She Meant Well

I had a high school English teacher who once said, “’She means well’ is the most damning of all compliments.”  The primary reason I have remembered this for nearly 60 years is that I heard “she means well” so many times growing up as an explanation for dear Aunt Emily’s behavior.

Aunt Emily was my maternal grandmother’s sister, so she was actually my great-aunt.  She never had children, and to my knowledge, only had occasional part-time employment, so this left her with adequate time to insert herself into the lives of others in both positive and negative ways.

She was sometimes hired by wealthy families to stay with their children while the adults traveled for extended periods of time.  She was a good cook and housekeeper, but not necessarily the best with kids.  She was pretty rigid and liked to lay on guilt trips.  I remember when I was quite young that she fixed me an orange with sections arranged in pinwheel fashion, a cherry in the middle, and sprinkled with sugar; but then she made it very clear that I was supposed to be overwhelmingly grateful to her for this snack. Apparently, my thanks had not been profuse enough, and guilt took away some of the enjoyment of that orange.

On another occasion, I was with her while she ran errands.  She parked the car illegally and left me alone while she ran into the bank or store or dry cleaners.  She instructed me that if a policeman came by and started to write a ticket, I was to tell him that my aunt would be back in a few minutes.  I was terrified that a policeman might actually come by and write a ticket.  I knew I didn’t have the courage to speak up to a policeman about my strange aunt.  My plan was to crouch down and try to be invisible in the back seat.

Aunt Emily did like to put on airs.  That branch of the family was from Alsace-Lorraine which over the years was sometimes German and sometimes French.  Everyone else in the family considered themselves to be German, but Aunt Emily always insisted she was French, even though her maiden name Bischoff is rather German.  The family used to joke behind her back that the older she got, the younger she dressed.  She was quite stylish and did sometimes wear things that seemed a bit out of her age range.  She was fond of big clunky earrings and bracelets.

Although she was in most ways prim and proper, she scandalized the family by sharing the little detail that she and her husband (great-uncle Art) took baths together.  TMI in that era!

Even as a child, I was aware of friction between my grandmother and Aunt Emily.  Sisterly love was not evident.  Aunt Emily was bossy by nature, and my grandmother seemed insecure by nature, and I recall some family feuds.  Long years after they had both passed away, my mother told me one of the sources of resentment.  Aunt Emily desperately wanted a child and never had one.  My grandmother had 5 children, although one died in infancy.  Three of the surviving children had brown eyes like both parents, but one had blue eyes.  Their hidden recessive genes got together on that one.  Aunt Emily and her husband were blue-eyed.  She tried to talk my grandmother into giving her the blue-eyed boy to raise.  My grandmother was livid.  How dare she ask her to give up one of her children!  The resulting anger apparently was underlying much of the animosity that was evident for the rest of their days.

Aunt Emily did try to be helpful.  My mother was bed-ridden during two of her pregnancies, one of which occurred when I was twelve.  I always knew when Aunt Emily had been to the house to clean for my mother.  I don’t know why she did this, but when she dusted, she was in the habit of arranging all sorts of items on the windowsills.  If I came home from school and everything from my dresser (except the lamp) was on the windowsill, I knew Aunt Emily had been there.

One of my mother’s brothers told the story of a time when my grandmother was deathly ill with a very high fever, and Aunt Emily decided it was a good time to defrost and clean out the refrigerator.  He was a logical fellow who saw this as quite bizarre.  I suppose “she meant well.”  Perhaps she thought it would take people’s minds off my grandmother’s dire condition.

Aunt Emily nearly killed herself once.  She decided her cellar floor needed a good cleaning.  She had no knowledge of chemistry and figured anything could be improved with bleach.  She mixed together several cleaning products and ended up creating a toxic gas.  She was almost overcome and barely made it out of the basement.

As they aged, Aunt Emily and Uncle Art became very dependent on each other.  She was the stronger one physically, and he was the stronger one mentally.  My mother, who was the closest of their nieces and nephews, worried about them.  Aunt Emily was no longer sharp enough mentally to pay attention to whether the food in her refrigerator was still safe to eat.  Ironically, she couldn’t clean out her own refrigerator.

After more than sixty years of marriage, they ended up in the hospital at the same time and died within 24 hours of each other.  The notice of Uncle Art’s death made it in the newspaper, but Aunt Emily’s did not.  People came to the calling hours expecting to see Uncle Art, and there was Aunt Emily too. 

One never did know quite what to expect from Aunt Emily.

A Work of Art

My great-uncle Art was an interesting character.  In part, because he was married to great-aunt Emily who was an even more interesting character.  Aunt Emily’s ability to cause upset in the family and talk people into situations they never expected to get into was legendary.  But, I’ll save her for another day.

Uncle Art was long-suffering.  He seemed to be able to ignore lots of things about Aunt Emily that others found annoying.  He was a smoker, and she wanted him to quit.  He would go outside thinking she didn’t know it was for a smoke.  She pretended not to know.  If she happened outside, he would stuff the cigarette up his sleeve running the risk of torching himself.

Uncle Art was a painter by trade.  He wasn’t exactly an artist, but neither was he the run-of-the-mill-slap-paint-on-the-wall type.  He was expert at painting gym floors in the days when all those lines were hand-painted.

Aunt Emily had a bedroom suite that I’m sure Uncle Art must have hand-painted.  It was shades of pastel pink and blue and had gold edges.  I thought it was beautiful and have never seen anything quite like it.  It made me think of pink-tinged clouds in a pale blue sky.  I have no idea what happened to it after they passed away.

Uncle Art could color beautifully with crayons.  He didn’t just take a green crayon and color the leaves on the trees in a coloring book.  He used multiple shades of green, and the tree came alive.  When he finished, the picture really was a work of art and a work of Art.

I wonder if there is another woman in the world who as a girl asked her uncle to color a page in her coloring book when she got a new one.  When he colored a page in my book, I felt like I had a special treasure.  I wonder what else he might have done with his life, if he had been born at a different time and place with different opportunities.

Imagine

This morning while I was baking a rhubarb pie, I thought about heaven.  Yes….rhubarb pie…specifically rhubarb custard pie…does cause me to think about heaven, which I assume will somehow be even better than rhubarb custard pie.

My mind then wandered to the contrast between “Imagine” by John Lennon and “I Can Only Imagine” by Mercy Me.  I am thinking that John Lennon, who didn’t want to believe in either heaven or hell, may well be in one of those locations.  I wonder if he would like to come back and rewrite his lyrics.

His song is beautiful musically and wistful, but I wish it was not a frequent selection used by high school chorus teachers.  It isn’t wise to have young people believing that there is no heaven or hell, and therefore, no eternal consequences.  Lennon apparently believed that peace and harmony can only be achieved when there is no religion.  There is plenty in our world today to support the idea that we would be better without “religion,” since terrible things are done in its name.  But religion is not the same as relationship.  We need for there to be a God who loves us and who provides a standard for our conduct, a value system to guide us.  Without Him, we are just left with a vague hope in something that will not be brought about by human effort.  We as a human race have been trying to bring about peace for millennia without success.

The writer of “I Can Only Imagine” is not wistful….he is awe-struck, and appropriately so.  How can the human mind wrap itself around the idea of coming face to face with an all-powerful creator who sustains the universe?  The only reasonable response is worship.

You have a choice about this.  You can worship him now by choice or at some point in the future of necessity, but at that point, it will be too late to experience heaven.  It won’t matter whether you have believed in it or not.

Be careful what you imagine.

Medical Costs-Part II

A family member, who lives near me, is currently visiting in another upstate New York city.  She has encountered a medical problem, called the doctor, and was prescribed a needed medication.  She is low income and her health coverage has lapsed.  She has been trying for over a month to straighten out the problem and get it reinstated.  The bureaucracy can’t get out of its own way and accomplish anything in a reasonable time period.  So, she does not have coverage for the medication and does not have money to pay for it.  She called me.  I agreed to call the pharmacy and use my credit card, so she could get the medication started as soon as possible.

Oh, boy….

The drug store where she is currently visiting does not have the medication.

The drug store here in town does not have the medication, so she does not have the option of getting it here when she returns tomorrow.

She is passing through another small city on the way home, and it has a drug store that is part of the same upstate New York chain as the other stores.  She can stop there on her way back home tomorrow.  They have the medication and when she talked with me, they had told her they would fill the prescription generically as it is quite expensive.

Even the generic sounded ridiculously expensive to me.  This is an old medication.  I remember giving it over 50 years ago when I was in nursing school.  I got online and looked up the cost.  I discovered I could sign her up for a discount card at drugs.com.  I called her and told her what I was doing.  She said the doctor had only prescribed 4 pills.  I determined that with the discount card the cost should be $38.

I called the pharmacy and was about to cheerfully give my credit card number when I was told the 4 pills would cost $260.  What?????

It turns out she had not been quoted the correct price.  They have only the name brand medication ….there is no generic available.

The brand name costs $260.

The generic with no discount card is $106.

The generic with discount is $38.

But since there is no generic available in any of the three cities that are possible places to obtain the drug, we are stuck with paying the $260.  She NEEDS the medication.  I am concerned that she can’t obtain it until tomorrow.  I talked to her about the issue and tried to impress that if the problem becomes severe, she should go to an ER.  I’m thinking a hospital might actually have the medication.

In regard to the unavailability of the generic, the pharmacist explained to me that many generic drugs are actually manufactured in Puerto Rico.  Since the hurricane devastation, these facilities are out of business.  I’m sure it isn’t possible to produce medications reliably with no power and no clean water.

If she keeps the receipt, she should be able to submit the cost once her insurance is reinstated, but I will have already paid the brand name price, not the agreed upon insurance price.

The pharmacy claims they only make about $4 on this prescription.  How can this be?  I understand when NEW medications cost a lot, because you are helping pay for the research and development, but this medication was not new when I was giving it to patients over 50 years ago.

What do people do who can’t call Grandma Ruthie?

Some Thoughts on Medical Costs

I did something stupid at 3 AM on Sunday.  I heard a sound I could not identify and decided to get out of bed and explore the house.  In retrospect, I’m pretty sure the noise was coming from outside through the open bedroom window.  But, I wasn’t sufficiently convinced of that to stop my exploration.  Finding nothing amiss on the main floor, I decided to check out the lower level…we did just get a new furnace.

I must have stepped off the top step as I reached for the light switch, and the next thing I knew I had tumbled down two steps to the landing that goes into the garage.  Both of my ankles rolled, and I heard a snapping sound first in the left one and then in the right.  My husband heard me cry out and came running to pick me up.

First decision:  Do I go to the ER in the middle of the night or do I crawl back into bed?  Is this a life-threatening situation?  No…it is not.  Can I bear weight?  It is painful, but I can hobble back to bed.  Is anything to be gained by rushing to the ER now as opposed to evaluating the situation in the light of day?  Nothing…except a whole lot of expense!  Seeking care at an ER when you could receive the same care at a doctor’s office or urgent care is a bad financial decision.  You may argue, “But, I have insurance.”  Right, but you pay for that insurance, and choosing to use a more expensive type of care does effect what we pay in the long run.

So in the morning, I still had pain on weight-bearing and with flexion, extension and toe-curling.  But, it was Sunday.  Can I wait until tomorrow?  Sure.  I will take some naproxen and spend the day with my feet up.  Once again…this is not a life-threatening situation.  If you are having chest pain, for goodness sake, go to the ER!  In fact, call an ambulance to get there.

Today I went to an orthopedic doctor and had X-rays.  There wasn’t much choice about that.  The evaluation was necessary.  No fractures showed up on the X-rays, but the doctor said both ankles were sprained and ordered a brace.  She suggested that I could get one brace and alternate back and forth between the two ankles or get two braces.  I was told they would call my insurance company….it will only take a few minutes….and a nurse would come back with the brace. 

Several issues emerged.  They were short-staffed and unable to make the call right away.  Could I come back and get the brace later in the day.  In the process of trying to decide that, I asked how much the brace was going to cost.  I have seen ankle braces in drug stores for less than $30, and we would pass a drug store on the way home.  The answer:  $125.  What?!  Can I see the brace?  Sure.  It had quite a bit to it….laces, Velcro straps, plastic stays in the side to stabilize the ankle…but still….$125? 

The nurse then suggested she could give me a paper prescription and I could take it to a drug store or medical supply company.  That struck me as a good idea, because I could comparison shop.  When she gave me the paper prescription, it specified a left ankle brace.  So…if the right and left are different, how am I going to alternate back and forth?

We stopped at a drug store on the way home.  They did not have the specific brace prescribed but had one for $17.99.  I figured that was good enough for the ankle that was the least injured, so I got it.  My husband suggested that I wear it on the most injured side for a bit and see if it helped adequately.  If it did, he would go back and get a second one.  I decided it didn’t support well enough for the more injured ankle, but it was fine for the lesser injured ankle.  Then I started to make phone calls.

One orthopedic supply business had them in stock, but they would cost $94 and I would have to pay it and try to bill the insurance company myself.

Another medical supply business, had them in stock, but did not participate with my insurance.  However, I could buy one for $45.

A third place, a drug store, admitted that they bill insurance companies a bit over $100 for the brace, and would sell it to me for $95 dollars if I came in with a prescription, but have the identical thing on a rack out in the store for $45.  No prescription required.

I suppose most people would obtain this brace in some way that guarantees the insurance company is billed.  I paid the $45 because I can’t stand the rip-off of the same item being billed for as much as $125.  Of course, I wouldn’t have known any of this except that the doctor’s office was too short staffed to get the authorization immediately.  That is the only thing that caused me to start asking questions.

I am certain this sort of thing happens all the time.  Medical care costs way more than it needs to cost.  We are not wise consumers.  Why on earth would you pay $125 for anything you can get for $45?