A Letter from a Dead Woman

On Friday, I told you about Jessica, my former student who was dying. She had been diagnosed with advanced lung cancer that had spread to her uterus. The treatment came late because it was just in the last year that she had health insurance for the first time in her adult life. She smoked, so that no doubt contributed to her condition, but many people smoke and many of them do not die at 43 of lung cancer because they couldn't see a doctor until it was too late. Jessica passed away yesterday afternoon.

I bring up Jessica again not to merely update you about her end. Last week, one of her closest friends sent me an email that Jessica had written in June 2010. It offers a picture of what it's like to be working paycheck to paycheck and not able to get medical care until it's too late, as well as the long-term cost of even doing that. You want to know just how cruel this nation can be towards the working poor? Let's hear from Jessica, who was writing to explain why she would not be able to attend her friend's wedding:

"As it turns out, my body made my decision for me, and I am taking it as a sign of hope and rejuvenation. I am fine now, but last week I had a sore throat. I didn't think much of it, since there weren't any accompanying symptoms (except exhaustion, which I'm used to). So I drank tea and used echinacea drops, etc. and slept a lot. Monday, I lost my voice and called out from my night shift to rest. That night it became difficult to swallow, and the nodes in my neck became enlarged and very hard, very quickly. Tuesday morning I went to my doctor and she sent me immediately to the Emergency Room. Turns out I had an abscessed strep infection that pushed my uvula into a position that blocked my airwaves. Very scary. They treated me with steroid & antibiotic drip and, thank God, it worked because they were preparing me for emergency surgery to drain the abscess, which I hear is not a fun procedure. I was discharged last night around midnight, and aced my follow-up appointment today with flying colors.

"I have energy and am not in any pain or discomfort, and my fever broke last night. However, I was put on home-rest until Monday, which means I will have missed a good 55 hours of work, total. Sometimes we have to be at our lowest in order to push past certain hurdles, and, while missing work will be an additional hardship, I am actually looking forward to the time to take care of other essential needs in my life, so its a mixed blessing. I have a positive outlook and am grateful that I received such good care in the hospital; although, as sick as I was I was rather horrified that there were so many sick people and very few beds, or rooms to put them in. I was in a chair in the hallway for a few hours before they got me a cubby/room and that was only after a team of doctors flipped shit because my (beautiful) attending doctor demanded that I receive immediate attention & I started to pass out a little.

"I became a teaching tool as the Head of the ED brought by another group of attending doctors & triage nurses so they knew what to freaking look for--right in the hallway, as people groaning & carrying oxygen tanks, were crammed everywhere! I also had a whipper-snapper of a young, pregnant triage nurse who pushed me through because another gum-snapping beauty would've kept me in the waiting room. Actually, I give all the ED personnel a lot of credit. They were bombarded, and they see all sorts of stuff, including the underbelly of human existence. A sore throat doesn't sound like an emergency when you're filling out a chart. But, those snap decisions are really the difference between life & death in many cases & even though it was hard to speak, never-mind advocate for immediate attention, I showed them the paper saying my doctor sent me, etc. I thought I was being 'dramatic' when I pointed to the paper that said, 'blocked airway' and said, 'Yeah, I think that means difficulty breathing!' Scary stuff. But, as I am fine now, I'm remaining positive and thinking of it all as a blessing.

"Unfortunately, I will not be able to attend your wedding, and I am very sad...

"Please do not feel obligated to respond point by point. I type fast and re-reading this, the only point I want you to take from this is: Everything will be much better soon! No worries! We can discuss the deteriorating state of healthcare in our once great nation at a much later date and fulfill my desire for drama to be kept onstage at a later, but hopefully sooner date. Until then, I am going to scope out your FB page. I can't remember if you set up one of those 'bride blogs' so I can see pictures of your dress, and flowers, etc. Oooooh! Have fun sweetheart!"

I was talking to my pal Neil about Jess on Friday. Neither of us has ever gone without health insurance. We said we couldn't imagine what it must be like, to know you're sick, to know you probably need help, but having to make a calculated decision to let yourself suffer and hope it doesn't get worse because missing work and going to the hospital would screw up your income? That's just alien to me. It's not, even now, for too many Americans.

On TV, recently re-elected Governor Scott Walker of Wisconsin actually said of his decision not to allow Medicaid expansion in his state, "Why is more people on Medicaid a good thing? I’d rather find a way, particularly for able-bodied adults without children, I’d like to find a way to get them into the workforce. I think ideologically, that’s a better approach, not just as a conservative, but as an American. Have more people live the American dream if they’re not dependent on the American government."

Jessica was an able-bodied adult without children who worked, at times, two jobs to pay the bills. This was after she had been an able-bodied adult without children who had worked full-time and gone to college full-time. It's great that you want to "get them into the workforce" through some kind of conservative magic, I suppose, although I'm also not sure what your definition of "workforce" is. But how about making sure that those adults stay able-bodied so they might enjoy the imaginary fruits of your mythical workforce? Because, Gov. Walker, your version of things is this: "If you stay healthy, one day we might be able to make it possible for you to have a job that might have health insurance." Walker should have Jessica's cancer shoved down his vile throat.

Conservatives always say that liberals want people to be "dependent" on the government. That's one of their favorite arguments for getting rid of the Affordable Care Act. I thought that, at least in theory, the government is us. It is the means through which we take care of each other; you can think of it as the contractor who makes all those programs we might want to make our lives possible. See, the difference is that liberals want us to depend on us; conservatives want people to depend on them or their corporate masters. We want to make a government that responds to the needs of people. They want to keep people on their knees and convince them they're walking upright. If you really give a damn that people might "live the American dream," you might give them the tools to do so and not just toss them like feathers into the capitalist winds.

The part of Jessica's email that hits hardest is her unending optimism. She always believed things were going to get better, that a corner had been turned, that this job interview would be the one. She spent the last two years of her life living that optimistic, almost never cynical view of the world. She was helping the homeless and the sick. She wanted to give back, even though the world had never given her anything other than the many friends she made along the way.

So we'll be there at her funeral to talk about how sad it all is, how helpless we all were. Are.