Hand to Mouth: Living in Bootstrap America (5 page)

It didn’t exactly go according to plan. First, we qualified for
Medicaid, and I started looking for an OB. There weren’t a ton of doctors accepting new Medicaid patients. Planned Parenthood doesn’t do prenatal care. I found my clinic through a flyer, advertising that it did in fact accept Medicaid and was enrolling NOW! In the waiting room for my first appointment, I realized that I was at a faith-based clinic. It was a church ministry.

Now, normally I’m cool with the Jesus folks doing the poor-people tending. It’s sort of their mandate, and I honestly do not care about the religious beliefs of anyone willing to make sure my kid gestates properly. But there are the charities that happen to be church-run, and then there are the church charities. I was at one of the latter. That distinction is important: Some ministries are set up by churches to provide a service, and some seem to be set up to proselytize, tacking the service on as an afterthought.

When I showed up, I was ushered into an office, where I did the initial paperwork and learned about all the things the woman helping me praised Jesus for. Her pencil didn’t break, praise Jesus. The weather was decent, praise Jesus. I honestly do not know what was in the paperwork she was walking me through; I was much too fascinated by this person who was nearly finished with the third page, praise Jesus.

After that, I was taken to an exam room, where I was greeted by a lovely young woman who took my blood pressure and asked me if I had a church home. She was followed by a nurse who told me that Jesus had a plan for this baby and congratulated me on making the decision to bear it. I asked
about maybe getting another ultrasound—my weird hormones and the sudden ability to bear children had me freaking out that this kid wasn’t viable, and I was terrified of coming to terms with having a child only to discover that it wouldn’t make it. But I was told that they only did ultrasounds in the third trimester unless there was a problem.

And that was the end of my appointment. No reassurance, no actual medical advice, no real exam. Just some routine tests and the clear message that Jesus wanted me to have this baby. I, certain that Jesus also wanted me to have an ultrasound and pretty sure that I could manage a pregnancy just as well without that sort of help, never went back. There didn’t seem to be much point in returning to a place that gave no better advice than to drink a lot of water and not get into a hot tub, which were both helpfully bullet-pointed on the packet of papers they sent home with me.

I did take a few stabs at finding a different clinic. The ones with open spots didn’t take Medicaid, and the ones that accepted Medicaid were full. So instead, I read a lot of books, called all of my old friends who had kids, and compulsively Googled things to find out whether they were normal or whether I should present myself at the ER. Eventually, I did just that when my daughter finally decided to arrive.

Any hospital in a large city is used to random pregnant women showing up to give birth. I think, though, that most of them have a doctor. They wanted to know who mine was, and I told them that I was pretty sure whoever was on call that night would be my doctor.

I actually don’t remember most of the process. I was in a room, then another room, and I was kind of too busy being in labor to really care what was happening. Tom took care of the paperwork; we gave them the Medicaid card and that was pretty much it. Then I had a baby. I think the process was probably streamlined given that there was going to be a baby soon whether or not the paperwork was done, and they much preferred that I give birth in the birthing room instead of in the waiting room, where it would be rather hard to clean up afterward.

We were visited by social workers a lot in the next days. I don’t know what all I filled out; they showed up at random times. If I was awake, they had me fill out paperwork. If I was asleep, they woke me and had me fill out paperwork. I’d failed to plan ahead and bring pay stubs with me, which the lady was kind of miffed about, so I had to bring those in later.

—

I’ve been called crazy. It’s not untrue. I suffer from a syndrome called We Don’t Know What the Fuck Your Damage Is. That is to say, I’ve been diagnosed with so many things that it’s impossible to tell what’s likely the real problem. I mean, clearly I struggle. Things that are simple for most people don’t come naturally to me. I have trouble bending my will to anyone, including myself. I’m reckless and impulsive. I’m irrational and prone to anger when I am in certain moods, and those moods occur more frequently than you’d expect. I go through
depressive phases, lasting days or months, and I can destroy my entire life through sheer inattention in three weeks flat, because even if you can’t muster the energy or the will to open your mail, they still want the money for the bills. At times I’m an insomniac, and at others I can’t get out of bed. None of these things are typically so bad for me as to be unmanageable, but managing them sometimes doesn’t leave much room for anything else.

It’s not like mental health clinics are thick on the ground, like the people who need their services. Being poor in and of itself is an aggravating factor in a lot of mental illnesses; the stress is pretty brutal. If you’re already kind of fragile, it can be really rough. I won’t say that a good clinic for poor people doesn’t exist somewhere, but I’ve never found a mental health professional who was willing or able to deal with only the parts I needed to fix, the insomnia and paralysis and depression (at least some of which is situational, and I’ll discuss that more in Chapter 4).

When I have sought treatment for these things, the professionals seem to only want to talk about my anger. They talk about my fatalism, my caustic outlook. They see these things as problems to be fixed. Personally, I think that anger is the only rational response to my world sometimes, but when you’re asking for services, you don’t get to pick what they treat you for. Either you agree with them or you’re labeled uncooperative and kicked out of the program.

The last time I found myself really struggling and went in, they told me that I would have to spend hours in treatment
each week. And that was the only option. It was either that or no treatment at all. So I chose the latter. Now, to be fair, I showed up in a right state. I was having a bit of a meltdown because I was terrible at my job and putting in too many hours to be failing that hard, and my husband was having a rough patch, and the kids were sick, and I had just realized again that this was it, this was life, this was how it was going to be until I died. The best I could hope for was that not all of these things would happen at once too often. I can see them thinking I was seriously this critical all the time.

I went to the clinic hoping that I could develop a relationship with a therapist who would then be able to prescribe me the drugs that have made me competent and invulnerable, the ones that stave off emotional disaster so that I can simply get through the crunch. Even at my most breakdowny, I generally realize that I am reacting irrationally. What I need from the mental health system that I have never been able to get is just enough support to maintain.

What I need, what would probably actually improve my life outcome, is someone who I can call, can see frequently for short stretches when I’ve hit a rough patch, and can then not call when I’m okay. Someone who knows my history and won’t question it when I call and ask, apropos of nothing, for something to help me sleep or avoid panic attacks. I need someone who’s worked with me for long enough to understand that I don’t really like medicine and that if I’m asking, it’s serious. In short, I need the kind of mental health support that many people with quality insurance take for granted.

When I’ve had the guts to see a doctor about an ailment, I haven’t had the access, and when I’ve had the access, I haven’t had the guts. Until quite recently, I was scared to death that if a doctor ever did find something really wrong with me, I’d be
completely
uninsurable, so I never went to the ER for anything that wasn’t obvious and small, like a bad flu or potentially broken ankle.

Mostly, if I’m honest, I’ve been scared of the
look
. It’s in doctor’s offices and around social workers where I get the lectures, the judgments, the stares. People treat me like I’m a fucking idiot, as though I am incapable of noticing this rather large problem, rather than incapable of addressing it before it becomes such a large problem.

I came in for a fair bit of judgment over a cyst I developed. Doctors assumed I was just too ignorant to notice it, rather than the truth, which was that I lacked insurance and it wasn’t life-threatening. I promise you, I was aware of the cyst I had for years. You can look up the gory details—it’s called a pilonidal abscess. I think it’s due to a tailbone injury I had as a teenager. A couple of times a year, my ass would swell and I’d smell like a rotting corpse for a few days in addition to the rather painful fact that I couldn’t sit or stand in any position that didn’t add to the pressure of the infection. It wasn’t until just after my first daughter was born, when I had three months of Medicaid left, that I could have it excised. Prior to that, it landed me in the ER more than once, and every time, I’d be told patronizingly that I could simply have it taken care of, and probably should. Every time, I asked the doctor if they’d be
willing to do the surgery at the rate I could afford; while I didn’t have any takers, it did, at least, ensure that I didn’t have to hear yet another explanation that surgery exists—as if it were something I’d never heard of simply because it was something I couldn’t have.

Preventative medicine, man, it’s a miracle. You can go to orthodontists and surgeons and eye doctors and rehab facilities after you throw out your back so that you don’t wind up bedridden and debilitated. You get antibiotics and painkillers and blood pressure medicine.

Seriously, vision care alone is a miracle that only happens to the rich, never mind the rest. They don’t get deep forehead wrinkles at thirty from spending their twenties squinting, they don’t get headaches that cause them to take a large amount of ibuprofen every day—which, as all the bottles are pretty clear on, can’t be good for you. They can see something in the first second it comes into their field of vision instead of five seconds later. The glasses and the decent food and the orthodontists—all of those things require money.

There is a price point for good health in America, and I have rarely been able to meet it. I choose not to pursue treatment if it will cost me more than it will gain me, and my cost-benefit is done in more than dollars. I have to think of whether I can afford any potential treatment emotionally, financially, and timewise. I have to sort out whether I can afford to change my life enough to make any treatment worth it—I’ve been told by more than one therapist that I’d be fine if I simply reduced the amount of stress in my life. It’s true, albeit unhelpful.
Doctors are fans of telling you to sleep and eat properly, as though that were a thing one can simply do.

Now, I’m not saying the system doesn’t work at all. I’ve had lifesaving treatment, like when my throat swelled so much they had to put a tube in it to keep me breathing. I’ve got friends who can leave their houses only because they found a program to get them a wheelchair. Many people have needs that the system is built to meet, and it does that fairly efficiently to the extent that there’s money.

The trouble is that we’ve left so many holes in the safety net Moby-Dick could swim through it. The system can’t support everyone who needs the help, and it’s led to a pastiche of half-finished treatments and conflicting diagnoses. We have the technology. Maybe we can start using it? There are a lot of us that would be awfully pleased to get some antibiotics.

I’m Not Angry So Much as I’m Really
Tired

A
lmost nothing is more degrading than standing in a welfare line. The people who are looking at you know exactly how much money you make, because they know how poor you have to be to qualify. And the workers are either lovely or the worst human beings you’d ever care to meet. I had a caseworker who called just to check in because she knew I’d gotten a new job. And I had one who ignored me completely, just had me sit silently at her desk until she needed me to verify my information. Then she ignored me some more, and then she told me I could go. I left, with no idea what had just happened. I called the state to find out what changes she’d made to my file the next day rather than speak up during that incredibly effective stonewall.

I’ve felt the poorest with the people who were supposed to be helping me. I get that their jobs suck and they’re
overworked, but I go out of my way to not be another asshole customer. I have my paperwork and a list of questions ready to go. I have all my references, my pay stubs, medical bills, everything. Indexed. Sometimes I don’t have a document, but then it’s on my list of questions, to find out what I can use as a substitute. But often, none of that matters, because I am poor and asking for the benefits that I am qualified for and entitled to as a citizen, and in some people’s eyes that makes me less than human.

Often enough, I
feel
less than human—or less than the human that I know myself to be. For example, I love to read. I’m a naturally curious person, apt to ask uncomfortable questions without realizing it because I just want to know something. But I don’t read when I’m working at minimum wage or near it. I’m too tired. I fall asleep because the effort of moving my eyes across the page and processing information is simply too much; my brain won’t allow me to use what little energy I have left on frivolities like self-improvement. It just wants me to stare blankly at a wall or flickering screen until I pass out.

Understand that when I say I am tired and in the same breath bitch about a lack of hours at work, it’s because I’m counting the totality of the shit that I have to deal with while being poor. It is super-inconvenient, all the time.

There’s one episode of my life in particular that was just the worst. I was working two jobs, with no car. I lived two miles from one job and three miles from the other. It wasn’t an inhuman amount of mileage; some people run that for fun. But then afterward, some people go home and relax.

So I’d get up in the morning, walk to work at about five a.m., and wait tables from six to about noon. I’d be home by about one, at which point I’d pass out unless I had errands to run. Then I’d get up at six, shower and fix my hair for the bar, walk three miles, tend bar until one or two in the morning, and either beg a ride from a co-worker or walk home. I’d get home at two or three, unwind, take a short nap, and start all over again.

Now, nobody can maintain that forever, and if I’d been lucky enough to get that many hours, I’d have been doing okay. The problem was that both these jobs were weekends or prime eating-out days only—three or sometimes four days each. So I’d spend Monday recuperating from the weekend, Tuesday trying to find better work (which also required more than a few miles of walking around dropping off applications), Wednesday taking care of the house, and Thursday taking a spare shift from one or the other job.

In other words, my commuting time was comparable to a typical suburbanite’s: one, maybe two hours. Except mine was on foot, and it was to jobs at which I was on my feet all day. It’s why I’ve never felt much need to exercise; I spend hours each day lifting heavy things and bending into impossible positions to get through stockrooms. I’ve stood and repeated so many times that I can assemble a cheeseburger in twenty seconds flat, assuming it’s got multiple toppings. Less, if it’s simple. You get plenty of miles in while running around a retail store or factory floor.

So I was either working or walking to or from work, about
sixty hours every week. How did I spend my remaining time? Well, remember that I was walking. I lived in a fairly central location, but it was just about a mile or two from anything I needed, like a grocery store or a Laundromat. I did laundry twice over the weekend because I could make my clothes last two shifts but not three, so that was six hours. I went grocery shopping once a week, so that was four hours. I slept, so that was around fifty. I spent eight hours or so every week looking for work locally. I went to the unemployment office once a week to check the job boards, and that was five hours. I generally picked up a spare shift on Thursdays, so that was another six or so. I showered at least twice a day, what with all the walking, so that was about seven hours a week gone to washing or drying myself. And that leaves about three hours a day for everything else.

I was always and forever dreading the next time I’d have to get off the couch. I would finally sit down, and I would realize that if I had any hope of waking up at a reasonable hour tomorrow, I really did have to be in bed in three hours, and the dishes still needed to be done, and the toilet needed to be scrubbed, and I’d promised someone I’d make them dinner because I owed them and they got sick and called in the favor.

When some wealthier people sense an unwillingness in lower-paid workers to move faster than they absolutely have to, or to do much of anything with their free time, it’s because we are marshaling our resources. We’re not lazy, we’re stockpiling leisure while we can. I can’t tolerate more mental exercise
after a full day of logistics and worry. Full capacity just isn’t an option.

We start the day with a deficit. Most poor people don’t wake up feeling refreshed and rested. When I wake up in the morning, I’m in pain. If it’s ragweed or wood-burning season, I wake up with insane headaches. If I’m spared that, there’s still my aching back, stiff from a night on a mattress that was worn out long ago. There’s not a moment in my life that my mouth doesn’t hurt; my tongue is raw from touching broken teeth and my jaw isn’t any happier about them. (I fully realize that some of the trouble is that I don’t know how bad I feel. There’s no baseline, no normal “healthy” to compare an average day with.)

I’m not trying to say that only poor people feel pain. The point here is that life is a bit peachier if you have medicine or are under a doctor’s supervision to treat these things. Allergies are less severe if you get allergy shots. My headaches are partially due to my jaw-teeth trouble. I realize the aging process would suck enough on its own—I’m generally less than pleased to have it helped along on a daily basis because I don’t have enough money to seek proper medical attention. For fuck’s sake, a decent
mattress
can be considered a contributor to an optimal health outcome.

But poor people wake up knowing that today, no matter how physically shitty we may feel, we can’t call in sick or slack off at our desk surfing the Internet. We have to go to our crappy jobs no matter what. We will feel guilty about the bills
and the dishes and we will firmly put them out of our mind as we march out the door in our polyester uniform shirts. Or worse, we will have to find something to do with our endless unemployed hours.

Sometimes, that’s all the day is, just another gray nothing. Other times, it’s already a bad day and people just have to fucking push me. I’ve got a bit of a temper, and I have trouble holding my tongue when I’m pretty sure someone’s being an asshole. My record from waking up to losing it is in the neighborhood of an hour. Mostly I make it through a whole day, but sometimes it’s just not in the cards. The night before my record-setting morning, I’d made it home from work at ten p.m. and passed out by eleven. I’d been working extra and was short on sleep to begin with. My boss called at five a.m. wanting me to come in. I drank some coffee and dragged my sorry ass out the door, and when I showed up, he was mad that it had taken me half an hour to come in. He’d been under the impression that when I said, “I’ll be there,” I meant that I’d use my teleportation device instead of the beater car I had at the time. I blew it off, figuring that he was just in a bad mood. But he simply couldn’t let it go—every time someone complained about this or that setup not being done properly, he said that if only I’d been there on time we’d have made it.

I lost it. Completely. This is the version of what I said that I can best remember through my blistering rage: “If you think I’m so goddamned terrible, why did you call me in? Did you not realize that I’d be on a fourteen-hour shift and that I was running on a few miserable fucking hours of sleep? WHAT IS
WRONG WITH YOU, YOU INCOMPETENT FUCKING ASSHOLE?” And I said all this in my outdoor voice. In front of customers. I spent the afternoon looking for work, as I was newly unemployed.

Being poor is something like always being followed around by violins making “tense” movie music. You know that commercial where the band Survivor follows a guy around playing “Eye of the Tiger”? Yeah, it’s like that, but the musicians are invisible and they’re playing the shower scene from
Psycho
. Nobody likes being harried, but for a lot of us it starts upon waking and doesn’t let up until we crash at night. Eventually, you just know that something bad is going to happen. That’s not paranoia or pessimism; it’s reality.

When my story went viral, I got a lot of blowback from people demanding to know how I dared to have children while I was living in a weekly motel. Well, I’ll tell you: That’s not how we started out the pregnancy. The VA didn’t end up paying us the living stipend that we’d expected so we’d gotten a cheap apartment. That was fine, for the short term. Until one day, when I was heavily pregnant, a summer storm flooded our apartment and destroyed everything we owned.

The landlord hadn’t paid for proper maintenance on the storm drains, and they backed up. We didn’t have family in the area, so we went to stay at the motel while we sorted out the damage. We’d been in touch with maintenance, who’d assured us that they’d take care of the water.

What we hadn’t realized was that the landlord’s version of “taking care of it” was having the guys run a Shop-Vac for a
while and then set up some box fans. This was to take care of a flood that was feet deep. The water soaked into the concrete walls so thoroughly that when we stopped in a few days later, you could see the mold growing to above your head.

We didn’t have enough money to pay for both the motel and our rent. We called the landlord to get a new apartment, maybe one that wasn’t toxic, and were told that the apartment was fine now that it was dry. We called the health department and the press, neither of whom cared much. The health department guy, in all fairness, happened to not be in charge of this particular issue and couldn’t tell me who was. But he agreed that we definitely shouldn’t live there, especially not with a baby.

The result? The landlord sued for eviction because we weren’t paying the rent on our flooded apartment. Cue the movie violins. Something as simple as a summer storm can mean disaster. So I learned to simply expect that if things felt like they were going rather too well, something would come along to knock me back into reality.

Gruff attitudes are rife among people with low-wage jobs. And it’s no wonder, really, considering the lives we lead. Yet many of our employers actually seem to think it’s reasonable to require unfeigned good cheer in their employees, and this I don’t get. It doesn’t make sense to hire people at wages that guarantee they’ll be desperate and then be disappointed when they’re not always capable of pretending otherwise. Look, I don’t like walking into a gas station or fast-food joint or box store and dealing with a bunch of sullen idiots either. But
people don’t seem to stop to wonder why we’re uniformly so pissed off and unhelpful. I think you’ll find that the happier employees are in general, the happier they are at work. It isn’t rocket science. My guess is that, like me, a huge number of poor people are depressed. Anger is one of the few emotions that can penetrate depression. It’s strong enough to punch through the haze, so a whole lot of people like me hold on to our anger. We cherish it. The alternative, at least for me, is a sort of dreary nothing. Anger and depression make for a cute couple, right?

—

Regardless of our mood, we’re never fully checked into work because our brains are taken up with at least one and sometimes all of the following: 1) calculating how much we’ll make if we stay an extra hour, 2) worrying we’ll be sent home early because it’s slow and theorizing how much we will therefore lose, 3) placing bets on whether we will be allowed to leave in time to make it to our other job or pick up our kids. Meanwhile, we spend massive amounts of energy holding down the urge to punch something after the last customer called us an idiot. People don’t have any compunction about insulting service workers, but it’s amazing how quickly they’ll complain about your attitude if you’re not sufficiently good-natured about it.

Our jobs are as much emotional labor as they are physical. What they are not, what they are never allowed to be, is mentally engaging. So we’re trying to zombie out to survive. We’re
not allowed to deviate from policy even if the policy is kind of stupid and counterproductive. Nobody is interested in our thoughts, opinions, or the contributions we might be able to make—they want robots.

Our survival mechanisms are the things that annoy the customers most. Next time you see someone being “sullen” or “rude,” try being nice to them. It’s likely you’ll be the first person to do so in hours. Alternatively, ask them an intelligent question. I used to come alive when someone legitimately wanted to know what I’d recommend. I knew everything about my products, having stared at all the boxes while I restocked them, but people rarely wanted me to tell them about anything more than the price.

What’s guaranteed to be counterproductive for you is demanding better service with a superior attitude. We’ll perform better service. But we’ll be sure to hand you the shirt that we know is stained, or the meat that’s within the technical limit of servable but will probably taste less than optimal. And we’ll do it with a shit-eating grin on our face and well-wishes on our lips, just like you demand but refuse to pay a single extra penny for.