Healthcare Reform - An Anecdote

When I was in first grade - or thereabouts, my mom found an ad in the local classified newspaper for some used ice skates.  She contacted the seller and by the end of day my sister and I had our own pairs.

The boy whose skates I acquired was my same age and we went to the same elementary school.  His parents were married, they lived in a single family home on a quiet cul-de-sac.  He had a basketball hoop in his driveway, a new bicycle in his garage and a soft, new leather baseball glove.  I had none of those things, but to us young boys the differences in our economic situations mattered little.  He became my best friend growing up and is still my friend today.

We did the things that many young boys do growing up in where we lived.  We explored the woods, played sports (me far more clumsily than he), and listened to music - record albums on his kick ass stereo with speakers taller than we.  Many of my firsts were his firsts - with many thanks to the generosity of his parents.  We went to see Def Leppard at the Hartford Civic Center.  We saw the Red Sox play at Fenway Park and the New England Patriots lose to the Kansas City Chiefs at Shaffer Stadium. We went to a concert at Radio City Music Hall (Flock of Seagulls).  We got arrested for vandalism at age 10 (a blog for another day). We snuck alcohol from a neighbor's cupboard and later I was present when he used the fake ID we got in New York City to buy our first six pack at a local package store:  Miller Genuine Draft.  At that time there was little that seemed significant enough to set our lives on different courses.

One winter day he went sledding in the woods behind his house.  He hit a rock and it sent him veering off course.  He slammed into a tree and ruptured his spleen.  The friend he was sledding with ran back to his house and thanks to both the quickness of his efforts and the expertise of the emergency responders, his life was saved. Though quite serious at the time, he recovered.  We all thought that he'd dodged the proverbial bullet.

Shortly afterward, though apparently not related to the accident, he was diagnosed with juvenile diabetes.  (Though the connection the his ruptured spleen and his diabetes isn't medical, they happened so closely that the two events are inseparable in my mind - the sledding accident a harbinger of his diabetes).  To say this was the end of his life as he knew it is putting it too tritely and mildly.  Far beyond no more sweets, sodas or sugar cereals, the psychological blow was - and still is - devastatingly omnipresent.  And practically speaking, he still has to face the facts of his diagnosis every waking moment.  Twice a day he fills a syringe with insulin and presses it into the folds of his stomach or thigh.  He must check his blood sugar several times a day.  In his youth he wasn't as careful as he should have been - few teens are.  His blood sugar would dip sharply and he'd have to find some candy to give it a quick boost.  Or he'd eat something too sugary and without the natural insulin to regulate it, he'd go into a hyperglycemic condition.  In his younger years, he'd flout the guidelines of healthy living.  He'd drink alcohol and eat poorly.  It was a poor decision, but somehow understandable.  It's hard for anyone to accept that they aren't able to do what their peers are and easy to see how one might attempt to.

Over the years, my friend and I grew up, moved apart, and took different paths.  I went away to college.  He didn't.  I traveled the world.  He didn't.  I married.  He didn't.  And while there are innumerable reasons for our divergent paths, I know that his life would have been far, far different had he not been diagnosed with diabetes.  Knowing that your life expectancy is reduced an average of 15 years because of a diagnosis can't be an easy thing to digest.  And while some might be able to use this information to propel them to live every moment to the fullest, they have a more rare special inner strength.  For too many others, the knowledge that your lifespan has been necessarily curtailed can cause a lifetime of prolonged and paralyzing depression.  Why should I bother is an all too frequent refrain.

Though we had a different set of life experiences, we have never failed to stay in regular contact.  He was at my college graduation and at my wedding.  When I used to come home to visit, I made sure to make time for him And this past spring when his father passed away, I made sure I was there for the funeral.  He is always amongst the first to wish me a happy birthday and I never, ever, forget his.  We don't have nearly as much in common as used to, but the common bond of our youth is unbreakable.  In many ways, his illness is a frequent reminder to me to be appreciative of all that I have - and thankful for what I don't.

In the last 10 years his health has steadily declined.  One of the most pronounced and consistent issue is with his eyes.  He has various vision troubles and it's very difficult - and dangerous - for him to drive at night.  Not only can't he see well, but the lack of confidence he has while driving further complicates the effort in doing so.  And while he's not legally blind, you wouldn't want him shooting an apple with an arrow off your head.  He can see just well enough to not qualify for disability.  After a period of prolonged health issues a couple of years ago he had to leave his job as he was unable to keep up with the responsibilities.  He was sick, frequently absent, and from the employers point of view, unreliable.  Because he can't work normal hours  - needing to drive only during daylight hours - and because he doesn't have a college degree finding a job, particularly one with medical benefits,  has proved near impossible.  He lives alone in a modest house, paid for by his family.

He has no health insurance.

Late this past summer, he awoke in the early morning nauseous and dizzy.  He made it to the bathroom but soon slumped on the floor, too weak and sick to his stomach to get up.  He rested there for 15 minutes before the fear of what was happening caused him to rally himself to get up.  He crawled back to the bedroom to his cell phone and called 911.  He took an ambulance to the hospital emergency room.  They found his blood pressure way out of whack, but soon stabilized him.  They ran several tests, but couldn't find anything specific to point to as the cause.  After several hours he felt somewhat better and they gave him some crackers to see if he could keep them down, which he did.  With his blood pressure back in a normal range and the nausea waning, they asked if he wanted to be admitted or go home.  He didn't exactly feel comfortable going home, not really knowing what had happened or if it would again, but with no health insurance the costs of staying were prohibitively expensive.  How's that for weighing your options?  He went to his mother's house to rest.

But later that same evening though his nausea returned - and with a vengeance.  His mother drove him back to the hospital, he toting a vomit bucket in his lap which he had to use often on the ride.  He was admitted to the hospital where he remained for the next five days for more tests and observation.  However, with the frequent blood tests and pressure checks, he wasn't able to get much rest and instead of feeling substantially better he now felt like he was suffering more from sleep depravation than from his original condition.  The doctors best guess was that the lining of his stomach was causing the nausea, apparently something that's not uncommon in diabetics as they age.  They sent him home.

He has no job.  He has no income.  He has no health insurance. He does have diabetes.  He does have to check his blood sugar four times a day (each test strip costing roughly seventy cents - over $1000/year - no subsidies there).  He does have to give himself daily insulin injections - as he has had to do for the past 30 years.  He also has a new blood pressure medicine to take, too.

And now, because of this recent bout with an undetermined complication arising from his diabetic condition, he has a hospital bill for $30,000.

What's more sad than my friend's story is that it's not unique.  His health struggle, now further complicated by a financial one, is the story of literally millions of Americans.  Could or should he have made some better decisions in his life?  Absolutely.  But he didn't choose to get Type I Diabetes; it chose him.  We are not all equally equipped to handle the health challenges that life presents, but we all ought to be equally cared for in the event they arise.