluating claims. We were there for a long time. At 8:00 a.m. the number on the board was 868. There was still a good chance that I might be rejected for not having enough proof of my address. I resolved to wait.

Outside it was raining. The day before it had been 80 degrees. Flowering trees were in bloom.

It has been “raining” in the restroom, too. When my bladder could wait no longer I slung my purse and briefcase straps around my neck, clutched my pants to keep the hems from touching puddles of liquid and nests of long black hairs, and crouched over a filthy toilet. There were only two soap dispensers. One was empty. I knew I would feel compelled to strip down and shower as soon as I got home. It was depressing. I expected nothing else.

The mess has been made by people who seemed earnest and sincere. Apparently, none could aim.

As I returned to the waiting area I encountered a man with a beaver hat with its flaps strapped up. He paired this hat with a t-shirt. What was his plan for the day?

At 8:30 a.m. the board said we were up to 871. A man in a purple on purple plaid suit with brown shoes, navy Nike socks, an African tribal scarf, and a Gourmet To Go shopping bag filled with stuff took a seat across from me. He had a black leather baseball cap and a winter jacket, too. He took candy from his well worn shopping bag and tried to give it to children, but the children wouldn’t take it. He told me he hoped that my shoulder would feel better soon. It was painful. I wondered how he knew.

At 10:00 a.m. the number was 883. A baby was screaming. Late arrivals had to be directed to the window at one side of the room. The people who waited for service took turns answering the late arrivals’ unspoken questions. Otherwise they stood there staring at a number dispenser that had no more numbers to dispense and signs that told only part of the story about how to get served.

The man in the purple suit was hitting on a voluptuous teen who sat with her mother. At times he hung over her shoulder staring down the front of her t-shirt. He offered her candy, too. There were other women he hovered near. He kept scurrying back to his shopping bag and drawing out treats to offer them.

I dropped my glasses and he ran to get them for me. I thanked him, but my eye contact was not grateful. His bag was the source of many treats for children and young girls. He offered no candy to me.

The rain stopped. The sun came out. In the waiting room we were frozen in time. The person being served was 892 for a very long time.

I hazarded the restroom again and found it worse. I prayed I would return to the waiting room and find the “line” moving. I returned to find everyone waiting while 892 continued to be served. It was 1:35 p.m.

When the number reached 895 we were allowed to wait in the interior waiting room. A woman sat beside me in a group of three connected chairs. She jiggled her leg until I thought my bladder might fracture and scatter like pearls from a broken necklace.

It was getting close to 3:00 p.m. when Ms. F called 903. I took a seat and offered my I.D., birth certificate, and pay stubs. Even now I blush as I recall my nervousness. I wanted charity. I have never wanted that before.

She entered my medical records number on her computer and invoices started rolling up onto the screen. At one point, Ms. F said, “Twenty-three so far.” She looked at me long and hard. “You have had a bad year, haven’t you, honey?”

Tears filled my eyes at her compassion. I had been watching her for some time. She was a tough woman. She spoke Spanish fluently although it was plainly not her first language. She gave folks a piece of her mind with the lash of a quick tongue when they were slow to respond. She sent people packing if they were unprepared.

I did not look away. I have medical bills well into the six figures from two hospitals. I had imagined I might be paying off these bills the rest of my life, which I hoped would be long. “Just how many jobs do you have?” she asked me.

“Two universities,” I answered.

“And you’re still working?” she asked.

“I have been working all along,” I answered.

She stared at me again.

I felt queasy. Whatever she decided, I would find a way to bear the cost. I was so grateful to be alive. The price would have to be paid.

“Let’s see what we can do about qualifying you for some help, honey.”

She typed. She scanned my documents. She studied her screen. She handed me papers to sign. The last one barely registered with me.

“Where do I sign?” I asked.

“You don’t.” Ms. F smiled a little. “You qualified.”

“God bless you,” I said.

“He always does,” she answered.

According to the form, I qualified for a 100% discount on whatever is covered. I have no idea what that is or means. But I walked back to my car as if someone had removed a six figure tumor from my shoulders.

I know the United States Supreme Court this week considers oral arguments for and against Obama Care. I understand that the Commerce Clause has been used to stop discrimination by intrastate businesses and to stop the growing of wheat by a single farmer. If the burden placed on interstate commerce by discrimination and farming for private use is enough to warrant federal intervention, then it seems a minor difference that the same government order one to buy something to ease a burden on interstate commerce. Nevertheless, people stand outside the courthouse screaming “Obama No” and “Obama Yes.” Have you ever imagined yourself in need of charity? If so, then maybe you can understand why I wish we had a way to make health insurance affordable for everyone.

The day was humbling for me. I have never asked for charity before. I have received scholarships, which are a form of charity. They were awarded for work performed. But I could not figure out a way to handle my medical bills without the county’s help so I asked for charity. I did not demand it. I did not utilize my talents to argue or debate. I was a supplicant. I asked for help.

I am grateful for charity. I will admit that I would be even more grateful to be able to leave that charity on the table for someone else. I spent yet another day in the company of people who seemed just as much (or much more) in need as I was, just as grateful for any help received, and just as deserving of help. But I learned something by asking for help. I learned that I need to ask for help to receive it. I learned that I want to live more than I want to be proud that I can handle anything myself. I need others just like everyone else does. I appreciate the fact that the people who extended charity to me treated me with dignity because it was painful to ask for that charity. I hope that I will be the sort of person who treats others that way when it is I who can extend help to them when they need it.

In the greatest nation in their world shouldn’t everyone be able to get quality healthcare? Thank you, Cook County and all of its citizens for helping me get that care. Thank you for creating a safety net for people in their time of greatest need. Thank you for using that safety net to help me. I will do my best to make the kindness a good investment for you.

%d bloggers like this: