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A DEATH IN THE FAMILY 1948-2004 by Judith K. Witherow
On December 2, 2004, my younger sister, Josie, died suddenly at the age of fifty-six. Suddenly, because it was unexpected by all of us. Quickly, because we are all used to treating or overlooking whatever ails us. And we seldom bother each other with the details. We have learned to continue on and use what home remedies we have acquired over the years. Doctors are rarely an option. With Josie they weren’t an option at all. She didn’t have insurance. And according to the laws of the state she was too “rich” to qualify for Medicaid. She worked two days a week at a local gas station even though the fumes worsened her asthma. The manager wanted her to work more days. But her long-time partner would always miss work if she dared to earn more than enough to pay for his gas, cigarettes, or truck repair. He wanted her to know he was the breadwinner in the family. His income kept her from qualifying for what little entitlements remain. Josie declined any offer by us to pay for a doctor, tests, or medicine. We now know that she was afraid he would punish her monetarily or physically. Death seems to open the mouths of many when it’s too late to change the situation. I’ve seen it countless times. Women believe that others have the same fear of their partner or husband as they do. He wouldn’t have been the first drunken, low-life, self-important sliver of slime that I showed the door out of her place. This time she kept the majority of his faults to herself. Her death stunned me with disbelief. I thought I would be the first one to die among the six of my siblings. I was the one with the “most” incurable illnesses. On November 23, 2004 I fell in the kitchen, and fractured my pelvis and several vertebrae in my spine. (It was nine days before the death of my precious sister.) This was my sixth serious fracture in less then ten years because of severe osteoporosis. I should have been hospitalized. But when you’re on Medicaid, “should,” “could” and “would” have nothing to do with the seriousness of any health problem. The ER doctor wanted to call an ambulance to take me home. But I declined out of sheer anger at the lack of treatment that I received. Our family endured severe poverty in the Appalachians. As a result we all deal with numerous diseases caused by malnutrition, genetics and environmental poisoning. Josie’s death certificate reads like a shopping list of curable diseases. Curable, if enough money is available for the medical establishment to provide ongoing treatment. This represents an often insurmountable obstacle for many without insurance of any type. Like a lot of grandmothers, Josie was helping raise four young grandchildren. She said they made life bearable. I hope with all of my heart that they did bring her happiness. Seeing the grief the four little ones act out tells me the feelings were indeed mutual. The night Josie was found unconscious at home, an ambulance took her to the nearest hospital. It happened to be at a military base. They were not equipped to deal with someone in cardiac arrest. Because of my injuries no one told me what was going on until after her death the next morning. I learned that the hospital had spent all night calling local hospitals to have her admitted to their ICU. All of them said they had no space. How quickly intensive care units become filled to capacity when the patient is without insurance and has numerous life-threatening illnesses. Such illnesses would not allow the patient to be treated and discharged quickly. I don’t know what type of person it takes to make these life or death decisions. But they deserve they same type of treatment when it is their time to pass over. My sister had one of the most tragic lives that could ever be written about. To know that she died like she lived is more than I can put on paper. One of her daughters told me some of the details. But I wish she had kept it to herself . After all, no one called me when I might have been able to use my experience with the medical system to get her help. Their main excuse was, “We didn’t know how sick Mom was.” The question has to be, “Why? Why did you allow her to be set aside like something you would toss out with the rest of the garbage? Why didn’t you know how sick my sister was? Oh, that’s right. She was able to keep doing everything she always did—except eat. And she went to bed as soon as she did the cooking and laundry for everyone else.” Forgiveness will be a long time coming. I’m not my sister. I’m the one who looked out for her from the time she was born. I helped her rent and later buy a house—despite lack of money or credit references. (I wanted her to live as close to me as possible.) I was the one who knows a few things about “working” the system. Now I am the sister who sits and relives childhood incidents: One day, back in the Appalachians, we were sitting on the rough-cut steps leading to the upstairs. You were about six years old, and I would have been ten. For some reason you asked me what I was going to buy when we were grown up and rich. Being anything but gut-sucking poor had never occurred to me. It was a fact I accepted. I couldn’t come up with an answer. I can still remember the smile on your little round face. You said, “I do! I’m going to buy all of the cans of Chicken Noodle soup in the world. And I’ll eat as much as I want to.” With a hug around my neck you followed it up with, “And, I’m going to share all of it with you.” Another time, when we moved to a house that had electricity and running water, you woke me up late one night to go downstairs. You were afraid a rat might bite you. (We had learned to rap on the floor before getting out of bed, so we wouldn’t step on a rat. Don’t ask me why the poor get overrun with rats and mice. It certainly isn’t for the food.) This time you were ten and I was fourteen. Very little had changed except our age. The incident again concerned food. You wanted me to sit on the steps and share a can of cold spinach with you. I pretended I wasn’t hungry and let you eat the majority of the greens. I hid the can deep down in the trash barrel so the loss would not be discovered. It haunts me that at the end—when there was enough food—you were unable to eat. I pray the Spirits have your plate heaped high. And there is a kind smile on their faces when they picture you walking that dirt road with your little legs bowed from rickets. If there is any justice to be had I wish just the opposite for those who have brought this country to its knees. The American Dream is a myth. It allows those in power to sleep while others are living the nightmare known as life. Judith K. Witherow is a poet, essayist and storyteller. An American Indian raised in rural Appalachian poverty, she writes about her life experiences with disability, gender, sexual orientation, race and class from a perspective influenced by her early heritage. www.jkwitherow.com
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Spring 2005
There isn’t a day the
memory of someone I loved and lost doesn’t claw at my being in an
unguarded moment. Sometimes I find myself laughing softly about a
past event we shared. More often, the pain is so raw that its
physical intensity causes me to stifle sounds that only an animal
would recognize.