Female Trouble
by Sonya Huber
Do men understand cranberry juice? Do they understand that in a woman’s head, there is a neural connection between a cranberry bog, nubby with a million tiny red bobbing heads, and a weekend of enthusiastic sex?
I hunched over a shopping cart filled with plastic liters of store-brand juice; Ocean Spray could run as high as $5 for a half-gallon. In a pinch, even “juice cocktail” with 20 percent juice would do the trick. I would buy stock in Ocean Spray, I joked to myself, if I had a stock portfolio. I took a slow and curative breath in to dissipate pain that radiated from my groin to my armpits. Must be a pulled muscle.
During the previous week, sex was had with the new boyfriend. Said sex was periodically interrupted by the worrisome creaking of his homemade loft bed, which swayed like a wooden hammock, and his manic cat playing the metal venetian blinds like a junk-yard band. Sex was also interrupted by graduate school classes and work (me) and work at the wood mill (him) and the labor activist conference (me) and by many pots of coffee, which sometimes led to more sex (us). Further sex occurred when I stayed at boyfriend’s apartment to avoid Gustavo, the labor activist whose car engine had exploded and who agonized over whether or not to divorce his wife and whether or not to go back to Guatemala. Sex was then interrupted again by driving Gustavo to the mechanic and then to the Greyhound station and purchasing him a ticket back to Iowa so he would leave. Sex resumed (along with sleep and eating and other responsibilities).
Sex was interrupted two days later by the arrival of my friend Sharad and his two buddies, who stumbled from a twelve-foot-high SUV in a piñata-like explosion of fast-food wrappers, clove-cigarette smoke, and empty CD cases. Sharad and the boys bought lots of beer and stayed up watching Kung Fu movies at top volume. I fled to my boyfriend’s house at 2 a.m. (sex). The next morning after coffee I went home to greet Sharad and the boys, who ate breakfast, broke a chair, and started drinking again. Then they watched more Kung Fu and finally I had to ask them to leave.
Too much coffee, not enough water or sleep. Where the hell were my kidneys, anyway? Kidneys had to be near my hips, not way up near my shoulder blades. Putting them so high up would obviously be a design flaw. So if that ache wasn’t my kidneys (clearly not), it must be the kind of healthy ache one gets from exertion and recovery, the signal of a crisis averted, the recharged body bouncing back from a near-miss. Yeah. And cranberry juice, just for good measure.
Gritting my teeth against the pain, I made another pot of coffee and surveyed my scribbled list of impending appointments in Chicago, a six-hour drive away. I should have trekked to the student health clinic to pee in a cup, then waited for the culture results and gotten my antibiotics. I knew the nurse would diagnose a urinary tract infection, the “honeymoon malady,” the most common infection in the human body, the infection that accounts for more than 8 million doctors’ visits a year in the United States. If you have not had one, imagine peeing Tabasco for a week straight.
No, don’t imagine that. Instead imagine me in my rented kitchen in Columbus, Ohio, two days away from a long-scheduled research trip that would lead to the end of graduate school. This was the sprint: the final leg, the dash to the finish line that drew from marathon runners the hidden reserves to power themselves along. The stupefication of fever allowed me to conclude that driving and writing were both sitting, so nearly laying down, so nearly the same as lying in bed. Using the same logic as countless ex-boyfriends who staggered to work and to the bar harboring bronchitis and strep throat and disturbingly infected wounds and chronic migraines, I decided to show my body and some stupid teeny bacteria who was boss.
This is me, though. I love healthcare. I was insured. Maybe if I had been uninsured at that moment, I would have known I was playing with my life. But because I had the bounty of the student health card in my wallet, I figured that for once my healthcare was under my control. That sounds logical, I guess, maybe even sociological.
And yet there is a yellow aura of sickly mania around my memories from these days, a nephrologic pushing and desperation to get the impossible done, the knowledge that after the summer, I would be booted from graduate school, plan-less. The linoleum in the grimy kitchen peeled. I had no plan. A hole in the wall sprouted wires from a phone ripped out by a previous tenant’s tantrum. I had a thousand resumes and a thousand envelopes. I had no plan. Like a charming cousin with a cocaine addiction, my body was always getting me into expensive trouble.
In a file drawer between my 1998 tax return and a warranty for a clock radio I no longer owned, I kept a manila folder labeled “Health Insurance Hell.” It contained records from an awesomely-named collections agency, the Medical Bureau of Economics. Because a doctor in Boston in 1997 had failed to submit a referral form for a minor outpatient procedure (even though I’d asked her three times to do so), I got stuck with a $75 charge. I disputed it, didn’t hear anything, then moved from Boston to Chicago to Columbus. MBE found me and let me know that $75 had mysteriously morphed into a $383.15 debt.
In graduate school $75 was quite a lot of money, and $383.15 was rent. I had a collections person assigned to my case, and he would leave messages like, “This is Neil. We need to talk.” Neil addressed me with restrained sarcasm, as if I’d charged a plasma-screen television and then flaked on the payments. He needled; he threatened to garnish my paycheck; he called me at work, at inappropriate hours of the evening and early morning. I wrote letters with bullet points, outlining the chronology of my treatment and the charges, listing every possible account number and doctor’s name, trying to convince him that this amount was not my responsibility.
Neil was not moved by my suggestion of a payment plan, and he was not moved by slobbering pleas for mercy or by temper tantrums of rage. If anything, he seemed to lose respect for me. Mom heard if a collections agency cashed a check bearing the words “Paid in Full” on the memo line, it couldn’t dispute the payment later in court. This sounded like using a horoscope as a binding legal contract, but I was desperate. I made out a check for $75 with “Paid in Full” on the memo line, and for some reason known only to Large Buildings, Neil disappeared from my life.
Over the coming years, I would begin to hyperventilate at the sight of an EOB. I would learn to call 1-800 numbers and challenge Claims Evaluators on their coding of medical procedures, saving hundreds of dollars every year. I would take such battles to my insurer, my state attorney general, and my insurance company’s patient mediation board. In my subsequent correspondence, I would mention the previous correspondence and use the words “subsequent,” “previous” and “correspondence.” These letters result in victories that feel so very, very unsatisfying. Sometimes I sit with my head in my hands and think about all the hours lost. I could have been learning Spanish. I could have learned to play the saxophone.
With my cranberry juice riding shotgun, I kissed the boyfriend goodbye and headed west on I-70, blasting music and cold air, forcing sickness from my body with bracing draughts of road-trip, blue-sky joy. The six-hour drive from Columbus to Chicago took eight with bathroom breaks, but in my triumphant victory over infection, I happily stopped at gas stations to climb out of my red pickup truck and feel the gravel under my boots. I blinked against a haze in my vision and turned up the radio, keeping a finger on the radio’s “seek” button and finding one Led Zeppelin song after another. In my complicated hybrid-classic-rock Tarot, Zeppelin on the radio signaled good luck and benevolence ahead--handy and affirming in the rural Midwest, which is enveloped like a forcefield in the song “Stairway to Heaven.” Under the favorable constellation of Zeppelin, my little red truck buzzed farther and farther beyond the boundaries of my health plan’s network of approved providers. The flatland of Illinois fanned out like a warm and welcoming pancake, the land that I love.
I reached my parents’ house and my old room, and all the past recoveries from various mental and physical ailments seemed to be cheering me on from the bench. “It’s nothing! You’re a star!” roared Mononucleosis and Chicken Pox from the sidelines. “Now get to work!”
I bent to grab a stack of notebooks, Pain shot around my torso to my sternum, and my scalp was soaked with beads of sweat. “Arggh,” I muttered, releasing sickness with my groan. I was now apparently a certified auto-New-Age practitioner. I mumbled “Testing, testing” into the tape recorder between gulps of lukewarm cranberry juice.
I went down to the kitchen for more juice and for assistance in building my fortress of denial. “Wow, I’m really sore,” I said to my mom. “I think I’m getting over something. Does that ever happen to you?”
As luck would have it, she was recovering from bronchitis. Her chest muscles, she said, had been sore for a week.
See? There you go.
The narrative cure—telling stories to heal—was also advocated by Brenda Ueland, Minnesotan author of the 1920s writers’ classic If You Want to Write. The book relates chapters of enthusiastic and invigorating writers’ advice infused with a pioneer can-do spirit. She also relates an anecdote about a violinist who cured a fever by staying up all night playing rapid sawing trills on her instrument. I’m too much of a wuss to write poetry through a sinus infection, but I envy the ability to blast a horde of viruses from the bloodstream with a to-do list and the healthy surge of production. And the research trip to Chicago was productive, but the most important lesson I learned was this: if I pee and it fizzes like soda pop, I should stop and find the ER.
The sad thing is, I knew this. Eight years before my attempt to slow-roast my kidneys, I summered on the East Coast with a three-month urinary tract infection. At the time I thought I was pregnant, syphilitic, HIV-positive or all of the above. The New York boyfriend who assisted me in developing the bacterial beast boarded a plane for a summer internship in Italy, leaving me alone with my organs. I conducted a women’s health-clinic tour of the East Coast. In rural Vermont, I resorted to repeated and expensive emergency room visits, begging rides from strangers and fellow students at the school where I was supposed to be studying. The harried nurses and doctors, busy with tractor injuries and power-tool wounds, lost my results and my records, then apologized for giving me the wrong antibiotics. In New York City, I learned to aggressively demand a bathroom in any bar or restaurant by muttering, “I’m sick” as I swung my elbows to parry away managers or waitstaff on my mad dash to the back of the establishment. I sprinted through the Metropolitan Museum of Art as I charted a course from bathroom to bathroom, retaining only a pain-tinged impression of a jumbled Kandinsky painting and a feverish swirl of the rooftop Rodin sculptures.
Medicine didn’t cure me. One pill made me pee orange—interesting but not helpful. I swallowed another fat pill and watched shiny and irregularly-shaped hives ripple from my arms and legs with the exact speed of ants swarming an abandoned glazed doughnut. The red globules splattered like rain on a window pane, but precipitating in reverse, from inside my body. I slept on any couch I could find and read women’s health pamphlets about the urinary tract. Desperate, I made an early retreat to the Midwestern comforts of home. And the infection eventually went away by itself.
Eight years later, with another civilization of bacteria in residence, I drove north to downtown Chicago for a day of research. I visited three mental health facilities, gathered reports and interviews, and stopped at a federal agency to file forms requesting figures on occupational health and safety. Tiny electric tracers speckled in my peripheral vision, yellow and purple dots in the gray March sky.
In an afternoon gap between appointments, I drove to a parking garage near a movie theater, turned off the car, and rested my head on the steering wheel. My thoughts seemed to creep by like trundling boxcars, and in the spaces between each thought, I saw daylight and nothing else. Combining Brenda Ueland’s art-cure and my friend Sharad’s Kung Fu movie recommendations, I bought a ticket to a John Wu movie. The blurred dances of whirling feet and glinting swords did not restore me. I sat in the back row of the darkened theater and bent my limbs into the folds of my body like a potato bug, shuddering against the edges of delirium.
My evening schedule included dinner with an ex-boyfriend. I’d wronged him on repeated occasions, and we’d scheduled a meal to finally sit down and discuss our demised relationship like two adults. I pulled up to the curb to collect him from a bus station. He slammed the door and settled in, turning to me to hear news about the last year of my life, eyes expectant with the hope for sanity and friendly release of bygone days that the formerly engaged must show toward each other. I started to cry. “I can’t do this,” I blubbered. “I’m sick; something is wrong. Something is wrong; I have to leave.”
His forehead creased in concern. “I’ll help. Where do you need to go?”
“I have to go to the hospital. I have to leave.” With my hair sticking out like a Chia Pet and tears and snot streaking down my face and my glasses, I dropped him off at another corner. It might have been at that moment that I transitioned in his mind from “ex-fiancé” to “most-regrettable-and-why-did-I-put-up-with-her-bullshit.”
Blinding red brake lights swirled in front of me. Heat came from inside me, and I knew, finally, that this was bad. I knew who was boss, and it was not my brain. I turned the truck south into rush-hour traffic on the ominously beautiful Dan Ryan Expressway. I called my mom. I called my boyfriend Donny in Ohio. “Something is wrong,” I said. I cried in the bumper-to-bumper traffic and set my fingernails against the maroon plastic of the steering wheel.
“Try to sleep,” said my mom, putting me in bed. “If you still feel bad in the morning, we’ll go to the ER.”
At midnight, I woke up in a dry heat with an urgent metallic sensation soaking my skull. I stood and the room pitched. In the dark, I trailed my hands along the wall toward my parents’ room, wondering namelessly like a five-year-old whether it was urgent enough to wake my mom. That downbeat, two, three, as I listened to Mom and Dad breathe (Dad with a schnuffle-snore) and watched mom’s pink fingers, flung across the covers, twitching. Felt guilt about interrupting a dream. I was being silly. Fevers passed. That’s what they did, and sleep cured all. I sighed against the froth in my head.
“Mom. I think we need to go now,” I whispered. “I’m not right.” Her eyes opened and focused so quickly that they seemed to reach back a few seconds in time to make up for the dream state, to gather the force needed to be a mother in the middle of the night.
In the black night we drove to the hospital, the same place I’d volunteered in high school as a candy-striper in a white-and-red striped ruffled smock. Growing up, I’d listened to people from church, friends of my parents, laugh and trade stories about mistakes made by doctors here, the wrong leg amputated. But I felt safe in the waiting area, muffled with normal noise of midnight television. Soon they would give me drugs and I would mend and get on with my life.
Instead they pointed to a cot and handed me a paper gown. “It’s freezing in here,” I shuddered. “Can I have a blanket?”
The nurse turned down her mouth. “No. You feel cold because your fever is 105 degrees.”
My grandmother, Elfriede Klejdzinski, died young in Germany after World War II. A kidney infection—probably caused by a UTI—killed her. Thankfully, we didn’t know this on the night of my ER trip. We figured it out years later, during a family research project with the help of Elfriede’s death certificate. Mom tells me the whole German family blamed my grandfather for not taking my grandmother to the hospital soon enough.
He told his wife to rest and see if she felt better in the morning. Then I imagine the curtain of fever descended. I don’t think she said goodbye to her children, who were nine, six (my mother), and four years old. It must have seemed like routine female trouble, a simple ailment. Chaos, caused by the assumption or hope that the body could cure itself, rippled outward from that bit of bacteria.
They gave me a room and a bed. I felt splattered and disjointed like a microwaved Jackson Pollock painting. I kept asking the nurses if I was going to die. They patted my arm and told me the fever was a sign that my body was fighting the infection. But I overheard them standing in the hall at shift change, saying to each other, “It’s still at 105” with muted frustration. They took my temperature every hour, clipped massive bags of antibiotics and anti-febrile medicine to the IV pole.
My mother and I argued.
“Call the nurse,” I said. “I feel really crappy. My fever’s up again.” I knew this because words would not connect in my head. They repelled one another like magnets turned the wrong way, refusing links to make meaning. I couldn’t remember how to worry, couldn’t tell myself any internal story. I was just a body gone awry, and the flavor of my personality was a taste I couldn’t recall.
“It couldn’t be up. They just gave you Motrin.” Mom wanted me better. I pressed the call button; the nurse came, took my temperature, and sighed. Yes, it was up. I glared at my mom—see, you are a terrible mother. You want me to die!
The nurses put ice packs under my armpits and at the back of my neck. When that didn’t work, they wheeled in a huge machine that pumped chilled water through a plastic blanket. I rolled onto the blanket and winced. The cold made my skin sting and my bones ache. “It’s better than an ice bath,” said one nurse. “And that’s next.”
The doctors came in and asked me to explain myself: “We don’t understand how a healthy woman would get a UTI this bad. Why did you not go to the clinic earlier? This infection is in your kidneys, and if it goes into your blood, there is nothing we can do.”
My parents and my brother and sister-in-law and sister crammed into the little room at Silver Cross Hospital. They told all the family near-death experiences we normally don’t talk about. We laughed hysterically about each one—or at least I did. My brother told me his story about getting a 105.7 fever in college; the nurses tried to put him in ice and he told them to fuck off and he left. So funny! And the framed print opposite my bed, the one of the purple flower, was so, so beautiful. And the Jell-O, the lovely green Jell-O, was so, so pure and clear and good.
On the third day my fever crept down below triple digits and stayed there.
“You look better,” said my mom, face creased and washed out with exhaustion. She’d sat by my bed all night.
“Yeah, yesterday your skin was gray. You’ve got some color,” said my dad. I shuffled into the bathroom, dragging the IV stand. I looked like a corpse, my skin the weird yellow-gray of a pre-tornado sky. My fingers itched for a pen and a legal pad. Praise the Lord, I needed to make a to-do list. Top priority, now that I would live, was the need to deal with the potentially catastrophic price tag of a three-day hospital stay… out of network.
I called the 800 number for my student health insurance. The claims agent asked a few basic questions but seemed eager to get off the phone. I asked in as many ways as I could think of, “Will anything bad happen to me now?” But it came out as, “Is there anything else you need from me?” What I meant was, will I be punished? Is the scary part about to begin, now that I’m back at the edges of normal life?
I wanted the Insurance Company to share my joy. I wanted to throw an “Alive Again” party with a piñata and candy and fruity drinks. I had not ever been that close to death. The bacteria had surged and been beaten back with the blessed, lovely panacea of modern technology. I do regret my Echinacea, Earth-First days, I muttered. I do love pharmaceuticals. Without the assistance of our amped-up and hyper-funded medical-research system, I would have been a bug splattered on the windshield. I vowed never to criticize healthcare again, because it had given me life. I promised myself I would gratefully write checks in whatever amounts were demanded of me.
Within a few months I’d be whipping myself into a case of terror and hysteria about a descent into kidney-induced collection-agency hell. A billing clerk would offer a payment plan (bless her) to save me from collections, and I’d pay the full $2,000, blissfully unaware that if I’d read the back of the tiny gray print on the hospital bill, I could have applied for a special “low-income” rate.
The next morning, the doctor arrived to set me free. He sat down at the foot of my bed and studied my chart, reviewing the victory of my clear blood tests. My mother smiled at him. My sister got up to shove my belongings into plastic “Patient Property” bags.
“So you’re in college,” he said in a mysterious East European accent. “We need you to avoid any more UTIs. I want you to do these things: first, try to avoid hot tubs. There’s a lot of bacteria in there. Have you been to any hot tub parties? I know that’s a popular thing in college these days.” I shook my head no. It was a waste of time to describe the wide chasm of behavior, resources, and angst separating graduate students from hot tub parties. He looked back down at the chart.
“Have you been having anal sex?” he asked good-naturedly. My sister spluttered, and my mother’s eyes seemed to detach from her mind, as if she were going to wait this one out somewhere far away.
“No,” I said.
He nodded. “Well, if you do, you know that you want to avoid the combination of anal and vaginal sex unless you wash very carefully. Veeeery carefully.” Mom nodded as if she were receiving instructions about caring for a houseplant or receiving penance.
“Finally, remember to pee after sex. Mmm-kay? Every time,” he said. He snapped closed the metal cover of my chart, shook my hand, and wished me luck with my urethra.
My boyfriend called from Ohio for the update. My sister handed me the phone and said loudly, with the delight of a one-liner she received from the heavens like a treasure, “You can have phone sex, but remember to pee when you’re done.”
I gingerly drove back to Ohio. I rested. I was a reformed body in gentle communion with her immune system. Who’s boss? No, not me. The organs, yes sir, yes ma’am. I drank cranberry juice and dipped my toes into the swirling current of graduate school.
Weeks later, the first bill arrived. I sat down on my couch, brave and solemn, determined to take this like a needle-stick, like a good and grateful patient. The itemized charges filled two pages, and each figure was calculated to a specific and eternally prime number, like $167.49. Each amount was imaginary. I studied the piece of paper as if watching the first flourishes of a ritualized form of warfare from an unfamiliar culture.
These symbolic implements – the dollar signs with their fierce threats – promised damage on the heels of healing. But I had faith in my pre-arranged voodoo garlic necklace, the Insurance Agency, which I hoped would reply with an equally mysterious show of force. I was now drawn in to the epilogue of healing, the forced expression of my gratitude with money I did not have.
The salvo was met with a response. “This is not a bill,” announced a bill-like statement from the Insurance Agency. This Explanation Of Benefits promised to explain something, which is supposed to mean “to clarify,” but the gesture was multi-layered, with a shift of alliances I could not decipher, a column of codes for benefits determinations and curt phrases explaining denial of coverage, reduced percentages, fees for services rendered. I thought I’d paid the Insurance Agency for its friendship and loyalty, but apparently I had not paid it adequate homage. The Insurance Agency and the Hospital, both Large Buildings, appeared to have a long-standing relationship cemented with secret winks and handshakes. They whispered strings of codes in a foreign tongue, a conversation I was unable to interrupt.
Other bills appeared. I came to recognize them because they did not need to clarify their intentions. They were bills, demanding, “Tear Off and Remit.” I cried whenever the mailman dropped letters through the slot. After the honeymoon of healing wore off, I was immobilized with financial guilt and fear triggered by the sight of my name in a modernistic sans-serif font, in all capital letters, glaring through the plastic window of an unadorned envelope.
I have never visited a prostitute, but I imagine an itemized bill listing the cost of each ear-lick ($0.89) and thrust ($4.03) would be a bit degrading. Similarly, the itemized bill from my near-death experience listing each blood test and kidney ultrasound seemed wrong on a gut level. It was either a bit too much information or not enough. It’s not that I didn’t want to pay the cost of health. I am cheap, but my cheapness is not the point. I wanted to pay the nurses directly. I would gladly pay for health itself and for the care that delivered this health to me. But the nurses received the same amount per twelve-hour, bloody, and heartbreaking shift whether or not they were kind, whether or not they joked with me. The blood tech did not get paid by the vial, but the hospital did.
At the time I was an apprentice in the land of the healthcare insurance ninja videogame. I knew some of the tricks. And yet when the truckload of kidney-infection bills arrived, I was clueless, utterly unaware of an additional level of magic spells and hexes that might have delivered me to safety. I added the figures and found that I owed a tenth of my gross income. How could I complain? I had to admit that $2,000 was a great deal for getting to see the rest of one’s life. Besides, I’d caused the whole thing partly by having sex and by being a workaholic. So I felt punished, as a Catholic girl is wont to do. And this time I could not blame a forgetful doctor or a paperwork snafu. I’d strayed from my network into the wilds of self-payer land.
Abusive relationships are sometimes characterized by a disturbing process called “traumatic bonding,” in which someone threatens you with injury or death. Then the meanie is filled with remorse and acts nice, and you feel saved and hopeful that you will never have to feel so scared again. You become grateful to this mean person for not being mean all the time, so you love them even more deeply for their nice moments. Then they get grouchy and threaten your life again, and in your terror you hope for the nice version to emerge, and when it does, you are soooo grateful and you try to figure out what you can do to never make the person mad again. And something about this rings true, reminds me of my relationship with medical billing employees and insurance cards. They are too powerful to hate. They usher you through the gates of healing, into health and the rest of your life. They relieve pain, and then they whack the shit out of you. And you spend so much time learning to be assertive and state your needs, when what you should do is leave and go far, far away, somewhere safe, like Sweden or Canada.