I was a junior in high school when my mother had her first heart attack. She was in her bed, moaning, crying that she couldn’t breathe.
We were too poor to have a phone, so I ran barefoot to the neighbor’s house, 1/4 mile down the road. I’ve never moved so quickly in my life.
It was a 30-minute drive to the hospital and, as we followed the ambulance, I prayed the whole time that my mother wouldn’t die. Over and over, an incantation I couldn’t control. “Please God, don’t let my mom die please God don’t let my mom die please God don’t let my mom die please God don’t let my mom die please please please please.”
I stood shoeless with my 14-year-old sister in the vestibule of the ER as the paramedics rushed my mother through a set of double doors.
They gave her a blood thinner. They cut a hole in her femoral artery and threaded a thin tube from her thigh all the way to the blocked vessels of her heart. Once there, they inflated a little balloon at the tip of the tube and used it to squeegee out the blockages.
The next day, she was released.
Because she had no health insurance, there were no plans for follow-up care, no prescriptions, nothing but her cut-up clothes in a plastic bag marked PERSONAL PROPERTY.
Her boyfriend was a veteran, as were a lot of her friends. They all had care through the VA which wasn’t great but was something. A few of them also had heart problems, so they would pass off some of their nitroglycerin tablets to her. She joked that they were her “drug dealers” but I could tell how much it bothered her to ask them for help.
It became commonplace to see her grimace with pain, then scrabble in her purse for the tiny bottle with someone else’s name on it.
My mother’s second heart attack happened at the start of my senior year in high school.
It was the night before I was scheduled to take the SAT.
We lived in a different place and the neighbors were a bit closer, but otherwise the story was the same. A shoeless run in the dark, fire truck lights splashing around the courtyard of our apartment building, racing behind the ambulance down the empty highway, watching through the back window as the paramedics frantically tried to keep her heart going.
I slept at the hospital and left from there to take the SAT the next morning.
When I got back to the hospital, my mother was groggily recovering from her second angioplasty. I told her my test had gone well.
She said, “I’m proud of you…I wish I had a burrito.”
We laughed and I hugged her and she showed me the crazy contraption that was keeping pressure on the spot on her thigh where they’d cut into the artery again.
The next day, I was honored by the San Diego Chargers as one of a few outstanding student athletes in the county. My boyfriend drove me to the stadium and attended in my mother’s place.
In the fall of 1996, I became the first person in my family to go to college. I lived on campus and life took over, as it does.
I talked to my mom on the phone every couple of weeks and I wrote in my journal how much it bothered me that I felt like I was growing away from her, from the life I had always known.
My mom had told me from the day I was born that I was destined to succeed. As I started to achieve the things she had dreamed for me, I could sense that I was being initiated into a part of society I’d never accessed before. I felt guilty that I couldn’t take her with me.
In February of 2000, my mom called me. “Al and I are getting married,” she said. They had been dating for five years and she was thrilled. “He’s finally going to make me an honest woman,” she joked. We talked a little bit about how being married would be different for them. She told me that she‘d be eligible for spousal benefits from the VA, including health care. She couldn’t wait to finally go for a proper check-up.
The wedding was set for March 11. They didn’t have a lot of money, so it wouldn’t be fancy. Just a simple ceremony with family and friends. For the reception, she planned to buy a big ham and make a bunch of sides.
On March 10th, I was rushing to finish work at my part-time job so I could drive the 90 minutes home. And I was stressed because I hadn’t picked up a wedding gift. My mom had never had a proper set of dishes, so I’d been saving up for six months to buy her a full eight-place-setting collection. I still needed to stop at Macy’s on the way out of town and I was running late.
As I packed up my backpack to leave the office, I got a call from my sister. She was 20 and six months pregnant. I could tell from her voice that something was wrong.
“Is it the baby?” I asked.
“No. It’s mom.”
My mother had her third heart attack at 6am on March 10th, the day before she was to be married. This time, the ambulance took too long to arrive.
My mom had turned 46 five days earlier and, other than her heart, her body was in good condition. The paramedics were able to resuscitate her. But the brain can’t survive more than five minutes without oxygen before its cells start dying. My mom’s heart had been stopped for almost ten.
As the official next-of-kin, the doctor mostly talked to my sister and I. The doctor took us aside and told us, “Your mother is in a permanent vegetative state. She will never wake up. Because she does not have health insurance, she will be transferred to a long-term facility where the care will be minimal.”
“Or,” he continued, “we can gradually increase the dosage in her morphine drip until she succumbs to respiratory distress and she dies.”
My sister and I talked. We cried. We argued. I was 21 and she was 20 and neither of us felt ready to make a choice like this. But for as long as we could remember, our mother had told us that, if she couldn’t function, she didn’t want to live. And with no money and no insurance, we knew she wouldn’t get acceptable care. So we told the doctor to make our mother die.
When we were little, my mother had read to my sister and I every night. On the evening of March 14th, we sat on either side of my mother’s bed and took turns reading aloud from a book she’d read to us so many years ago.
We tried to finish the book, but it was too long.
I tried not to fall asleep, but I was too tired.
I woke up at 3am on March 15th, 2000 and my mother was dead.
She was 46 years old. She died of a preventable condition, simply because she could not afford regular medical care.
After my mom died, we discovered an envelope in her dresser drawer. It was titled TO BE OPENED UPON MY DEATH.
Inside was a letter addressed to my sister and me.
One night when she was all alone, sometime after her first heart attack, my mom sat down and wrote this letter.
Because she knew she was going to die.
She knew that she was going to miss most of our lives.
And she tried her best to fit an entire lifetime of mothering into a few pages of lined paper.
I am sorry I couldn’t leave you more to help make your lives on this earth easier. You two are my legacy. You are a bright light in a sometimes dark world. Use that to light your way. Know that I am ALWAYS with you.
The most important thing in life is love. It is all that we take with us when we leave this world. Please take care of each other, watch out for one another — for me, okay?
Believe that I am ALWAYS with you. Not even death could keep me from my baby girls. Be good, loving, giving human beings. I’ll be watching over you always and until we meet again, I wish you happiness. Never settle for anything less.
With all my heart, with all that I am, I love you always,
PS: Pray for me!
As I write this, I trace the impressions her pen left and I remember that she used to tell me how lucky we were to be born Americans. “We are the richest, the best, the most powerful country in the world,” she told me.
I grew up believing that America took care of its people. On March 15, 2000, I learned in the hardest way that I was wrong.
For me, universal health care isn’t a policy conversation.
It’s not a political talking point.
It’s the fading sound of my mother’s voice.
It’s the fact that, every year, the outlines of her face get blurrier.
It’s catching a flash of her in my daughter and having to go hide in the bathroom so my three-year-old won’t see me sobbing.
It’s the difference between a world with my mother in it and the one I live in now, where all I have of her are a few blurry photos and a letter I can’t look at without bursting into tears.
My mother was undereducated and underemployed. She drank too much and she smoked too much. But she was my mom. Her name was Maureen Main. She hated her middle name, Mildred, so used her confirmation name, Katherine, as her middle name instead. She was funny and weird and she did the Sunday crossword puzzle in pen. She wrote poetry that she submitted to the local newspaper. She always complained about her drivers license photo because she said she looked like Charles Manson (and she kind of did). She played “Landslide” on the guitar. She was a great cook and an even better baker.
She was my mom. And she died. Because she was too poor to afford a doctor.
Over five years, my mother had applied for Medicaid several times. And every time, she was denied.
A month after she died, a letter arrived in the mail. She had been approved for Medicaid.
This final application had been submitted by the hospital and was approved posthumously, to reimburse the cost of caring for her during the last few days of her life.