"Stay and Fight" by Sarah Horne

I work in the healthcare industry, at a nonprofit organization for the homeless and economically disadvantaged in Milwaukee. We provide primary care and psychiatric care to a client base of thousands. In this industry you hear the term "burnout" thrown around quite a bit. You see caseworkers and outreach workers enthusiastic and happy one week and then quitting abruptly amid a flood of tears and cursing two weeks later. You see a lot of glassy eyes and slumped shoulders. You hear a lot of off-color bordering on inappropriate gallows humor because sometimes laughing about all of it is the only way my coworkers can make it through a day.  I work in the medical records department, so my contact with the clients is minimal, but the medical records room has become a place for employees to trade war stories and not only vent about clients and other employees, but express wonder and frustration about what's going on in Washington these days.

A lot of what I am about to tell you is going to seem impossibly underinformed and somewhat naïve, because as closely as I am following politics and the elections and the state of the health care industry in the United States, and even though I feel like the last year has absolutely galvanized me and made me feel sick and hopeful and angry and afraid, the fact is that I come from a comparatively privileged, lucky life, and there is still so much that I just simply don't know. I had two parents who loved me and wanted the best for me growing up. I went to college, got an English degree, went through all the trials and bitching and moaning about the cares and worries that come with a sheltered good-girl middle class life. I was protected by my father's health insurance until the age of twenty-five. Even though the following five years were kind of unsettling if I really thought about what could happen to me and how much it would cost to fix me if something did happen, and how $8.50 an hour temping jobs were really not going to cover it, the fact is nothing major did happen. I've never even broken a bone.

Compare my story to the people who come into the clinic every day. These are people who have fallen through the cracks. These are people who grew up in The Bad Parts Of Milwaukee, the ones who you hear about on the six o'clock news and cluck about, and who you get all liberal white self-righteous about while feeling powerless to do anything. You feel either guilty or secretly relieved, relieved because you are not them, and then you feel guilty about your sense of relief. These are men and women who trade sex for drugs every day. These are men and women who have seen emotional, sexual, and physical violence all their lives and escaped to the streets and to homeless shelters and to the fog of drug abuse because they can't take it anymore, and they are the people who stay with their abusers because their abusers are the only ones in the world who truly know them and claim they care. Sometimes it is less dire than that—sometimes they come because they are working, can't afford health insurance and just need a professional to talk to. The extremely dire situations are the ones who are handled by the caseworkers, the people who are on SSI and can't handle things that we take for granted like being able to pay an electric bill or being able to handle a trip to the grocery store. These are the people who don't bathe for weeks—not because they are crazy or psychotic, but many, many times because they have known some kind of abuse in their lives, and if you smell bad, people stay away. It's a shield. It's the only way they know to signal to the world that they have known and experienced intense, unthinkable pain.
Our client base is growing exponentially what feels like every week. Sometimes it is more paperwork than I can handle, and I am just the goddamn file clerk. It is growing not only because a recently-expanded staff of caring, talented doctors, but also for reasons that are less sunny and optimistic, I fear—every day that this economy gets worse, every day more people are falling through or coming out of the woodwork or having psychotic breaks. Not only are there more people, but these people's worlds are shrinking, because more times than not our clinic is the only place that they can go in Milwaukee. I learned very recently that it's not uncommon for a victim of sexual assault and the victimizer to have appointments on the same day, and that often times victims will stop coming to the clinic because they feel unsafe in the waiting room. And what happens to these people if John McCain gets elected, if there is a spending freeze on everything except defense and veterans' affairs? What happens if Sarah Palin's wishes about the power of the vice president is expanded, or if she becomes President and abortion becomes outlawed and women have to pay for their own rape kits? What if the fears that my friend has expressed in conversation that there is going to be more competition for grant money in the world of nonprofits regardless of who becomes president and that we can no longer afford to operate as a clinic come true and close down altogether?

There is the school of thought that goes if you think in terms of "what if's" constantly you may as well just stay in bed for the rest of your life. I think the problem with where this country stands right now is that we who did not agree with the policies and actions of the Bush administration got to a point where we felt so beaten down that there was no point in fresh outrage anymore. This is not to say that activism stopped or to diminish the accomplishments of those who did fight for what they believed in—it's just that it felt quieter to me.
I can't be quiet anymore. I can't sit around coffee tables anymore and talk about how awful everything is now and will be in January 2009 if the wrong man becomes president and vow again that I am going to move to Canada. I am going to vote for Barack Obama because I actually believe in him, instead of voting for him simply because he has to be better than the alternative. I believe that Barack Obama cares as much about these people whose stories I hear about, who I see in the waiting room, who I see on the bus every day. And I am going to stay and fight.

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