Hide Your Children, and Bats

Yesterday, I did some of the best writing in the whole wide world. The best ever ever ever. Me and David Sedaris, we were communing. The three intertwined stories ala "This American Life" turned out so funny and enlightening that poor David was beginning to worry about his place in the literary world. I was thinking to myself, "I don't really have a wardrobe suitable for accepting awards." You'll just have to trust me on this, because a) that super-stretch would be really nice for me, and b) no one will ever see the blog that resulted. After devoting seven hours to thinking the whole thing through on a drive home from the beach Monday, and then about three hours writing it last night, I quickly went to get permission to publish from my daughter, who was the subject of one of the hopelessly intertwined stories. It was just a formality  --  the part from her young childhood was so adorable (not embarrassing at all), I just knew she wouldn't say "no." She did.

For today's blog purposes, this means "update" instead of our originally planned programming.

I am on my fifth day of quitting smoking, and not one millisecond closer to seeing any light at the end of this tunnel, unless the light is a headlamp in the psyche ward. This is not my usual hyperbole here. I am convinced people like me who haven't quit smoking yet experience withdrawals differently from everyone else. Whether this is really true does not matter one iota to me right now. If my boss were a trace less kind than she is, or if I didn't have the good luck of working in my own office where if I bite my lip hard enough no one will hear me, I would not have made it through this day without a cigarette.

Imagine being covered head-to-toe in the worst possible poison ivy or jock itch (I'm guessing on the latter of these), with no hope that it will go away for weeks, no position you can get into to relieve the insane itching and pain, no pharmaceutical that works to help. That's how bad the rage that welled up inside of me was. Imagine there is something you can buy over the counter that makes the agony go away in an instant, but everybody says it causes lung cancer or some other similar fate that is supposed to be worse than the one you are in, at some point in the unknown future. You could be creamed by a truck before it happens.

First I wanted to break things indiscriminately, hit and kick solid matter until my bones broke  --  that would certainly get my mind off the current unbearable pain. I was thinking, when I could think, what an idiot I had been, not to foresee this and lay in a heavy-duty baseball bat for the occasion. Again  --  not hyperbole; every word of this is precise and true. I stomped around like a mad woman, looking for what could reasonably be broken, when my eyes lit upon several pieces of leaded crystal in my office that, quite literally, have the company name etched on them. I didn't begin throwing them as hard as I could onto the grass outside  --  but it was a very, very close call. Instead, I dropped onto the floor and cried into my arms, folded on the seat of my chair, for one entire hour. And not a nice, cathartic cry, but a crazed snotty gushing of curse words, loathing, and despair. Think Jim Morrison's "brain squirming like a toad." When it was over, it wasn't really over  --  I was just too exhausted for anything but pushing my storm cloud around from one place to another. The look on my face was something like a woman's when she is practicing Lamaze, as she is trying to keep her mind on her focal point at the height of childbirth.

Meanwhile, last night and tonight, my daughter  --  innocent, unknowing babe  --  keeps coming to me, to read aloud various essays she has written for school.

Phoenix From The Fire. I Hope.

I had a reverie this morning, in which I changed my living will to state that I am to be kept on the Cadillac of life support, forever. My legal directive came to pass, so beautifully according-to-plan that health insurance executives flew their jets right into our little town and threw themselves, weeping, at my family members’ feet. Please! Please! We’ll do anything! Just agree to cut her off! They offered their souls in exchange for a signed DNR. To which my family said, “ew.”

Because this blog is public, let me be clear: It was just a reverie. I do not want under any circumstances to be kept in a permanent vegetative state. It scares me to no end, to think that certain members of my Catholic fundamentalist family would take that paragraph all the way to the Supreme Court.

But oh how I relish the vision of those execs writhing in agony.

All of this was because last night, I was told that my health insurance would not devote one nickel of its astonishing profit to help me pay for the $250 nicotine inhaler my doctor prescribed for me. Our regular pharmacy doesn’t even keep one in stock. “I’d have to order it for you,” the pharmacist told me. “It’s been years since anyone has bought one.”

Well no shit. Let me look into a loan first. A credit card, maybe. Let’s bring one more for-profit industry into this gathering of vultures. If you’re a reader whose mind rushes to a cost-benefit analysis, smoking vs. smoking cessation, kindly think for one second about blaming the victim first. Tobacco addiction is expensive, but the cost is borne in dribs and drabs, one pack or one carton at time. If your average Joe The Plumber is going to trade the cost of one for the other, he has to quit smoking first.

In the interest of full disclosure, later today a different pharmacy sold me the inhaler at a huge discount. I don't know why  --  I suspect it's because we pay an optional, additional monthly premium for upgraded health insurance  --  but I'm not asking any questions for fear it was a mistake. On behalf of so many others, I still bear lots of ill will against a host of profiteering demons in this mess. Remember the original pharmacist's words? Most nicotine replacement therapies are sold over the counter in this country, where insurance is not even a remote possibility. And when was the last time you heard of an in- or out-patient nicotine drug rehab facility?

Nobody my age who is still smoking wants to. Nobody wants to strangle to death slowly, nobody wants in on the health care nightmare, nobody wants a piece of their face cut off or a voice box sliced up or to have a crippling stroke. Plenty of my very close genetic relations have died torturous deaths because of cigarettes, smoking to the last, ashamed and so sorry for what they “had done” by making their families endure their horrible ends. Extraordinarily intelligent, beautiful, artistic people. Every one of my genetic siblings has smoked heavily, beginning in their teen years. Note that I am adopted, did not “imprint” on smoking behavior, and am the only smoker in the entire extended, adoptive family that raised me. I didn’t know my “genetic” family, or of our extremely similar, powerful cravings—for dairy products and tobacco, for example—until I was 16 years old. (And already a pack-a-day smoker…) My bio-mother said repeatedly that our drive to drink milk was the pure Norwegian in us. It was always a bit of a joke to me until I read the book Why Some Like It Hot by Gary Nabhan, and readjusted my big-britches attitude and understanding of genetic propensity.

Whatever the biological reality, nicotine addiction is hurting you, whether or not anyone in your family lights up.

Almost six years after Peter Jennings’ death, his mea culpa for having smoked makes me sad and angry. “I was weak,” he said when he announced his lung cancer diagnosis, so visibly full of shame for smoking after a lifetime of doing so much else. I wish instead he was furious, and got numbers like these into the discussion:

—In 2008, Medicare paid $55 billion just for doctor and hospital bills during the last two months of patients' lives. (http://www.cbsnews.com/stories/2010/08/05/60minutes/main6747002.shtml)

—The same year, Philip Morris International boasted a profit of $16.3 billion on sales outside the United States.  (http://www.nytimes.com/2009/05/06/business/06tobacco.html)

—In 2009, the top five earning health insurance companies averaged profits of $12.2 billion. (http://thinkprogress.org/2010/03/09/zirkelbach-profits/)

Obviously, I spent about 10 minutes of internet “research” here. It appears that it would take quite a bit more for some reason, to get a figure for US profit on tobacco sales. Somebody else find the primary sources, and argue all the statistics and numbers that could be pulled into this debate. I already know, from long personal experience, that it’s not in the tobacco, health insurance, or health care industries’ general financial interests to help people quit. I can't even dream of health insurance industry executives begging my family for mercy in the end — Medicare is picking up the tab in the cost-of-dying matrix, what doesn’t bankrupt us as individuals, anyway. We will pay and pay, coming and going.

Here’s how serious I am about this. If I die a smoking-related death tomorrow, or next year, or anytime at which I look remotely like the photograph used for this blog, use the same photograph for my obituary, and don't crop out the cigarette. Tell the world I fought to quit my whole life, and tell the world I did not want to go this way. But also tell the world I do not apologize. Until we all quit blaming the victims, until we fully accept this for a devastating, heartbreaking disease with genetic origins, and fight like hell for research and against such insane profitability, we’re going to lose loved ones this way. Until everybody stops clucking at people like me and starts demanding holistic answers, we the “little people,” smoking and non-smoking taxpayers, are going to foot the bill—in advance with our Medicare contributions, and after death with the sales of our estates. Bend over, friends.

Yet, I am not Joe the Plumber; I can afford the $250. I am one of the lucky ones who could make the decision to ante up the bucks, whatever my insurance decided. I slept on it and then called around until I found a pharmacy that had a nicotine inhaler in stock, just in time for my quit date of April 9, 2011. I asked how much it would be at this particular establishment.

“Will your insurance help pay for it?” the pharmacist asked first.

“No,” I answered. “Assholes.”

One second of shocked silence and she burst into bitter laughter. I guess not too many people just say it. A few hours later she rang up the sale for me, at just $25. Maybe she forgot a zero. Maybe something else more hopeful, from an insurance perspective, happened.

Undoubtedly, at some point, someone else less lucky than I am right now will be standing in line at the same pharmacy, terrified that it's far too late for quitting. And that someone else will not be so lucky. The pharmacist will hand over the drugs that help a human being endure chemo, or will collect someone's last dollar for the month. I'd be willing to bet you a $250 nicotine inhaler that the word "assholes" pops into her mind.