Tag: medicine

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Days Are All We Have

The medicine finally arrived. Duly marked with labels indicating the radioactivity and biohazard contained within, with warnings proclaiming, “Chemotherapy Drug.” It’s a jarring image, a far cry from the friendly paper bag that our neighborhood pharmacy places my statin drug in once a month. Once you open the box and encounter that label, even before you get to the bottle with the medicine, it’s as if the universe is giving you one last warning: do you want to live or die? Do you want to ingest this distilled form of chemical or radioactive poison into your body to kill cancer cells or boost your red blood count? You have one more opportunity, and this is it. You can’t say we didn’t warn you. That’s what a label like this is trying to tell you. If you go down this road, this dance you’re doing with death is about to become more intimate. The label asks, “are you ready for that degree of mortal intimacy?” If you are and you trust your doctor, it’s time to move past the label and live life on a delicately balanced, biologically hazardous chemical edge.   

He may have the medicine in hand, but I’m still scared. When will the side effects start to kick in? Will he tell me? I doubt it. I offered to come and sit with him for the first 48 hours.  He wouldn’t hear of it. His support network there would look after him. Now, I will have to look on from a distance, at scary drug labels, and listen for subtle, desperate changes in his mood, voice, and tone. Or I can roll the dice and show up at this front door bearing groceries and love. I can say, “I’m staying for a few days, and I don’t give a damn what you think.” I do have options. I can be the answer to my prayers.

There are practicalities. We may have won the battle, but the war is not over. The medicine took too long to arrive, and it’s only approved until the end of the calendar year. We’ll have to go through this same struggle with the insurance company, the doctors, and maybe the VA once again in a matter of days.

Days are all we have.

–Richard Bryant

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The Insurance Company Said “No”

The insurance company said they wouldn’t pay. In forty-eight hours, they gave an outright denial. How do you like them apples? A man is dying of cancer. A series of oncologists and hematologists at two hospitals decided on the proper medical treatment for this specific cancer and prescribed the appropriate medicine. It is an expensive medicine by any reasonable standard for those with and without insurance. The specialized pharmacy receives the request to prepare and ship the drug upon authorization from the insurance company that they’ll pay for the medicine. The insurance company says no. Who are these nameless people who’ve decided my father should die or receive a drug less effective than his doctors deem necessary? I want to meet them. Will you look me in the eye? Did you go to Sloane-Kettering for your residency? What do you know that his doctors, those who gave him a first and second opinion, do not know? Or is it solely a question of money? Paying out of pocket isn’t an option. Death, however, is always out there just beyond the horizon. There’s no copay for death. It may be easier on the pocketbook, but I’m told it’s emotionally draining and spiritually painful for the dying and those who love the dying. I guess this is my life now.

We appeal their decision. I say “yes” to life. Scripture asks, “death, where is your sting?” Paul, I can tell you. It’s in a rejection letter from Aetna.

The daily dance between life and death goes on.

–Richard Bryant

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The Sin of the $3000.00 Co-Pay

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My dad is ready to start his treatment. The doctors have decided to start with experimental oral medicine. The side effects sound horrific. What did I expect, the occasional headache and rash? No, the treatment appears as bad as the cancer itself. When he left the doctor’s office this morning and told me the name of the drug and the facts, I couldn’t believe what I heard. This was going to be as awful as I expected. I guess because he’d waited so long since the biopsy, we’d been lulled into a sense of complacency. Whatever he took would be a pill, like a Tylenol, that would magically increase his red blood cells, and he’d feel fine in no time. How could I have been so stupid? It was never going to be that easy. We may have wanted it to be simple, but that was a fantasy. Today, the balloon burst and reality hit home.

I told him this wouldn’t be the kind of medicine he could pick up at CVS or Walgreens. I was right. I hated being right this morning. He called me as he left the doctor’s office.

“You can’t just go by CVS to get this medicine,” he said. “You’ve got to order it and then FedEx it to the doctor’s office. It’s going to take another two weeks.”

I knew this would happen. He’s got cancer, it took almost two weeks from reading the biopsy to get the prescription, and now we’ll wait another two weeks to get this high-powered drug. I didn’t want to gloat about being right, especially when he said that his red blood cell count continued to fall, and the doctor said if it went much lower, he’d need a blood transfusion. The man has no energy. It’s hard to see him unable to do anything without becoming exhausted and fatigued. That’s not my dad. I could hear a sense of desperation in his voice for the first time. When I was there at Thanksgiving, I could tell he was tired. Today, however, I hear despair. This scared me. I don’t quite know why this frightens me.

He told me the co-pay for the medicine would be $3000.00 a year. Let that sink in a moment. I wonder if that despair I heard was him wondering if his life was worth an extra 3000 dollars a year. Sure it is. There’s not a debate. He can afford it. If the starts the medicine now, in this calendar year, he’ll pay 3,000 dollars now and again on January 1st.

Perhaps he, like me, was thinking about those who get their biopsy results, receive a diagnosis, and are told they can take medicine, which will immediately cost $3000.00-$6,000.00, and they hear a death sentence. What do people who can barely afford to live, pay bills, buy gas and food, and pay for their housing do when faced with lymphoma? Do they die slow, painful deaths while insurance companies and the medical-industrial complex take thousands of dollars from those who can afford to pay? Yes, people die like this every day.

Meanwhile, I preach Jesus as the reason for the season and shepherd a church where the most significant issues seem to be the scriptural authority and human sexuality. But, boy, are we wrong. We could be a voice for the voiceless in our pews and community, those marginalized dying who have no resources for life itself. But instead, we fight over the context of two thousand-year-old words in dead languages that are dividing the living faster than cancer cells.

A $3000.00 co-pay for any lifesaving drug is a crime. It is a sin against both God and man. I’m not sure anyone could write a prayer of confession to get humanity off the hook for causing people to choose between life and food, life and rent, life and work, life and children, life and anything. I’m not sure of much of anything anymore. God have mercy on our souls. O Come, O Come Emmanuel.

–Richard Bryant

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Biopsy Results Part II

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8:38 AM. The biopsy results arrived this morning. They were delivered to his email via MyChart, the ubiquitous bearer of all medical news in 21st-century America. He forwarded a copy to me. The diagnosis, read by a pathologist, confirmed the earlier findings from the bone marrow biopsy: lymphocytic leukemia/small lymphocytic lymphoma.

He tells me the next step is a meeting with a committee of hematologists and oncologists who will examine his blood tests and earlier biopsy to determine how best to treat his form of leukemia. A committee? I don’t like committees. Having served, chaired, and still sitting on numerous committees, I have an inherent distrust of the deliberative process made manifest in committees, particularly church committees. Committees are one of the most dysfunctional means humans have found for making decisions. Putting human life into a committee’s hands is almost too dystopian to consider, especially when it’s happening to your father.

Do the members of this cancer committee get along with one another? How do their egos impact their decisions? Do they see their patients as people or just names on a page? Will they hold a vote on the right course of action? Are their votes determined by a simple majority, two-thirds of those present, or like a jury (since man’s life is at stake)? In other words, do their decisions need to be unanimous? Do family members have any voice in their process? They don’t answer those questions if you send the doctor a message via MyChart. So here I sit, in the waiting room called today.

–Richard Bryant

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