With and Without CareI.

I miss the ease of walking into a doctor’s office without my checkbook. I like knowing I can visit a hospital without first figuring out what my deductible may be and whether or not I am about to have a pre-approved procedure. I do not enjoy receiving repetitive invoices each week from doctors, anesthesiologists, nurses, and various unrecognizable professionals. I don’t know these people or why I needed them.


I do not mind paying taxes. I am not rich. I recognize how little I contribute to the big picture. This is what taxes do; they pool and contribute resources so we all benefit. Someone helps pay for me. I help pay for someone else. I enjoy the roads, the schools, the essential services, and peace of mind my tax dollars provide. I miss paying higher taxes: taxes that subsidize medical care, not just for me, but for everyone. I have always considered medical care to be an essential service.


When her head hit the concrete, the crack of the woman’s skull echoed throughout the café. She had been standing and then she fell, flat as a plank, to the floor. The plastic hair clip holding back her grey curls snapped and shattered and wedged into her skin, into her scalp. Dark crimson blood oozed from silver strands of hair. The barista called 911. “I think she had a stroke. She didn’t know how to answer when I asked what she wanted. She’s breathing, but she’s out cold.”


I imagined my visit to this small Ontario town would be uneventful. It was a short visit with my brother coming from across the country — the middle place for us to meet. He would be catching a flight back to Calgary later that week. I would be driving back to Michigan later that day. My brother has recently become a grandfather. He wants to see his grandson grow into a man.


The woman came to just before the medics arrived. She argued she was fine. She just tripped. We heard the lie. We saw her fall. We saw her eyes closed, her mouth open, her head and sweater soaked in blood. They helped her sit up. They helped her on a gurney. They wanted to take her to the hospital. She did not want to go. It was her right. She had plans to meet friends for coffee.


It had been years since my husband visited a doctor. He had to, seventeen years ago, for a pre-hire medical. He has insurance. He doesn’t care for doctors. He doesn’t like the dentist. He just turned forty. Now it sounds different to him when he hears of high school friends who are ill, who die. It’s become more personal. He sees our future, wants our retirement. He has agreed to a check-up. He will again.


The woman’s hair clumped up in a bloody mess. She held a palm against her scalp. She told the medics she would visit a walk-in clinic later if necessary. She returned to the counter and placed her coffee order. The barista handed her a mug. The woman took her seat alongside her friends, talked about the weather. She sat in the booth behind me, her bloody head mirroring mine.


When I sit in the doctor’s office, I overhear a conversation. The clerk is on the phone, explaining to the caller how she can spread out her fees, use a payment assistance plan. Her voice is scripted in empathy. She hangs up, takes the next caller on hold.


When it is available and accessible, it’s easy to drop in for a check-up. Not much thought or planning is necessary to screen for this, for that. You call in, make an appointment, show up, and when the appointment is over you leave. No checkbook. No strategic savings plan. No ten easy payments. Not everyone takes advantage of what is available to them. We only miss what we no longer have.


The woman from the café would not have had to touch her pocketbook. She would not receive a bill after returning home from the hospital. She still didn’t want the service, the attention. She sat with her friends, sipping her coffee, as the blood on her head dried. She said she had a headache, but would be fine. She left the café and boarded a city bus. The bus driver watched through the rearview mirror, her injury too much to hide.

Lori A. May is the author of The Low-Residency MFA Handbook. Her essays and reviews may be found online with publications such as Passages NorthThe Iowa ReviewHippocampus MagazineConnotation Press, and New Orleans Review. Canadian by birth and disposition, she now calls Michigan home. Visit her at www.loriamay.com. [The author has posted a discussion of the genesis of this essay on the Brevity blog.]

Photography by Michael McKniff