prev a pre-existing condition next
2001-06-25 | 4:55 p.m.

When I got pregnant with the girls, it was a surprise. I was working as a freelance copy editor and had no insurance. I tried to buy insurance, thinking I would have to pay a fortune for it, but I couldn't find it at any price. Nobody would sell it to me because I had a 'pre-existing condition.' Meaning pregnancy. Do you mean to tell me, I asked one woman at an insurance company, that I could get an abortion today, then buy insurance from you afterward, then get pregnant again tomorrow, and that would be acceptable?

"Right," she said, without a trace of irony, much less sympathy.

So I didn't see any doctor, nurse, or midwife for the first five months of the pregnancy. The clinics wouldn't see me, either, even though I said I would pay. They weren't set up for it. The woman on the phone at one clinic advised me to go to the emergency room at Highland Hospital to get prenatal care. That didn't strike me as the best use of the system's resources, but she assured me it was the only way to get into the system.

Still, I didn't want to do it. I didn't want to go to Highland, where the doctors had made a name for themselves by performing Vietnam-style triage on drug war gunshot victims. I lingered, loitered, hemmed and hawed. I joined Internet newsgroups and read books and tried to reassure myself that everything would turn out okay if I could just get through this time. It was a dreadful time of year. It rained almost every day that winter and flooded everywhere. When I think back to that time I think of rain, mud, and dark skies. The dark hardwood floors and stone fireplace in our apartment felt perpetually damp. I was sick for days, weeks, months. I thought I had stomach cancer. I thought I had AIDS. Even after I realized that I was pregnant, I still thought I had cancer because I felt so horrible all the time. I puked constantly. For a while, the only thing I could keep down was Jell-o. I developed a morning ritual: brush my teeth and tongue, puke, then brush them again. Once I puked up a blueberry Pop-Tart in the shower, and the sight of it on my feet, half-digested, swollen, and mottled with purple, was so disgusting that I puked again at the thought of it. (I haven't eaten a Pop-Tart since.)

Finally my niece Bambi talked me into signing up for Medi-Cal. One of her friends had done it and she knew how it worked. I said I didn't want to go on welfare, for God's sake, and she said it wasn't going on welfare, it was just Medi-Cal. I couldn't stomach the idea of signing up in Oakland, for some reason, so I drove 30 miles to my hometown to sign up. She went with me. I remember going up to the window to get my application form and the clerk asking me questions in a loud voice. Each time, I replied in a soft voice, trying to get her to follow suit. When she asked me the father's name, I hesitated for a split second and she immediately barked, "Do you know who the father is?"

"Yes!" I hissed, then sputtered, "Of course I know who the father is!" I was severely put out by the insinuation, though I also realized that the woman was not trying to insult or demean me. That would come later, primarily from doctors and nurses. Health-care providers, I can attest, often treat Medi-Cal patients like livestock.

I'll tell you one story to illustrate my point and then I'll stop. After they figured out I was having twins, I wasn't allowed to see a midwife anymore, but had to see a regular OB/GYN. They assigned me to this guy who obviously didn't take the slightest interest in my case. My Mom lives across the street from the clinic offices, and I was over at her house one day feeling really sick and she told me to go over there and get them to take my temp, because I felt so hot to the touch, and to give them a urine sample because I thought I had a urinary tract infection. So I went over and explained my situation to the receptionist. Turns out the OB was right there, and he stood behind the receptionist and spoke to me through the little window. He could have let me into the office, but instead he made me speak to him across the window, with everyone in the waiting room listening in.

He asked what my symptoms were. I told him fever and chills, achiness, frequent urination.

"You don't get a fever with a urinary tract infection," he said, authoritatively.

He looked down and started writing something on his prescription pad.

"Well," I said, "can someone take my temperature, because I think it's pretty high."

"Take it yourself when you get home," he said.

He tore the sheet off his prescription pad and handed it to me. I looked at it blankly, not only because it was illegible, but because I was sick and uncomprehending---was he really refusing to take my temperature?

"I don't have a thermometer," I rallied (this wasn't true, but I didn't know where it was, and besides, home was 30 miles away and I didn't feel I should be driving).

"You can buy a thermometer at Walgreen's for about two dollars," he said, and walked away. He didn't even bother to tell me what the prescription was for.

I started crying before I'd even closed the office door. I felt he had treated me like something less than a human being. I knew I was sick, but he didn't seem to believe me, or maybe he just didn't care. It was incredibly humiliating to know that he wouldn't waste a thermometer on the likes of me. I knew I would have been angrier and stood up for myself more if I hadn't been so damn sick. I did get in my car and drive home, shuddering all the way with terrible chills. The next morning I went to Highland. I sat for several hours in the waiting room, during which I watched a talk show segment about a young girl, maybe 12, who had, unbeknownst to her family, given birth on the toilet and then buried the baby in the backyard. Eventually they put me in an examining room and then promptly forgot about me for another hour or so. I was swooning by now. Eventually I checked in with a nurse and was finally admitted. My temperature was 104 degrees, I had a kidney infection, and I was severely dehydrated. I stayed in the hospital for about a week, where they treated me exceedingly well. I remember they had to put my IV in my foot because my veins are so difficult to work with. But it was either that or my neck and I was all for the foot when I heard that. I swore I would never go to that horrible jerk doctor again and I never did. Since Medi-Cal wouldn't allow me to see a midwife and considered me a high-risk patient, I managed to talk my way into a practice of elite, Harvard-trained perinatologists in Oakland, who were well-mannered enough never to give the impression that they held my income against me.

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