The Face of Texas Healthcare

I made the decision to run for the Texas legislature because of my inadvertent involvement in a needless death. When a young man sought my help to get treatment for cancer, I saw the tragic impact of Texas public policy on real human lives. I can no longer look away.

Although I am a full-time educator, I still do some pro bono legal work, so when I received a call asking if I would help a young man get on Social Security disability, I agreed. He came to my office wearing a bandana over the lower half of his face. I wondered what he was hiding but didn’t think too much of it at the time. My intent was to finish the interview quickly, get the process started, and get back to my own work. As we talked, the bandana fell and I was confronted with a sight so shocking it’s beyond my powers to describe.

The entire lower half of his face had been eaten away by cancer. His teeth, bones, and what was left of the muscles of his jaw, chin and cheek were fully exposed. Saliva had drenched the bandana, and pus oozed from the open sore that should have been his face. As I suppressed both the gag reflex and the urge to cry, I felt ashamed of my revulsion for a fellow human being in such desperate need. Knowing he must feel my visceral reaction to such a sight, I had to force myself to look into his eyes—a lovely shade of blue, I noticed—and tell him the truth. There was no way to complete a Social Security claim in time to help him—he would be dead before the first check arrived. Besides, he insisted he was still able to work if only someone would hire him. I think he knew why they wouldn’t: they couldn’t stand to look at him.

Over the next hour, I learned more than I ever wanted to know about the health care system in Texas. Our local hospital could help when he needed emergency care—stop the wound from bleeding or control the infection—but they don’t treat cancer. The charity hospitals in Dallas and Fort Worth offer free services for their county residents—he lived in Cooke County. The American Cancer Society only does research—they don’t treat patients. None of the many contacts I made could even give me a list of charities that I might appeal to. As I made phone call after phone call, my client became increasingly distressed and passed me a note, “Please find someone to stop the cancer.” Finally, I got a woman on the phone who told me, “Just bring him to the emergency room at John Peter Smith, and if it’s as bad as you say, they will have to take him.”

I did as she suggested and he was admitted that night. But, of course, it was too late to save his life. I asked the social worker there, “At what point would skin cancer be an emergency that would warrant mandatory admission?”

“When the patient is dying.”

“When would skin cancer so disable a patient that they could get Social Security disability and thus qualify for care?” I followed up.

“When they are dying,” she replied.

When they are dying? Is that when we should care?

I still have trouble getting the image of that young man’s wasted face and wasted life out of my head. I can’t unsee it. The revulsion I felt on our first meeting parallels the revulsion we try to avoid feeling with regard to the state of Texas health care in general. At some level, we all know that human beings are suffering and dying because Texas has the highest rate of uninsured and the worst health outcomes in the world’s richest nation. We can all read the statistics and understand on an intellectual level that more needs to be done, but most of us don’t have to stare it in the face. It’s easier to just look away and pretend that young men like my friend never existed.

Since this encounter, I have felt that to do nothing more makes me complicit in such needless deaths. Perhaps by running for office, I can at least force the conversation. Maybe I can keep some people, even some elected officials, from just looking away.