I am learning another side of abuse -- what it is like to be struggling financially, to not have enough...I feared the medical bills, so I didn't go to the emergency room. And now the bills are going to be bigger than I would have paid had I gone to the Emergency Room right after I fell and broke my arm.
And then there is the matter of what I was doing when I fell and broke my arm. I bring this up because I so often hear people blame those who have suffered misfortune for their misfortune. I wasn't drinking and doing something stupid. I don't drink alcohol. I wasn't taking risks. I was simply taking an early morning walk for my health.
People ask me about my arm all the time because it is pretty obvious. I carry the arm in a sling. Everywhere, in every store I visit, the counters by the cash register are high up. I can sign with my right hand if the counters are low, but low down counters are rare. Boy can I identify with people confined to wheelchairs. The first President Bush signed the Americans with Disabilities Act signed some twenty years ago, but our society remains arranged for the able bodied with relatively few concessions to the less abled. We still place the majority of the burden on the person who is hurt to find their way without help.
All the time I meet people who have no health insurance. They ask me how to obtain healthcare, where to go, what to do. Perhaps it seems like a no-brainer that I should have gone to the emergency room after I fell. But it wasn't so easy at the time. First, I am a single divorced mother. Who is going to care for my kids? Who was going to drive me? I think a taxi driver would not have been able to cope with my pain and disability. An ambulance would have cost a $1,000.00. The friends who give me rides are older ladies. I am normally the person who gives rides to other people. Second my injury resembled an injury from 2007, when I also fell on the ice and recovered from a torn ligament on my own. I've usually been able to recover from my illnesses ad injuries on my own without a doctor. I went through four cases of pleurisy without seeing a doctor in the last three years. Once the pain was so severe I hurt no matter what I did. I bound my chest and stayed in bed for a week. People told me I was lucky I did not end up in a hospital, but I managed on my own. My kids have gotten really good at cooking. House cleaning, not so much.
Only about 15 out of the 51 years of my life have I had good health insurance. It is always easy to say what I should have done in hind sight. I saw the Family Nurse Practitioner at my Multnomah County Health Department clinic this last week, She told me probably the orthopedic specialists at Oregon Health Sciences University, when I finally get in to see them, will "re-break" my arm and set it in a cast or splint for a period of time afterwards. She told me than an old, unhealed broken arm is not considered urgent care, but that if I had gone into the emergency room within the first four to six weeks after my fall, they would have been able to "set" my arm in a cast. Actually, I began to seek out medical care about 3 and a half weeks after I fell -- when it was becoming obvious that I was not regaining movement in my right elbow. My first step in seeking healthcare, because I was uncertain of where to go, was to type "Free Clinics Portland Oregon" into a search engine. A list of clinics popped up. I called one and got a message machine. I called another and was told it was for people under 30. I called a third and was told they did not serve people not on the Oregon Health Plan. I called another clinic on the list few days later and got an appointment at a Naturopathic Clinic. I knew they might not be best for a bone dysfunction so I asked if they could refer for x-rays and Physical Therapy. The receptionist said they could. I was seen at that clinic 5 1/2 weeks after I fell -- still within the outer limits of having my bones reset and put into a cast. I was seen by Naturopathic students who care measured my elbow and put me through a variety of range of motion exercises. They concluded that I had no broken bones because all the bones were still in place. They thought the problem was inflammation and that everything would get better when the inflammation receded. However, they also referred me to a Chiropractic Clinic. At the Chiropractic Clinic I was told that my elbow was broken and that I would need surgery. I was also told that I really needed the x-ray the Naturopathic students did not think I needed. The clinician lined out the free clinics with access to x-ray machines, which were mostly Multnomah County Health Department clinics. X-ray machines are expensive, and most free clinics can't afford them. That day I called up Multnomah County Health Department and found out that they have restrictions on taking new patients. I was told to call back every morning at 8 AM until I got an appointment. Two days in row I called about 10 seconds to 8AM per the time on my computer. The second day I received an appointment at a clinic some distance from my house. I took it. I didn't want to wait any longer. The clerk who gave me the appointment told she was one of seven operators, each with 35 people on the line. More than 200 people needed appointments. Only a handful received them. The day I arrived for my appointment at Multnomah County Health Department, I was told that my provider was out sick, and I was offered another appointment two week away. I insisted on being seen and was seen by a young, newly minted Physician's Assistant. She prescribed an x-ray and Physical Therapy.
The x-ray technician saw the x-ray and said, "I am going to show this to the doctor and see if she will see you today."
The doctor gave me the bad news -- my radius and ulna are dislocated and the portion of the epicondyle that held them in place chipped off.
She conversed with an orthopedic surgeon at OHSU and told me that I'd been seen at OHSU the next week. She also had me fill out an application for Project Access as Multnomah County Health Department does not provide specialty care. Project Access is a not-for-profit organizastion that offers access to specialty healthcare through volunteer physicians. She also gave me the phone number for the financial eligibility department at OHSU. Apparently for lower income patients, OHSU offers a 75% discount. My guess is they do so because they receive some public funding. Getting that discount as well as an appointment at the Orthopedics Department is not so easy. I had to make multiple phone calls.
One day, more than a week after the first time I was seen at Multnomah County Health Department, I called to find out that Project Access still had not received my application for care from Multnomah County and that the Orthopedics Department at OHSU still had not received my x-rays. I am really grateful for Multnomah County Health Department, but they have cut so many corners to try to provide as much care to as many people as possible, that they are not very efficient. I burst into tears. How much time and how many phone calls would pass before I received the care I needed? It seemed like an eternity to me. I needed to call the Orthopedics Department at OHSU one more time to ask for an appointment once again, but I needed to cry out my frustration before speaking to another person. When I composed myself, I made that call. I was placed on hold by the receptionist to wait for the appointment clerk. I got tired of holding the phone in my left hand and put it down and on speaker phone. In any case, it is hard to write down information and hold the phone at the same time. I normally tell whover I am speaking to that I need to use the speaker phone.
When the appointment clerk finally answered, she found the speaker phone annoying.
She spoke sharply, "Take off the speaker phone."
It was all I needed to push me over the edge into tears again.
"Stop screaming at me," the appointment clerk screamed at me.
"I'm not screaming; I'm crying, " I sobbed.
I tell this story for a purpose. When you are sick and hurting, you don't know where to go. We have resources for the poor but they tend to be scattershot and inadequate. If your illness is really serious, the Free clinics can't do much for you. If you don't know where to go and what to do to begin with, it is hard to know where to go and what to do.
If I had known that OHSU discounted their services for people with financial challenges, I probably would have shown up in their emergency room on February 19, but I did not know about and fully understand that discount until April 19. Getting the help I need has taken multiple phone calls and multiple trips to multiple clinics the last 6 weeks or so, and I still have at least a month or so to wait before I receive the proper healthcare.
I've been through multiple crying jags.
"Why did you make my life so hard?" I scream at God.
The little voices in the back of mind keeps saying, "So you can understand a modicum of what it is like, what down and out people without communication skills and resources have to go through when seeking help."
Those voices also say, "Tell the story so other people know."
These days being down and out and lacking healthcare is a common affliction in our country, but it s always an affliction for many survivors of abuse.
See that homeless person lying drunk in the street. Talk to them about their lives. You'll meet the elderly Vietnam Vet and increasingly the young Afghanistan or Iraq Vet, you'll meet the schizophrenic who probably can't give you a coherent story, you'll meet the young woman who is a child sex abuse survivor, the man whose father got him addicted to drugs when he was a boy, the man who was abused in a monastery where he went for refuge from child abuse, the man who was sexually abused in many of the foster homes he cycled through as a child...
These people are not bad or lazy, they are struggling with deep wounds the rest of us cannot fathom. And our society is just not there for them. There is help. The not-for-profits are limited in what they can do. The specialty care is hard to get and what is available, is provided on a shoestring.
When you are already depressed, you get even more depressed when you can't get the help you need, when you have to jump through many hoops and wander here and there, struggling to get the help you need.
Which brings me to the Catholic Church and the clergy abuse scandal. The Church has many valuable charities and shelters and soup kitchens, clothing closets. Probably many clergy abuse survivors have received help from these charities anonymously. What the Church is not so good at doing, is helping those in need who identify themselves as clergy abuse survivors -- despite employing people whose job is to help clergy abuse survivors -- Victim's Assistants.
The Victim's Assistant for the Archdiocese of Portland attends Ascension Catholic Church. Actually she sings in the choir, but she attends a different Mass than I do. Mostly she attends Church incognito. Most people don't know what her job is.
One day in 2007 a survivor called me up. He was referred to me by another survivor. The survivor had vandalized a number of building, including a Catholic Church or two. Sometimes his rage and pain overtook him. But now he wanted therapy. He was facing felony charges, and he was afraid of being overtaken by rage and pain again. He asked me to help him so I suggested that the Victim's Assistant for the Archdiocese of Portland might be able to help.
I approached her at Church and told her that this survivor wanted and needed therapy.
"He's speaking to you?" she asked, "Tell him to call me."
So I told him to call her himself.
The time he called me, I asked him how things went. He told me that she had told him that she could not speak to him because he had an active lawsuit against the Archdiocese of Portland, that his attorney had to ask for therapy. So I urged him to ask his attorney for help obtaining therapy.
When he called me again, I asked how it went.
The survivor told me his attorney advised him against seeking therapy. I know that particular attorney was unusual in that he was not particularly supportive of therapy but that there were others who paid for their clients to receive therapy.
Let me make clear what the problem was. The Victim's Assistant would not work with me and the survivor's lawyer was not interested in seeking therapy for his client and the lawyers for the Archdiocese would not allow the Victim's Assistant to speak to the survivor directly because he had an active lawsuit against the Archdiocese.
Rules are important. They must be followed. But even when it means that people who need help don't get the help they need?
Still later I found the survivor other sources of free therapy, but he was no longer interested. Through the years that have passed he has struggled with depression outbursts of anger and drug and alcohol addiction. He really needed therapy.
There was another adult female survivor I worked with who had a similarly frustrating experience when it came to obtaining therapy from the Archdiocese. I suppose that the Victim's Assistant was just following rules, but the rules seemed more important than the actual people in need.
I know what these survivors went through when they went to the Catholic Church for help -- despair, because they did not fit the rules. The very act of asking for help is wounding.
I don't think we can wait for Church leadership to act. They are too attached to this earth, too worried about bank accounts and buildings. We ordinary Catholics need to get together and do the work that is needed to show the way. For people who don't want to pay taxes -- get out there and get volunteering at shelters and schools and soup kitchens and free clinics. Or get out your wallet and donate.
I know too, the fear of Church leadership about finances. I am living that fear too. We have so many potential bills. How are we going to keep body and soul together?
My finances are precariously balanced, but I think I don't have much choice. I am 51. I haven't worked in 15 years. I couldn't work after my son was born. He has been diagnosed as being on the autism spectrum, although he has had much therapy and is doing well, I had to stay home and care for him for years. Who is going to hire me?
But I have my 501 (c) 3 not-for-profit designation. I have some innovative ideas. I know what to do grow and am doing it although it is slow.
I decided that I am still going to try to Walk Across at least some parts of Oregon to End Abuse and Heal Wounds. I'll be confined to Portland and the Oregon coast, where my friend Mary Lou is willing to help me.
I am broken, but I am not bowed.
I am broken, but I can still walk.
As long as I can still talk and walk, I will advocate for survivors of abuse.
I might have a cast on my arm..or a sling.. or a splint, but I will be there.