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Being poor and sick on the Texas border


I got up before dawn to drive Nicolasa 45 miles for a thyroid scan. Nicolasa, a 34-year-old mother, has a thyroid condition that is leaving her blind and at the risk of several other complications. She is very, very nervous about this trip to the doctor, for she wonders how she will pay for the medicine she will need. She wonders if she will be able to raise her children. She wonders if she will live much longer.

Although Nicolasa has been in the United States since 1991, she hasn’t been able to make much of a go of it. Her husband abandoned her in 1997, and she and her three children live from day to day, practicing a kind of biblical faith that I am sure they would trade in for something a little less stressful.

Nicolasa is poor, but according to the state of Texas’ guidelines for obtaining help, she is not “indigent” as she manages to bring in more than the $242 a month limit for a family of four. The compassionate conservatism of our state says that anyone who can house, feed and clothe a family of four on $242 a month is doing just fine, thank you.

But even if Nicolasa were indigent, there is no public hospital in the Brownsville, Texas, area. For that, she would have to travel by bus more than 350 miles to Galveston. That, of course, means finding someone to take care of her children and crossing the border patrol checkpoint north of Brownsville. An “illegal alien,” she may or may not be allowed to continue on. Then she would finish an eight-to-10-hour bus ride, receive her treatments and turn around and come back. She would probably end up camping out in the waiting room for one or two days.

The Texas border is not a good place to be poor and sick, although there are an awful lot of very poor and very sick people here. If you break an arm, for example, and you have no money or insurance, you might go to the emergency room, but they won’t cast it for you. Women are encouraged to get Pap smears and mammograms, but if cancer is discovered and you don’t have sufficient financial resources, you literally will be sent home to die -- unless you are indigent. An indigent patient might qualify for the long trip to the University Hospital in Galveston. The trip back, suffering from the exhaustion, pain and nausea of chemo or radiation treatments, is long indeed. Not all patients keep up with the regimen, resigning themselves to their fate of being very sick in a self-proclaimed compassionate society.

Nicolasa is a lucky sick person. While she does not qualify for any help from the rich Texas state coffers, she is a part of our parish nursing program. The Marist Brothers sent the program some money to cover cases like these, so she will have her tests done, and then she should have some sort of support to purchase her medicines.

Nicolosa is a clear reminder of the people both President Clinton and Texas Gov. George Bush have failed. The tale of the Clinton administration’s inability to pass an effective health care plan that would care for all U.S. residents is well known. The ineptitude of Bush’s “compassion” is not a well-enough-told tale. Suffice it to say that fully 26 percent of Texans live without access to health care and that the state is going to have to return $450 million to the federal government -- funding earmarked for uninsured children, but unused. A professor of public health at the University of Texas remarked, “This sort of inefficiency can only be explained by the arrogance caused by much wealth in the hands of so few people.”

When we arrived at the radiology clinic, the receptionist looked at poor, small Nicolasa, and then she looked at me, and asked, “Is this woman of sound mind?” And I thought, “Maybe not, not if she chose to live here.”

As we left, Nicolasa, who doesn’t speak English, asked me what the woman had said. I lied and told her, “She was just worried about you.”

Nicolasa responded, “That’s why I like it here. People care about you.”

On the way back to the parish, I was listening to the news about the Republicans who had gathered in the City of Brotherly Love to celebrate their new sound bite -- “compassionate conservatism.” As I left Nicolasa in front of her two-room shack, I started thinking of how the best things have been reduced to sound bites, to meaninglessness. “Compassion,” a powerful, wonderful sense of being at one with a suffering human being, is now just another phrase to be tossed around, to be “tested” with focus groups, to be ignored.

I then turned off the radio and went to look for some medicine.

Marist Fr. Michael Seifert works in San Felipe de Jesús Parish in Brownsville. His e-mail address is miguelseif@hotmail.com

National Catholic Reporter, September 15, 2000