The Unprofitable

Her illness is urgent. The system is not.

Note: I’ve received a few messages about the recent slowdown in publishing and commenting. I wanted to share why and offer something that speaks to the systems we’re still navigating, even when the headlines are elsewhere. Please know that I read and deeply appreciate every comment you all leave. When I am able to write, it’s a refuge, even if not a pleasant one.

Recently, my mother was diagnosed with a rare and aggressive cancer.

The kind that’s almost never caught early. The kind that demands fast decisions, urgent procedures, and coordinated care just to give someone a real shot at comfort—let alone survival.

What followed was not urgent. It was quiet. Avoidant. Dismissive.

She was uninsured after spending most of her life paying premiums for coverage she hardly used. She lost her job and thus her medical coverage on April 1st and that, more than her diagnosis, shaped everything that came next.

The first hospital gave her a stent to relieve the bile duct blockage—but when her labs stopped improving, they discharged her anyway. She was admitted to a second hospital days later. Jaundiced. Vomiting. Weak. And still, no one would give a straight answer about what was happening or what would be done. Every procedure was delayed. Every promise was vague. At one point, we were told that a needed treatment wouldn’t even be available until public assistance paperwork cleared.

What I’ve witnessed since has been horrifying—but not surprising.

Because this is what happens when you are sick and poor in America: care is rationed not by need, but by paperwork. The uninsured are deprioritized—quietly, bureaucratically. Families become the only case managers. And time is treated like a currency you shouldn’t have asked for.

Hospitals don’t have to say, “We hope she dies before this gets expensive.” Their systems are designed to do that work silently.

It’s why I’ve been a bit more quiet. Why I haven’t been as present. Because I’ve been in the hospital with someone the system is already treating as a foregone conclusion. I can’t unsee what that looks like now. And I know I’m not alone.

While the headlines churn with national tragedy and institutional collapse, people are still sitting in waiting rooms, on hold with insurance reps, begging for care that should’ve come without a fight. We’re grieving in real time—not just the people we’re losing, but the systems that were never built to hold us.

This isn’t about one person. It’s about a country that trains you to disappear once you’re no longer profitable to keep alive.