Extremely Abbreviated Description of One Female’s Pain

1

Last year, a doctor’s aide took my vitals. I sat at ease in a chair, until she told me matter-of-factly that my heart was beating fast enough to warrant a trip to the emergency room.

Had I exerted myself before going to the doctor, she wanted to know. I hadn’t. The hospital where this doctor was located was out of the way, inaccessible by public transit, so I’d taken an uber to the front door. I’d even taken the elevator to the neurology clinic, shamefully choosing not to walk the two flights of stairs from the main entrance.

“No,” I responded.

“You’re lucky we caught this. I’ll have the doctor talk to you right away.”

2

The only reason anyone caught my heart abnormality was because of my headaches. They’re migraines, technically. I’ve always gotten them, at least since I was a little kid. I’d long ago given up on doing anything about them. But after I had one so bad that I fainted and wound up in the hospital with a skull fracture, I was forced to go through the motions of seeking the cause of the pain. I soon gave up on finding the cause – rather, my doctors soon gave up. So I sought medications that might at least relieve the pain. That’s why I was at a neurology clinic getting my vitals checked.

It feels tired to write about being a woman with headaches, but that doesn’t make it any less true. And it is tiring to be a woman with headaches. I am tired of it.

3

I write too often about fracturing my skull. I reference it compulsively. Only when reading Leslie Jamison’s essay on female pain did I admit to myself why. Jamison quotes from a memoir by Lucy Grealy, a woman who had childhood cancer and whose face was disfigured by it, cause for the title of Grealy’s book: Autobiography of a Face. In it, Grealy writes, “I was excited by the idea that something really was wrong with me.”

“Grealy had been craving the identity-locus of damage even before it happened to her; and was happy, as a little girl, when trauma first arrived,” writes Jamison.

For the first few days in the hospital after fracturing my skull, I was torn between fear of dying and self-pity. These are related feelings: self-pity follows from awareness that one is too young to experience fear of dying, and this acknowledgement often strengthens that fear, goading a person to think of all that she will miss should she die.

For me, this manifested as yelling deliriously at a nurse. “You don’t understand, I can’t have a head injury!” I screamed, trying to keep her in my field of vision despite being strapped into a too large neckbrace, which forced me to look straight up at the white ceiling if I wanted to minimize the cutting pain the brace caused as it sliced into my too small, too thin collarbone.

“I finally have a job where I need my brain” I yelled, no longer able to see her.

When the nurse reappeared in my line of vision, I told her to let me check myself out of the emergency room. If I left, I reasoned, the injury would cease to exist. If I was someone not in a hospital, I would no longer be someone who needed to be in a hospital.

I lost consciousness before I could hear her response. Maybe she didn’t respond at all.

I soon acclimated to my new existence as someone confined to a hospital bed, someone who understood how to use a bedpan and who no longer cringed at the needle stuck into her arm every four hours by a blurry amalgam of nurses, made indistinguishable in the darkness of late sterile nights when she, or he, woke me from sleep to prick me for another blood sample. A new feeling came over me, not unconnected to fear or dying or self-pity, but distinct: I felt grateful. Something very bad had happened to me, something no one could deny was terrible. I had a traumatic brain injury. I might not recover. The doctors told me I had a brain hemorrhage. They told me that my spinal fluid could flood the space between my spinal cord and my skull, and that this could kill me.

I did not cease to fear for my life, or wish I hadn’t gotten hurt. But given that I had, I felt precisely what Grealy felt. I was excited by the idea that something really was wrong with me.

4

I know better than that. I know I should be what Jamison calls a “post-wounded” woman. “Post-wounded women know that postures of pain play into limited and outmoded conceptions of womanhood,” she writes, and it’s true.  I fear my parents will read this essay and misunderstand me. That they’ll be hurt, or horrified, because they haven’t read Jamison’s essay, or think my excitement about being an authentically unwell, tragic woman compares in magnitude to my resentment and self-pity about my health. It doesn’t.

And yet…

And yet, I have a new wound; one I could be accused of choosing to prolong for the sake of pity. Ever since fracturing my skull, I’ve become paralyzed at the thought of making an appointment with a new doctor, or keeping up with the old.

I managed it for a year or two. I saw the neurologist, who gave me three different sets of pills for my headaches. I saw the ENT specialist, who explained to me that while I might never get my sense of smell back – a loss that came from a piece of my skull slicing through the nerve endings that translate odor into scent – I might. He wouldn’t say anything more definitive, surely fearing litigation. I saw a therapist, who saw a young woman so wounded as to be unfixable, so she gave me some pills, and I stopped seeing her.  I saw a specialist who was supposed to tell me why I felt dehydrated all the time, which, combined with the migraine, had caused me to faint in the first place. He cut open my lip and sewed it together again, testing for Sjogren’s Syndrome, an autoimmune disorder that was the only explanation he could think of for my dehydration. I can still feel the stitches through my face. When he told me I’d tested negative, I saw someone else, who gave me pills to take three times a day, pills meant to stimulate saliva so my teeth wouldn’t decay, the enamel eroding and rotting the bone at an accelerated rate. I saw a dentist, who saw a thin girl with no enamel left on her teeth. “Are you bulimic,” she asked, adding that repeated exposure to stomach acid erodes one’s teeth. Even when I explained my condition, she seemed to still see a bulimic. I saw my new primary care physician, who helped me coordinate all these doctors, until she didn’t.

So now, I see no one. For the most part, this is okay. But when it comes to the heart abnormality the neurologist found, I never saw a cardiologist. It was over a year ago. I can’t seem to make myself schedule an appointment. When an ex saw me continue putting off the call that could have gotten me an appointment, he first tried to help. Then he gave up. We broke up, with him telling me to “see the doctors already, I don’t understand what is so hard about that.” I told him I would.

When I told the guy I see – “I wouldn’t call us ‘dating,'” he once told me, so I don’t – that it’s been over a year since a nurse discovered my heart abnormality, he told me I should see the doctor. I didn’t respond.

Jamison would probably add me to her cases of women dwelling in woundedness. She would be right. But I’d add – and so would she – that it’s more complicated than that.


Note: I’ll incorporate this essay into a longer piece elsewhere, but I wanted to share it as is in the meantime.

 

We’re All Poor So Let’s At Least Make Health Care a Right

healthcare

This is the bill for my hospital stay after I fractured my skull two years ago. Had I not had been young enough to be covered by my parent’s health insurance, I’d have been responsible for nearly $40k – and that’s ignoring other bills, like the $2k charge for the fifteen minute ambulance ride to the hospital.

In the two weeks since I wrote about the aftermath of that injury, one of my doctors caught a new problem: a fucking heart problem, of all things.

He added one more prescription to the eight on file for me at CVS. The pills stack up on the bureau in my room. They stack up because I don’t take them as consistently as I’m supposed to. Because some of them have weird side effects. Because a dozen pills a day is a lot to remember.

Most of the prescriptions have a minor price tag, a few dollars mysteriously not covered by my health insurance. $5, $10, $15. Nothing outlandish, but it adds up.

It’s lucky this doctor caught the heart problem. A tell tale sign showed up when his assistant took my vitals. I’d never have brought it up otherwise – the occasional racing heart, shortness of breath, full body weakness. It’s the least of my problems.

Before I left, I had my co-pay – $40 this time – for seeing this doctor, one of the best neurologists in one of the best medical systems in the country. $40 might seem like nothing in comparison to all that…and yet, I have health insurance. In the context of monthly visits to specialists, co-pays compete with groceries. And that’s with health insurance.

Without it? Who knows what these dozen daily pills cost. And were I still making as little as I used to, I doubt I’d have made that $40 appointment. On minimum wage, no one would have caught my heart problem.

We need to demand a system of health care that won’t force me and millions of others facing the same grinding combination of poverty and a failing body to cold quit prescriptions and avoid doctors as soon as we find ourselves without decent health insurance and maybe even when we have it. To those who mealy-mouth responses about realism and earning what should be a right, people like Hillary Clinton among others, I’d like to force them to watch millions of lives fall apart in the absence of free access to doctors.

And if we don’t make health care a right? Well, maybe I should hold onto those extra pills accumulating in my room – consider it a stockpile for a darker future.

The Abortion Debate

“Watch a fully formed fetus on the table, its heart beating, its legs kicking, while someone says, ‘We have to keep it alive to harvest its brain.’ “

GOP presidential candidate Carly Fiorina stated on national television during the most recent GOP debate that the above scene was from the controversial (and highly edited) videos of Planned Parenthood offices filmed by the conservative Center for Medical Progress.

The scene Fiorina described never appears in the videos.

But as anyone who watched Fiorina deliver this lie during the debate might have noticed, the description of the scene and the assertion of facts work on two different registers. By vividly describing a gruesome scene, Fiorina kept our focus on the morality of abortion. While leading feminist organizations put the bulk of their efforts into building the Democratic Party instead of a movement, the Christian right has spent decades building a veritable ecology of movement actors. This is why the right now controls the terms of debate, posing the question of abortion as one of morality and thereby allowing anti-choice activists to present themselves as morally-enlightened even as they stalk, threaten, harass, and assault abortion providers and the women seeking their services. These leaders claim to be ‘defenders of (fetal) life’ while endangering real women’s lives with anti-choice restrictions, of which there were 205 from 2011-2013, more than in the entire decade prior.

The greatest evidence of the right’s dominance over the abortion debate comes from Planned Parenthood’s Democratic Party defenders. While Hillary Clinton continues to position herself as a supporter of women’s reproductive rights, her description of abortion as a “sad, often tragic choice” cedes ground to the anti-choice frame, qualifying women’s demands for equality with a moralizing that can only strengthen the right. Meanwhile, Martin O’Malley minimized Planned Parenthood’s role as an abortion provider, emphasizing that 97% of its services have nothing to do with abortion. Even Bernie Sanders minced words, rightly stating that federal funds don’t go toward abortions but failing to defend abortion as such from conservatives’ ruthless attacks. By hedging their defenses of Planned Parenthood, Democrats have accepted the right’s terms of debate. In doing so, Democrats are gambling that anti-choice forces support women’s access to less controversial reproductive health services. In this, they are mistaken.

That the funds currently being held hostage as a mark of allegiance to anti-choice fervor by conservatives have nothing to do with abortion is unfortunate proof of the wrongheadedness of Democrats’ wager. These are Title X funds, which go toward family planning centers, many of which are administered by Planned Parenthood. The federal funds, as Sanders noted, cannot go toward abortions. To tie them up in political posturing is to knowingly deny poor and working class women the right to basic health services, including cancer screenings, STD tests, and annual check ups.

The numbers on what happens when poor women lack access to health services are definitive. According to the Guttmacher Institute, without family planning services, poor women have higher rates of unintended pregnancy, which in 2008, occurred at five times the rate as among higher-income women.* What follows from here is predictable: higher rates of abortion and higher rates of unplanned birth, with poor women enduring the latter at six times the rate of higher-income women.

These numbers suggest that if abortion was actually what conservative leaders opposed, they would increase funding for reproductive health services and family planning. Add to this that 48% of women who underwent late-term abortions explained the delay as stemming from difficulty in making travel, work, and childcare arrangements for the time spent traveling to a provider, and it’s clear that the continued rollback of providers and flood of state mandated waiting periods for women seeking abortions guarantees that more women will get late-term abortions in the future.

Anti-choice activists and their leaders in Congress aren’t stupid: they have think tanks and journalists crunching these numbers. They know these laws will result in more abortions. We cannot simply ‘speak truth to power,’ repeat this data, and expect people like Fiorina to change their minds. We similarly cannot wait on Democrats to admit that in 2015, Roe v. Wade is almost non-existent for working-class, rural, and disportionately black and brown women across this country.

For those of us who would take up the unapologetic call for ‘free abortion on demand,’ we must refuse the right’s framing. We should instead argue for the right to abortion as central to the broader fight for women’s equality, which cannot be achieved without control over our reproductive choices, but also without free child care, a living wage, and paid maternity leave. The demand for control over our bodies was a cornerstone in the broader feminist struggle for full equality. To deny women this right is to attempt to reverse the gains won by feminists and call for a return to conditions of even greater inequality.

It’s important to note that when we argue for free abortion, this is based on a recognition of the race and class determinants behind a woman’s ability to choose. In 1970, before abortion was legalized in New York, over three-quarters of the women who died from illegal abortions were black and Puerto Rican. Today, poverty continues to be the most common reason women cite for getting abortion. And with women on average paying nearly $500 out-of-pocket for abortions, along with forfeiting hundreds of dollars in wages thanks to the obscene distance they must travel to access an abortion provider, we must emphasize the ways anti-choice restrictions disproportionately impact working class women of color, and strategize accordingly.

When the anti-choice movement’s actions ensure higher rates of abortion, we cannot respond effectively if we take them at their word that what they oppose is abortion, not the threat of women’s equality that comes with bodily autonomy. Instead, we should recognize their embrace of women’s oppression in every cynical invocation of ‘family values,’ an ideology where women are never queer, never trans, never lesbian, and always in the home. We should hear it when they condemn single mothers for using government assistance to raise their children while simultaneously criticizing working mothers for neglecting their kids. We should hear it in their continued denials that rape is ‘real’ rape if the woman was friends with, dating, or married to the man who raped her.

For the anti-choice movement, women, and women’s bodies, belong to men, and are of value to the extent that we perform the unpaid domestic labor this economy relies upon. Free abortion on demand is a threat to that control, providing a route for women to make their own choices in the meaningful sense of the word.

This is why we must recast the fight for abortion access as a fight for women’s full equality. If those morally opposed to abortion want to reduce its frequency, they should join the fight for a living wage, free child care, and paid maternity leave. The majority of Americans continue to support the legality of abortions, but with Democrats and Republicans eroding the conditions necessary for women to access this right, we cannot look to these political leaders for help. We must instead build a movement that shifts the terms of debate to focus on women’s right to reproductive justice, unapologetically affirming women’s right to choose to have or not have children, to give birth unshackled, to access good schools and livable housing, along with securing access to reproductive health services, including, yes, abortion.

*Higher-income was defined in the data as women making 200% the federal poverty rate