Saturday, December 20, 2014

Cancer Conundrum
November 14, 2013 by John Karlovec | No Comments

Cancer not for the faint of heart.

From my earliest childhood days, I always associated cancer with the maternal side of our family. It seemed that this awful affliction was more prevalent among relatives from West Virginia. Grandma McCray succumbed when I was only eleven. Uncle Ronald passed later. The disease was all too common across Appalachia. I learned to fear its presence as a dreaded foe that took away those I loved.

So when my father confessed to us that he had developed colon cancer, in the 90’s, we were undeniably shocked.
A medical crossing over of sorts? It seemed unthinkable.
He made a doctor’s appointment before telling any of us, to avoid causing undue concern. Eventually, battling this malady involved three different surgeries, over a period of several years. He was left with a permanent colostomy.
This experience made me truly understand the fragility of life itself. As a result of complications in 1997, he reached the point of death. We literally stayed up all night at the hospital, with members of a local church. We prayed for his life to be spared.
With daybreak, God was merciful. He survived against the odds.
While watching him fight to be healed, I mused over lyrics from a favored poet and musician, Lou Reed. A composition from his recording ‘Magic and Loss’ depicted this sad situation with great authenticity:
“I see the Sword of Damocles
Is right above your head
They’re trying a new treatment
to get you out of bed
But radiation kills both bad and good
it can not differentiate
So to cure you, they must kill you
the Sword of Damocles hangs above your head.”
Later, a cousin on my paternal side, close in age to myself, developed similar issues. He had a cancerous tumor that was all but impossible to treat. All of this caused a great deal of personal anguish and family stress. And of course, an enormous amount of medical bills.
When I reached the age of fifty, my doctor urged that a screening for this particular kind of cancer be performed, immediately. In view of my family history, her advice seemed logical and prudent.
Emotionally, I prepared myself for the screening. It was a step to be taken with some trepidation and a mood of sobriety. Yet one undeniably necessary to preserve my health.
But when I spoke to a claims administrator about our workplace insurance, this plan was derailed.
“Not allowable,” she said, dryly. “It is an unneeded expense.”
I assured her that my genetic history with the disease was extensive. Both brother and sister had manifested pre-cancerous polyps in their colon.
“Not allowable,” she repeated. “We will not cover the cost.”
I was struck by the fact that my insurance came through a labor union that had lobbied extensively to elect candidates who supported President Obama’s ‘Affordable Care Act.’
“How is it possible to deny such a procedure?” I asked.
The claims administrator was very specific.
“Unless you are bleeding, we will not pay,” she observed.
Carefully, I explained that when my father manifested such symptoms, he was well beyond early detection. His cancer proved difficult to treat and returned even after radiation and chemotherapy. It literally brought him to the brink of oblivion.
The cost, in physical and monetary terms, was staggering.
“We will not pay,” she repeated.
In the next year, two other employees at my workplace met a similar fate. Though they also had extensive histories with the affliction, our insurer would not cover a screening.
It represented the most frightening proposition — health decisions being made not by a trusted family doctor, but instead, by a faceless administrator in a faraway office.
Even a simple blood test for prostate cancer proved to be too costly for this insurer. After my doctor requested the check, I received a bill for $1,274, to be paid immediately.
While making arrangements to satisfy the cost in installments, over the course of a year, I remembered the words from the claims office.
“We will not pay.”
In current terms, this situation left me at odds with both doctor and family.
My personal physician was adamant that the procedure be performed, immediately. And my cousin from Gallia County admonished me to have a colonoscopy, no matter what financial peril resulted. Yet I remembered an uncle who admitted that having the screening left him in debt for thousands of dollars.
Having survived a near-miss with bankruptcy while having knee surgery, only four years ago, I felt uneasy about encountering another money mishap. Still, not having the procedure seemed a bit like playing Russian Roulette.
There was no obvious solution.
I pondered getting a different job. Other stores where I had worked as a retail manager offered a different benefit plan. But the poor economy would make that kind of move hard to accomplish. Moreover, with system-wide reform on the horizon, it might not matter.
The clock was ticking. And I felt afraid.
Cancer? Inside my body?
Tick tick tick.
Another brush with bankruptcy?
Tick tick tick.
The Sword of Damocles? Swinging like a timekeeper’s pendulum?
Tick tick tick.
Grandma McCray. Uncle Ronald. Cousin Rob.
And too soon, myself.

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