Perhaps it was in the confines where the broken and walking dead assembled that the murmur first unfurled. Here, aseptic in spirit but festering with contagion, down the formaldehyde halls void of natural sunlight, was a room full of corpses that flickered into and out of consciousness under the constant glare of the fluorescent lights. Disease did not discriminate the decomposing bodies that congregated there: formerly black or white or yellow or brown, now they were all different shades of ash, connected to tubes and machines that stripped them of their humanity in the name of preserving it. All eyed the television set airing scenes of a distant world that had long since forgotten them, their corneas glazed over until a vaguely familiar image appeared before them. Suddenly aroused out of their vegetative states, the masses of bald, stubbly heads lifted as they writhed to muster their energy reserves, swooning and swaying with a frenzied elegance, like a flock of startled ostriches. “Obamaaaaaaah”, they expired languorously, a hardly audible collective moan.

The scene would have been beautiful in a poignantly tragic way, were it not for the smoldering desperation in the air, so bleak it choked.

Desiree was among them. She had once been absolutely glamorous, a caramel goddess with amber eyes and Himalayan curves, whose intimate treasure—according to past lovers—smelled of cantaloupe and honeysuckle. Now her flesh resembled petrified birch and her skeletal frame reeked of pestilence and the paclitaxel currently coursing through her veins. At 31, she was sentenced to menopause and possibly death, right when she should have been at her peak. Too feeble for emotion, she was no longer outraged that her life and left ovary could have been spared, had the appropriate tests been performed in time. But her health insurance provider felt that it knew more about Desiree’s health than did her physician, refusing to authorize certain laboratory exams until the cancer had already metastasized.

Next to her was Laura, Desiree’s 57 year-old chemo sister, who shared a similarly sinister story. Their cold cadaver hands, comprised of nothing more than tendons and bones under a waxy patina that was once skin, clutched one another as the infusion lines delivered the next dose of imminent horror. For Laura, the nausea brought on by the chemotherapy was somewhat of a blessing, as her disease had placed her on the brink of bankruptcy, and edible food was a luxury. When her sarcoma resurfaced after a 2-year remission, Laura’s health management organization (HMO) determined that her cancer qualified as a pre-existing condition, thereby refusing to cover any treatments or laboratory assessments. Always resourceful, Laura found an experimental trial for which she qualified, but in exchange she exposed her veins blindly to a mystery substance being tested in humans for the first time…it wasn’t too toxic to rats or monkeys, they told her. “Obaaaahma”, she whispered, glancing over at Desiree as they exchanged an entire conversation in just one look via their own unique intravenous telepathy.

Mary heard her and came to check up on Laura, searching for a pulse she could not feel, even though Laura was still breathing…barely. Mary had just swallowed a thousand milligrams of ibuprophen and chased it with two cups of coffee to quench her pulsating headache. Some nurses were able to detach and treat their patients like numbers, but not Mary. So she often drank, mostly in moderation but often excessively, to drown the pain of the empty beds vacated by lost friends, their silence echoing her own loneliness. Lately her life seemed to mirror one of those supernatural slasher flicks, where characters slowly succumbed to torturous deaths at the hands of an intangible assailant. Except for her, the tenacious protagonist, though a surprise ending could always be in the plotline. She liked Laura, and even adopted her little terrier once Laura’s immune system was too weak for harboring pets. “Yes, Hope-bama,” replied Mary with an empathetic smile that soon waned, since those syllables were associated with so much uncertainty. Not for her own future—Mary could care less who wrote her paychecks—but because she could not bear the thought of the fragile being disappointed; they had already been shattered enough.

Nearby, in an adjoining sector, Ryan Takahara lay five pounds lighter in a hospital gurney, still in a state of shellshock over the news that his right arm had to be amputated pursuant the motorcycle accident that left it crushed and maimed. It all seemed so surreal, his memory blurred from the morphine and the denial, such that he could not recall how he went from his first post-college job interview to his present state in less than eight hours. According to his last recollection from that morning, his limb was still attached to his body, albeit just hanging by a tangled mass of tendons and ligaments. His thoughts skipped from reflection to bitter conjecture in a macabre opioid maelstrom, and he wondered if the doctors would have put more effort into salvaging his appendage had he been insured; had they taken their Hippocratic oath with blatant hypocrisy? At the very least they might have consoled him with a decent prosthesis, instead of callously suggesting that he could get a “good one” in Japan. Too dejected to inform the tactless intern that his family had been in this country since the Gold Rush, Ryan just lay there in a catatonic trance, trying to ignore the burning sensation coming from his phantom digits as they waved goodbye, hoping that somebody would wake him up from this nightmare. Through stained-glass eyes he briefly looked up at the television screen and let out a long rueful wail, “Ooooooohbama”, before closing his eyes and slipping into another narcotic-induced slumber.

A few floors below sat Eduardo, accompanied by his son Javier, for that week’s physical therapy session. A stroke affecting his frontal lobe had left Eduardo with a type of aphasia that resulted in a cruel condition whereby he could understand others but could not speak or write in intelligible phrases. No matter how much he focused and concentrated, all that came out was a jarbled compilation of jibberish and disjointed syllables. Aside from his language impediment, Eduardo had made tremendous progress in recovering from the other impairments brought on by the stroke, and his family was hopeful that he would somehow be able to overcome his speech problems—even though his neurologist told them this was impossible. The neurologist, his family insisted, didn’t know Eduardo, or that he was as stubborn as a donkey. They had been told that Eduardo wouldn’t make it out of his coma, yet after nine days on life support, he did. Eduardo was truly moved by his family’s unfaltering faith in him, and he yearned to communicate this. He wanted nothing more than to express how sorry he was when his insurance policy reached its coverage limit and his family inherited tens of thousands in medical bills for past and ongoing treatments, forcing his sons to drop out of their universities in order to work to pay off the monthly installments. Moreover, he longed with all his heart to tell his sons how much he loved them, and that they should pursue their own dreams instead of bailing out their troublesome old donkey father. Javier was presently looking down at him, smiling so handsomely, and encouraging him to complete the exercise his neurologist had laid out. Eduardo looked down at the table before him, his peripheral vision catching sight of the television in the corner of the room. “Obbb-bbbba-ma-ma-ma”, he stuttered, to an audience of incredulous doctors and his ecstatic boy.

Just around the corner, inside the hospital’s pharmacy, Margaret was rummaging with quivering fingers through the stack of prescriptions in her purse, trying to determine which medications she could get this month. Her prescription plan only covered generic drugs, meaning that she had to pay full price for the two drugs she needed to delay the progression of her Parkinson’s disease. The cost of both medicines alone almost exceeded her meager pension, and then there was the synthetic thyroid hormone to correct for her non-functioning gland, her asthma inhalers, the wide assortment of heart medications, the bisphosphonates for her osteoporosis, and the antacids to counteract for the severe heartburn caused by the bisphosphonates. Thus, Margaret had the burden of playing healthcare roulette once a month: which drugs did she need most at that time? Sorting the prescriptions in order of importance, she figured that osteoporosis and heartburn were the least of her worries, and maybe she had enough doses left in her inhaler to last her another month. As she held up one of the papers against the light to better discern the handwriting, she caught sight of the image broadcast on the pharmacy’s television monitor. Margaret watched, her heart racing with expectation, when suddenly, she felt the tell-tale signs of her airways constricting. Reaching for her inhaler, she gasped, “Oh-bah-mah”, and realized that she probably needed to refill her inhaler after all; the heart meds would have to wait for now.

In the adjacent medical building, Samir, known to most as “Dr. Patel”, was taking a few minutes aside from his busy schedule to meet with Donna, a pharmaceutical sales representative. Donna worked for a company that manufactured a biologic product for rheumatoid arthritis that, in Samir’s opinion, demonstrated an unparalleled efficacy profile with minimal side-effects. The venerable doctor would have liked for all of his patients to take this drug, but many had exorbitant co-payments or their policies excluded coverage for the weekly injections that cost $2000 per dose. Doing his best to meet his ethical obligations, Samir attempted to scavenge as many free samples as he could from Donna, which he then tried to ration to his patients most in need. He understood from Donna that her company was setting stricter limits on the number of free samples they provided, but that she would give him as much as she could regardless of how many vials his office purchased. In doing so, their conversation gradually shifted to the great healthcare divide, and Samir vented about his contracts with certain health insurance companies, how he had agreed to see 3,000 patients in exchange for half a million dollars annually because it sounded like a fortune at the time, but that after the malpractice insurance, renting out the office, maintaining his inventory, and paying for his staff and their benefits, he was left with a pittance even though on paper he charged $150 per office visit. The system was dysfunctional enough, and he shuddered to think about the quality of service physicians would be able to provide for their patients should healthcare be nationalized.

Donna, for her part, expressed concern that scientific innovation would suffer at the hands of socialized medicine. In her opinion, this was anti-Capitalistic, and would be the demise of this country’s prominent foothold in an industry that improved the quality of life of patients worldwide. She had already overheard some of her colleagues in Research and Development state that there would be no incentive for pharmaceutical companies to invest billions of dollars on the commercialization of a drug, and her company’s stock plummeted each time the President gave a speech on healthcare reform. Both Donna and Samir nodded at each other, commiserating with an awkward formality, until Samir was informed that his next appointment had checked in.

As he escorted Donna out in his usual refined manner, they both paused to look up at the waiting room monitor, the latest high-definition plasma model. “Oh look, it’s Obbama”, Samir pointed, over-emphasizing his “b”s in order to compensate for the accent his children often chided him about. “Good thing I’m not in this business for the money”, he muttered with sincerity in front of a room full of approving faces, his own face involuntarily grimacing at the possibility that he would no longer be able to provide his family with the standard of living to which they had grown accustomed. Donna sighed compassionately and shook Samir’s hand. Upon closing the door to his office, she immediately grabbed her mobile phone: she could be laid off at any moment, so protecting her stock portfolio was imperative. “Uh-Oh_bama. Pharmageddon: Sell!”, she texted with an astounding robotic dexterity to her in-law the broker. She chuckled to herself as she sent this message, but only for a second; it was funny and yet not funny, given her situation.

From his slate cubicle inside a stainless steel skyscraper, Robert could not see the surrounding Manhattan skyline, but he could feel her weight that day. Fast-talking and occasionally foul-mouthed, Robert adored the city that had cradled him since birth, and he viewed his job—as exhausting as it could be at times—as one of its blessed traditions. On this particular day, his phone had been ringing non-stop since the market first opened that morning. Robert was not surprised when he received Donna’s message, for he had been trading pharma stock all day, and he would have advised her to do the same. There was something special about that day, and Robert waited for the President’s speech with great trepidation. While he felt that the sick should not suffer, he also believed that any policy that would raise taxes would send the nation into a deep depression. Making just over $100,000 per year, Robert himself was in the highest tax bracket, but after state, federal, and local taxes, he only had approximately half of his wages in a city with one of the highest costs of living in the country. Nobody had ever given him any breaks when he was a little punk growing up in Brooklyn, and that was before Brooklyn began its gentrification. He had supported himself through school, he worked harder than all of his colleagues, and he could not stand the thought of the fruits of his labors going toward funding healthcare for those who were too lazy to put in their fair share. Robert was on the phone with his man on the floor when the press conference started. “Hold on, Hank”, he said, “Oh-Bummer is about to give another speech”, smiling with smug satisfaction upon hearing the sardonic cackle coming from the other line, the anticipated accolade for his recycled wit.

Walking just a few blocks away from Robert’s building was David, who was returning from a weekend of hedonism in Montreal with a few of his classmates. Along the way, he had stopped by a Canadian pharmacy to pick up some topical ointments for his mother’s psoriasis, since they cost one-sixth of what they did in the US, despite being manufactured and packaged by the same company and at the same site. David was on his way to deliver the medications to his mother when his route was blocked by pedestrian gridlock. People seemed to be congregating at Times Square, and like a typical New Yorker, David decided to follow and see what all the commotion was about. He observed the wide-eyed and open-mouthed throngs of spectators staring at something on the screens above, so he did the same and looked up. “Obama, eh?” he asked himself while shaking his head in amusement at how quickly he picked up the Québécois colloquialism. David did not know what to make of the healthcare issue; he still possessed Youth’s illusion of immortality, as well as the comfort of knowing that Canada was just a few hours away.

Those around David were chanting the same name in different ways and with different intonations, as were individuals in different states, cities, and towns across the country. Some said it with faith, others with hope, others with skepticism, others with dread, and still others with ambivalence. A cacophony of voices expressing a myriad of opinions as diverse as their sources. An estimated one million people marched before the Capitol on September 12th in protest of the President’s healthcare plan. Had he heard them? The crippled and chronically ill were greater in number but lacked the physical capacity to march. Had he heard them?

Pacing back and forth while Secret Service gave the green light to step out, President Obama couldn’t help but feel a bit anxious about the speech he was about to deliver. He had solicited feedback from key opinion leaders representing all sides of the healthcare debate, and was about to propose a new plan that he felt was the best course of action for the country. There was a sense of biological frailty about him at that moment—his lips were parched, his body had a gnawing hunger for a cigarette, and his stomach felt queasy, either from that morning’s breakfast or because he knew that many would not be happy with his message. More importantly, he had been plagued by a severe case of insomnia throughout the preceding week, the onset of which was triggered by an unrelenting low-frequency buzzing sound in his ears.

Obama awakened from his pensive reverie once the signal was given. He centered himself, and proceeded to walk toward the podium with an elegance befitting a President. The boisterous room fell into a hushed silence immediately, and even the photographers stopped clicking away pictures. Once at the podium, he poised himself and opened his mouth so as to begin his speech, but then paused for a second upon realizing that the buzzing sound that had been tormenting him for days had suddenly disappeared…and then he grasped its significance.

The nation was listening.



Tag der Veröffentlichung: 05.11.2009

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