March Updates

Sam
A few weeks ago, I drove Sam to a job interview at an area nursery. He interviewed for over an hour for a minimum wage job. When he came out, he said the interview was "good but not great." He then laughed and said, "well, it wasn't as bad as the one at the call center."

On the way home, I suggested following up the interview with an email thanking the interviewer for his time. That triggered a frustrated reaction from Sam. He had no problem with working for minimum wage if that is what a job paid and he took it, but he didn't like to have to appear grateful or jump through hoops to get an entry level, minimum wage, grunt work job.

I asked him what he meant by "jumping through hoops."

"You know, like make phone calls every few days to tell them how interested you are and ask if they have made a decision, and then find out you didn't get it." He added, "A person that wants to work should be able to show up, fill out an application, say 'I'm willing to work,' and be hired right there."

He then got quiet and said, "I guess there are just too many people looking for work and too few jobs."

Sam was right as to too many applicants and too few jobs. The NY Times recently ran a story on the millions of Americans who may never work again thanks to the Great Recession. Luckily, Sam got his foot in the door and has been hired on at the nursery - not by the manager he interviewed with, but by another (a longtime friend of mine). He starts next Monday.

He will be working 40 hours a week, $7.50 an hour until August, when he hopes to start college in Oregon.

Sam is ecstatic. I took him to the grocery today and he radiated happiness. The job, per my friend, "can be really boring, grueling work - weeding, watering, potting plants." Sam doesn't care. He likes hard labor and he is so delighted to be heading back to work that he just beamed at everyone - me, the cashier, the little kid in the aisle.

"I'm so happy to be going back to work," he said more than once.

It shows.

Oncology
I recently wrote that I would be seeing my oncologist this week. Today, I had a voicemail waiting for me: Dr. Bully would be seeing Tim's patients tomorrow.

Just hearing his name caused my heart to race. I immediately called the oncology clinic back and started in with a "there is no way I will see Dr. Bully" statement. The receptionist waited until I paused to breathe and then reassured me that she understood and they would reschedule me.

"You're about the fifth patient today to call and ask to be rescheduled rather than see Dr. Bully," she added. (She called him by his real name, for the record.)

That was an interesting comment.

Patients are often selective about who they see. A cancer patient sometimes is understandably very reluctant to see anyone else but "my oncologist," because the treating oncologist knows the case history and patient's history better than anyone else.

On the other hand, I have to wonder if some of it is due to Dr. Bully's treatment of patients. I know it is in my case. If Dr. Bully had treated me with a smidgen of dignity and respect, I would have agreed to see him tomorrow.

Dr. Bully rides again, apparently, but not over me.

Fragility

Being poor takes time because you live in such a fragile world that you spend all day worrying about and dealing with things, tangible and intangible, breaking down.

I recently attended a daylong workshop on the program "Bridges Out of Poverty," taught by Phil DeVol. He's the one who made the above observation. He went on to define poverty as "the extent to which a person does without resources." Resources include financial, emotional, intellectual, physical and other quality of life factors.

One Bridges exercise is to evaluate one's own resources in the different categories and rate them on a scale of 1-5, 5 being the best. I have not done the exercise in full, but it came to mind this morning as I dealt with some healthcare matters ("physical").

On healthcare, I give myself a 5 (quality of doctors), a 2 (my overall health, which is pretty good except for incurable cancer), and a 0 (no insurance, no coverage, no nothing), for an overall score of 2.3. Because of the 0, I spent some of my morning visiting a financial counselor at the local hospital, which is where I see my oncologist (who is one half of the 5 score, my wonderful personal physician being the other half).

I went to see the financial counselor for two reasons. First, I receive a 35% discount from the hospital because I am uninsured. If I saw a counselor, that same discount would apply to all of my oncology visits at the hospital as well. That's about a $35 savings and given that I see my oncologist next week, I needed to do that. Second, I just had a very specific blood test done for next week's appointment and I wanted to know the cost of the test. (Note: Finding out costs at a hospital is surprisingly difficult, due to the labyrinth-like nature of hospital billing systems, which have been permanently warped courtesy of the insurance industry. We never did find that figure.)

So out I went, spent about twenty minutes with a harried but genuinely warm counselor, filled out some paperwork, and came home with more papers to retrieve and get back to her as soon as possible.

I need to get them back quickly not merely for my own benefit, but because it turns out that our local hospital, which was consumed several years ago by a BIG Columbus-based system, is closing its financial counseling office at the end of this month. Everything related to financial assistance will now flow through one central portal somewhere else.

The counselor made it clear, with a tone in her voice I could not quite decipher, that Corporate was calling the shots on everything. I would have to fill out financial aid papers, involving income declarations and proof of income, for the new system to evaluate my status.

Just hearing that brought me to tears. Admittedly, I was already on edge. Financial dealings having to do with my healthcare are touchy topics to begin with. Healthcare is my fragile world.

Being faced with paperwork was more than I wanted to deal with this morning. The counselor knew I was stressed. She probably talks to stressed individuals all the time. After all, we live in a country where we have historically chosen not to care whether medical care is available and affordable for everyone. (Thank you, President Obama, for saying that is so wrong.) In the midst of this Great Recession, my guess is that her cubicle is full of financial woes.

She all the same took the time to sit down with me, fill out the new paperwork, then list what additional proof Corporate would need.

I asked the counselor twice whether the 35% discount applied no matter what my income was. As sweet as it would be to get a larger discount, 35% makes a huge difference and I needed to hear, apparently more than once, that it applied to any uninsured patient. As it is, I can only afford to have some lab work done and see my oncologist once a quarter, which is shaving my healthcare needs very closely for the cancer I have. (I don't make huge sums of money, folks.) My repeated question is an indication of the fragility of my medical resources: tell me the discount I have will not be affected, because I am really, really counting on that resource to continue to exist.

I wonder if Corporate has considered the effect of eliminating the local office. People in hospitals tend to be people with lots of stress to begin with, regardless of their income levels. How to pay the hospital bills is only one of those stresses. People with chronic illnesses, like an incurable cancer, are constantly dealing with a fixed level of stress because they know that "chronic" means "always."

My stress level rises steeply when I have an oncology appointment approaching. If I had had to have the same discussion over the phone that I had today in person, I would have hung up and cried, then eaten all the rhubarb bread left over from last night's Legal Clinic. Instead, thanks to Susan the counselor, it took only three pieces to calm me down.

I will probably spend 45 minutes or longer gathering the paperwork that Corporate needs to determine if I qualify for more than the standard 35% discount. I will deliver it in person locally rather than ship it off into some unknown void, which is what awaits me after July 31.

Next week I see my oncologist and get my test results. I will try not to worry too much between now and then. The numbers are what they are and we will deal with it when I see Tim. I will also try not to worry too much about the cost of the test that was done yesterday. We need those numbers; I needed the blood test.

One thing I won't worry about is the financial paperwork that took up this morning. Ultimately I will get a determination as to whether I qualify for more than a 35% discount, but I know that in no case do I get less than a 35% discount.

What I don't know is what happens to the local financial aid staff when their office is closed at the end of next week. Has Corporate found places for them in the new department or is that function being outsourced? Has Corporate found other positions at our local hospital so they can continue to work in this community?

Or has Corporate given them a pink slip and shoved them into a suddenly fragile world?