Many people are apparently tempted to think that the issue of health care reform has arisen recently, and that it can be considered separately from other issues that surround it.
20 years ago. The case for health care reform was urgently apparent. Dramatically apparent. Scarily apparent.
This is a story of why we need the public option now, from 20 years ago today.
Attention must be paid.
“Grandiosity,” he said. “What the world needs is more grandiosity.” He looked both ways as if worried some shadowy figure might be watching from somewhere in the cheap motel complex as he hung outside his door, wearing groucho glasses. Richard was a huge guy. He weighed well over 300 pounds. He had a grizzled grey beard, wore wire rimmed glasses and t-shirts with a collection of large and small holes in them. They were a kind of trade mark, a way of daring the world to criticize. I never saw him in anything else. “Attention should be paid,” he said, waving me into the room. We had come to enjoy a few minutes of conversation as we changed shifts. It had only been a matter of weeks since we began working together.
Richard died that night, October 17, 1989. Exactly 20 years ago. I was driving a cab that he owned and we shared night shift/day shift 12 hours each. I drove the cab home to his motel room at 7am and picked it up there when he drove in at 7pm. That evening, it had just gotten dark and I was just heading down the interstate when he sent word through the green text message display of the dispatch computer saying he needed me to come take him to the hospital.
I asked him what was going on as we raced to the hospital. All he said was, “It hurts.” He handed me his wallet with a look that said, “you will need this.” I took it from him, skeptical of the necessity, thinking I would return it to him. “Yeah, yeah,” he waved, grimacing and frowning in impatience and reassuring that it was OK, all at the same time.
Around 3:30 in the morning I could no longer stay awake in the plastic chairs of the waiting room, so I went home to sleep. Even though I was a night shift driver, I had done some stuff during the day and was walking comatose to start with. Not uncommon in cab drivers, actually. When I think back on that period I am often confused as to whether it was day or night in my memory, because going back and forth between day and night shifts really messes up your sense of time and space. As soon as I was awake I called the hospital to find out how he was.
The admitting clerk said in a bored voice, “There no record under that name.”
“What! I said, could you double check?” That was kind of alarming. Did Richard get released and have to call another cab to get home? He would be pissed. I insisted and, described what happened. I got put on hold and then someone else picked up. After several more arguments, finally someone came on the line, a nurse who had been in the ER in the wee hours. She informed me that about 5am Richard had had a massive cardiac arrest during a catheterization procedure and that I should call the morgue. I couldn’t believe my ears. She repeated her advice, this time in a more sympathetic tone. The coroner himself answered and described him – by his weight. I was hoping it was an error. But it wasn’t. He wanted me to come over and give him Richard's ID. Later, as I handed this to him, he offered to set aside the axe-murder victim and prepare Richard for viewing so I could pay my last respects.
As this fully sank in, the TV set was full of news of the earthquake in San Francisco. I lived there for a year and one of the apartment buildings that was down and on fire looked like the one that I had lived in with a girlfriend. My youth! Up in flames! Overwhelmed then, I nevertheless regret to this day that I let the coroner's offer pass. I think of him in his black rubber apron with the grease and blood flecks, sympathetically looking at his watch, sighing and going back to his work. I think of Richard, his large feet overhanging the steel table. I'm sorry, Richard.
I found the letter, as I went through his stuff to send whatever was left to his daughter.
I helped organize the service, which the president of American Cab Company of Austin, Texas sponsored and I read it aloud in the rented room of the funeral home for the 20 or 30 or so cab drivers and friends who came.
On top of a fake Greek column style stand at my right, which would have held an urn if there had been one, were the huge running shoes he always wore with those Groucho glasses perched on top.
His doctor wrote, “Because of your apparent inability to pay for your medical care, I will no longer be available to treat your medical problems after March 20, 1989.”
The bill he couldn’t pay was $400.00. He couldn’t afford the prescribed pills either.
He had been a dairy farmer in upstate New York. He loved the farm life and never anticipated doing anything else. He lifted weights – and cows. I was asking him about this one time as we sat in the cab when suddenly, he raised his hand to command silence. He turned up the radio as the beginning strains of a piano concerto came on the all-classical station. He listened raptly and with tears in his eyes. “So beautiful,” was all he said.
His daughter told me that he had a stereo system installed in the cab of a tractor that he drove on the farm so he could plow fields and listen to classical music at the same time. She had not heard from him in a while and was in the process of getting ready to be married when I reached her. She was saddened, but not totally shocked. Richard had a family, I found out. An ex- wife and three kids. The farm had gone bankrupt. He tried to run a restaurant and a grocery store but those didn’t work out either. Then his wife divorced him. Totally lost, he stepped out on a highway and hitch hiked away from the land he loved and where he belonged. He became a homeless wanderer who wound up in a flophouse in Los Angeles.
The morning of that last day, we sat around for a while and shared stories about weird things, dark things and death. One day, he had come back to the flophouse after being out for a while to find police swarming around it. “They arrested a former marine for raping – a guy,” he recalled. More or less, that’s when he decided to get the hell out of there and try and get himself together.
He wound up in Austin, Texas driving a cab, eventually putting a down payment to buy one and become an owner-operator. The $30,000 Plymouth Gran Fury II with a police highway pursuit engine (which could take 24/7 taxicab operation for over 500,000 miles) was about half paid for. He was making a comeback, working every day including weekends and holidays to make the 340 dollar weekly operating lease/note payment. He was just barely able to eat, using an old two burner Goodwill hot plate in his room. But he was making it. He kept his American Cab unit #38 washed, waxed and in tip top shape. He even had leather seats put in as well as a good stereo system. As he ended his shift on that last day, he was grieving over the fact that he had left the spotlight on, which had burned a neat round hole in the front seat. He also complained about his ankles swelling. Indeed, they were huge. That should have warned us.
He was going without any kind of health care and so there was no one to call.
When the issue of health care reform arises I think of Richard. He died 20 years ago at the age of 48. By then it was already apparent that there was something wrong with the health care system when a guy who worked as hard as a guy could work could get cut off by a doctor for not being able to pay 400 lousy dollars and when he could not afford pills that might have kept him alive. But there was and is a bigger problem. A guy who found the joy of living in being a farmer who could pick up and carry a cow and who cried when he listened to classical piano was not able to keep his family , could not find the American Dream within his grasp, no matter how hard he worked. It might be fairly said, that what he really died of was a broken heart.
Maybe you could say that is beyond the scope of the health care system, and maybe it could be argued that there was and is funding in place for indigent care through taxpayer financed hospitals. But, there is a stigma attached to being poor which may go against an image of being a strong individual, not needing welfare. An heroic figure, taking his last stand, making a comeback in his own Louis L'Amour story may find it more healing to do without that stigma.
When I first met him, American Cab #38 was just driving up. I approached the driver, a very large guy with wire rimmed glasses and a grey grizzled beard. He wore that T shirt with the obvious holes in it. I stuck out my hand and introduced myself saying that I understood he needed a driver. “Fuck You,” he said in greeting with a fierce expression on his face and a twinkle in his eye. I laughed at the ironic gruffness belying a zest for life and that is probably why he took me on. He grinned that I got his joke.
Attention should be paid. He would say that if he were still around. He would only be 68.
He was right, there should be more grandiosity in the world. There is too much chickenshit small thinking.
If only more members of Congress had the heart of a dairy farmer/cab driver.
There is apparently more than one way a heart can fail.
Attention should be paid.