Editorial by Louis Ackerman

I have not had very many moments in which I have had to defer to other people in order to express myself. I find words quite easily and I am quick to share them. I planned to talk about healthcare in this piece but a friend from high school (and newly minted Doctor *high-five*) recently wrote about healthcare and I was struck speechless.
Here is “Nothing Left to Give” by Rachel Kallem-Whitman, Ph.D

“I wonder what I’m going to be like when I can’t afford my meds anymore.

Hmmm.

Because eventually health insurance will become even more of a luxury than it already is and only the 1% will be able to afford all the co-pays and treatments and appointments and surgeries and medication — you name it.

Inevitably I’ll run out of money.

I’m married to a cis white man so I imagine for a while he’ll be able to negotiate favors. His skin and his sex will give him connections. His master’s degree and his Anglo-Saxon, easy to pronounce, non-threatening last name will give him instant access.

But let’s be honest, how long can that last? 6 months max?

Because the cost of medication is going to keep increasing. It’s gonna sky rocket.

Men who aren’t doctors making decisions about the vitality of pills. They probably don’t care that it’s a matter of life-and-death because to them money is what matters.

And who are we to think that medicine shouldn’t be a business? Medicine is all about stocks. Medicine is about investing.

Medicine is money.

I bet my husband and I will be able to scrape together enough cash for anti-psychotics for a stretch of time. More locker room banter will buy us some leeway — a price cut for good ole boys — even those with crazy wives.

But yeah. We’ll run out of money, we’ll lose our insurance, the price of meds will keep going up, and then I’ll lose my mind.

I’ll do my best to titrate off everything as slowly as possible — parcel out my pills as best I can. The lithium, the seroquel, the lamictal, the ativan, the klonopin, the zoloft, the birth control.

Yeah that last one will be the first to go. Which will be a big problem if I get knocked up while I’m on my other meds because I’ll be forced to bring a fetus with gills and a face full of glassy eyes into the world.

No abortions, not even for fish children conceived on drugs that seep poison into my womb. I’ll have to give birth and then bury it. Closing all its eyelids ceremoniously at its Pence-sponsored funeral. Good night, sweet abomination.

I imagine I’ll count out my meds carefully.

Gingerly putting smaller and smaller piles of pills into my day-of-the-week plastic organizer, breaking them in two so they’ll last longer. Savoring the sanity for as long as possible. Bracing myself because I have no choice but to go back to the chaos that is unmedicated bipolar. Coaching myself that I can do it. Telling myself it’ll be ok, even though I know it won’t.

And then I’ll be down to only one or two pills a day.

I’ll lick my index finger and dutifully trace it across the plastic walls of my prescription bottle. I’ll coat my tongue with lamictal residue as I try to steady my thoughts. Reminding myself I need to focus.
Without my meds I think crazy thoughts and the world is a crazy place, so I’ll vigilantly remind myself to STOP THINKING CRAZY. I’ll dig my fingernails into my arm, scolding myself not to be scared. I bet if I bleed I will be braver.
Soon enough I’ll stop sleeping because my ideas will keep me awake. And the voices and the visions. The delusions will do me in, I bet money on it. And even though I might be manic for a while — I might see this brilliant beauty radiating out of a broken existence, telling everyone that there is light and hope and divinity, I see it, I feel it — I will be so fucking annoying because the sane world truly sees and feels the suffering. A crazy, enthusiastic messenger from god is the last thing people need amongst the very real ruin.

The mania will crack and then everything will erupt. I’m frightened and falling apart and I see spiders that no one else sees and taking my last klonopin won’t do a lot.

At this point, probably nothing.

And if I survive that madness, if I don’t slit my wrists, or jump off a bridge, or dive under a car running from my psychosis, depression will take over. I will cry and lay still and do nothing but wait to die. Sometimes using my last scraps of energy to pray to die.

My meds are a matter of life-and-death. They are for a lot of people.

With the way America is turning it feels like this nightmare that I play out in my mind sometimes might actually come true.

That all of us crazies will lose access to the tools that keep us less crazy, so we’ll wind up crying and yelling and laying down in front of our houses because we’ve got nowhere else to go. No pills in our medicine cabinets, no refills at the Rite Aid, no pills in our palms, not enough money to buy 1200mg of lithium for the night.

And the more I play out this scenario, imagining that this is our inescapable future, scheming how I’ll ration my psychiatric drugs — my pill cutter becoming a priceless device — the more often I come to the part of the daydream where I have to confront myself with the truth that I WILL run out of meds. What will that be like? What will I be like?

And as I keep thinking about how someday soon there will be nothing left to take, I feel myself going legitimately crazy. Twirling through thoughts about this Trumpian hellscape makes me grow increasingly paranoid, it spikes my anxiety, the delusions are stacked too high behind my ears.

I think about Trump’s America and what it will look like and I think, maybe I should take fewer meds tonight. I’ve got to save them!

I’ve got to plan for The End, as I know it.

Keep my crazy ass afloat for as long as possible. Ration with a fevered passion. Less meds now, means I’ll last longer, I think. I become nervous and agitated and fidgety and hollow and depressed and lost and so beyond hope that even today’s meds are becoming useless.

I’m bipolar and broken. Ahead of schedule.

It just feels like I’m practicing for what it’s going to be like when I can’t afford my meds anymore.

I wonder how long it will take me to snap.

Hmmm. I guess we’ll see.”

I want to thank Dr. Kallem-Whitman for her consent in sharing this piece and her courage to share her journey with everyone. She writes on Medium and can be found on Twitter @RKallemWhitman

As a Progressive, I firmly believe in civil discourse with everyone, including dissenters. I prefer to engage with people who disagree with me because I may learn something. If you surround yourself with people who always agree with you then you will stagnate in an echo chamber of your own opinion. To that end, I will answer any and all questions that any readers have, just send me an email at setxprogress@gmail.com, my name is Louis Ackerman and we will keep moving forward.