Tag: Appalachia

Decade Challenge, AKA Still Homesick

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Yesterday, I found a picture of Gomez and me.

Someone took that picture a decade plus a few weeks ago at my boss’s Christmas party in 2009. We were smiling and hopeful. We were secure.

I was still an accountant.

It was a snapshot of life before.

Before Gomez’s immune system started to eat his joints, and before the million dollar pancreas incident; when we were able to afford whatever it would take to get him well because “medical care or groceries” wasn’t a choice we’d ever had to make.

Before Gomez got a second master’s degree; when Elroy still had a college fund.

Before one bad career decision made in good faith snowballed into 100 more bad decisions – each one with a worse outcome than the one before it.

Before my dad passed away.

Before we gave up the life and home we had made for ourselves because we trusted people when they gave us their word.

Before our spirits were bruised because we spent a year without a home of our own. When being “homeless” was an abstraction instead of something we had actually experienced.

Before I had ever experienced betrayal or carried around the leaden weight of grief; when I was able to tend to my mental health because I could afford to do it. When an appointment didn’t mean taking a half a day off work and trying to line up a driver for the hour-and-a-half trip because I was still able to drive and the therapist’s office was five minutes from my job.

When “back home” was a day trip destination instead of actually “home.”

Before epilepsy.

When “Everything will work out. It always does” was something I believed with all of my heart; when that phrase gave me enough hope to make it through the occasional rough day. Before it became a mantra that Gomez and I use daily when we discuss situations that we don’t have any real solutions for.

The 2010s simply broke me, but I keep scanning the horizon for brighter skies.

Protest Smells Like Waffle House Grease

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My dad went to Disney World when I was seven years old. For the rest of his life, every time I would bring it up, he would argue with me that he only went to Epcot – like that was supposed to dull the sting of him going without me or bringing me back a plastic orange juice sipper souvenir in lieu of a set of mouse ears.

Four years after Dad “only went to Epcot,” my parents told me that we were going on vacation. This was huge since our family had never taken a vacation. Dad worked in road construction, so the summer months were when work was good for him, and most years, the winter months saw him unemployed and left my parents barely making it from one month to the next.

It was 1992. I was 11 years old and in sixth grade. Our vacation was scheduled for February, so my mom arranged for me to take a week off from school. We were going to Atlanta to visit my dad’s sister, then on to Disney World for a few days. To this day, I cannot figure out why we took this trip. My dad hated to drive. My mom STILL refuses to drive outside of a two-family-cemetery radius from her house, but I wasn’t worried about their motivations. I, who had never really been outside of the shadow of our trailer, was going to Disney. I was going to see The Mouse and come back with that set of ears that my heart had spent years yearning for. I was going to Disney, by God.

The five of us – My mom, dad, sister, grandmother, and me – loaded up in my grandmother’s 1985 Buick LeSabre. If my math is correct, the average age in that hunk of American steel was 37-ish years old. Granny’s Buick was the height of luxury for its time, or any time, for that matter. The exterior was white, and it had burgundy, crushed velvet interior. It was the type of car that, if you took a sharp curve on a narrow road too quickly, you’d find your front bumper in a ditch while your back bumper hung over the hill on the opposite side of the road. The front seat could serve as a bench seat, if you wanted to flip the armrests back. The driver’s and passenger’s seats had pockets on the back where Granny would stash her road atlas and Kleenex. If you dug down to the bottom of those pockets, you could usually find at least half of a roll of wintergreen Certs. The car had all of the most modern technology – cruise control, power windows and door locks, and a cassette player. We loaded our suitcases in the trunk, stashed the “adult” road cooler in the front seat at Mom’s feet, and Granny, my sister, and I settled into the backseat. I stashed my road cooler at my feet and tucked extra batteries for my Walkman safely into the pocket on the back of the passenger’s seat.

We stopped for our first road meal at a Waffle House somewhere between Clintwood, Virginia and Atlanta. We stopped at a different Waffle House for our second road meal before we reached the ATL. My memories of our time in Atlanta are sparse – I was laser-focused on the Disney prize. I do remember seeing the Knoxville Sunsphere for the first time. I also saw my first city skyline. We went to Stone Mountain and took a cable car to the top. We went shopping at Marshall’s. I remember those nights in Atlanta being the first time I ever heard traffic at bedtime.

The morning we were supposed to depart Atlanta and head for Disney was a blessed and glorious day, indeed. I woke up full of hope and optimism. Would I get to ride Space Mountain? Could we go to Animal Kingdom? I had already decided that I would spend my time in the car that day making a list of all the things I wanted to see and do, then prioritizing that list to make sure I got the most fun in that I possibly could.

“Your dad decided that Orlando is too far away. We’re going to Myrtle Beach instead,” Mom told me when I made it upstairs. What? Had Orlando moved since we left Clintwood? It wasn’t too far away from Atlanta when we loaded up in the car and left. Did Rand McNally lie?

I cried a lot because there wasn’t much else I could do. I was surly the entire trip from Atlanta to Myrtle Beach. We stopped at a couple more Waffle Houses. We got lost and drove 30-some miles out of our way, which meant Dad was surly, too. I contend that us getting lost was because the adults burned through the contents of their road cooler too quickly (and they probably didn’t eat enough at either Waffle House). Finally, we made it to beautiful Myrtle Beach. The temps on that early February day were in the low 50s.

To soothe my disappointment, my sister took me shopping at the Gay Dolphin. I got disappearing ink and plastic vomit – neither could fill the void that not getting mouse ears had left in my life. Mom paid without complaining. We got dressed up and ate dinner at some Calabash place because that’s what you do when you’re in Myrtle Beach in February. Our last day there, the weather was nice enough to spend the day on the beach. “Nice enough” meant that it was sunny and not too cold as long as I wore a sweatshirt and long pants. I cruised up and down the shoreline on a rented recumbent tricycle and mourned the Disney trip that never happened.

We hit the road for home and stopped at a new Waffle House for our first road meal on the return trip. I was still surly, but at least we’d be home before bedtime. Late that afternoon, it was time for lunch/supper, and Dad wheeled the Buick into yet another Waffle House parking lot. In my mind, the trip had fallen apart when we headed east out of Atlanta instead of south, but in reality, the last Waffle House stop is what blasted our family vacation into bits of smothered, covered shrapnel.

I wanted McDonald’s. I had asked for McDonald’s. I was sick of Waffle House. My dreams of Disney had gone down in flames. I just wanted to get home. I wasn’t really that hungry anyway. So 11-year-old me decided that I would exercise my right to protest peacefully by just not going in to the Waffle House. I’d hang out in the car and read a Babysitters Club book or listen to my Vanilla Ice tape on my Walkman. It seemed like a reasonable enough plan.

Except I wasn’t the only one who was over our travels. My dad, who was tired of driving, tired of being in a car with four women, and tired of me pouting about not getting my way, was not having any of my parking-lot Gandhi antics. He burst out of those Waffle House doors, and I jumped out of the car to meet him. And right there in that Waffle House parking lot, we had our first of many showdowns of will. Eventually, I relented because that’s what you do when you’re 11. The rest of the trip home was quiet and tense.

Memory is a tricky, subjective thing. The same trip left very different impressions on me and my sister. I remember that trip as the first time I felt disappointed because someone changed his or her mind, and I remember the first time I ever saw the ocean, even if it was the grey Atlantic in the dead of winter. My sister, who was almost 26 years old at the time, remembers that trip as the first time she ever heard our dad say the F-word.

Rural "Healthcare" Brought to You by Ballad Health

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Living in an area that is ravaged by the opioid crisis can make getting decent healthcare a bit tricky. That is why my family and I still travel two hours to see our primary care physician for illnesses, as well as for routine checkups and such.

But what happens when you have a seizure so severe that it scares those around you badly enough to call 911 while you’re still unconscious?

Well, here’s what I have been able to piece together from my husband’s eyewitness recollection and thoroughly reviewing my records regarding what happened to me after I was transported by ambulance to Dickenson Community Hospital in Clintwood, Virginia. It’s important to know that I had been seen in the same ER six months before when I was transported there by ambulance after suffering a seizure at school. That time, I came in conscious, was monitored, released, and recovering at home within a few hours.

Not long after I arrived in the ER this time, I suffered a second seizure. My husband, who was at my bedside at the time, notified the ER staff that I was seizing again. No one answered his calls for help or came to deliver basic seizure first aid until I turned blue. In order to stop the second seizure, the ER staff administered a 2mg dose (or, as I like to call it, an elephant tranquilizer dose) of Ativan via IV. Thankfully, the Ativan stopped the seizure, but it also kept me functionally unconscious for the next 48 hours.

While I was DCH ER, the care team ran a series of lab and imaging tests. One of the blood draws revealed an elevated ammonia level – well over twice what is considered normal, in fact. The labs also showed a mildly elevated alcohol level and an elevated thyroid hormone level (something that has never been abnormal in my life). Someone on duty in the ER asked my family if I drink (I don’t). My husband/my mother/they both told the care team that I don’t drink. However, instead of taking their word for it and simply re-testing the labs, the care team noted in my chart that they were concerned that I was experienced DT-related seizures due to alcohol withdrawal.

This resulted in a transfer to a hospital two hours away (hello to another ambulance bill). I was admitted to the hospital some eight hours after the first seizure. My ammonia level was immediately checked at the “new” hospital, and the level was normal. But because the staff at DCH ER shat the bed and refused to believe that my husband and mother were being honest when they said I don’t drink, the hospital CT-scanned my abdomen (hello CT scan bill). The scan was normal. The ammonia level was normal. But I was still fed lactulose for two days (hello hospital pharmacy bill).

About the only thing the hospital didn’t do during my mini-vacation there was call or notify my primary care doctors, whose office is RIGHT ACROSS THE ROAD. The few people familiar enough with my medical history to answer questions about my alcohol use (or lack thereof); who could have explained that I have Gilbert’s Syndrome, which means my bilirubin levels tend to elevate when I am sick, stressed, or hungry; who know that I have had seizures in the past, but had not yet been diagnosed with epilepsy did not even know that I was in the hospital that sits less than 50 yards away from their office. I was unable to advocate for myself during this time – elephant tranquilizer, remember?

People are human, and humans make mistakes. In my case, though, the mistakes, the refusals to listen, and the faulty judgments compounded and left me owing a hefty bill that I cannot pay for tests and treatments that I never needed in the first place. I spent three days being treated as an alcoholic (despite anecdotal and laboratory-confirmed evidence to the contrary) instead of having the tests and care I needed to try to pinpoint the cause and proper course of treatment for my epilepsy.

After I was released from the hospital and reviewed my records, I immediately filed a complaint with DCH ER. After three months without a response, I called today and learned that they had dismissed my complaint and closed the investigation because, according to them, “there’s no way they could have messed up.”

I hope I never have to visit DCH ER again – I’ve given my husband strict instructions to just keep me on my side and drive as fast as he can to get me to Pikeville should I suffer another seizure. He knows where the needle and thread are and how to use a tourniquet in case I’m bleeding out. I’m going to make him watch The Dollmaker later to learn how to perform a hasty tracheotomy. But, for the sake of everyone else who doesn’t have a choice – or maybe for my own sake one day if I do something else to piss off the epilepsy gods – Here’s my advice to the DCH ER staff: Listen to your patients. If your patient is unconscious when he or she arrives, listen to his or family. If you run a test and that test reveals results that are out of line with what the patient or their family tell you, speak with the family about it, and RE-CHECK THE LABS. You don’t have an easy job, especially in this area. But don’t let what you normally see cloud your judgment of everyone who comes through your doors. Better yet, don’t judge at all. Just listen and put yourself in your patients’ shoes. Also, it’d be a great idea to brush up on epilepsy first aid.

Homesickness

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I’m currently wading through what I’m calling “a dark night of the soul.”

Maybe it’s the time change after we “fell back” earlier this month.Maybe it’s the starkness with which the seasons change up here in the mountains.

Maybe it’s the antiepileptic medication.
Maybe it’s the 55-gallon drum full of trauma that I’m dragging around while I try to dig to the bottom of it all, understand my feelings, and clear it all out.
Most probably, it’s a combination of all the above.
I spent my first year back here convinced that I would feel more at peace once we found a house. Okay, that’s not exactly true. I spent our first three months here thinking we had a house, then I spent the nine months after that trying to find a house. That was the prize that I kept my eye on. Just find a place to live, and everything else would sort itself out. Eventually (almost a year to the day after we moved), we closed on the house we’re living in now.
Then I was diagnosed with epilepsy, which means I can’t drive for at least a while.
Then Gomez and Elroy met a deer in the middle of the highway and almost rurnt my little car.And the hits just keep coming.

Seeing how happy Elroy was here and seeing Gomez flourish at his job were enough to sustain me through a solid year of the three of us living out of one bedroom, but I don’t know how much longer that sustenance will last.

I’m homesick, but my homesickness isn’t for one specific place.

I’m homesick for a pre-mined Yates Gap that doesn’t have a clear view to where my grandmother’s house used to sit and for a Fremont that doesn’t smell like the sulfuric pits of hell.

I’m homesick for our old house because that’s where I watched Elroy grow up.

I’m homesick for my life before I came back “home” – when distance was the reason I felt like we were always on our own because the truth is that absence is a choice, and the truth hurts so much.

I’m homesick for the option to shop from more than one grocery store, for a Wal-Mart that doesn’t take the better part of an hour to get to, for decent healthcare that doesn’t require taking a sick day and spending three and a half hours on the road to access.

I’m homesick for our barely-middle-class life, for a time when the idea of having to pay for braces for Elroy or a routine oil change or an annual property tax bill didn’t send me into a “how are we going to make it this month?” panic.

I’m homesick for the anonymity that living in a larger (relatively-speaking) area provides. That way, I could seize out in school in peace without having to assure my mother months later that I absolutely did not have a stroke despite what “everybody” says.

And despite all of my backward-looking sadness, I know that we have to make this work. We chose to move here, out of everywhere in the world, and we don’t have the option to change our minds now.

Sometimes Enough Still Isn’t Enough

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In 2011, Gomez experienced a health crisis. I’m not using hyperbole; he was an extremely sick man, and now he has what I teasingly call “the million-dollar pancreas.” At that time, I was working as an accountant for a regional coal business. Gomez was teaching. Elroy was a toddler. We were living two hours away from anyone who could help us out with childcare. I was working 10-12 hour days and sometimes working out of town for a week at a time because our company was in the midst of being acquired by Mean Green. For two solid weeks, I worked in the office and came home to help care for Elroy while I watched Gomez as he lost 30 pounds and turned a sick shade of deep yellow.

Thankfully, we were encouraged by The Best Healthcare Provider in the Entire World to drive to Charlottesville to seek answers at UVA. We drove Elroy across the mountain and dropped him off with my mom, unsure of when we would be returning to get him. I drove through the night as Gomez snoozed in the passenger seat (something a well Gomez would never do). I was worn out, worried about Gomez, and stretched so thinly that felt like I would shatter if someone looked at me wrong.

But I didn’t have to worry about how we would pay for Gomez’s medical care or our travel expenses. He had health insurance through his employer, and he also had secondary coverage through the plan that my employer offered. At that time, I earned the bigger salary, so we lived comfortably. We were six years into paying the mortgage on our house, so we had started making a bit of a dent in the principal balance. And let me be clear, even if I had been worried about how we would pay for his care, I would still have taken him to UVA. There is no amount of money that I wouldn’t have paid or debt I wouldn’t have gone into to have a healthy Gomez.

Now, the roles are reversed. I’m the one scaring Gomez with my health problems, and he is the one taking care of me. But somehow, our situation now is more tenuous than it was eight years ago. Now, we are one month into paying off a new mortgage on a new-to-us (but definitely not extravagant) home. Now, we are less than seven years away from Elroy going to college (if that’s the path he chooses). Now, we are paying off student loans for a second Master’s degree, in addition to two Bachelor’s degrees and a first Master’s. And we’re doing it all with much less cash flow coming in, since I left my accounting career for one in education, and we both took significant pay cuts to return to the Coalfields. So when I woke up in the (newly minted, healthcare-vacuum creating Ballad Health) hospital a couple of weeks ago, not only was I scared about my health and crying to see Elroy, but I was also worried about the bills that my special brain were racking up. Gomez would never admit it, but I know he was worried, too, because he’s much more fiscally-conscious than I am.

Following my seizure in February, I made Gomez promise to never call an ambulance again after I saw the bill for the ride to the ER. He didn’t have a choice this time, because I was in worse shape than I was last time. When I saw the neurologist last week, Gomez and I had to ask her for an alternative to the anti-epileptic medication she suggested I try, because the one she mentioned doesn’t offer a cheaper, generic option. People in the United States are making choices about their health based on what they can afford and not based on what’s best for them – and that only applies to the people who are fortunate enough to have access to healthcare in the first place.

Gomez stays working at least two jobs, on top of taking care of me and Elroy. There was a time last year when I had two part-time jobs in addition to my teaching job. I had to back off from the part-time work, though, because it turns out that waking up at 3AM on weekdays and pulling all-nighters on the weekend to teach English online to students on the other side of the globe can drastically lower one’s seizure threshold – and there are only a handful of part-time work options open to someone who lives in this area, consistently works around 60 hours a week at her full-time gig, and can’t drive. We each have a Bachelor’s degree, piles of additional continuing education training, and Gomez has not one, but two, Master’s degrees. We drive older cars. We live in a 54-year-old home that’s value is less than half of the national average. We only have one child. We’ve taken exactly one vacation in the past seven years.

I’m not saying that we shouldn’t be having such a tough time or that we deserve more than others because we are college-educated. I’m complaining because no human being should have to worry about how much it’s going to cost to stay alive. I’m complaining because no one should have to choose between a gallon of milk and a day’s worth of medication. I’m complaining because the years I spent studying business and accounting coupled with the time I worked as an accountant for a regional healthcare corporation allow me to see how dangerous the current iteration of our nation’s “healthcare” system is. I’m complaining because, while we might be able to figure out a way for me to afford to live, there are tens of millions of people in our country who can’t even afford to die because they make less money than Gomez and I do and live in areas where everything – from housing to groceries – costs more than it does here. I’m angry because the very people who created this gross, profit-driven, “bootstrap” mindset of American life are the same people who destroyed an entire middle class and made it impossible for anyone who makes less than a six-figure annual salary to make it under even the most modest lifestyle – AND they’re revered as pillars of the nation and oracles of business acumen. They’re creating policies that affect us all, and they aren’t even qualified to do so (I’m looking at you, Betsy DeVos). I’m thankful for all of the love and support that our community has given us over the past few weeks, and I’m thankful that what we are going through isn’t worse, but I’m angry because we are surrounded by people whose situations are worse, and it doesn’t have to be that way. I’m angry because our generation was sold a bill of goods that is rotten. Getting an education, being honest, and working hard are not enough to create a better life anymore; those virtues are only enough to barely eek by, if you’re lucky.

Backstory

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18 years ago, just a few weeks shy of my 21st birthday, I loaded what little furniture and few belongings I had into a moving truck and ran away from my hometown. I got married. I graduated from college. My husband and I bought a house and had a son. Last summer, we took the opportunity to move back to my hometown, a decision that kicked off a chain of highs and lows, warmth and isolation, contentedness and uncertainty.

This year has been, without a doubt, the most difficult year of my life. The highs have been mild, feeling like gentle knolls, while the lows feel like being at the bottom off a quicksand-filled canyon.

We have found ourselves (I’m in my late 30’s and my husband is in his early 40’s) completely starting over, except this time, we are starting over with an 11-year-old son. That raises the stakes quite a bit for us. Starting completely over was not part of our plan when we decided to move. I have spent most of our time here scared and ashamed while facing the realization that moving might turn out to be the worst mistake we have ever made.

We’ve spent the last year as a part of the nation’s “hidden homeless” population. We aren’t living in the street, but we don’t have secure housing of our own. This is due to myriad factors, but the current (read – nonexistent) real estate market in our little town has made it extremely difficult for us to find suitable housing that we can afford on teachers’ salaries. For me, almost all of the lows stem from not having a home to retreat to at the end of a difficult day at work. As an introvert, time alone is what resets my brain, but not having a home of our own means not having anywhere to be alone.

The highs are subtle, but somehow they’re enough to help me make it through the lows. The sunrises here can be breathtaking. The thunderstorms are spectacular if they don’t scare you into hiding in the basement. My husband and son are happily exploring the local fishing scene, and the fishing is good. The sense of community and the kindness of relative strangers have brought tears to my eyes more than once. Every now and then, I hear proof that a hint of my native, Appalachian accent has crept into my son’s own dialect.

And still, I feel lost and homesick for our old life in our old home.