Side Effects™, Act 3: Here Right Now
I don’t know how to begin her story because I know, and she knows, how it will end. And every time I think about it, I break.
I’ve avoided writing this essay, pushed it to the very edge of my deadline because it hurts too much. It feels like her eulogy even though she is still breathing and smiling and loving on her family in the windswept reaches of southern Idaho.
Elizabeth is going to die. She knows how it’s going to happen. The only question is when.
I know that’s unpleasant. We don’t like talking about death or cancer on their own, and certainly not together. We prefer cancer quiet and unobtrusive, without any visible scars or deformities, an abstraction and a hashtag, with death relegated to an obscure bit player in the wings that can’t upstage life’s final triumphant curtain call.
And, in fairness, we’ve had so much death in this sick and pitiful year. We lost hundreds of thousands of lives, including our own that we thought we knew so well. We’ve mourned and grieved behind our private and public masks.
You’d be forgiven, therefore, if indifference blunts the edges of your attention a few paragraphs into this premature but necessary memorial to a woman who isn’t your mother, daughter, sister, spouse, family, or friend.
The essentials, then, are these:
In January 2018, what Elizabeth thought was a routine stomachache turned into an emergency room visit that led to the discovery of the softball-sized cancerous tumor blocking 95% of her colon, the full length of which was carved out a few weeks later.
Aside from intermittent fatigue in the weeks leading up to the fateful trip to the ER, she had no other symptoms whatsoever.
Traces of her stage 4 metastatic colon cancer are still actively trying to end her life as you read this, three years and more than 60 chemotherapy treatments later.
Stage 4 is clinical language for a terminal, fatal diagnosis. The five-year survival rate of stage 4 metastatic colon cancer is 14%, which means there is an 86% chance she will pass away before January 2023.
She was only 41 years old when she got the worst news of her life, and she’s been fighting for it ever since.
By now, you can predict the financial strain on Elizabeth, her husband Curtis, and their three kids. She shut down her hairdressing business at a local retirement home, cutting their household income in half overnight. 20% of the little that’s left goes to the bills, and it’s not enough. The overdue notices and stress fill and flood everything.
They perform the same diabolical calculus as millions of other cancer patients – electric bill or credit card bill or mortgage or groceries or water or car payment or medicine? Their credit rating drops 100 points, down to 650, and may sink even lower as their slow and late payments mount.
She explains to each creditor and utility how sick she is, why she can’t pay them in full or on time, and asks for any leniency or adjustments on her balances or payment arrangements. She thought they had programs in place for customers facing financial annihilation from cancer or another chronic illness. None of them did, not even one.
After dozens of tedious and emotional phone calls, she negotiates a truce with their collectors. She’s relieved but exhausted by the effort at a time when her energy is in short supply.
But she’s not quite done yet. One more institution remains on her call sheet – Idaho Central Credit Union, who holds her car, truck, and credit card accounts.
How does Idaho Central Credit Union respond when she contacts them to explain how sick she is and why she can’t pay them on time?
Silly question; Side Effects™ is about and for credit unions, so this is the point where the credit union steps up and saves the day.
Not so fast.
So sorry, ma’am. There’s nothing we can do. That’s what Elizabeth remembers hearing from her credit union. They make no effort to accommodate her in any way. They are the only institution to offer no assistance to her whatsoever.
Surprised? So is Elizabeth. She expected more, better, different from the largest credit union in Idaho.
At wit’s end, she tells ICCU they’re the first company that hasn’t been willing to make even one adjustment to a late payment. She tells them how disappointed she is, hopes her feedback will get passed along to someone higher up but doesn’t expect anyone to care or anything to change.
Not so fast.
“I think we could’ve done a better job giving her a path forward, and acknowledging that she had significant stressors and anxiety that was stemming from her payment, coupled with her situation.”
That’s a quote from Tommy Butler, ICCU’s Director of Member Assistance, talking about Elizabeth’s situation with me on Zoom. He continues:
“We could’ve done a better job of [creating]a partnership and a commitment to continue to work with her, or offering her a payment plan that was going to work for her going forward.
[We could’ve done a better job of] giving her hope and knowing we were a partner and that we were going to walk through her situation together…I think we really could’ve alleviated some of the stress she was feeling, and really connected with her.
Through this experience with Elizabeth, it’s helped me put a face on [financial toxicity]. It’s inspired me to provide more training to the people on our front lines to not just jump into the bureaucratic response about things, but really see somebody and try to connect with and understand them.
That connection and that commitment to working together and making their financial payments work for their situation is just as important as understanding what’s going to happen to their financial situation over the next three months. Asking them to be their partner is so important.
With everything that they are probably already dealing with – the fear, the uncertainty, and the doubt – [just as important] is offering them hope and offering them a path forward so they know it’s not something they need to continue to worry about. It doesn’t have to capitalize their thoughts. Their thoughts can be with their family and their health and with their treatment plan…and not with the debts they have with Idaho Central.”
These are the answers that Tommy gave when I asked him about Idaho Central’s initial and subsequent responses to Elizabeth’s situation. You can hear him bring these words to life in Elizabeth’s short film.
Please understand the gravity of what Tommy said. ICCU fell short with a terminal cancer patient, and they are willing to say so on the record, on camera. I’ve worked in and around banks and credit unions for over 30 years and have never heard any financial institution admit anything like this. It took courage and humility for Idaho Central Credit Union, CEO Kent Oram, and Tommy Butler to publicly admit they were wrong.
Empathy and understanding leads to change, which ICCU has:
- Reinforcing the value of empathy in every member interaction and to, in Tommy’s words, “recognize the person before the risk.” This is consistent with Dr. Zafar’s exhortation for all financial institutions to acknowledge the suffering of another.
- Improving the frequency and quality of their communications with members like Elizabeth who are experiencing financial distress, so they can focus on their hardship, not their accounts.
- Creating a medical forbearance program that would allow a member to forego multiple payments for loans during a given period based on the seriousness of their ailment and expected duration of their hardship.
Elizabeth, unfortunately, is changing, too.
“There’s been progression,” she declares softly as we huddle near the fire pit, a necessary defense against the cold autumn wind whipping through the scorched forest surrounding us.
It’s been two months since my first visit, where she told me everything I’ve just told you. That interview was at her house, a cozy bungalow on the outskirts of Twin Falls, Idaho. This conversation is at a campsite called Fallcreek, a rugged sanctuary two hours away from Twin, tucked into the foothills of the southern Idaho mountains.
Progression means that the doctors have found new spots on her scans. They could be benign. They could be fatal. Doctors will decode and diagnose once more. Their findings can’t change her suffering, though.
“I don’t feel good,” and her voice quavers. This is a new and ominous development. She’s never felt this bad in the three years she’s been fighting for her life. She’s tired, always tired now. The 60-plus chemo treatments she’s endured in the past three years can’t keep the terrible shadows off the x-rays, can’t stop her from weighing the impossible treatment decisions she must soon make.
But on this day, she chooses to smile through the pain because Fallcreek is their paradise.
Curtis and Elizabeth have owned this site for as long as they’ve been together, retreating to it every weekend they can when life, health, and weather cooperate.
Seven years ago, a 200-foot wall of flame destroyed everything at the campsite and in the surrounding 100,000 acres. Dozens of permanent and seasonal residences, including theirs, were reduced to smoldering heaps of ash, metal, and melted siding.
Undaunted, Elizabeth and Curtis chose to rebuild at the exact same location, under and among the wounded forest, a testament to the faith and hope and love that transcends the ravages of this broken world.
At the edge of camp flows a creek that has murmured through the rot and rise on either side for millennia. The water glides over the rocks, smoothing each grain by grain, the most patient of sculptors. River to rain to river, forever and ever, amen.
I follow Elizabeth down to the creek’s edge. She sits with her knees to her chest, listening to what has always been, knowing what will soon be. She knows what’s coming is beyond her reach and reason. Its arrival isn’t up to her anymore.
Cancer cannot abuse her here. She is here, right now. She is strength and legacy all and at once, praying for a few more months of health so she can meet Remington, her first grandchild.
She is at peace, life’s sharp and pointless edges smoothed by the love flowing around and over and through everything, the love that has been and always will be, forever and ever, amen. It is all she has. It is all she needs.
If memory is the knot we tie in time’s fleeting thread, then let my unsteady hands craft one here because this is how I’ll always remember Elizabeth.
And this is how I want Remington to remember her…which is why I have one more letter to write.