Sean's Ear Infection

When a child gets sick, a family’s schedule gets upended. Parents debate who’s in a better position to miss a day of work. Then there’s the trip to the pediatrician followed by the wait at the pharmacy with a fussy kid. Under the best of circumstances, it won’t be a great day. I'd like to take you through what that day is like for a low-income family.

The alarm clock goes off at 5:30 a.m. You work the breakfast shift at a fast food restaurant. Your husband likes to get down to the home improvement store by 6 a.m. That’s where men line up hoping to get selected by contractors for day labor. You wake your 14-month-old, Sean. He’s been congested for a few days and hasn’t been sleeping well. This morning, you see beads of sweat on his forehead, which is hot to the touch.

You take a deep breath before you tell your husband the bad news, “Sean has a fever.” You and your husband earn too much to qualify for Medicaid -- which amazes you, because “too much” is not a phrase you’d use to describe your income. But Sean is covered under a program called the Children's Health Insurance Program. You’ll have to come up with a $15 co-pay. That’s doable. The problem is getting him to the doctor. Neither of you can afford to lose a day’s pay. You go downstairs to your cousin Ashley’s apartment. (It would be easier to call, but you didn’t pay your phone bill last month.) Ashley cares for Sean during the day. But she doesn’t want Sean to give whatever he has to her kids. She won’t take him to the doctor and asks you not to drop him at her apartment as long as he has a fever.

You make $8.25 per hour. Your husband makes more like $12, depending on the job. So you’re the one to miss work. You go back to Ashley’s so you can use her phone to call your manager, who sounds peeved. You know she has a pile of job applications three inches thick on her desk. You hate to disappoint her.

Not every doctor takes Sean’s insurance. You need to ride two buses to get to the right pediatrician. It’s 45 minutes on a cold day. Sean is miserable and cranky. At one point, he does some high-decibel crying that gets you dirty looks from your fellow passengers. You offer him a juice box. You sing to him. Nothing helps.

You wait 20 minutes at the doctor’s office. You’d had a little fantasy about getting Sean seen and well quickly so that you could make it to work for the lunch rush. This is fading fast. Finally, you and Sean are ushered into an exam room, where a nurse takes his temp. “101,” she says. “Have you been giving him Tylenol?”

“No,” you answer. You don't keep over-the-counter medicines in the house. Insurance does not cover them.

The doctor examines Sean and tells you he has an ear infection. He gives you a prescription for an antibiotic. “Does this need to be refrigerated?” you ask. When he tells you that it does, you ask if he can prescribe another drug that does not need to be kept cold. Your refrigerator is broken.

"It’s a tough day in your house,” the doctor says with a smile. “When’s the repairman coming?”

You smile back. “I'm not sure.” You haven't called a repairman.

The doctor writes a prescription for another antibiotic. He tells you to give Sean an over-the-counter decongestant and Tylenol and to call if Sean gets worse. You figure that’s about $16 in medicine that insurance won’t cover.

You take the bus home and stop at the pharmacy. You were right, $16. Sean has his eye on a puppet by the cash register. You’d like to get him a treat, since he’s so miserable. It’s $8.99. That’s impossible, you realize.

The doctor appointment was at 10:30 a.m. It is 1:30 p.m. when you get home. Even if you could get another sitter, it’s too late to go to work. You lost $49.50 in wages today. You spent $31 on medication and co-pays and another $4 on transportation.

Your husband had a friend who offered to fix the fridge if you provided the parts. You’d gotten some extra shifts this month and hoped that might happen. But even with a bit extra cash, you usually end up making some hard decisions. Do you buy enough diapers to get Sean through the week or do you pay the electric bill?

“We’re never getting that fridge fixed, Sean,” you sigh.

You boil some water to make him oatmeal and banana for lunch. You read that bananas have calcium in them and you feed them to Sean a lot now that you can’t keep milk in the house. There’s no TV and not a lot of toys around here. You are Sean’s primary source of amusement. You’re stressed out and would like to step out on the fire escape for a few minutes to just gather your thoughts, but Sean has gotten his second wind.

“Are you going to be better tomorrow so Mommy can go to work?” you ask him.

“Yes,” he says.

You really hope he’s right.