erin j bernard, vsco, trump mask, donald trump mask

Health care’s luck mandate: why the not-sick-and-nearly-dead should worry, too.

Last week, I visited the dentist. It was a rather mundane undertaking: a pleasant hygienist with a difficult-to-place accent cleaned my teeth, and as he did so, he entertained me by musing on a variety of topics: Portland’s increasingly untenable traffic “(The whole city is a highway!”), tips for remembering to floss (“Keep your floss in the shower!”) and praise for my good oral health (“These are very healthy teeth!”).

Not that I can take much credit for that last one — good teeth, like so many other things, are often a genetic lark. In my 20s, I didn’t have consistent access to health insurance, so I only had my teeth cleaned every few years. Also, I smoked. (Like, a lot.) Also, I didn’t floss much. (Like, ever.) Also, I drank gallons and gallons of black tea. But the compliment gave me a pleasant sense of moral right-ness, as did my conversation with the dentist after my teeth were picked and cleaned and fluoridated to a pristine and pearly white.

She noted some minor discoloration along the ridges of a few molars and recommended that I come back for sealants to keep those ridges from graduating into eventual cavities. Then, when I expressed concern about the hassle of keeping the permanent retainer recently glued to the back of my lower front teeth clean, she set my mind at ease.

“We can help you that,” she said. “Just keep coming back every six months, and you’ll be fine.”

I paid $20 and headed out the door. It was sunny outside. I got into my car, and I drove away.

erin j bernard, vsco, trump mask, donald trump mask

A few days later, I got a bill for a visit to a specialist a month or so back. It was really one of those abundance of caution kind of things — my tonsils had been chronically swollen and inflamed throughout the winter, and I wanted to rule out any serious issues. The doctor I met with checked out my tonsils, asked me a few questions, and told me, again, that I didn’t have much to worry about. Scanning my chart, though, she muttered aloud, either to me or just to herself, that I seemed to have seen a lot of physicians over the past two years.

I have. For various unpleasant ailments, from pneumonia to miscarriage; and for various less foreboding reasons: another (successful) pregnancy, blood sugar testing, a visit to the dietitian to help me drop the baby weight after I delivered.

Each time, I’ve paid $20.

I know I’m lucky: my husband has Cadillac coverage through his teaching job, and that beneficence extends to me, the poor writer who’d previously skirted along for a decade with either no insurance at all, or the catastrophic kind that you’re too afraid to use anyway.

I’m lucky because when the dentist recommends frequent cleanings and other preventative measures, I can agree to them without wondering if she’s just trying to sell me shit.

I’m lucky because when my throat hurts and that latent hypochondriacal bent gets me fretting over tongue cancers of various horrifying sort, I can have them looked at. If the news is good, I can shelve my neuroses. If it’s bad, I can take action, again, without grave concern over the costs.

And, even when I draw a horribly, disgustingly unlucky card, as with my miscarriages, I am lucky: if, despite a massive course of strong medications to help things along, my body doesn’t expel the lost little fetus on its own (it didn’t), I can see a doctor who will hug me and then gently lay me down on an exam table and perform a procedure ensuring a safe, fast end to a pregnancy that had already ended anyway. And even if it hurts (it did), and even if I cry (I did), the furthest thing from my mind is what I’m going to have to pay in recompense for my shitty, shitty luck.

leaky bucket, hole in my bucket, erin j bernard, blue bucket

Life is suffering. The Buddhists were spot on about that one. And nobody can save anybody else from their portion of unpleasantness, of bodily pain, of shoddy genetics, of the painful consequences of poor choices at some stage or another. I suffer, too, but still I say I’m lucky, because a team of medical professionals is at my side as I go through life, ready to minimize my suffering in whatever ways they can. Because that’s what medical professionals are supposed to do. Because that’s what health insurance is supposed to do: rally together a band of people working together to keep Erin from suffering unnecessarily.

The current machinations of our Republican-majority Congress enrage me. They fluster and confound me. They shock and disturb me. But they don’t make me worry about my own prospects. Not too much, anyway. My family is definitely not rich. We’re probably slightly below the middle-class curve when it comes to income, thanks mostly to my choice in careers (writing). But, thanks to his union, our health care situation is about as stable as it gets.

We as a culture need to start an honest conversation about suffering. What it is, what it means, who it touches, and what our collective attitudes toward health care might indicate about how we regard suffering itself.

We need to talk about who we deem as worthy of having their suffering alleviated, and why. We need to talk, too, about whose suffering we are willing to abide, and why. We need to talk about blame, and blamelessness, and the shameful causal link between poor health outcomes and poor social supports. We need to acknowledge that blocking Americans from accessing this basic human right is a form of structural violence. We need to recognize that, each time we angrily swat aside legislation intended to universalize access to this care, or stonewall every attempt made to remedy the problem because it isn’t totally exactly perfect, we are reinforcing and condoning that violence.

Health care — and the health insurance that enables us to access it when we require it — is many things, but above all, it is an inoculation against future suffering. It is preventive as well as reactive. It is merciful as well as democratic. It is kind as well as economical. And making it available to all Americans is a philosophical and moral obligation as much as a practical or curative one: the religious traditions that color the broth of our melting pot have always commanded their ilk to root out and ease suffering wherever it is encountered.

bergman, scenes from a marriage, no favors, erin j bernard

As for me and my own suffering, I’m not too worried. Not for the moment. Like I said, I’m lucky. Maybe you’re lucky, too. But let’s not go getting smug about our karmic good favor: bad luck comes for so many of us, eventually. And when it does, it’s liable to strike from deep in the root, in the place where nobody’s thought to look. As with an abscessed tooth, the rot comes on like a fever or a bankruptcy: slowly, and then all at once.

And what does the bearer of such misery deserve in his moment of bodily suffering? A shot of Novocain and the gentle, manicured hands of a specialist; or a draught of whiskey and a greasy leather strap to bite down on as the tears run down?

Choose for him or her, if you think it’s your right, your duty, your DUE, but do choose carefully. Because luck runs out. What you pick for others, you may well be picking, also, eventually, for yourself.


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