First, my student insurance quickly collapsed. I exceeded the laughable $750 annual cap on prescription drugs in a little over a month. My other option was Medicaid, the national program for the poor or disabled. Medicaid asks not, 'Are you sick enough to qualify?', but 'Are you poor enough?' It does not have room for those who can support themselves but cannot afford their medical bills; those who are often told, as I was recently, to make themselves poor by spending money--or, as elderly couples in Kalamazoo, Michigan, and elsewhere have been instructed, to pay for their funerals now to shed excess funds. The reasoning behind such advice is counter to the work ethic many of us learned as children. In essence, the government is telling us to become welfare recipients for insurance. Leave welfare, and you lose your coverage.

With no other alternative, I had my patrons write letters in which they confirmed that they had loaned me the money I possessed. With proof that the money I had wasn't mine, I waited the better part of a day at Harlem Hospital for an audience with a Medicaid clerk. She looked at me, at my application, then at me again, and said, 'I can tell you now, you ain't gonna get it.' I asked her why, and she said that there were thousands of others more needy than I.

It took over three months, but I did get it, and eventually Medicaid saved my life. During those three months without coverage I relied on the generosity of the medical community, whose doctors still take seriously the Hippocratic oath's injunction to do no harm. One resourceful medical worker, whose motto was 'We helps those who needs it most' provided me with free samples and recycled drugs -- that is, drugs donated by patients who no longer need them, or by the relatives of patients who have died. Recycling is as illegal as it is widespread, but it's necessary when so many can't get what they need. I have given medicine I no longer use to medical centers, and I have been helped in kind. In fact, a few months before my transplant, I visited an acquaintance who had just received her kidney. Though still groggy and in pain, she promised me that the remainder of her Epogen supply, a drug that helps create red blood cells, would be mine. She saved me thousands of dollars.

I also had necessary medicines air lifted from Spain, where, as in almost every other industrialized country but this one, the government regulates prescription drug prices. My friends sent me what I needed, incredulous every time I bemoaned our Kafkaesque system.

Once Medicaid was in place, I began in earnest the hunt for a kidney donor. A donated organ can become an unrepayable gift heavy with obligation and gratitude. But a lifelong quid pro quo is better than the alternative, namely, joining the waiting list for a cadaveric organ. Those who are on the list must wait their turn for someone to die in a hospital while on a ventilator. Though organs are the scarcest medical resource, Western countries have wisely outlawed their sale, preventing their becoming a commodity available to the highest bidder only. The contradiction that organ donation should transcend economics, while the medical coverage to keep these same organs healthy should not, has apparently escaped our legislators' attention.