You are currently browsing the tag archive for the ‘Medicare’ tag.
“There is a season for everything, and a time for every occupation under heaven: a time to be born and a time to die,” a declaration attributed to Qoheleth, a sage by profession and a Palestinian Jew living in the third century BCE. Qoheleth and others developed the Book of Ecclesiastes as a corrective to counter the empty philosophies of Stoicism, Cynicism and Epicureanism that had vulgarized life in Israel and eviscerated traces of the Sacred. Life was empty; knowledge, virtue, love illusory.
Yet, a sense of the Sacred permeates this short book, sacralizing the totality of life: its impetus, Creator God and no other.
Fast forward to the present. Despite later prophetic utterances, even those of the God-Man Jesus of Nazareth, not much has changed, save for solitaries harboring the Sacred within their depths, save for some churches whose Spirit-filled members give thanks and serve with joyful hearts—such is my perception.
I return to yesterday’s green flag and my continuing eligibility for receiving hospice care— “Six months or less to live,” I was told. Others have judged the proximity of my physical death, as if Creator God has no say in the “work of his hands.” The obsession to conform to Medicare’s rules and regs, constantly under revision, keeps the sickened system contorted beyond fixing. The specter of this fiscal dragon continues sprouting new fire-spewing crowned-heads, terrifying its work force.
Qoheleth was more than accurate when he declared “a time to be born and a time to die.” No health care executive can make this decision for me. I belong to Another.
“It’s not surprising that this has happened,” said the nurse practitioner from hospice, come to evaluate my continued participation according to Medicare guidelines. Twice last year, I was almost discharged for not being sick enough.
From behind her mask, her dove-gray eyes filled with compassion as she responded to questions of my physical decline the past two weeks: sunken brown eyes, skeletal frame, snaking veins crisscrossing my abdomen, thighs, and arms, and protruding ribs like a xylophone. In my bathroom mirror stood the image of a forlorn Nazi prisoner milling around the ice-packed grounds of Auschwitz. I paused and looked again, pinched the flabby skin of my bruised forearm. This was real.
“Your symptoms give specificity to your decline,” she continued, “especially the weight loss, despite the amount of food which you eat. Your advanced years, your weakened metabolism, and your diseased lungs also stress your breathing and wear you down,” she said while folding her notebook and dropping it in her pouch. “You now fit our hospice template: six months or less to live.”
I heard the words, “six months or less to live,” that defined the limits of my terminal illness, but still had to open my psyche to this reality and to surrender more deeply to the implications of my transition. I’d been in a holding pattern for over two years, blogged my experiences, worked the Twelve Steps of Chronic Pain Anonymous, and even participated in ZOOM meetings for the terminally ill. Now, there was palpable change in my body that required response, providing that my mental faculties hold out.
No more denial. No more rationalization. No more idealization.
More than ever, each twenty-four hours is a gift from Creator God to be cherished.
It was February 1, 2022, an overcast day, twenty-eight months since my sign-up to receive hospice care for my diagnosis of Interstitial Lung Disease with Rheumatoid Arthritis.
The doorbell rang. It was the hospice nurse practitioner to evaluate my continue participation that occurred every six weeks, given the Medicare protocol for my disease and treatment.
During our last evaluation, my insides had jellied when she said, “Liz, you continue doing so well, perhaps too well. Not much decline since our last being here.” She looked away, then added putting away her stethoscope, “We’ll certify you for another benefit period, then re-evaluate next month. Now, you’re not to worry. We’ll work this out.”
But I did. I still remembered the compassionate response of the ER doctor that Halloween morning, 2019, “You’ve come to the right place, Liz. From here on out, palliative care will serve your medical needs. No more going to hospitals for tests. No more doctors’ offices.”
Only after the nurse left did I learn the difference between hospice and palliative care: Patients not ill enough to qualify for hospice and too ill to benefit from home care services. Perhaps that’s where I belonged.
Yet, hospice did pick me up.
“I said this would work out,” the nurse practitioner said, her eyes smiling behind her mask. “We’re going to hold on to you, after all. That new medication for your breathing warrants our continued surveillance.”
I smiled, another experience of God doing for me what I could not do for myself.
Heart Whisperings 