My dad's type is small for a cancer.  It's aggressive, but hasn't spread.  It's one of the most treatable types.  We're lucky I suppose.  He was diagnosed in March and I've been meaning to write about the financial aspects of our ordeal.  I got my parents' permission months ago.  It seemed to me it would be an informative and useful thing to do, to show people what it's like to be sick in America.  

And money is straightforward enough.  I envisioned telling you about my parents' budget, outlining their monthly medical expenses, describing the intricacies of their insurance coverage, damning the medical industry with facts and numbers.  No need to get all emotional about it, it's all there in black and white.

But I've found that I can't write that imaginary article.  I've tried, but things are all tangled up somehow in everything else.  They've become fragmented. I'll start with a fact and find it stuck to a feeling.  I'll relate an action and find it wrapped in a memory.  I've lost the ability to be linear.

Here's a piece of it:  The man I call my dad is really my step-dad.  I wasn't even small when he married my mom.  I was fully grown at the time.  Yet he's been my only dad and a word that once meant nothing to me is now filled with love and memories.  He's a good and kind man, always young at heart.  He was a journalist for 40 years, but he'll correct you if you call him that.  "What's a journalist anyway," he'll say.  "Sure they went to college, but can they write?"  He calls himself a newspaper man.  

He tells a great story, my dad, and he loves a good laugh.  He's got a big heart and has led a big life.  He's been a wonderful grandfather for all of my son's twenty years.  We walk into the hospital every day now to get his radiation treatment and we pass through this lobby.  

I think it's designed to impress, but it doesn't.  It's just too big.  I know my parents feel it, too.  My dad shrinks a bit in his wheelchair every day and I get angry at this excessive lobby for making my dad feel small.

His heart's another piece:  He went in for a physical in the early 90s and ended up having a quintuple bypass.  His heart was so bad they wouldn't even let him walk up the steps to the hospital.  Although he was a union guy and had good insurance, the medical bills wiped out their savings.  Not long after, he was forced into early retirement.  He wasn't so young at heart after that.  His life started shrinking then.  So did their finances.

As we walk through the hospital to the cancer center, there are so many nice touches -- soothing aquariums, beautiful flowers, even a grand piano --

-- but I can't enjoy them.  I'm thinking about the money, the costs.  I suppose in this system it makes sense -- they have to attract customers, make a profit.  I wonder about the people who do these jobs -- tend the garden and clean the ponds -- do they have health benefits?  Can they afford treatment here?

It doesn't seem right to be so concerned about money at such a time.  It seems so grubby and mean.  But there's the reality of a fixed income and no amount of staring at fish can distract me from that.  It's consumed me these past weeks.  I've gone over and over the budget and the numbers don't work.  They have insurance.  It all seems reasonable at first -- $15 co-payment for the doctor, $30 co-pay for specialists -- it doesn't seem that bad in pieces.  As a whole, though, it adds up.  It crushes.  Two visits to the doctor and three to specialists just last month -- $120.  And they already pay $226 a month for my mom's insurance and $95 a month for my dad's.  Not to mention over $600 a month for the medications, and that's just the co-pays.

The last visit he was supposed to get a shot and they sent us home instead.  It cost $1,500 and needed pre-approval from the insurance so we had to wait.  The co-pay on the shot would be 33%.  And the bills had come in for the tests, the ultrasound, the CT-scan, the MRI -- almost $800.  They didn't have it.  

A few years ago, my dad's pension people had informed him they were canceling his $20,000 life insurance policy and replacing it with a $10,000 health savings account.  What seemed like an affront at the time now felt like a godsend.  I spent two weeks going through all their paperwork, statements, receipts, frantically trying to get reimbursed for expenses paid over the years to cover the current expenses.  

And they won't even tell us how much the radiation will cost.  They claim not to know, but said it will be "thousands."  We're wondering how long that ten grand will last, if it will get them through these 42 days.

I know my dad is thinking of this as I wheel him into the cancer ward.  There's an indoor fountain and various art that I presume is supposed to be comforting.  "What is this, a museum?" my dad asks.  

The waiting room is pleasant and has its own pond just outside the window.  

There's coffee and tea, magazines and a puzzle.  A fridge stocked with juice and fattening nutrition drinks.  We all grab drinks every day, working off the same impulse -- might as well get what we can out of them.

That first day my dad looks down.  I'm staring at the pond and I suddenly see him.  I see him objectively -- the newspaper man with the big life is gone for now.  The survivor of the Great Depression, the Air Force man, the jazz musician, all distant memories.  I see my dad, my son's beloved grandpa, looking fragile in this room.  He's sick and he's suffering.  What's worse, he feels like he's a burden.  He fears he can't pay for all this and feels he failed somehow.  He told us the other night that we'd be better off without him.

I reach over and pat his arm.  We're not sappy people, neither of us, and we take some pride in that, but he clasps my hand on his arm and tells me he's so happy he has me for a daughter.  That he's proud of me and that I've made his life so much better than he'd imagined.  I kiss him on the top of the head and say I love him too.

When the technician wheels him out to the treatment room, I sit for a minute and am suddenly consumed with fury.  I am incensed at this system that profits off the sick.  I am enraged that it's made my dad feel small.  This is a place where people come to face death.  A place of healers and transformations.  If that's not sacred then I don't know what is.  

For a moment I feel strong in my rage and I want to tear the art off the walls and smash the windows and run the moneychangers out of the temple.  But just for a moment.  Nothing will be solved by a smashed vase.  Nothing will be solved by one person.  The problem is too big.  The rage quickly passes and I'm just tired and sad.  I go sit at the table and stare at the puzzle for awhile, but I can't get a single piece to fit.