Wife Wednesday Episode 11 – Medical Bankruptcy & Cost of Caretaking

What a phrase means as a concept, and what it means when your own wife says it out loud about the two of you. On gig work, generosity, and the real math of caregiving nobody puts on a pamphlet.

I knew what the term meant. I’d used it in essays, in healthcare policy pieces, in something I sent to the Cato Institute once. I thought I understood it. Then my wife said something in passing that ended that.

We were talking about the general madness of gig work — and you’d be surprised how many people end up needing it, many with full-time jobs already. That’s the part of this story people miss. It runs through apps that demand more than the actual skill: internet connection, obviously. But also an email, and the email isn’t valid until verified by text, so now you need a working phone plan too, on top of the device, on top of whatever the job itself requires. All of it, just to make $18. Or $75. Privacy and “data breach,” anyone?

Melody said, mostly rhetorical: “What about poor people? People like us — people who are medically bankrupt?” And there it was. I’d been using the phrase as a concept. She’d just used it as our address. For the record: before Melody’s health went into decline, I had a full-time job, vehicles, side income, three degrees, decades of experience across industries.

We’re not here because of anything Melody did, or any one villain — though one healthcare system did plenty in 2025 and early 2026 to help us along. It’s simpler and stupider: her conditions cost time. Missed work, then less work, then care instead of contracts. Tolls. Fuel. Medication. Charting, appointments, coordination. A hundred small costs that don’t show up on any single bill but show up everywhere, eventually — and there are only so many hours to spread thin. Not just mine. Every caretaker’s.

Saturday, I donated plasma to afford Monday’s trip to treatment. Monday, the car found new ways to be expensive, in a week gas also spiked out of spite. That’s the actual math while we wait on payment for finished contracts — and if I had the bandwidth to build inventory and pull honey, there’d be income from the business too. There isn’t the bandwidth. That’s the point.

I’ve heard both sides — passionate defense of the poor, passionate blame of them. Mostly, from people who look and were educated like me, it’s blame: “no reason to be poor in this country,” “poor by choice,” “go to school,” “make better choices.” Did Melody choose two chronic, terminal illnesses? Did I not go to school — three degrees? Did thirty years across two industries not count as good choices? “Just get a job,” like the hundreds of applications I send weekly, cutting grass and hauling junk for a few bucks besides. None of it matters if it can’t be used. Over a year, more than a hundred applications a day: one reply, three interviews, six months. What does bite isn’t always legitimate — a recent gig paid eighteen dollars for four hours, and that’s not the outlier, that’s the going rate for a lot of my neighbors. Plasma pays $30 to $70. Draw your own conclusion about which is steadier income. And it’s not abstract: someone can be annoyed that gas is a dollar more expensive while, for someone else, that same dollar decides whether they can get to work at all. Not a guilt trip. Just the math for a growing number of people every time the cost of ordinary things ticks up.

We would not have gotten this far without the generosity of parents and real, actual friends — I’ve known that from the start. What I hadn’t clocked until Melody said it out loud is that it makes us exactly the population we’ve both spent years talking about helping. We have a support network, like most people hopefully do. That hasn’t made it easy. It’s meant we haven’t been homeless. Yet. No one owes us anything — but if you’ve sent Melody $5 or $20 like it was nothing, we hold that in the same high regard as the bigger help. Living this way, $10 is a lot more to us than to most people sending it. Both kinds of generosity got us here. Neither embarrasses us to say out loud, because it was a choice, and we’re grateful for it.

I hope this helps you see your own community a little differently — without the rose-colored glasses, and without waving it off because it doesn’t fit a political narrative. This is life a lot of families are living, right down the street from you. The next time you’re in a waiting room and see a pitiful-looking patient and a grumpy partner beside them, just know they’re tired, have a million things on their mind, and likely their own mental and physical health has been forgotten about entirely.

The Part That’s Actually a Job

Living with chronic and terminal conditions is a full lifestyle most people never clock in for. Most days I’m up around 4 or 5 — chores first, then email, submitting for work, checking whether any payments cleared, tallying the day’s expenses, planning everything else around whatever’s left. That part is dependable. Once Melody’s up, I get a real read on the day, but not before. Some days she needs someone with her, hands-on. Other days she handles her own laundry without a second thought. Nobody knows what her body’s going to demand until she’s actually up and I can see it for myself.

Lately the flips land worse — she’s able to do less, so I do more. Cleaning, cooking, bathing, rescheduling appointments, answering messages that pile up because there’s only one of me. The house rehab has nearly stalled. The land doesn’t ask permission before it grows.

The bees are feeling it too. Last year I missed the honey harvest outright — hospitalizations, then the usual summer rain the moment we were finally home. That one stung: the honey was there. I saw it, tasted a couple of samples, then lost the window anyway. This year it’s not hospitalizations, just the math of hours — her care, the property, and whatever gig work pays, all competing for the same finite me. I’ve likely missed the window again, for a completely different reason, which is its own kind of insulting. Looking to the fall flow instead, with the weather adding its own wrinkle to the math.

To be clear: none of this is a complaint, or anyone’s fault. When one spouse can’t carry their part, the other picks it up. That’s how marriage works — not martyrdom, just the job. I’d do it again without being asked. I’m also exhausted, in the way you only understand once you’ve lived it. I finally understand that look I’ve seen for years on other caregivers’ faces.

Where the Body Actually Was This Week

This was also the week pain sent Melody back to the ICC — not the scheduled trip from a couple weeks back, a different one.

A provider appointment came first, ahead of labs or transfusion, and that alone triggered a palliative care referral and a direct send to the ICC.

She also had a couple of nosebleeds this week — unrelated, but not reassuring, given the anemia and low platelets.

Here’s the part I’ll actually brag about: her oncologist followed up on the new pain medication he’d authorized Monday, then checked in again two days later, unprompted, just to ask if it was working or if she needed something else. Patient-centered care by any real definition. Proactive. Not standard.

We also spent a stretch in a different hallway, looking at the pollinator garden. Somewhere in the middle of all this, there were bees that weren’t mine, doing exactly fine.

Where That Leaves Us

Now that I’ve laid out this much of our finances, I hope it’s a clearer picture of what real life looks like for families like ours. If you want to help, the link’s below, always open. If you can’t, or don’t want to — no worries at all. It’s an option, never a demand.

Click the button below (hover over and you will see Melody’s name)

Next week: the numbers finally look like good news, and I make a nurse explain herself.