When Death Seems Less Daunting Than Bureaucracy

July 18, 1993|DIANNE KLEIN

Lillian Dionne has led me back to the bedroom to see her friend, Berta. Berta is not really her name, which is Bertha--Bertha Hanley--but her friends have always called her Berta. She prefers it.

Moments before, Lillian had explained that today is not a good day for Berta, even though the day has hardly begun. Berta is 92 and ill. Lillian is 80 herself.

Berta and Lillian live together in a small apartment in San Clemente with Kelly, the Shetland collie. Kelly is very protective of his mistresses; he growls at strangers even when told that this one is OK.

Lillian introduces me to Berta, who is stretched out in bed with her eyes closed. They open at Lillian's voice, which then explains about the letter she had written me, and asks if Berta would like to talk. Berta again drapes her eyelids closed. This is taken as a no.

Perhaps this is better, Lillian says. Talking about her situation just makes Berta more depressed. Lillian will handle it. Lillian, Berta's friend of 50 years, has been handling a lot.

What has brought me here is Berta's letter, which Lillian wrote and Berta signed. In a way, Berta's situation, and that of thousands in similar straits, has been covered before in the newspaper.

Only you probably don't remember because if you read about state budget cutbacks you see numbers and percentages and dollar amounts, not Berta's name or anything about her life. And if you read about Medi-Cal, well, you are better informed than most. Or else you just like dull.

The fact is even Berta cannot figure out the hodgepodge of formulas that have now determined she is well off enough to start paying more of her medical costs. It doesn't make sense.

If you want a figure to orient you, think of 5.8%. That's how much the Legislature cut back last year on its payment to the state and federal program called SSI/SSP, whose rates are tied to Medi-Cal payments. This year's cutback is 2.7% on top of that.

At the same time, Berta's Social Security check--her only income source--was raised a little by the feds, to a monthly $693. This put Berta in a bind.

She is now making $7.41 "too much" for the state to keep paying for her prescription medication. Henceforth, it said, the charge for that will be $73 a month, which Berta doesn't have. She would like to return the $7.41, but such is not possible in this particular twilight zone.

And incidentally, Berta has no savings, as being a big believer in charity, she has given it all away.

Of course, she could go into a nursing home--where the government would pay for everything and allow her $35 a month for extras--but that was where Lillian had rescued her from three years before. Berta had a tendency to break a lot of bones in that place, and it seems a stroke went undiagnosed.

Did I mention that her doctor says a move to a nursing home would surely kill her now? Well, he says it would. But even I can see that.

Lillian says this business with the bureaucracy has just convinced Berta that it is past time to die.

Lillian has appealed the state decision on Berta's behalf, but everybody connected with the motion agrees that it will be rejected flat out. The mathematical formula was followed correctly, after all.

What about a hardship exemption? Hey, baby, we've got hardship cases up to here. And we can't go making exceptions now.

Since getting Berta's letter, I have talked to a lot of government employees about her and her "case." Many of them were sympathetic, especially the ones closer to home.

These are the people who are more likely to connect the numbers with human beings, who know that cases have lives, or at least that they did. These are the bureaucrats who told me that the system they administer is a nonsensical mess. Then there were others who said, quite coldly, that that's tough.

"This story has been done a million times," one department head in Sacramento told me. "The legislators know about all the 92-year-olds out there."

Which is fine. The government doesn't have all the money it needs and times are tough. Maybe what Berta really needs is a lobbyist and an ad campaign, or a celebrity bowling match.

But that is not her style. She is a giver and has been all her life. Lillian calls her a "holy woman," and when she does, tears rim her eyes.

Berta worked from the age of 16 to 76, most all of it as a registered nurse, seven of them while she was a Catholic nun. (The Pope released her from her vows after she developed pernicious anemia, a serious blood condition brought on by the convent's restricted dietary rules.) Also, this does not include the 10 years after that of volunteering full time.

Now, however, Berta is too sick, and depressed, and down to 90 pounds. She is waiting to go. She has so many friends in heaven, she tells Lillian. That will make it especially nice.

But Lillian tells her that the world would miss her prayers. And, of course, Lillian would miss her, too.

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