Kitchen table. Nurse practitioner. An hour and half discussing my blood work, DEXA scan, and urine analysis. I have been too ill for regular office visits, so primary care, phlebotomy, even X-rays and ultrasounds have come to me. It might have been otherwise.
No co-pay. No premium. Just healthcare. Oregon Health Plan, the State of Oregon’s Medicaid program, covered this appointment. It has covered me since its inception in 1994—including the two years it took for my application for disability benefits to be approved. It might have been otherwise.
Application denied for Supplemental Security Income (SSI)—the federal welfare program of disability benefits for those not eligible for Social Security Disability Insurance. Appeal to an Administrative Law Judge. Free lawyer from Legal Aid Services of Oregon. A harried Jewish woman with a keffiyeh and a kind smile compiled seven jumbo green binders of evidence on my behalf. It might have been otherwise.
Fluorescent lights in a downtown court room. Beeswaxed-skinned, white-haired medical expert. Questions about my diagnosis. Bulky vocational expert at the next table over listing my education, work history, severity of my symptoms. Said the magic words: there are no jobs in the national economy she can do. The judge ruled in my favor. It might have been otherwise.
A check (current benefit: $994/month) from the Social Security Administration deposited into my bank account every month without fail since July 2003. It might have been otherwise.
Nothing but $135 in food stamps to live on while waiting for the administrative law judge to hear my appeal. Stayed with a father-figure friend in his own precarious rental. It might have been otherwise.
A mild remission. Rental untenable. A return to graduate school. Student loans and student housing. It might have been otherwise.
Days I could leave my bed and get to class dwindled. A monthly SSI check now paid for a subsidized 250 sq. ft. poorly-insulated, cockroach-friendly studio. The waiting list in 2005 was a mere four months. It might have been otherwise.
Five years later, another waiting list. I reached the top just when its best unit became available: 600 sq. ft., one bedroom, fourteen-foot balcony, view of Mt. Saint Helens. It might have been otherwise.
Even sicker over a decade after being approved for SSI. Numbers and signatures from my primary care provider and me on an application for a total discharge of my student loans. Department of Education approval. Three-year waiting period. No more calls and letters from Sallie Mae. It might have been otherwise.
Laundry impossible. Lifting my arms to wash my hair a struggle. Multnomah County Aging and Disability Services assigned a case manager. Seventeen years of handling my home care workers, my Medicaid, my SNAP benefits. Always a quick phone call away. Even called me once to say. “I was thinking about your situation last night while I was doing the dishes and I think I might have figured out a solution…” It might have been otherwise.
Today my home care worker—paid for by the Oregon Health Plan—picked up my prescriptions. Did my laundry. Washed my dishes. Cut up kale for me to cook with later. Made my bed. Helped me take a bath. It might have been otherwise.
An acquaintance online. A few years passed. He asked how I was. Sicker than the last time we spoke. “I hope you get lucky,” he said as our conversation ended.
Oh, but I have been. Frighteningly so.
Silvering-haired woman presenting the news. A flurry of firings and congressional clauses that will snip and gash the safety net for years to come. Soon, I fear, it will be otherwise.
MICHELLE STRAUSBAUGH is a chronic illness management specialist writing from a bed in Portland, Oregon. Her work has previously appeared in Hippocampus Magazine and Burningword Literary Journal. She writes erratically at behindthesurface.com.
