My wife books an appointment with a nephrologist. A nephrologist—we learn—is a kidney specialist, and there are two reasons my wife will see one. First, a primary-care doctor has flagged excess protein in her urine. Excess protein is most likely due to dehydration, the doctor explains, but there’s a chance it could be something kidney related. She refers my wife, just in case. But this isn’t the only reason my wife will see a nephrologist. The second reason she will go is because she can; I have a new teaching job—fourth grade—and the school pays for half of a decent PPO plan. For the first time in five years, my wife and I can visit a wide network of specialists. We have entered our Age of Less-Shitty Health Insurance.
“Call me as soon as you’re out,” I tell her. She promises she will.
IN MY EARLY 20s, I began saving my health insurance cards. Every new job, every move, every change in plans. Anthem BlueCross, Molina, Oscar…. My collection has become a stack, inches thick. I don’t know why I started collecting them. I must have found something darkly absurd with the system even then, back when I had no need for doctors or hospitals. When everyone I loved and would come to love was healthy, and always going to be so.
My wife calls after her appointment. She is trying not to cry. Then she’s crying. She’s not dehydrated, she tells me. The nephrologist, by examining her blood and a patchwork of past records, has determined that her kidneys are in rapid decline. Have been in decline for approximately five years. Had my wife been diagnosed earlier, the nephrologist explains, treatment would be a different story. But now, after a half decade of unchecked deterioration? The nephrologist is blunt: This is extremely serious, she tells my wife. Your kidneys are failing.
WALK COMPOST BUCKET to neighborhood garden. Bike at sunset. Read in bed. Cuddle with Dog. Watch stand-up comedy. Stay present. What has happened has happened. We are husband and wife. We have now. The past shouldn’t matter. But oh my God it does.
The five years in which my wife’s kidneys were failing overlap almost precisely with our Age of Extremely Shitty Insurance. During the Age of Extremely Shitty Insurance, I tutored, I installed solar panels on rooftops, I taught at a youth prison. I weighed crates of lobsters as a deckhand
