Snakes and Tails by Bradley K. Rosen
“I contracted the virus back when I was a casual IV drug user”
If you pulled all of the minerals out of a person’s body and sold it to one of those kinds of places that like to buy minerals for a fair price you might be lucky enough to get four dollars and ninety eight cents for them. Water, oxygen, salt, iron, magnesium, zinc, chromium. We’re talking about very small quantities here. Turns out that when taking into account the whole of a human body, a person’s skin is worth more than the actual minerals, but still, the skin doesn’t amount to much. If you skinned a large woman with large breasts you would be lucky to get three dollars and fifty cents for her skin alone. Don’t ask me what the skin buying people might do with the skin after they buy it, I don’t want to know.
Purses maybe, or galoshes, or a wallet maybe. A wallet made out of human skin, rub it the right way and it turns into a suitcase.
Sorry. My bad. But my father, also a bad joke maker, he told me never to apologize. That bad jokes are one of those things that makes us humans, well, human. They are part of what makes us imperfect, and as they all say, you can’t have the light without a little bit of the dark. You know, the ying, the yang. The saints and sinners. The darkness and the light.
One, of the many, of my own personal imperfections is the fact that I have Hepatitis C. Have had it for who knows how long really. Probably in the neighborhood of something going on forty years now. I can base that amount of time upon the idea that I contracted the virus back when I was a casual IV drug user back in the 1970’s. Back in the experimental stages of my youth. Nasty virus that Hep C. Scars up a liver little by little without a person ever really knowing about it. For a long time I was oblivious to the fact that I had Hep C. Only found out about it ten years ago. The Hep C that sat around wreaking so much havoc that my liver ended up getting so confused it gave itself the cancer.
Though the cancer may actually kill me, it is a mixed blessing. Because before I was diagnosed with cancer the insurance company had refused to pay for the treatment that was going to make the Hep C go away. The treatment is reserved for the sickest of the sick and in such cases ceases to be a preventive measure in lieu of taking on a more of a stabilization kind of role. You see, the fact that I have had Hep C for so many years and then cancer of my liver makes me a good candidate for a liver transplant. Therein the cost of a new liver being so expensive that it is not a good thing for my new liver to become infected with the old Hepatitis C that is still alive in my body.
Talk about the chicken chasing the egg.
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After a lengthy conversation with my liver doctor the pharmacy became the next step forward in the quest for my cure. The pharmacist, he looked like he was in his early thirties. Surely he was a grown man, but in the grand scheme of things he was still just a kid to me. Good looking. Healthy skin, healthy body weight. He wore the traditional long white lab coat that one might expect a pharmacist to wear. The name of the pharmacy was embroidered in cursive with bright red thread into the side of the coat opposite of his heart. For some reason I judged him to be of a family man, with maybe a good looking wife and two kids and two car payments waiting for him at home. I had seen him working at the pharmacy many times before and though we certainly hadn’t seen enough of each other in social settings to have learned to call each other friends we were friendly with each other in a clinical professional sort of way.
The drug that I had been prescribed was a new one to me and therefor elicited a consul with the resident pharmacist on duty, namely the young healthy skinned pharmacist.
He handed me the opaque orange plastic bottle with the white cap that was half full of pills. His eyes never left the computer screen in front of him.
“Full name and birthdate,” he said.
I always wondered why he never remembered my name. I suppose it was because he had lots of customers, too many of which to remember names let alone birthdays. But still, I thought that maybe I would prove to be an exception. I was in there all the time.
I turned my head and looked at the people waiting in the drug line behind me. There was four or five people there including an elderly man with a walker, and a rather large woman leaning her forearms on the front handle of a half full shopping cart. At the front of the line, too far away for me to touch but certainly not too far away to be able to hear me whisper was a woman. She was cute by my standards. A long haired brunette in jeans and a white toothed smile. She looked like an Isabella.
I looked down at the label on the bottle as I told the pharmacist my name and birthdate. The name of the drug a new one to my vocabulary. The bottle contained fourteen pills.
“Had these before?” the pharmacist asked.
His skin was milk white. Probably the result of the inside lights that shone down upon him eight to ten hours a day, five or six days a week. He had the beginnings of what might eventually turn up to be a mole on the right side of his chin.
“Take one a day,” he said. “Preferably with food.”
I picked up the paperworks that came with the drug. May cause headache, nausea, skin rash, loss of hair, etc. etc. etc. I scanned over all of these quick, I would look at them later, in private, when my mind had more time to torture itself with the what ifs and the how could it be’s and the really? My hair? At the bottom of the paper was the price of the drug and the price of what I would owe.
Turned out what I owed amounted to be nothing. My insurance was picking up the tab.
The tab was twenty two thousand dollars.
I teetered a little bit onto the backs of my heels.
I didn’t really do all of the math until later, but I knew in that moment the humongous cost of what this treatment was really going to be.
Twenty two thousand dollars. For fourteen pills. One thousand five hundred and seventy one dollars a pill. My doctor had told me I was going to be taking this drug for twelve weeks. That meant I was going to have come back six more times. Six more refills. The whole run of this treatment coming in at one hundred and thirty two thousand dollars.
“Expensive,” I said. “The price of tea in China.”
A little rush of blood ran through the pharmacist’s milky white skin, causing it to turn the slightest shade of pink. The point of his chin motioned to the little card reader with the screen and the stylus that sat there on the counter between us.
“Check the box and sign please,” he said.
I picked up the stylus and checked the box that told the world I had accepted his consul and then I signed my name on the line next to it x marks the spot.
“Some lucky bastard is buying fancy mansions and boats and trips to Jamaica,” I said.
The pharmacist’s eyes expanded and allowed more light into the middle of his blue irises. The light transforming the look in his eye into something that I could trust, into something familiar to me, into something that meant this man knew what it meant to work for a living. That this man was not much different than me. That he knew what it was to swing on a swing set, to smell a dog’s breath, to love a woman or a man.
Isabella muffled a cough behind me into what I assumed to be the inside crook of her elbow. She was a polite person like that, that had the common sense enough not to spread her germs around to the rest of the planet.
“Do you have a rewards card?” the pharmacist asked.
“I didn’t pay for anything,” I said. “How’s that work?”
“You get free gas,” he said.
I gave him my phone number. My phone number was the same number as my rewards card.
“I feel like I need an armed escort,” I said.
“What was that?” he said.
It is not an easy thing, to be able to joke around with a pharmacist.
Isabella had her nose into her phone but as I walked past her she looked up and our eyes met. She looked at me like only a woman can. And I could tell that she knew that I was really sick. That I had the Hepatitis C and the cancer inside me. Though I was oblivious to it myself, I knew that my skin looked yellow from time to time. That I had a slight case of the jaundice. She coughed again into her elbow, a harsh, deep, rasp of a cough. I smiled at her and nodded my head. I wanted her to get better, and I could tell by the way she smiled back at me that she knew that I wanted her to get better too.
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Two years ago I was on a trip to Costa Rica. I was there for three weeks and stayed with my friend Vanni, who lived in a beautiful house with a beautiful garden by the sea. My friend had a large bushy mustache and graying hair that covered most of his body. He was short and stout with a strong back and strong arms and if I was to pick him out to be any animal I believe I would see him as a sloth. Not because of a lazy nature typically associated with an animal as aptly named as a sloth, because he was a hard worker, and Vanni certainly hadn’t much laziness born into him, but a sloth for his hair, for his choice of living in solitude with the forest, and for the smile that seemed to be permanently implanted onto the front of his face.
One day we went to town, an hour drive from his house on bumpy rocked dirt roads. We went there to buy a week’s worth of groceries. The market small, filled with fresh meats and produce and packaged cookies and beer and butter and bread. We took our mostly filled shopping cart to the checkout line where a small woman with brown eyes and skin and dark, almost black hair ran the cash register. At the end of the conveyor belt a man, also small with brown skin and eyes, started to box up our groceries. The man was skinny though wiry, like a spider monkey, and he was missing one eye.
I could tell by the way my friend and the man bagging groceries communicated that they knew each other well. They signed with hand gestures and formations of their silent mouths. The man was deaf and mute. We paid the cashier in Costa Rican colones and I started to lift one of the heavy boxes to carry out to the truck.
Van stopped me, with a firm hand on my arm.
“Let him do it,” he said. “It’s his job.”
I thought he was being ridiculous. I was perfectly capable of carrying a box of groceries to the truck. But I wasn’t going to argue with my friend who had lived among these people for over twenty years. So we went outside and stood by the side of the pickup truck as the deaf man made three trips back and forth until all of the groceries were loaded. My friend Van pulled a wad of money out of his backpack and unrolled a few bills and handed them to the man.
“Muchos Gracias,” Vanni said.
The man half bowed and clasped his hands in front of him as if in prayer.
On the long ride back to Van’s piece of paradise by the sea we had a conversation about the man who boxed our groceries.
“He doesn’t work for the store,” Van said. “He works for tips. People they take care of him. That is one of the beautiful things about this country. They take care of their own.”
“What happens if he gets sick?” I asked.
“Shit I don’t know, I suppose he takes an Advil,” Van said.
“No that’s not what I mean,” I said. “I mean really sick.”
“Well,” Van said. “He either moves to the big city and hopes for the best or he gets rich real quick.”
“What do you mean?” I asked.
“Cash only,” Van said. “Down here its cash only.”
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If the average human being’s skin and minerals are worth five dollars on a good day, it would take 26,400 dead corpses to be able to buy one treatment for one human being to eradicate the Hepatitis C virus from their system. And the thing about it is, my skin would be worth the same amount as the man who boxes groceries in Costa Rica.
On April 12, 1955 Jonas Salk, the face behind the development of the polio vaccine was faced with the question of why he didn’t patent the vaccine and therefor reap the riches that surely would have found their way into his pockets. His answer was a simple one. “Can you patent the sun?”
The same sun that shines the same kind of light on both me and the man from Costa Rica. The same light that shines on all of the people’s from all of the corners of the world. The skin of three hundred and fourteen people to buy one pill. The 24,600 people’s skin needed for one treatment laid end to end nothing anywhere near close enough to bridge the gap of distance between the earth and the sun. The sun that we all have come to count on. The sun that insures us all of its perpetual light. And still some will die, not because mankind is not brilliant or inventive or determined, but because of the newly found importance in the value of greed and money over the value of life itself that have made themselves evident in this new society that we are all now a part.
You see, the snake, it chases its tail, and the chicken, it is beginning to have a harder and harder time figuring out where it was that it laid its egg in the first place.
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Header image courtesy of Vanessa Moselle. To view her photo essay " These Human Shells," go here.
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Bradley K. Rosen was awarded a Bachelor of Music from the University of Oregon in 1998. He played for twenty five years as a professional rock musician before settling down in the Portland area. He still plays drums in a local rock group and plays timpani with two community orchestras. He has recently finished his first novel, The Bunkie Spills and is currently working on his second novel, which involves a taxidermied cat and nine lives. His work may be found in the anthology The Frozen Moment (Publication Studio), as well as in The Portland Review (Fall 2013 Issue 60.1).