Ma’s Way: Going Without Medicaid (Part I)

            When Ma gets locked up, my life goes to hell—and Ma got locked up Friday.  Let it be clearly understood that Ma is a good woman—a good wife and a good mother.  When her son Mike brought home his 14-year-old friend, Patti, who was having terrible trouble with her own mother, Ma took Patti in.  Five years later, when Patti married Mike, Ma was pleased.  Ma was—as all people of the North Country are—a hard worker.  She worked as a private-pay home health aide in Upstate New York.

            New York State is composed of two separate entities:  New York City, which is a rich, powerful, megalopolis, and The Rest of Us, who are mostly poor, insignificant and rural.  If you exclude New York City—which many of us would like to do—the rest of New York State has an economic picture about as bleak as Missouri’s.  We are not a healthy, wealthy state.

            Outside of New York City, which is known as Downstate, there is Western New York, also known as Buffalo; the Syracuse area, variously called Upstate or Central New York; and the North Country, where Ma lives.  The North Country is occupied in about equal parts by people, pigs and cows.  It is occupied in greater part by rocks.  It is not easy country to farm, and it is made much worse by the fall of snow, which was so great in 2007 that it made headlines with the Associated Press of Pakistan.

            Parish, N.Y., which is where The Weather Channel reported from—probably because it had a motel—got about twelve feet of snow in about a week.  Nearby Mexico, N.Y., which is where Ma lives, but which does not have a motel, got more.  By comparison, New York City got 27 inches—inches—and declared itself in a state of abject desperation.  Upstate, we call 27 inches a bad day at the beach.

            So here we have Ma, good woman that she is, working in poor Upstate New York as a private-pay home health aide, which means she has absolutely no benefits.  None.  Zero, zilch, zip.  No overtime, no vacation, and certainly no health insurance.  But that’s okay because Ma has a husband, and her husband does have all those things, so she’s covered.

            Then Ma’s husband dies, so Ma buys a small house with his life insurance payout.  Actually, Ma thinks of it less as buying a house and more as buying land.  (“Buy land; they’ve stopped making it.”)  The land (with house attached) is across the road from where Mike and Patti live in a trailer with their four children.  The children—three boys and a girl—range in age from eleven to one.

Mike is driving truck and Patti is working as a home health aide, too, but, unlike Ma, Patti is working through an agency.  This is good because two years ago Mike was injured in an accident and was out of work for a long time.  That took all their money and then some.  Their debt load is ruinous and he hasn’t been at the trucking company long enough to get insurance, so it is a good thing that Patti can pay an enormous portion of her salary for health insurance while he pays for frivolous little extravagances like food for the kids.

Mike and Patti are young and strong, and deal with it.  Ma, not so young and a new widow, develops a severe tendency to get depressed.  In some parts of the country when you get depressed, you see a therapist.  In Upstate New York, you shovel snow.  If there is no snow to shovel, you go to a bar—bars being the only form of entertainment that is known in rural Upstate, outside of shooting marauding pigs.

What Ma does not know is that she now has bipolar disorder.  She does not know this because there is only one public mental health clinic in the entire county and it collects insurance, which she doesn’t have, so she doesn’t go ask them about it.  Instead, she goes to a bar, which is what a great many people with bipolar disorder do:  they become alcoholics in the process of deadening their depressive pain.

So now Ma not only has depression but also alcoholism, and she complicates the picture by doing what most people in bars do:  she brings home a drinking buddy, in this case, Fred.  Fred is not working—claiming some sort of disability, whether of mind, body or spirit not being exactly clear.  Ma is now in serious trouble and repeatedly getting busted for driving while under the influence of self-administered drugs for the mistreatment of depression.

Then one day while Patti and I are at the store (I am disabled and Patti is my home health aide), she gets a phone call from Fred, who is not only an alcoholic but also an idiot.  He says Ma didn’t come home last night, and follows it with the little tidbit that she’s in the Intensive Care Unit in a hospital in Syracuse.  She got drunk, drove home, went off the road, hit a tree and broke her neck, not to mention several other important body parts.  Fred was involved in ways that are not entirely clear but have something to do with him leaving her at the bar to drive home alone, and knowing that she was in the ICU for seven hours before calling her family.

Life as we knew it came to a halt for several weeks.  There were Ma’s patients to be cared for.  Patti’s children needed babysitters.  A Health Care Proxy had to be gotten so Mike could make decisions for Ma.  A Power of Attorney had to be gotten so Patti could make decisions about Fred—mostly, whether she would kill him or not.  Fred’s main contribution was to make ATM withdrawals for himself from Ma’s bank account.

By the time Ma was medically restored enough to be discharged, she had been properly evaluated and diagnosed with bipolar depression and alcoholism.  Syracuse, being a big city and having a teaching hospital, gave Ma the full treatment.  Antidepressants were prescribed.  A social worker got her signed up for Medicaid.  She was referred to a substance abuse group, a mental health clinic, and physical therapy.  (To be Continued)

About annecwoodlen

I am a tenth generation American, descended from a family that has been working a farm that was deeded to us by William Penn. The country has changed around us but we have held true. I stand in my grandmother’s kitchen, look down the valley to her brother’s farm and see my great-great-great-great-great-grandmother Hannah standing on the porch. She is holding the baby, surrounded by four other children, and saying goodbye to her husband and oldest son who are going off to fight in the Revolutionary War. The war is twenty miles away and her husband will die fighting. We are not the Daughters of the American Revolution; we were its mothers. My father, Milton C. Woodlen, got his doctorate from Temple University in the 1940’s when—in his words—“a doctorate still meant something.” He became an education professor at West Chester State Teachers College, where my mother, Elizabeth Hope Copeland, had graduated. My mother raised four girls and one boy, of which I am the middle child. My parents are deceased and my siblings are estranged. My fiancé, Robert H. Dobrow, was a fighter pilot in the Marine Corps. In 1974, his plane crashed, his parachute did not open, and we buried him in a cemetery on Long Island. I could say a great deal about him, or nothing; there is no middle ground. I have loved other men; Bob was my soul mate. The single greatest determinate of who I am and what my life has been is that I inherited my father’s gene for bipolar disorder, type II. Associated with all bipolar disorders is executive dysfunction, a learning disability that interferes with the ability to sort and organize. Despite an I.Q. of 139, I failed twelve subjects and got expelled from high school and prep school. I attended Syracuse University and Onondaga Community College and got an associate’s degree after twenty-five years. I am nothing if not tenacious. Gifted with intelligence, constrained by disability, and compromised by depression, my employment was limited to entry level jobs. Being female in the 1960’s meant that I did office work—billing at the university library, calling out telegrams at Western Union, and filing papers at a law firm. During one decade, I worked at about a hundred different places as a temporary secretary. I worked for hospitals, banks, manufacturers and others, including the county government. I quit the District Attorney’s Office to manage a gas station; it was more honest work. After Bob’s death, I started taking antidepressants. Following doctor’s orders, I took them every day for twenty-six years. During that time, I attempted%2
This entry was posted in American medical industry, Depression, Government Services, Health Care, Inpatient psychiatry, Medicaid, Medical care, Mental Illness & Health, Poverty and tagged , , , , , , , , . Bookmark the permalink.

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