A working mother in Forest City, NC discovers chest pains but faces a $2,000 deductible she can’t pay. This is her story of fighting for healthcare when the system wasn’t built for her.

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Hard Times in Forest City: A Story of Survival and Persistence

Part One: The Night

I’m layin’ in bed and I can’t sleep. That’s nothin’ new. Most nights I lay here listenin’ to Caleb snorin’ through the walls—boy could wake the dead with that racket—and thinkin’ about stuff I don’t want to think about. Tonight my chest feels like somebody’s got their hand inside me squeezin’ my heart like they was wringin’ out a washrag. Not sharp pain exactly. More like a pressure. Like somebody’s sittin’ on my chest but they ain’t heavy enough to hurt, just enough to make you know they’re there.

I’m forty-three years old. I work at Pilgrim’s Pride in Morganton, third shift, cuttin’ chicken parts on a line that don’t never stop movin’. You stand there for eight hours with rubber boots on feet that swell up big as watermelons, and you got this constant noise in your ears that you don’t even hear no more until you get home and it’s quiet and your ears are ringin’ like somebody’s pokin’ a finger at a bell inside your head.

My boy Caleb, he’s fifteen. His daddy run off when Caleb was six, and I ain’t seen hide nor hair of that man since. Last I heard he was down somewhere around Atlanta with some woman who don’t know what she gotin for. Caleb don’t talk about him much, and I don’t push it. Some boys got a daddy that left, some boys got a daddy in the ground. Either way, it ain’t the kind of thing you sit around talkin’ about.

I’m layin’ here and I’m thinkin’: is this what a heart attack feels like? I seen my mama have one when I was nineteen. She was standin’ in the kitchen one second, holdin’ her chest and makin’ this face like she was smellin’ somethin’ bad, and the next second she’s on the floor and I’m screamin’ for my daddy and she’s gone. Just like that. Gone.

I don’t want to wake Caleb up. I’m sittin’ up now, on the side of the bed, feet touchin’ the cold floor, and I’m rubbin’ my chest and I’m thinkin’: if I die right now, what happens to him? He’s fifteen. He don’t got a daddy. He got me. And if I go, who does he got?

That thought ain’t the kind of thing you let yourself think, but layin’ there in the dark with your chest squeezin’, you don’t get to choose what you think.

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Part Two: The Wait

Dr. Pemberton’s office is that little brick buildin’ on Oak Street, the one next to Family Dollar. I been goin’ to that doctor since I was smaller than Caleb, back when his hair was dark instead of gray, back when his nurse Gloria wasn’t yammerin’ about her grandkids yet.

I told the receptionist—Shelby, her name is, and she got this way of lookin’ at you like she’s judgin’ your whole life by the way you’re dressed—I told Shelby I needed to see the doctor somethin’ urgent. She looked at me over them glasses she don’t need wearin’ pushed down her nose and she said: “He can see you next Thursday.”

“Next Thursday? I’m havin’ chest pains.”

“All our patients got somethin’,” she said. “You can fill out a form and we’ll call you if there’s a cancellation.”

That’s how it is round here. You can be dyin’ and they still got you waitin’ two weeks. Not because they don’t care—Dr. Pemberton cares, I believe that—but because they got a hundred other people just like you, all of ’em hurtin’, all of ’em waitin’.

So I filled out the form. I sat in that waitin’ room with the tissue boxes that always got the cheap ones that fall apart in your hands, and I watched the little TV mounted in the corner where some preacher was yellin’ about Jesus Christ savin’ us from our sins, and I thought: if Jesus saves anybody, why don’t he save us from this? This waitin’, this fear, this not knowin’.

They called my name after two hours. Two hours I sat there listenin’ to that preacher and watchin’ other people come and go—old folks with walkers, young mamas with babies that wouldn’t stop cryin’, a man with his arm in a sling who looked like he’d been in some kinda accident. We all sat there in our own private misery, not talkin’ to each other, pretendin’ we was alone even though we was packed in that little room like sardines.

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Part Three: The News

Dr. Pemberton come in and he sat down and he looked at me, and I could tell somethin’ was off. He’s a good man, Dr. Pemberton. He don’t pull punches but he also don’t look at you like you got two heads. He looked at me like he was sorry about somethin’.

“Delia,” he said, “I got your test results back.”

“Okay.”

“I’m seein’ some irregularities on the EKG that I don’t like. Couple things, actually. Your blood pressure’s up—148 over 94, which is high. And the EKG shows some changes in the electrical activity of your heart that suggest there might be reduced blood flow.”

I felt like the floor dropped out from under me. I was still sittin’ in that chair but I felt like I was fallin’.

“What does that mean?”

“It means we need to do more tests. A stress test, probably an echocardiogram, and I want you to see a cardiologist at Rutherford Regional.”

“How much is all that gonna cost?”

He leaned back and he did this thing where he rubs his forehead like he’s got a headache, and I knew before he said it. I knew.

“Delia, I wish I could tell you it was gonna be cheap. I can’t. The stress test alone could run fifteen, sixteen hundred. The echo’s another five, six hundred. And the cardiologist—you’re lookin’ at another consult fee on top of that.”

“I got a two-thousand-dollar deductible, Dr. Pemberton. I don’t even got two hundred in my bank account most weeks.”

“I know.”

“How’m I s’posed to pay for this?”

He was quiet for a second. Then he said: “There are programs. Rutherford Regional has financial assistance. If you qualify based on income—and with what you’re makin’, you probably would—they might cover some or all of it.”

“Probably?”

“It’s not guaranteed. You got to apply. There’s paperwork.”

“I’m s’posed to fill out paperwork and hope they say yes while I’m over here wonderin’ if my heart’s about to stop?”

“I know it’s hard. I know it ain’t fair. But you’ve got options, Delia. We just got to find ’em.”

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Part Four: The Call

That night I called my sister Carla. She’s over in Spindale, works at the Walmart distribution center, got two kids and a husband who’s a lineman for Duke Energy. They’re doin’ okay—better than me, anyway—but Carla ain’t never made me feel bad about it. She’s the kind of person who’d give you the shirt off her back and not mention it again.

“I’m scared,” I told her. “I’m s’posed to get all these tests and I don’t got the money and I’m scared.”

“What’d Dr. Pemberton say?”

“He said there might be programs. Financial assistance. But I got to apply.”

“Then apply.”

“Carla, I can’t even think straight. What if they say no? What if my heart’s messin’ up and I can’t afford to find out how bad it is?”

“Then we figure somethin’ else out. But you ain’t even tried yet. You don’t know what they might do.”

“Carla, I’m tirin’. I’m so tirin’. I work nights, I come home, I make sure Caleb’s doin’ his homework, I try to sleep, I wake up feelin’ like I didn’t sleep at all, and now I got this chest thing. I’m tirin’ of fightin’.”

My voice cracked on that last word. I hate cryin’ in front of people, even over the phone. It makes you feel weak, like you can’t control yourself. My mama used to say tears was for people who couldn’t do nothin’ else, and even though I know that ain’t fair, even though I know sometimes you just got to cry, I still feel that way.

“Delia,” Carla said, “you remember Dorothy Hendricks?”

Dorothy Hendricks. I hadn’t thought about her in years. She was one of them women at church who was always helpin’ out, always organizin’ food drives and fundraiser dinners. She had this laugh you could hear across the sanctuary.

“Yeah, I remember her.”

“She got sick. Three years ago. Pancreatic cancer, stage three. And her husband had just lost his job at the mill before it shut down—they didn’t have insurance neither. Do you know what she did?”

“What?”

“She fought. She picked up the phone and she called everybody. She called Rutherford Regional, she called the health department, she called the American Heart Association, she even called her state representative’s office. She found out about this program, NC MedAssist, that sends free medicines to people who qualify. She got her chemo covered through some kinda clinical trial out of UNC. And you know what?”

“What?”

“She’s still here. Still comin’ to church. Still bringin’ her casseroles. It wasn’t easy. She had to travel, had to fill out a million forms, had to make a whole lotta phone calls. But she didn’t give up.”

“I’m scared, Carla.”

“I know, baby. I know. But you ain’t alone. We’re gonna figure this out.”

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Part Five: The Grind

The next morning I woke up and I made myself a cup of coffee—not the good kind, the cheap kind that comes in a big tin can and tastes like somebody burned dirt—and I sat at my kitchen table and I made myself a list.

First item: Call Rutherford Regional, ask about financial assistance.

Second item: Call NC MedAssist, ask about free medicines.

Third item: Call Western NC Community Health Services, ask about the sliding scale.

Fourth item: Don’t give up.

The first call took three hours. Three hours of hold music that kept cuttin’ out and gettin’ quiet and then blarin’ loud again, of bein’ transferred to people who don’t know what they’re talkin’ about, of explainin’ my situation over and over to strangers who sound like they don’t care.

First I called Rutherford Regional. I got transferred four times. First to the main number, then to patient services, then to someone who said they was in finance but didn’t know nothin’, then finally to Sharon.

“Financial assistance,” she said. “Let me explain how this works.”

She told me about the charity care policy. If I made below 200 percent of the federal poverty level—which for a family of two is about thirty-six thousand a year—I might qualify for help. I told her I made thirty-two thousand, and she said that put me in the range.

“There’s an application,” she said. “I’m gonna email it to you. You’ll need to provide proof of income—pay stubs, tax returns—and we’ll process it.”

“How long does it take?”

“Usually two weeks. But if you mention it’s for cardiac evaluation, we can often get you scheduled while the application is pending.”

“So I might still gotta pay?”

“Not necessarily. If you get approved, it could be retroactively applied.”

“Could be.”

“There’s no guarantees, but it’s worth tryin’.”

Next I called NC MedAssist. Thirty-seven minutes on hold. The music was this old country song about a dog and a truck, and I musta heard it six times before a woman finally got on the line. Her name was Patrice.

“NC MedAssist,” she said. “How can I help you?”

I explained about my heart, about not bein’ able to afford medicines, about the blood pressure medicine Dr. Pemberton wanted me to start.

“We can help with that,” she said. “We provide free medications to North Carolina residents who are uninsured or underinsured and meet income requirements. We can also help you apply for Patient Assistance Programs directly through the pharmaceutical companies.”

“How does that work?”

“You apply through us. We send in the paperwork. If you’re approved, the company sends the medicines directly to you. Some of them even have mail-order options so you don’t gotta pick ’em up.”

“And it’s free?”

“If you qualify. Based on your income, you probably would.”

Probably. That word kept comin’ up. Probably, maybe, could be. Nothin’ definite. Nothin’ certain. Just like everythin’ else in this dang life.

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Part Six: The Forms

The application was forty-seven pages. Forty-seven pages. I ain’t never seen so many forms in my life. There was income verification, there was proof of residence, there was a questionnaire about my health history, there was a section about assets (what assets? I got a 2012 Ford Focus with a check engine light that’s been on for two years), there was a signature page that had to be notarized.

A notary. I didn’t even know what a notary was until that day. Turns out you gotta find one, and they gotta watch you sign, and they charge you like ten dollars for the privilege. I went to the bank—First Citizens on Main Street, the one by the post office—and the lady at the counter looked at me like I was askin’ for a million dollars.

“You need a notary?”

“Yes, ma’am.”

“For what?”

“Medical forms.”

She sighed like I was the biggest inconvenience in her day. “There’s a notary public upstairs. Third floor. But you gotta have an appointment.”

“I didn’t know I needed an appointment.”

“Well, you do.”

So I went home. Called the number. Made an appointment for the followin’ Tuesday. Missed a half-day of work because that’s when they could see me. A half-day of pay I’ll never get back.

Then there was the income verification. I had to get my pay stubs from Pilgrim’s Pride. I put in a request with HR, and they said it’d be ready in three to five business days. Three to five days when I was supposed to be sendin’ in this application that was already overdue in my mind.

And the tax returns. I ain’t got a tax preparer—I do ’em myself on that free software online, and I always end up owin’ money because I claim the wrong things. I found the papers, but they was crumpled in a drawer where I’d stuffed ’em last April, too upset to file ’em proper.

Caleb found me on the kitchen floor that Saturday, surrounded by papers, cryin’.

“Mom? What’s wrong?”

“Nothin’, baby. Just… this stuff.”

He knelt down next to me and started gatherin’ up the papers. He was wearin’ that hoodie he loves, the gray one with the hole in the sleeve, and his hair was standin’ up like he ain’t brushed it.

“What is all this?”

“Medical stuff. I’m tryin’ to apply for financial assistance so I can get my heart checked out.”

“Why didn’t you tell me?”

“I didn’t want to worry you.”

“Mom, I’m fifteen, not five. I know what’s goin’ on.”

I looked at him, this boy who’s almost a man, with his mama’s stubborn chin and his daddy’s temper, and I felt this wave of love and shame all at once. Shame for not tellin’ him. Love for the way he just started helpin’ without askin’ questions.

“You want to help me?”

“Yeah. What do I need to do?”

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Part Seven: The Wait (Again)

They scheduled my stress test for three weeks out. Three weeks of not knowin’. Three weeks of my chest hurtin’ every time I climbed the stairs at work, every time I carried in groceries, every time I just breathed too deep.

The first week I got a call from Rutherford Regional. My application was incomplete. I was missin’ a page. I had to print it out, sign it, and fax it back. I don’t got a fax machine. I don’t even know where to find one. The lady on the phone said I could scan it and email it, but I don’t got a scanner.

“I could go to the library,” I said.

“That’s an option. Or you could come to the hospital and use our machines.”

The library is over past the old textile mill, the one that’s been closed for ten years now. It takes me twenty minutes to drive there. The hospital’s on the other side of town, past where they built that new gas station. Both ways was about the same.

I went to the library. The librarian—a woman about my age with glasses on a chain around her neck—showed me how to use the scanner. It took me four tries to get it right. My signature kept comin’ out blurry.

The second week I got another call. My application was still incomplete. I was missin’ a different page now, some kinda disclosure form I didn’t remember seein’. I asked them to email it to me. They said they couldn’t email it, I had to come pick it up.

“I can’t come pick it up,” I said. “I work nights.”

“Then you can have someone pick it up for you.”

“I don’t got nobody to pick it up for me.”

Silence on the other end.

“I guess you could mail a request,” the lady said. “But that could take another week.”

A week. Another week. I’m s’posed to wait another week while my heart’s actin’ up?

I went to the hospital after work that Thursday. I was still in my Pilgrim’s Pride uniform, still smellin’ like chicken, still tired from standin’ on my feet for eight hours. They gave me the form at the front desk. The woman who handed it to me—she was young, couldn’ta been more than twenty-five—she looked at my uniform and her nose kinda crinkled like I smelled bad.

“Here you go,” she said.

“Thank you.”

I drove home in the gray light before dawn, holdin’ this form that was supposed to help me, feelin’ like I was carryin’ the weight of the world.

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Part Eight: The Win

Three weeks later, I woke up at 4 AM to drive to Morganton for my stress test. The stress test is where they hook you up to all these wires and make you walk on a treadmill while they watch your heart on a screen. They start slow and they get faster, and you’re s’posed to keep walkin’ until you can’t anymore or until they see what they need to see.

I was nervous. I been nervous for three weeks, ever since Dr. Pemberton gave me that look. I didn’t sleep the night before. I laid there thinkin’ about my mama, about how she was standin’ in the kitchen one second and gone the next. I thought about Caleb, about what would happen to him if I just… stopped.

The hospital was bigger than I remembered. Or maybe I just don’t go there enough to remember. It was cold, too, that kinda cold that seeps into your bones, and I wished I’d brought a jacket.

They called my name. A nurse with kind eyes took me back to a little room and started stickin’ these stickers on my chest. They was cold and sticky and I flinched.

“Sorry,” she said. “They always feel cold.”

“That’s okay.”

“You nervous?”

“A little.”

“It’s gonna be fine. Just do what they tell you and you’ll be okay.”

The technician who ran the test was named Mike. He had this calm way about him, like nothin’ could rattle him. He explained what would happen, showed me the treadmill, told me to just say if I needed to stop.

They started me walkin’ slow. Then faster. Then they raised the incline. My legs was burnin’. My chest was tight. But I kept goin’.

“Okay,” Mike said, “you can stop now.”

I stopped. They took the stickers off. I sat there catchin’ my breath.

“How’d I do?”

“I can’t tell you the results. The doctor’s gonna review ’em and call you.”

“When?”

“Probably tomorrow.”

Tomorrow. Another day of not knowin’.

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Part Nine: The Answer

Dr. Pemberton called the next afternoon. I was sleepin’—third shift, remember—and my phone woke me up. I fumbled for it, saw his number, almost dropped it.

“Delia?”

“Yeah.”

“I got your stress test results.”

“And?”

“There is some evidence of reduced blood flow to your heart muscle. It’s not critical, but it’s something we need to address.”

“So what does that mean?”

“It means you’ve got what we call ischemia. Your heart’s not gettin’ enough oxygen, especially when you’re exertin’ yourself. It’s why you’ve been havin’ the chest pain.”

“Is it gonna kill me?”

“It’s not gonna kill you today. But if we don’t treat it, it could get worse. We’re gonna start you on some medications—blood pressure, cholesterol—and we’re gonna keep an eye on it.”

“But what about the cardiologist?”

“I’ve sent a referral. They should be callin’ you to schedule.”

“The medications—how much are they gonna cost?”

“I prescribed generics where I could. The blood pressure med should be affordable, maybe ten, fifteen dollars a month. The cholesterol med… that one might be more. But there’s programs that could help.”

“Programs again.”

“I know. I know it’s frustrating. But they’re there for a reason.”

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Part Ten: The New Normal

That was four months ago. I’m still workin’ third shift at Pilgrim’s Pride. I’m still drivin’ that forty-six miles round trip four days a week. I’m still countin’ every penny.

But I’m also still here.

I’m takin’ my medicines every mornin’—the blood pressure one and the cholesterol one and the little aspirin that Dr. Pemberton says might help keep my blood thin. NC MedAssist helps with the costs. I still pay about thirty dollars a month total, which ain’t bad. Caleb helps me remember to take ’em, like a little reminder on the counter.

I go to the recreation center three times a week and walk the track. It’s this old buildin’ over by the middle school, the one with the leaky roof in the gymnasium. The track’s indoor, which is good because it rains a lot in these mountains, and it gives you this view of the gym where kids are playin’ basketball and old folks are doin’ exercises. Most days it’s just me and a few other regulars—an old man who walks with a cane, a woman about my age who’s losin’ weight, a teenager with earbuds in who probably shouldn’t be there but is.

I still get chest pains sometimes. Not as bad as before, and not as often, but they come. Usually when I’m stressed, or when I’ve been on my feet too long, or when I eat somethin’ bad. Dr. Pemberton says that might not ever go away completely. The heart’s been hurtin’, and it leaves scars, and you just gotta learn to live with ’em.

Caleb helps around the house more now. He don’t complain about it, neither. He just does stuff—takes out the trash without bein’ asked, washes dishes, even cooked dinner a couple times. Spaghetti with hot dogs, which is what I taught him, but still. He learned it from me, and that’s somethin’.

I still got bad days. Days when I look at my bank account and feel like cryin’. Days when the plant lays off more people and I wonder if I’m next. Days when my chest hurts and I wonder if this is finally it.

But I also got good days now. Days when I walk the track and I don’t hurt at all. Days when Caleb laughs at somethin’ stupid on his phone. Days when I call Carla and we talk about nothin’ for an hour.

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The Ongoing

I’m writin’ this on a Sunday afternoon, sittin’ on my porch, watchin’ the sun go down behind them mountains. They got this golden quality this time of year, like the sky’s on fire, and the shadows stretch out long across the holler. It’s real pretty. Most days I can appreciate it.

I’m still s’posed to see a cardiologist. They finally scheduled it for next month—two months after Dr. Pemberton sent the referral. I’m nervous about what they’ll say. I’m nervous about the costs. I’m nervous about everything.

But I’m also still here. Still breathin’. Still fightin’.

Dorothy Hendricks came to church last Sunday. She looked good—thin, but good. She hugged me after the service and told me she heard I was havin’ heart trouble.

“You gotta take care of yourself,” she said. “You gotta keep callin’ and pushin’ and not let ’em give up on you.”

“I will,” I said.

“That’s all any of us can do.”

That’s all any of us can do.

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Resources That Might Help

If you’re in Forest City or Rutherford County and you’re facin’ somethin’ like this, here’s what I learned:

Rutherford Regional Medical Center Financial Assistance
Ask for the Charity Care or Financial Assistance department. Ask for Margaret if you need help fillin’ out the forms. Be prepared to wait. Be prepared to call back. Be prepared to not give up.

NC MedAssist
Phone: 1-866-331-9598
Online: ncmedassist.org
They provide free medications to North Carolina residents who qualify. Takes a while to get approved, but it’s worth it.

Western NC Community Health Services
Asheville. Slidin’ scale fees based on income. They helped me understand what I might qualify for. The people there was kind.

Rutherford County Health Department
They can help connect you with resources. Not sure exactly what they do, but they was helpful when I called.

Dr. Hayes, Cardiology
Rutherford Regional. He takes charity care patients. I ain’t seen him yet but I’m s’posed to next month.

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This ain’t easy. Nothin’ about this is easy. But you ain’t alone, and there is help out there, and sometimes—just sometimes—you got to make a hundred phone calls and fill out a thousand forms and sit on hold for hours and deal with people who don’t seem to care, and then sometimes it works out.

Keep goin’. That’s all I can tell you.

Keep goin’.