Affording care: the politics of wellness

I’ve been thinking about what it takes for the average person to get care. I don’t even think this is about good care, unfortunately, just plain care. The answer, I find, is disheartening. Women and men avoid care until they are in crisis. The kind of the services one accesses depends on the resources at one’s disposal. Once at the hospital, the quality care varies drastically according to the gender, socio-economic class, and skin color of the patient. In addition, the historical trauma, discrimination, physical and emotional states of the patient can further transform the experience. Never, for example, take pain medicine before you go to the doctor. Being in any nearly relaxed state is not conducive to optimal care. Better yet, be a white male of about 28. I’m told you will receive the red-carpet treatment. I don’t mean to be glib, but it seems that too many of us are going without the basics. There are too many factors interfering with our wellness.

Chronic conditions such as pain and disability tax the body, mind and spirit of people who must endure them. I just met a very nice 89-year-old woman and her daughter at Kaiser. I overheard the two women discussing shingles in the waiting room. I was adamant that she get the vaccine, to which the daughter replied that her mother has had shingles for six years. As I looked into the eyes of the elderly woman, I had so much compassion. I apologized profusely. There was no question in my mind that she was suffering in all her regal kindness. All I could offer was a recommendation that she try Chinese herbs, which she seemed eager to try. While I told her that it worked for me, I wonder what she would think about an additional weekly out-of-pocket expense. Later that day, I found myself in casual conversation saying that I only had shingles for six weeks. It’s all about perception.

I’m convinced that poor people are made to wait needlessly. It’s: “Line up for this; line up for that.” Wait three months for surgery you needed last year. Like my mother, she is 70, has a benign tumor in her nose, and terrible health insurance. Instead of scheduling the procedure, her doctors have prescribed her another batch of antibiotics. This is not only bad healthcare, it’s also silly. First, the antibiotics are not going to shrink the tumor; it’s beyond that as were the first two regimens demonstrated, which is actually my second point. She’s already had two doses of ineffective antibiotics before the diagnosis, neither of which helped her condition. And they wonder where the superbugs are coming from! Hello? Third and possibly last point: when they perform the surgery, (why do they call it a performance, anyway? This is a juicy question that I’ll have to explore. I suspect the gallery-style operating theatres of 19th century Europe.) they will have to prescribe more antibiotics. Meanwhile, poor mom is suffering and lowering her resistance while this tumor is already complicating her life and interfering with her ability to work. Did I mention she works in a school with children? Why she’s working in a school kitchen at seventy-years-old is easy: she’s a poor immigrant woman. They work until they drop, and sadly, they’re not the only ones. If you’re not in the top 5 percent, keep your working papers handy.

The shadow side of this is that my mother’s prescriptions are so expensive that she rations important diabetes medication. Two other women I know make medical choices based on economics instead of the quality of care, and not by choice. Both struggle to afford expense medications, just as my mother does. Another friend’s prescriptions are in the several-hundred-dollars-per-month category. Rather than getting the best medicine for her condition, she gets the more affordable option. Who are these companies planning to sell these pills to, anyway? It’s legalized extortion.

There are simply too many barriers to wellness in our society. How about sadistic, misogynistic techniques like mammography? They’re enough to make any sane woman crazy. I’m convinced that mammography increases the risk of cancer after having only one exam in which my tiny breasts were clamped into a metal device, multiple times on each side, each at odd angles, causing both bruising and swelling; a cold clamp is tightened on the breast as sweat and tears flow down the face and neck; this is followed by several doses of live radiation. Women, this is no joke. I started crying about 20 minutes into it, and I didn’t stop for at least an hour afterward. How does anyone survive that test? Who dreamt up such a nightmare? Oh, I totally forgot to mention that this happens while the victim stands in front of the cold steel table, shirtless. Women line up and wait hours to have this done. I kid you not. It’s like a medieval torture device—that women pay for and undergo willingly. So let’s evaluate the evidence:

  • Torn and bruised tissue
  • Broken blood vessels
  • Physical and emotional stress
  • Physical and emotional trauma
  • Radiation
  • Yearly repetition of all of the above

Do the math. If I were a cell, I might mutate under those conditions. Ridiculous! Maybe mammography saves lives, but I can’t help wondering at what cost. I remain unconvinced. So do several other women, who I love and trust.

At present I persist in seeing the acupuncture doctor. Apart from wanting to avoid neuralgia, I’ve started to take more careful looks at the gorgeous babies trapped beneath the glass on Dr. Kang’s desk. Apparently, he’s quite famous as a fertility doctor. Any way, for now I’m mostly making sure that I don’t have shingles for the rest of my life. That’s just not okay with me. Each visit costs $90 per week for herbs. This is pricey, especially when you consider this is an out of pocket expense. So how does the average woman, who wants natural healing options, afford alternative healthcare? I’m not sure I can answer that, but it’s led me to think about sacrifice. Since I’m Dominican, I grew up hearing about the value of sacrifice all my life. But really, what does it mean? Well, it’s giving up something you love for something which may potentially be more important, for example, luxuries for your children’s clothes. That translates into to money for me. I’ve never been particularly attached, so long as my needs are met, but this is really cutting into my lifestyle—that and my recent choice to quit one of my jobs. So for $360 per month, I can cure my neuralgia, or I can buy a car or something. A no brainer, when I think of it. To stay healthy, I gave up a toxic environment. Now I need to pay extra to stay well. Hmm…

I’ll say this. I know the herbs are working. Here’s how: the other day I whacked my bare toe on a table leg. As I prepared to react—nothing happened, until about 10 seconds later when the message finally reached my brain. Just as I was explaining that it didn’t hurt after all, I gave a hearty yowl. This delay in the synaptic messages delivery from the PNS to the CNS is significant. Neuralgia is a condition caused the inability to shut down the pain signals of the body. After I soothed myself, I smiled and went on to brew my nightly medicinal herbs. I know that I’m getting exactly what I’m paying for. How wonderful.

Mental health counseling, chiropractic care, massage, gym membership, acupuncture, Somatic Experiencing, yoga—all out-of-pocket expenses—are often expensive and not covered by health insurance. When those services are covered, they’re generally offered to those among us who already have a wealth of resources. This is a good spot to plug Charlotte Maxwell Cancer Clinic for women that provides complementary care for women who were poor before cancer. (Learn more here: http://www.charlottemaxwell.org/). The practitioners offer their services such as massage acupressure, Reiki and hypnotherapy for free in the CMCC clinics, and on occasion, at the home of women who were poor before being diagnosed with cancer. For the rest of us, we need to provide for our care. It’s not an option to go without these types of services and care. It’s easy for me to say that since I don’t have children; however, I am willing to support the care of women around me with fewer resources, and I’m not the only one. I have been a member of a powerful community of people who share resource. Ultimately, we’ll either pay for preventive care and services, or we’ll pay the doctor for prescriptions that don’t always work. Personally, I’d rather not stress out and get shingles. If I had it to do over, I’d go for a few more massages. We need to value ourselves and our well-being by prioritizing our care. We owe it to ourselves and to our families.

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