“When I write up the documentation for your claim, I’ll follow the language I’m getting from your doctors here at Mayo, but I’d also like to hear about your situation in your own words.”
The mellow physical therapist made those chairs sound empowering, and we discussed their drive wheels and how to configure them for the lifestyle that I wanted. Beside him, a woman with Reliable Medical Supply grasped every little consideration. She knew how my needs would relate to the controls and the specialized gizmos and even the padding. We were all close in age, but they were likely some decades away from a state remotely like mine. With effort, I mirrored their calm and pragmatic attitude. No one got emotional. They could also better understand me that way, since tension in my throat or face degraded my speech. Even smiles made me slur, and so I couldn’t get too eager delivering my silly quips. I had to think about baseball. The therapist nodded as Danielle or I spoke, and I pondered his olive complexion and local, small-town background. I flashed on how I’d heard some people in the northland call themselves dark Norwegians. However he’d come by his color, he radiated solar warmth.
“These machines do cost… a great deal of money, as I’m sure you can imagine. It can be tricky to justify specific features as matters of need. I’ll certainly do my best, and you’ll be able to appeal any decision, but there tends to be a ceiling on what we can expect to be covered.”
It seemed that I would beg for something I desperately didn’t want: a fully customized, tricked-out, and motorized wheelchair. Such a thing had never even rolled through my dreams, and it was a bitch to accept my circumstances. But, I understood that we would build a bionic base of operations for what remained of my life. It was a big deal. We would have to find a way to pay for things that insurance wouldn’t. The two professionals seemed keen to apologize for our coming tangle with the industry, but at least we had some coverage. I thought of Hollis, and how his seizures had overwhelmed his brain and then our income when we were already down. We’d been remiss in that instance, gambling that we could slide for a month while paperwork cleared, but then I guess I’d like to think that our lapse had some context. Do you recall a certain American International Group, Inc., or AIG? The insurance, yes, insurance conglomerate tempted the events of late 2008, when it failed to hedge against its own arrogance and set off a panic that upended everything.
Security. Stability. For-surety. I hadn’t put enough ballast in my financial life, but in other realms, I’d let misgivings fix me in place for too long. I’ve read that people most regret the things that they didn’t do, the stuff they’d been too scared or stiff or subjectively busy for. At times, I’ve reassured myself by judging others. I’ve marveled at the grim way that some people play defense! I picture a man, pale inside his stronghold of stone. Through slits meant for arrows, he peers out at the moon. He imagines blessings beyond his walls, and how he might leave to seek after them, but instead he’ll make a stand. Against all that’s uncertain. How will he handle a disease like mine, with its insidious beginnings from within? How can he watch diagnosis dominate his future, leaving him the past to rehash and the now to grasp after? I can say that I’m grateful for the things I’ve chosen or stumbled into that scared and enlarged me. Some of them were arguably irresponsible or came with drift; with surrendering initiative. But, can’t you grow while being a bit reckless? Of course, commitments can be plenty risky and stretch you in unplanned ways. I guess I just figure that you want to meet life with an open heart, rather than calculation. While you can.
Besides a husband, father, and friend– roles which offer their perils and pleasures—my titles have been musician and carpenter. Now, artistic ambitions are often knocked. Question: What do you call a musician without a girlfriend? Answer: Homeless. Ouch! Or, dig this: How do you get a bass player off of your porch? Answer: Pay him for the pizza. Bam! So simple and instructive. But in lieu of money, musicians chase a blend of craft, fellowship, and transcendence. They may lose and yet find themselves along with an audience, if they can avoid self-conscious yips and comfortable ruts. And yes, they’re often lovable. Carpenters are supposedly “workers” who trade their sweat for some coin. Can’t you do better than that? And isn’t it dangerous and hard on your body? Admittedly, construction is especially vulnerable to an economic downturn. Just ask me. But then, who knew that carpenters solve cerebral puzzles as the sky sweeps over them? I sure found out. And though I built things for others, I was the toughest one to satisfy. When a complex project turned out well, I unabashedly admired my work. In our society, people’s jobs rarely line both their souls and their pockets. Too often, it’s neither. But ideally, isn’t someone’s work indivisible from his life and character? I’d hate to now realize that, above all, what I’d prized was insulation. That I’d most wanted insurance.
So I wonder, then, what we should make of a semi-decent person who gets fulfillment, money, and bedrock stability within the widely despised health insurance industry. I know I sure twitch at the thought of actuaries, cold and cadaverous, spinning fate in a centrifuge and skimming off profit. Promising to help mend the lives that break in qualified ways. But this person whom I’m imagining—though close to those horrors—sleeps easily. Her employer gives her surety because she’s mastered the process of reviewing medical claims, knows how to lead, and can make a denial stick. I tried to inhabit her on the ride home from Rochester. What could a person like that feel for my disease and how it whittled me? Danielle and I moved through the majestic autumn landscape, with its fields full of corn like shredded parchment paper. The sky rang with blue and gold. Bales of hay lay scattered on the pastures. But what I saw, ghosting over all of it, was that claims manager. She was mid-thirties and wore a blouse with a keyhole neckline. She had a chestnut bob and eyes like the lake beyond her Chicago office.
Andrea was proud of her team. Whenever she felt worn down and her world bled out its color, she flipped through vibrant mental slides of her people. Her talent. She’d recruited many of the adjusters herself. They liked to outdo one another, and she encouraged this because she was admittedly asking them—and herself being asked—to do a lot. Their play was competitive, too. She liked to laugh and flirt and loosen with them after hours, but there was a line, and back at the office they knew her deep marine eye contact in the morning meetings. There was so much coming down on all of them, so many claims to settle and filter. To adjust. She’d intonate a sober note of disappointment if it was warranted, but then move on. The approach worked. Claims were processed more quickly and neatly under her leadership than they had been with Megan’s, who’d been way too passive. Andrea actually loved the insurance business! She knew exactly how it’s games were played and that was fortunate, because she wanted so much out of work and life. At times she wondered if it shone on her skin, like when she ran through the wind off of Lake Michigan. Some flush must’ve been contagious within her team, a sense of being alive in this supposedly dry industry. It was their secret, and they ran together.
She needed to be first to arrive at their office and among the last to leave. It probably wasn’t sustainable, but she didn’t plan to be in this particular position forever. She was laying down a marker, like she’d heard a politician talk about on Fox. She’d noticed that the sun itself topped the skyline with less urgency as the season deepened, but this was not the time for Andrea to ease up. Maybe someday. Now, swiveling to meet the face of her favorite adjuster, the buoyant Jonah, she saw that his smile was too tight.
“What’s up?” She declared this more than asked it, seeing that he was rattled. He inhaled. “So, I’ve got a problem with a file that I capped out last week. The claimant wanted a powered wheelchair with every single bell and whistle known to man, and I couldn’t find any sort of precedent to grant that level of, you know, bling. Right? So, I sent back a limited acceptance letter. And somehow, the claimant himself—not even a doctor, though that would be plenty weird—he got my effing cell number and he’s been blowing me up all weekend, leaving messages that are super polite and sincere, but he’s damn sad and it’s messing with me.”
“Shut up! Seriously? So, that’s clearly a first!” She clapped her palm to her forehead.” I’m so sorry he harassed you! We’re going to document this, okay? Whatever we can do to help you and to protect the team in the future. Shit! That is so unsettling, the direct contact. Of course your cell number isn’t listed on anything we send out. He should’ve called our front number and been transferred to arbitration. The guy must’ve done some real digging to get your cell! You have to be weirded out. What even makes the claimant and his people think that he needs such a high-end chair, anyway?”
“He’s got this intense degeneration in his nerves, the ones that move the muscles. It’s a something lateral sclerosis. I guess it’s brutal. I do really feel for him, you know, but like I said, there’s just no precedent. What do you think I should do?”
“I’ll call his PT after our team meeting, Jonah. I’m glad that you brought me into this. Besides, I really need you to be yourself today!” She touched his shoulder and squeezed for a moment. “Let me talk to them here really soon, all right? I’ll be gentle, don’t worry.”
Gentle, she thought, because Jonah seemed unnerved. By sadness? The guy’s laugh always made her Mondays. His gaze had also failed to map her body’s contours, something he usually pulled off with discretion but a flattering sense of appetite. Her phone buzzed in her pocket. A text from a number she didn’t know. “Do you feel me?” Weird.
She shut the door to her office. Out in the cubes, the crew was getting rolling. It was like triage layered over edgy banter, a sexy hospital drama for a nerd such as her. But she needed to think.
Instead, her smart phone began to vibrate with alarming urgency, like in a severe weather alert. The screen was black and flashed red lettering. Loading Advanced Empathy App….Please Allow [ ] or Deny [ ]. She made a sharp noise of surprise and pecked the “Deny” box, but the phone swelled into its ring tone, a loop of house music that normally steadied her, but now felt artificially intelligent. The incoming number was a string of ones. She had a wild impulse to hurl the phone to the floor and smash it with the heels of her pumps, but she fought it back. Instead she answered, “This is Andrea.”
Back when she was maybe seven years old, she’d been with her grandparents at their lake cabin, on the communal dock with its weathered wood and styrofoam. Her grandma was going to hose her off; get the sand that would chafe everything if you let it. But, when the water hit her skin, smelling like sun-warmed vinyl, it felt so incredibly wrong! Her body tried to fold in on itself, shoulders and hips and knees drawing together against her will. She felt powerless. Clenched. She must have screeched, something made her grandma swing the hose off of her, saying, “What in the devil, child?” Her grandpa came clomping down the dock as she yelled that the water hurt her. He was a perceptive man, and finally he whistled sharply. There had been something about an outlet or a wire, something slipshod that sent electricity into the water.
Thirty-odd years later, Andrea drove her phone hard against her own head as she again felt that powerful, involuntary tightening in her right arm and down through her chest, and it was hard to take much more than shallow breaths. Her sense of her surroundings grew unstable and then it all dissolved. She saw entirely new and unfamiliar things; heard and felt them, too, but with the creepy certainty that she wasn’t in her own skin. There was some sort of a lab, where a bearded man ran needles into someone’s muscles—it sure felt like her own—with a thin wire feeding from each needle. He asked her to flex, repeatedly, as he studied a screen and listened to the grainy sounds on a speaker. Then, wearing a suit in a small office, the same man pushed and pulled on her arms and legs and head at different angles, frowning as he urged her to resist him. He had her touch her own nose and make rubbery faces. He scratched the sole of her foot as if to draw something from her, while she stared at the windowless walls thick with diplomas and awards. Then, after hunching over a computer in silence, he turned and spoke earnest words to her.
“It’s quite serious. You shouldn’t be getting weak and stiff like this. I’m going to order a large panel of blood work, an MRI, and a lumbar puncture, or what’s commonly called a spinal tap. Right now we have a fairly long list of things that we’re looking at. You should know that cancer is on that list. Autoimmune disease is on that list. ALS…is on that list.”
Then Andrea was on her side upon a soft table, a white sheet crinkled beneath her. Her face was toward the nearby wall, her body in a loose fetal position, and her pants and underwear tugged down so that she felt the air on her butt crack. A woman stood behind and over her. “I’m just going to mark the spot where I’ll go in,” she was saying. “Right between the L4 and L5 vertebrae.” Something pointy wiggled against her spine. “Did the doctors say what it is they’re looking for? You’re just so young.”
Now Andrea was again within her own body and her private office with the door closed, with a sleek phone jammed against her ear and no one hearing her moan, no grandpa running to see why. Her ear throbbed and now that doctor was in there with his prickly beard. “The last few tests all came back negative.” He paused. “I’m afraid that we’re left with ALS. I’m sorry.” Then she heard a pop from within the phone itself, something wound so tight that it broke. And she could move again. It seemed to be over.
Andrea collapsed at her desk and watched the distant glint on the lake. What? This was not at all okay! Was this schizophrenia, or one of those other really unthinkable conditions that she’d learned about in college psychology class? She hit some online searches, and as she typed, her right index finger and parts of her hand and forearm seized in a cramp. Pain and a feeling of frustration, but then the muscles released. Whoa. Her searches just made her feel more anxious, and she decided to try and put the whole episode aside for the moment. Get some familiar control going again. Thankfully, the details from the experience were fading fast, but there was a strong afterimage of a doctor, or perhaps her grandpa. Something had been wrong and she’d felt extremely frightened. And sad.
Like Jonah. She pulled up his recent files and found the one that he’d spoken of. Could her bizarre adventure be related somehow? This couldn’t wait any longer. She needed to get any and all weird, remotely threatening bullshit off of her plate right now. The claim was out of Rochester, Minnesota. The Mayo Clinic. They were usually consummate pros over there. She found the PT’s number and dialed from her land line.
Her title did not impress the man who answered. Nor did her voice, it would seem. That was probably because her rapid, precise diction and tonal shading were most effective when they accompanied her eyes. But, she had to admit that her tongue felt a bit thick just now. Like she was on her third margarita at El Tejaban! Her words always just burbled out, but now they took concentration. What was going on with her? The guy on the phone was certainly nice enough, much more than that, actually. He was just irritatingly patient with her. As if she needed to learn something. He sounded like he might be smiling. She made her case on the disconnect between the claimant’s current condition and his request.
“But it’s all medically necessary, Andrea. This is a progressive disease. It only gets worse! There aren’t even meaningful treatments, let alone a cure. Mr. Carr has been falling with a cane and a walker, and so I’m sure you’d agree that he needs to be in a chair. But, I don’t think you understand that we’re still early in the course of things for him. He’ll be using the chair for a while, so it needs to be able to adapt and expand to meet his specific and increasing needs over time. Those needs are truly alien to most of us. But it’s the situation that he’s in.”
She brought up the way that Jonah had looked that morning. Shaken. Why was this Mr. Carr calling her adjuster directly? That wasn’t defensible, was it? How would he have gotten the number, anyway?
The physical therapist laughed like it hurt his ribs to do so. “I certainly didn’t put him up to it, but I will tell him that those actions are hurting his cause. He seems like a good man, but I can imagine that he’s a bit desperate. He was in his prime. I’d really appreciate your personal accommodation in his case.”
Andrea had to admit that Mr. Carr probably deserved a great deal of sympathy. But did he deserve an eighty-thousand dollar payout by her employer, for what were arguably quality-of-life rather than medical issues, when maybe half of that amount would do? She needed a strong close to this year, because corporate was watching her numbers closely. Things were so unsteady with all of the new, sick people getting insurance and the healthy ones dodging premiums. She didn’t think for one second that it would bankrupt the company, though. The amount of money sluicing through the place was ungodly! There were people above her—and, of course, there were the shareholders—who could certainly handle smaller bonuses and dividends. But, they wouldn’t get to blame her if that had to happen. No way. She was a climber.
“I believe that we sent Mr. Carr a generous but limited acceptance letter,” she replied. “We want to help, but we have norms that we follow. Proven standards. I suggest that he contact an arbitrator if he’s not satisfied. You’ve certainly made a good case, and perhaps a third party will side with him. I do wish him luck.”
There was a long pause. “I see. Well, I’m so glad that I was able to address your concerns.” Just as that ripened to the point where she smelled it, he hung up.
As Andrea stood, it seemed like the casters of her Aeron chair were lubed with fresh silicone spray. Her trunk lurched diagonally beyond her center of gravity and…she just couldn’t recover! She went down on the industrial carpet with a squawk. Someone was knocking on her door, and then they opened it. “Andrea?”
It was Chris. Why did it have to be Chris? He was as hunky as they came, and he played little games where he teased his full respect for her, or maybe that was the wrong way to put it. He had a hell of an edge, and this was a very awkward way to meet him on a horseshit morning. How was that?
His hair and his cultivated stubble hovered over the situation. His mouth fought to stay neutral as she struggled to her feet. “Ka-rith!” she exclaimed. Wait. It was supposed to be, “Chris.” Nice and crisp, right? Now, his eyes were the dynamic ones as they tracked her at double frame-rate, darting and flicking over her.
“Too many mimosas this morning? Why didn’t you share?”
“I doan know whas going on with me too day. I doan feel right. What can I do for you, Chris?” Her speech was deteriorating. Was she having a stroke? This was getting scary, but she was tough and no one would see her be vulnerable. Hell, no! Chris kept on appraising her, clearly amused but curious.
“Well, it’s Jonah. He was like a zombie and then he just walked out. Nobody knows where he went or what’s up with him. Did you talk to him?”
“Yes, but weer not fin nished. Can you keep evey one cool while I track him down?
“You know it. But what about…”
She was moving past him. Her butt and calves and thighs felt wooden. She had to nearly force each step; really focus on mechanics. As she reached for the knob on the outer office door, her shoulder cramped and she had to put her left hand over the one already on the knob, just to turn the damn thing. What was this?
She rode the elevator to the tower’s ground floor, heading for the Starbucks coffee shop. She often brought individual team members there for performance reviews or on occasions when she thought a neutral setting was called for. Jonah loved his coffee, so there was a chance that she might find him there, collecting himself.
She scanned the room but came up empty. Damn! She didn’t recognize the barista, a tall, middle-aged woman who seemed nervous. She was probably new. Andrea approached her with stiff strides and leaned against the counter.
“Hi! Have you theen a lung guy, in a salmon colert thirt? He might eff come through here in the las hour?”
Her voice was both nasal and hoarse. She was honking, and to her own ears she sounded quite drunk. But the barista had a different take. She put her hands in the middle of the counter and leaned across with a straight back and her neck fully extended, close enough for Andrea to notice her imperfect teeth and coffee breath.
“I AM SORRY, BUT I HAVE NOT SEEN ANYONE LIKE THAT THIS MORNING.” She shouted it with robotic affect, boring into Andrea to make her understand. Because she thought she was deaf, maybe. Or slow.
Exasperated, and with effort, Andrea ordered an iced coffee. But as she took a seat and her first sip, something went wrong at the point where her throat branched into separate pipes for stomach and lungs. She sprayed coffee across the table! Luckily, no one was nearby, although several heads turned. She took a few more sips, holding the liquid in her mouth and then breaking the swallowing into discreet and manageable steps.
She brought out her cell, intending to try Jonah. But the phone was fried or something. When she tried to use it, the damn thing vibrated angrily and red lettering spelled out: Advanced Empathy App in Progress!! Time Remaining: 2hrs 18min 37sec. Please Standby.
She just wanted to get the fuck out of there. She rode the elevator three stories below street level. As she walked up the incline of the parking deck toward her Audi, her lower body might have been fighting against a waist-deep current, with flippers on her feet! She heard herself grunting and cursing. Beside her vehicle, she struggled to fish her keys out of her purse. Everything was so hard and awkward. After sliding onto the driver’s seat, she pulled her legs inside with her hands as if they were prostheses. Turning the ignition required everything she had. As she put her right hand on the gearshift, Andrea noticed that the musculature between her thumb and forefinger had melted away, leaving an apostrophe of bone and a hollow socket. She began to feel a pulse of true horror and disbelief. What was this, what did Jonah know? And that PT in Rochester and his client, what about them? What about whatever was happening with her cell phone? And that whole hallucination thing? She felt poisoned or cursed. Attacked. This was evil! She was determined not to give in to panic, though.
Driving up out of the parking deck into daylight was exhausting. Negotiating the tight turns required her to keep lifting her arms to reposition them on the wheel, and they were leaden. It felt like she’d lost her power steering, as well. When she went to pull her card out of the scanner at the gate, she found that she needed both hands to grasp it. She just didn’t have any pinch strength!
She made it back to her condo without incident, and there must’ve been luck involved. As she parked, she wondered if she should have driven to the hospital, instead. No, no, she was probably just stressed or overtired; having some sort of a breakdown, right? Because she was crazy healthy. She ate organic everything, and drank measured red wine and practiced yoga and jogged. Weird wasting diseases happened to people who ate bush meat and brains in New Guinea. Right? Her mind was just messing with her and she needed rest; maybe some meditation.
She had to climb three steps in front of the building, and they were hell. She used the railing to pull herself up, groaning with exertion. While she was doing this, a pert blonde whom she’d seen around bounded past, her bottom half dipped in lululemon. That bitch! All nonchalant with her heart-shaped ass that functioned so well.
Andrea nearly fell as she entered her unit. It was like stepping on ball bearings. She moved carefully along the hallway, sliding her hands along the walls. Once in the bathroom, she removed her clothes with maddening effort. The mirror showed her something monstrous. All over her body, muscles were twitching and jerking and pulsing and writhing. Her upper arms had withered so that they were spare as ax handles. Her shoulders were bony prominences. Most awful of all, her belly pooched out! It wasn’t fat, exactly, but more like her innards were pressing on abs that had no tone. None. She couldn’t suck it in!
She would shower; take a nice, long hot one and nap beneath a fan. Get some freaking rest and then…see what was what. There had to be an explanation for this. Right? There had to be. She bent carefully and turned the lever on the shower valve. The water warmed and she tried to empty her mind; prepare for the suddenly intimidating process of entering the tub. One leg slowly came up and over, her toes dragging on the cast iron lip. Made it. She walked her fingers up the tile above her head like a spider, forcing her hand ever higher until it could grasp the pipe behind the shower head. Now, she ever so carefully brought her second leg into the basin, shuffling and sliding her feet into a stable position. With her one hand still gripping the shower head, she reached behind her and pulled the white curtain closed. She let the water do its work.
Only one arm now had the strength to bring shampoo to the top of her head and massage it through her hair. The other arm palmed the tile in front of her, keeping her from falling forward. Then she made the mistake. After she’d rinsed the backside of her head as it hung down, she simultaneously tilted her face back, used her stronger arm and it’s fingers to comb her hair away from her forehead, and took her weaker hand from the tile to clear her closed eyes of any remaining shampoo. Then she was suddenly past a point of no return. She was falling backward. Shit! She couldn’t recover; couldn’t take a step back to stabilize. It seemed like she fell forever. After her head struck the tile at the back of the stall, it slid down and banged against cast iron, finally coming to rest on the slope of the tub, her chin tucked to her breastbone. Hot water hammered her face.
She couldn’t sit up. Not even one inch! Nor could she rotate her torso. The water kept coming, and it got into her mouth and down her throat and found the wrong pipe again. She coughed weakly. Those muscles were failing, too. Jesus, it was even hard to breathe! It felt like bricks were on her chest and she had a flash from that play, “The Crucible”. A man asking for more weight.
Andrea realized that she would die there. She couldn’t even raise her hands to cover her face, and the water and the weight would be too much. She was not at peace, realizing that she had gotten so many things wrong. She had no husband or boyfriend or partner of any sort. No pets. Her parents and her brother were thousands of miles away, and she knew they wouldn’t hear her scream now inside of their minds. They’d stopped listening for her a while ago, even for her laughter. Because she’d grown too insulated; too smug inside her titles and her steady rise toward the top of…what? An insurance company? The kids on her team cared mostly for themselves, anyway. They’d had some fun together, but who would even remember? All of those claims, they had been real people with pain that she’d instead spun into numbers.
She felt the thump of her front door closing. Then, over the spray of the shower, a strange pair of sounds closed in. First, a combination of tap with thunk, and then a drag. On the wooden floor. “Thap!…drag…Thap!…drag”. Ever nearer. Then a man was singing an old song by Peter Frampton. “Doooo you, YOU! Feeeel like I do? Lemme hear ya. Doooo you, YOU!” he demanded, now right outside the bathroom door, “Feeeel like I….oooh. Everything okay in there?” She could only moan.
Through the translucent shower curtain, a shadow lurched toward her feet. “Thap!…drag”. A hand peeled back a bit of the curtain, reached for the shower valve, and turned off the water. “My goodness, let’s get you a little more comfortable! Don’t worry now, this will all be over soon.” The shadow lunged toward the end of the tub where her head was throbbing. “Thap!…drag”. The hand again peeled back a small portion of the curtain.
A man stood over her. He was Andrea’s age, tall and stooped in an odd way, and he held onto a cane. His face was unexpectedly kind, and a little sad. He was trembling; twitching.
“So, I’ll bet you can guess who I am. I’ve been in touch with Jonah, who has great things to say about you. My physical therapist, not so much. He advised against this but…you know, several people in my life had suggested that I’d make a good teacher. It’s too late for that now, at least formally or professionally but, in you I saw an opportunity for, what do you types call it? Continuing education. I get the feeling that you’ve learned a lot today.”
He turned and looked at her phone on top of the sink. “Anyhoo, I’d better be off and you’re going to need a nap. When you come to, I think you’ll be wide awake, more awake than you’ve ever been in your life. This one goes to eleven!” He laughed but then seemed embarrassed. “I apologize, that’s from a dumb movie called “Spinal Tap”. Hey, but you know something about those now! All right, well, I’m sorry this had to be so awkward and creepy and weird, but I figure I might as well die trying. Do you feel me?” She nodded weakly, and blacked out.
Andrea awoke in darkness. Before she realized what she’d done, she’d sat up and climbed from the tub and snapped the light on. The mirror showed a toned and supple body. She was back! She wrapped herself in a robe and sat at her dining room table, opening a laptop. She would write two letters. One would be the full acceptance of an individual medical claim. The other would offer her employer her resignation. She was in her prime, after all, and didn’t need to hedge against her own life.