Archives for category: Health

I know that I’m extraordinarily blessed in that I live in a country with a safety net and that my health insurance costs are capped by law. There are a lot of complaints about Dutch medical care, and I’m sure that if I delved deeply enough, I’d find some horror stories. However, in the Netherlands, and in most of Europe, catastrophic illness doesn’t bankrupt the insured. Note that no one here is uninsured – the benefits system is such that a person in straits for whatever reason is still covered. If you’re not in straits, the system requires each person to pay for a basic level of coverage. At the moment, that basic level costs something like EUR 110 per month. (I don’t know the precise number because I take advantage of a higher level.

I don’t know how to address things like GoFundMe pages for people who suffer catastrophic illnesses or emergencies or simply get blindsided by insurance companies that cover ambulance company X, but not ambulance company Y. Too bad that company Y was sent when you called 911. No, it’s not that I don’t know how to address these things, it’s the fact that we’re still stuck in the situation that people aren’t covered for illness by default. When the Clintons tried to work out some kind of universal health coverage in the US in the 90s, they were beaten back by the insurance industry. When Obama tried the same thing, he was beaten almost from the get-go. The fact that he managed to eke some success out of all that political capital, and all that bloody opposition is a credit to the man.

I worked in healthcare for several years in the 90s. My mother was a medical secretary and my stepdad was an EKG tech before he moved into fundraising at the same hospital. So I’ve always had some input and insight as to how these systems work. For an idea, see the history section of the Wikipedia article on health insurance in the US.

Because Franklin Roosevelt sidestepped the issue at the time he was pushing for various reforms in social policy, the medical industries were able to consolidate their efforts against any kind of socialized medicine. By the time Truman took up the gauntlet in 1949, the AMA was prepared. And for 80 years they and the various for-profit healthcare organizations have fought tooth and nail to prevent any kind of socialized care in the US. And because everyone with full-time employment in the US has an insurance option through one of these plans, the money keeps flowing up to the healthcare industry. Woe be to you if you have to work multiple part time jobs to make ends meet, because it’s unlikely any of them will provide you with a company-subsidized option. So no matter what you do, you’re in deep to the industry should you need care. Of course, those who are uninsured or underinsured will hesitate to go to the doctor when there’s something seriously wrong. Heaven forbid the coronavirus gain a foothold in the US, but even without it, those at greatest risk for spreading communicable illnesses are those least able to take the time to get care for them. Even in my office (software company, generous work from home options), I have colleagues who feel compelled for whatever reason to come into the office when they’re seriously ill. (I shared a crowded train with one a couple of weeks ago – he’d been home for a few days, and was obviously still sick, coughing into his hands and rubbing his eyes. Alas, the drug store was all out of hand sanitizer because of the latest rush on the stuff.)

So not a week goes by that I don’t see a GoFundMe call on Facebook from someone whose friend is needing money for catastrophic healthcare costs. One level of compassion is to give something to each of those. This is reasonable, but also ridiculous, given how much money should be in the system but isn’t. Ridiculous because it’s somehow easier and better for those with little enough money already to help each other than for the obscenely wealthy to ease up on the greed in the system. It’s another version of the rich guy, working class guy, and immigrant/poor guy looking at a plate of cookies. As the rich guy takes all but one, he says, ‘Look out, the immigrant’s gonna take your cookie.’

I honestly don’t know what to say anymore about this situation. For several years now, I’ve seen the comment that this is the point at which the French started building guillotines. I think on a gut level we know that in France politics suddenly became bloodsport and didn’t stop until the engineers of the Reign of Terror were themselves sent to the scaffold. We also seem to have sufficient bloodsport/bread/circuses/entertainment to keep us looking the other way as the things we deserve as members of this society, as contributors to the social contract are taken away.

It’s not a just matter of someone less fortunate than we are taking our cookie, it’s that along with all of the other basics that are part of surviving and thriving together, compassion calls on us to fund as individuals what should be funded by society as a whole.

Edited to add this link, posted to the same day I posted this entry:

“You wouldn’t think you’d go to jail over medical bills”: County in rural Kansas is jailing people over unpaid medical debt

In the dream, I wake from a dream of swimming thinking of the story as I walk down streets paved with large rocks. It’s one of those dreams in which I’m in wide canals as the water gets higher and the current and waves throw me in the air and I come back into the water and float or swim some more. In this revery, I’m walking through the boulders thinking of another story about swimming. Both the town in the dream and the town I wake in have old crooked buildings. But the town I wake into is hotter and arid. I look at a ceramic display on a street corner with words from prayers in Hebrew and English and possibly other languages, and continue walking towards my flat thinking of writing about swimming, about learning to swim, and about water.

Canal-Walk-Foot-BridgeA man, thin, wizened, about 55, stops me and asks if I have money. He wears shorts that are a little baggy on him and a faded t-shirt, though he doesn’t seem like a bum. I think of the small wallet in my pocket which contains maybe 40 euros. He speaks to me immediately in English, which is odd. Tells me I’m brave for admitting about the money, and ask if I mind talking with him. The small avenues are paved like something out of Gaudi or Hundertwasser. As I would in waking life, I do talk to him even though I’d rather be walking home and thinking about writing and thinking about swimming.

We sit on a bench for a bit and he tells me that he makes naambords (signs that go next to the front door of Dutch houses with the family name and house number) – that he makes them just with street names and post codes for the city. He shows me a catalogue printed in colour on cheap paper. In it there’s a picture of very young him – maybe 20 wearing big glasses with plastic frames. It looks like an early 1980s photo of a radio shack geek. His parents encouraged him to do woodwork, as he had a passion for it. I tell him we’ve only this year bought a naambord, and I think of the slate one we actually have. He tells me it doesn’t matter. His name is something like Garry Barr.

I walk back home, thinking I want to write this story down. About the swimming dream and learning to swim and about meeting Garry Barr. The place I arrive at has a cave-like entrance that reminds me now of Tim Dedopulos’ place up from Nerudova (near Prague Castle). There’s a shop just inside and I ask after some chocolates, half-distracted because I want to go inside and write. I’m thinking of a ream of paper I’ve recently bought and of my typewriter. The shop is tiny and I ask if he has chocolate – the proprietor takes down a shoebox from a high shelf – there are white kit-kat bars that come in double packs with eight sticks. I know I don’t want that many, but they’re only a euro so I buy one. Whatever I’m carrying is bulky and I pass Jeff Rubinoff (an American friend of mine from Prague) who asks after the chocolate and I point him to the shopkeeper, instead of giving him half of what I’ve just bought. Even in my dreams, I’m greedy.

I’m a little anxious to start writing – I don’t want to lose the content of the dream and the discussion with Garry Barr. I have images still of swimming down wide canals with waves that toss me in the air and make me fear just a little bit breaking my legs as I hit the bottom, but that never happens in these dreams – the water is never too cold, and I never fear drowning more than just a little – it’s too exhilarating.

Down a short low corridor that feels a little like a cave, I enter a very small apartment, ready to eat a little of my chocolate bar and start typing. The room I enter is small, crowded and dark. My wife is ironing, and points to a bed on top of which a skinny girl of indeterminate age sleeps, wearing only a pair of panties. I’m disappointed because the noise of getting out the typewriter and the paper, even though I know where they are, will wake the girl. At this moment, I wake myself, needing to write.

Often you hear people say that suicide is never the answer – that there are always other ways out, that no problem is so huge that it can’t be talked out, that solutions are available. I’ve had periods of black depression, but what I call black depression is some people’s brightest day. And otherwise it hasn’t come that close to me – friends and colleagues of people I know, primarily. That’s not entirely true: My first wife’s father committed suicide a couple of months before she was born. This had many effects on her life and on our relationship. 

For some, death is the only logical move forward. Oliver Sacks wrote recently for the New Yorker about writer and actor Spalding Gray’s last couple of years. Being in Gray’s head must have been harrowing, and having read Sacks’ account, I don’t at all begrudge Gray that release. (In short, an auto accident left him with some brain damage that severely affected his ability to write and concentrate.) Is Gray’s case extreme? No way to tell. Every such death is different. 

Knowing of Ian Curtis’ epilepsy makes his suicide a little easier to understand, but I can also guess that a 60s/70s upbringing in working-class Manchester didn’t offer a person much respect for that kind of inner torment. (Curtis was the main writer and lead singer of Joy Division. in 1980, he committed suicide on the eve of the band’s first US tour.)
I just offer two possible examples. 

Most Western societies, it seems, condemn and stigmatise suicide in a number of ways – the term ‘cowardly’ comes up a lot. On the other hand, communities in general don’t seem to offer a lot of support. 

I hate the place I have to go to to write about this, so I’m not going to write much more, but I just want to say that if you have suicidal thoughts because of a relationship, or money issues, or because many of the facts of existence just weigh on you, or any other reason, please find some people to talk to. There is help, even if it seems too far away or too little or too late. Please try again. There’s more hope than you may think. 




Not necessarily in that order. On August 5, 1986, my father turned 48 years old. On that date, I was 19 years, 4 months and 8 days old. I took him to a club in Santa Monica to see two comedians. The first was a juggler and the more interesting of the two, at least from dad’s perspective. I think he juggled bowling balls and apples at the same time, though I might be mistaken. The second was the guy who did the sound effects with his voice in the Police Academy movies. I was quite taken with his use of a digital sampler. Dad, an engineer and patent attorney, told me after the show that the technology in the sampler was similar to or derived from that used in radar. I’ve never verified this. I wore a silk necktie given to me by my ex-girlfriend for the previous Hanukkah on which I managed to spill sour cream from my nachos.

heartA couple of weeks later, the night before I returned to San Francisco for my sophomore year at SF State University, we had an argument about what I was going to do with my life. I was having a hard enough time just being in school and trying to pass my general ed without figuring out my future, though I had some idea that I wanted to teach.

It was the last time I saw him, not counting the day before he was cremated.

We argued about my future at least once more on the phone, though probably two or three times in the seven weeks before I returned to LA for the funeral. He probably died of a heart attack. There was no autopsy. Though he had a family history of heart disease, he hadn’t been to a doctor in ages. His mother died of cancer less than a year before he died, though she, too, had had a heart attack at 48. (She was single-handedly running an ice cream parlour in DC and, from the stories I heard, living on coffee and possibly milk shakes.) His father had died about ten years before, though I don’t recall the cause. I want to say it was coronary artery disease, but I’d need to verify.

So, in case you haven’t done the math, in about four weeks, I will also turn 48. For a long time I had this division of my life into three parts: The first 19 years, the last 19 years, and the 10 in between (which didn’t quite conclude with my separation from my first wife – life’s not quite that poetic). I figured when I was much younger that if I got beyond 48 myself, then everything else would be whipped cream on top.

My wife is aware of my obsession with the upcoming birthday, and tries very hard to keep me from overdoing my workouts. She had an uncle who died relatively young whilst on the treadmill at his gym. He was also under doctor’s orders to exercise for health.

I eat relatively well, am a little overweight, run for fitness, and see my doctor at least once a year. The most recent labs were all within normal limits. Blood pressure still slightly low as it has been since I was 22. My plan is to stick around for a great deal longer – 10 weeks or so after my next birthday, Rachel and I will celebrate our 5th anniversary (and almost 11 years together). I look more and more at my other family members. My father’s sister is still kicking ass and taking names at 74 or so and my mother just celebrated her 75th. And my maternal grandparents both lasted well past 80, including 53 years together. My mother didn’t think she’d see an anniversary like that, but has been with my stepdad for 39. Well on the way, really.

I miss my father most when I dream about him. In dreams, I often try to make him happy with what I’ve made of my life. He was brilliant (Engineering Princeton, JD from Georgetown) and astoundingly clever, though sometimes not very smart. Only in his last few years (and with his third wife) was he on his way to being happy. For my part, my life overflows with happiness most of the time, and as long as I’ve brought a fraction of that to other people, I can go when it’s my time without regret.