I was in pajamas watching Miss Marple when I first noticed I had cancer. It was the middle of the day, but I was in bed with a cold, surrounded by the detritus of minor illness: balled-up tissues, cups gummy with the remains of juice. The lump under my armpit felt like gristle in a chicken breast. I told myself it was an inflamed lymph node. On TV, Miss Marple clutched her handbag suspiciously, but I was only 32, mostly healthy, and underinsured. A doctor's visit cost money, and like so many millennials, I don't have any, so I put it off.
It was two months before I got the lump checked out. According to CNBC, that's not unusual for my peers. People in their 20s and 30s often skip or hold off on health care because they simply can't afford it. I had $70-a-month insurance that would partially cover a catastrophe, like an emergency-room visit or hospital stay, but was mostly a means of avoiding the fine that comes with having no insurance at all. The Affordable Care Act brought insurance to millions of people, including me, but high co-pays meant just as much waffling over whether an illness was "doctor's-visit-worthy" as before.
My gynecologist told me the lump didn't feel serious but sent me for a biopsy. The doctor who did the biopsy told me it didn't look like cancer and sent me for a mammogram. The nurse who did the mammogram said not to worry. Everyone chanted my age: 32, 32, 32, as if it were a talisman against cancer.
The talisman, like my health insurance, was worthless. I got a $1,500 bill for the biopsy, a $200 bill from the gynecologist, and a diagnosis of breast cancer. The kind-voiced nurse practitioner on the phone with the news told me that my New York State–run insurance was so bad she couldn't even find an oncologist who would take it. "We'll keep trying," she told me. I never heard back from her.
When I got my diagnosis, I was teaching two classes at a community college, writing corporate blog posts during my office hours, and selling $22-dollar-per-pound cheese at night. I'd realized too late that a Ph.D. in creative writing doesn't come with any guarantees for an academic job. I tried a nine-to-five reporting gig for a year. But a decade of full-time collegiate writing and researching left me able to finish my two daily 650-word reporting assignments about digital marketing and search-engine optimization in about two hours, meaning I spent the other six idly reading the Internet or crying in the bathroom.
So I decided that piecing together an income by pursuing disparate interests was a more exciting way to live, closer to the life of a grad student than a grown-up. With nothing more than rent to worry about, it didn't matter that I had less than $1,000 in my checking account and $150,000 in student-loan debt. It wasn't until I found out I was too broke to even discuss my treatment options with an oncologist that I realized why people trade fun for stability.
Not long after I got the news, I locked the door to the bathroom in the Brooklyn apartment I shared with two roommates and my partner and stripped from the waist up. I didn't even have a bathroom mirror, just a hall mirror in a chipped gilt frame propped against the window screen. A cross breeze often knocked the mirror askew so that I had to reposition it before I squatted to knead and stretch the skin of my defective breast, trying to see an outline of the thing that would cost me my protracted youth.
Before I had cancer, I could pretend "poverty" was performance art. My clothes mostly used to belong to other people: an old man's plaid bathrobe, a silly mom sweater embroidered with chessmen. My gaudy dishes came from garage sales and antique stores. The couch came from the returned-or-irregular section of Ikea. Money seemed like such a silly thing until I needed it.