Wednesday, October 07, 2009

Think It Couldn't Happen to You?

by Zinta Aistars

Sure it could. If it could happen to me, it could happen to you. All things are possible, and with time and various puzzle pieces falling into place, the impossible is possible, too. That applies to the good stuff as well as the not-so-good stuff, and, oh woe, the really nasty stuff, too.

After two years of procrastinating and willfully ignoring my doctor’s advice, I finally got my baseline colonoscopy done. Once a person steps over the threshold of 50, it’s on your to-do list, and as the years go by, it ranks up higher and higher on that list. It is important. Doctor reminded me, and I kept ignoring her, because most of what I heard about colonoscopies is icky and so very easy to ignore. The laxative powder, I heard, was especially icky. Smelled bad, tasted worse. Guzzle it down with 64 ounces of something, then make a run for the bathroom and camp there for hours. Fun. The procedure itself? Well, if nothing else, downright humiliating, don’t you think? I thought so, and putting it off because of a busy schedule was ever so easy to do.

Thank goodness for wellness programs. Last couple of years, I’ve been with a new insurance company, and one of the things I like about this company is that it doesn’t just cover bad things when they happen, but encourages doing good things to prevent bad things from happening in the first place. Turns out this approach is cheaper for everyone in the long run. I even get a financial break for doing good things. Every year, I sign up for a wellness program that gives me points for being healthy and taking care of myself. That adds up to discounts on my premiums. I take yoga and Tai Chi classes, for instance. I keep a log of daily walks with my chow pup. And, I get credit for keeping up with whatever I should be doing at my age … like getting a colonoscopy.

Once again, I came very, very close to canceling the appointment. Work was piling up on my desk, and the last thing I could afford was to take a couple days off—one to prepare and one for the procedure—for some preventive health measure. No, wait. The last thing I could do was to take time off for colon cancer. The work stars aligned, and I didn’t cancel. Face it, I’m always going to be busy. If patterns hold, I will be even busier next year than I am this year. Colonoscopies are never convenient, but they are smart. Okay, Z, let’s get this done.

So I did it. The powdered laxative did not stink. It didn’t even have a taste. I mixed it in with my ginger ale and downed it, took a good book and my BlackBerry with me to “the powder room,” and got myself ready. No big deal. The next morning, I had an IV attached to my hand to keep me all liquidy, I was wheeled into an outpatient operating room, and a very pleasant doctor came in and asked me about the ethnicity of my name.

“Wait, wait, let me guess!” Dr. T. held up a gloved hand to stop me from answering.

He guessed. Took him a couple minutes, and he had it: my name is Latvian. I was impressed. He knew about the large and bustling Kalamazoo community of Latvians, and as he told me about some Latvian friend he had, I drifted off into Neverland. Or, I fell off a cliff into Neverland. All I know is that I remember nothing, not even being humiliated, only that I woke up in the recovery room some indistinguishable time later, and a smiling nurse was telling me that Dr. T. had found and removed three polyps, all benign, and I was as good as almost new.

Three polyps. I blinked. Sounded like a lot. Three too many, in fact.

“That normal?” I asked.

The nurse shrugged and smiled.

“Dr. T. will want you to schedule your next colonoscopy in three years.”

Okay, so I’d talked enough to family to know that three years was just a little bit of a red flag. Dad didn’t have to do one more often than once every ten years, and mom had to rinse and repeat every five (he’d never had any polyps turn up; she had had one or two).

As I drifted back out into the world, it occurred to me how important it was to listen to my doctor, keep up with wellness programs, and do what I must—on schedule. Another year of procrastination and the result could have been …

I didn’t want to think about that.

I thought about that. What a blessing it was that this procedure is covered by my insurance program. I thought about the time in my life when I didn’t have health insurance. I drew a deep breath and thought about how many, how far too many—I’ve been reading in the news that there are some 45 million Americans who do not have health insurance—cannot do what I just had done, and would be forced to procrastinate, not out of cowardice or embarrassment, but because they had no choice.

Suddenly, the great health insurance debate hit home. Not that it was the first time to hit home. Years ago, as a newly divorced, single parent of two small children, I found myself without. I left a very comfortable lifestyle—a large, beautiful home in the suburbs of Cincinnati; a family business that was growing by leaps and bounds; seven vehicles in the driveway (yes, seven); maid service to do my housecleaning for me; a nice, fat savings account; and health insurance to cover the entire family—to forge out, tots by each hand, and make a new life for and by myself. For all the security and niceness, the husband attached to that scenario found a bit too much fascination at the bottom of a bottle. It was time to go before that beautiful and easy lifestyle came crashing down on us. I left with nothing but a few personal belongings and my kids.

It takes a while to build from nothing. The beginning years were hard, very hard. Name it, and it happened. Murphy’s Law was a real presence in the lives of my little family of three musketeers without anything but my mama’s love to hold us together. That’s all a different story for another time. But the point of this story, at this time, is that I would find myself a single mama with two babies depending on me—and no health insurance.

Accidents happen, and when my boy heated oil in our tiny apartment to pop some popcorn, the oil overheated, burst into flame, and when he dove for the pot to get it off the flaming stove, I dove right after him. His hands were burned, both of them in moments blistering up so that it looked like he had two pink turtles perched one on each hand. Another splash of hot oil had splattered across my face and into my left eye. Half blinded, I called my parents to drive us to the nearest hospital. Heck with me, but my son was in serious pain. I had no idea how to pay for this, but what’s a mother to do?

Later, in the hospital emergency room, once I had been assured that my son’s hands would be just fine, and he appeared to be comfortable, sporting two heavily bandaged hands that looked like white boxing mitts, the doctor leaned over me and peered into my eye. By now, a thin, opaque white skin had appeared over it. And he was telling me something about needing a corneal transplant to save my eye.

I blinked my good eye at him. “No,” I said.

He blinked back at me. “What do you mean no?”

“I mean no. No, I have no health insurance. I can’t pay for anything like that.”

“Do you understand what I’m telling you? That your eye will probably remain blind? That you are going to lose your vision in this eye?”

“I understand,” I said. “Do you understand that I have no money? That I have no idea how I will pay for my son’s medical care, let alone mine?”

I recall his frustration. Even anger. I wasn’t sure whether it was aimed at me or my situation, but there was no choice here to be made, so I simply accepted what I could not change. There was nothing to debate. It was all I could do to feed my kids and pay the rent. A seeing eye was a luxury.

He treated me as best he could, and he bandaged up my eye, and he sent me home, insisting I return a couple days later to his office. “Don’t worry about paying. Just come to my office.”

I recall that kindness. I recall the blessing of a small miracle, as a few weeks later, he carefully slit and peeled the opaque white skin from my eyeball, and I was able to see with my left eye again. I blinked and saw the doctor’s grinning face—through both eyes. My perfect vision was no more, but it was still good.

As I recall, it took many years for me to pay the hospital for our emergency care, especially when there were times that I had to choose feeding my babies over paying the medical bills. When I had returned to work the next day with my bandaged eye, my boss told me he would have to let me go. He couldn’t have somebody working the front desk looking like I did, with a patch over one eye and a seared red spot across my left cheek where the oil had splashed. I wasn’t good for business.

All of this was a long time ago. Seems almost a different life now, looking back. A different person, even, another me. More hard times followed, and more jobs that paid just barely enough, and it was several years before I finally had health insurance again. Things happened, and kept happening, and most of them were not good. But I kept working as hard as I could, sometimes balancing as many as four jobs at one time. I raised my kids, not without bumps along the way, and today, they both have college educations, and I am working in a terrific place … and I have terrific health insurance. My son, however, who is working full time and still taking some college classes in the evenings and on weekends, has no health insurance. My daughter, even with her master’s degree, is staring down a possible layoff, as funds dry up for nonprofits like the one where she works, as irony would have it, helping the poor and the still forgotten. She could well be without health insurance very soon, through no fault of her own.

Something is wrong with this picture. Really wrong. No one is or was a bad person in this story. No one here did anything wrong. No one here was unwilling to pay dues or work hard.

The highest percentage of the poor and uninsured are women and children. My story could have had a very different ending. My son might have had two crippled hands. I might have been blind in one eye. And, I might have had to pass on preventive care, like a colonoscopy that nabbed three little nasties that might have eventually turned into one very big nasty, costing me—and costing others around me who must take on the financial burden of those who cannot pay, cannot afford preventive care, only show up in emergency rooms when there is no alternative left. I could easily have become a major expense I would not have been able to afford, even in my much improved living situation of today. Because we all pay. Now or later, for ourselves or for others, we all pay.

Consider if anything like this, or anything remotely like this, could possibly happen to you … or to your children, or your grandchildren, or your best friend. Think it couldn’t happen to you?

What do we do about this?

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