SURVEY
You have been selected to complete a survey. The purpose of the survey is to gain information about your health and wellness. Your answers are confidential; they are used only for policy research and to better understand the health challenges Americans face today. Participation is voluntary. There is no penalty if you decline to complete it. You can learn more about the survey, and the work of our federal agency, on our website.
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“Do you have any questions, Mr. Rivers?” says the phone interviewer. She has a warm voice, the voice of someone who uses the word hon a lot.
You ask how long the survey will last.
“About 35 minutes,” she says, “depending on the size of your household.”
You tell her you are the only person in your household.
“About 35 minutes, then,” she says. “Any additional questions?”
35 minutes is not an insignificant amount of time. You could, of course, decline to participate, but the truth is you have little better to do. It is 3:27 pm, and the only things you have done today are work on the 1,000-piece jigsaw puzzle scattered on the kitchen table and ignore your sister Madeline’s phone calls. She knows you are ignoring her calls; her response is to call at 20 to 40-minute intervals. She also texts various emojis. So far, these have included: the orange angry face, the telephone, and, for reasons that are unclear to you, the pineapple.
You put your phone on speaker and set it on the table, amidst the scattered puzzle pieces. You run your tongue over your teeth, which can best be described as fuzzy. You have not yet brushed them today, and your mouth still tastes like the Coke you drank in lieu of the coffee you ran out of, because who has the wherewithal to go to a store and buy coffee? Truly, you would like to know. You would like to shake their hand. “No additional questions,” you say.
The interviewer starts by asking for basic demographic information.
You tell her: white, non-Hispanic. You tell her your date of birth and confirm your age, which is 27. You are unmarried, without children, and have lived at your current residence for six months or longer. You tell her your occupation (waiter) and that your employer does not currently provide health coverage.
A text message appears on your screen. It is from your sister Madeline: the snail emoji. A minute later: Maybe answer your phone.
“Do you currently have health coverage?” the interviewer asks.
“No.”
“What are the last four digits of your Social Security Number?”
Here, you pause. You wonder if the survey is an elaborate ploy to steal your identity. For one thing, a telephone survey seems odd in the age of the internet. But then, you are not overly troubled by prospect of identity theft. You question the wisdom of anyone who chooses your identity, of the billions of identities, to steal. If you were to steal someone’s identity, you would give it a lot of thought beforehand. You tap a puzzle piece against the table and decide you would steal Tony Danza’s identity. He has a shitload of money and a relatively low profile, which means not a lot of people have thought to steal it.
The interviewer clears her throat. “Sir?”
“Why do you need my Social Security Number?”
“We use it to link your answers to those of other respondents.”
You provide her with the last four digits of your Social Security Number, clicking a puzzle piece into place. To be clear, you are not a puzzle person—you are actually something of a social animal. The puzzle belongs to your mother, who found it in her closet two or three months ago, before she died of pancreatic cancer. The box was still wrapped in plastic when she pulled it from the shelf. “I have no idea why I bought this puzzle,” she said. She was sick then, but not as sick as she was going to be. She still had some meat on her bones. “I never opened it and now it is one of a million things I’ll never do.” It sounds morbid, but your mother was not a morbid person. She was having a low moment, on account of the cancer. In the meantime, you have discovered that assembling the puzzle is the right kind of mindless activity. The wrong kind of mindless activity, such as drinking a glass of water, or brushing your teeth, leaves you feeling inexplicably blank.
“The next few questions are designed to understand your health and access to health care services,” the interviewer says. She asks for your height and weight. She asks how frequently you exercise. “Do you smoke cigarettes?” she asks.
“No,” you say. It is basically true.
She asks if you could walk 100 yards, or the length of a football field, without difficulty. If you could walk 500 yards, or the length of five football fields, without difficulty. If you could walk up to three flights of stairs without difficulty. “Would you characterize your overall physical health as Excellent, Good, Average, or Poor?”
You stand, pick up your phone, and walk athletically to the refrigerator, where three cans of Coke and half a lime remain. You bought the Coke to mix with rum, but you ran out of rum before you ran out of Coke. Is that an indication of Excellent health? Probably not. You take a can from the shelf and crack it open. “I would characterize my health as Good.”
She asks if you have experienced arthritis (no), hypertension (no), asthma, (no), or diabetes (no).
Another text message appears on your screen: Maybe remember I have a key to your apartment, your sister writes.
It’s true: you are someone who loses keys on a regular basis—a trait inherited from your mother—and your sister is not. At one time, it had seemed like a good idea to give Madeline your extra set, but now you see how wrong you were.
“Have you ever postponed medical, dental, or vision care,” the interviewer asks, “because you were concerned about the expense?”
“Yes.”
“Have you seen a medical professional within the last twelve months? Including a general practitioner, nurse, nurse’s assistant, urgent care or emergency room physician, specialist, or mental health professional?”
You tell her that, yes, you have.
“And was the purpose of your appointment for routine care,” the interviewer asks, “or to treat a specific problem?”
“In theory,” you say, “it was to treat a specific problem.”
Your sister was the one who scheduled your consultation with the therapist two weeks ago, a month after your mother died. Because you’re wandering around like a bored zombie, she said. She also used the word reeling at some point, though by that time you had pretty much tuned her out. Needless to say, you failed to show up for the consultation. Then Madeline scheduled another appointment, appeared at your door 45 minutes before it started, and escorted you to the office on the bus. The two of you waited in a small room with a (fake) plant, listening to the wall clock tick. You wondered what kind of therapist neglected to invest in a non-ticking wall clock.
She turned out to be younger than you expected, with the dark, unruly hair of someone with mental health issues of her own. She wore earth tones and clogs, and she seemed like someone who would brag about not having a smartphone. What brings you here today? she asked.
My sister, you said, even though you knew perfectly well what she was getting at. You glanced at the poster of Edvard Munch’s The Scream displayed on the wall, which seemed a little on the nose. Then the two of you sat across from each other, waiting for your grief to present itself in a neat little package, but all you were able to summon was contempt for the therapist and her museum gift shop art. And your sister, for dragging you there. Your sister, who had the temerity to schedule a second appointment (or third, if you include the one you skipped). That appointment is today. That is why she is calling. It is why you are avoiding her calls.
“And was the medical bill mailed to your home address?”
“Yes.”
“2201 Ontario Road,” she says, “Apartment 418?”
In the background, you hear a dog barking affably. “Is that your dog?” you ask.
There is a pause. “It is.”
“It’s nice you can work from home. Or can you bring your dog to work?”
The next pause is long enough you wonder if you’ve been disconnected. You glance at your screen; the call is still going. “I work from home sometimes,” the interviewer says. You had pictured her in a drab cubicle. In fact, you had pictured her existing in a drab cubicle, all day and all night. But of course she has a home. People live in homes, unless they are homeless. “What’s your dog’s name?”
“Bernadette.”
You can picture Bernadette: a chocolate lab. Old and stubborn, with mournful eyes. She has a dog bed near a window, where she can bathe in sunlight for hours at a time. It takes a lot to compel Bernadette from her dog bed—an enticing bone, maybe, or the promise of a leisurely walk—in part because the interviewer has gone to great lengths to make it comfortable, lining it with soft blankets and vacuuming it regularly to remove fur and other debris. Probably, if you saw Bernadette’s dog bed, you would be tempted to lie in it yourself.
“How old is Bernadette?” you ask.
“Sir.” There is a hint of edge in the interviewer’s voice. “Let’s return to the survey.”
You take a sip of Coke, the carbonation fizzing in your mouth. “Fine,” you say.
“Now I am going to ask a series of questions about pain,” she says. “How often do you experience pain? Never, rarely, sometimes, a lot, or all the time?”
You tell her sometimes.
She asks if you experience pain in your head, neck, or shoulders (sometimes), or in your back, hips, or knees (sometimes), or in your hands or feet (sometimes).
“Is your pain ever so severe it prevents you from going to your job?”
“No.”
“Is your pain ever so severe it prevents you from seeing your friends or loved ones?”
“That’s a dark question,” you say.
She clears her throat. “The questions are designed to gain information about your health and wellness.”
“You said that already.”
“Would you describe the pain as acute, or general?”
“Both.”
“If possible, can you pick one or the other?”
“I would describe it as acutely generalized pain.”
It takes the interviewer a few extra seconds to record your answer. “And is your pain more severe than your mother’s pain?”
You squeeze the Coke can. It buckles beneath your grip. “What?” you say.
“What?” the interviewer says, alarmed.
“Could you repeat the question?”
“Certainly.” She speaks more slowly, this time. “Is your pain manageable with the use of over-the-counter or prescription medication?”
You snap another puzzle piece into place, not answering. You have assembled maybe three-quarters of the 1,000 pieces, and the image is starting to emerge. It is a view from Park Güell in Barcelona: a curving overlook, a vibrant array of buildings, a piercing blue sky. Barcelona, you think, is another thing your mother never did. But she was a fan of views. Not vistas, necessarily, though she liked those fine, but views that were interesting if not beautiful. For instance, she loved the look of an industrial skyline with a water tower and various earth-polluting smokestacks. When she saw a view she liked, she would grab you by the wrist—she had a strong grip—and she would say, Look, and you would say, I’m looking, and she would say, Look harder. And she would stand there, holding onto your arm with her white-knuckled death grip, until she decided you had looked at it hard enough. That was the kind of person she was.
It hits you suddenly. You experience it as you might a large wooden plank that is placed on top of your body and then pressed down upon, hard. “Oh my god,” you say. “My mother is dead.” The words hang there, ugly and gleaming. You feel a prickling behind your eyes, though you are not yet crying, and when you take a breath, a strangled sound escapes from your mouth. You wonder if the interviewer will mistaken it for a cough. “Sorry,” you say.
“Do you need a second?” the interviewer asks.
“Sorry,” you say, again. You are crying now.
She tells you not to apologize. She tells you to take your time.
It is hard to tell how long you take. You think, for some reason, about the week before last, when you went to the sauna at the Korean spa, and the only other person there was this old, non-Korean man, and when you sat down he looked at you with great sympathy. You look like you could use a good sweat, he said. It was hot in the sauna, obviously. Uncomfortably hot. But it was the kind of discomfort you could settle into, that you could curl up inside of. For a few minutes, at least, the heat of the sauna was the only thing you felt.
You swallow. You breathe in and out. “Okay,” you say to the interviewer. “Let’s continue.”
“Actually,” she says, “I have just one final question. What’s your mother’s maiden name?”
“That’s a strange question,” you say. You look at the picture of Park Güell, which is so bright and colorful, with mosaic tiles and trees and houses that look like something from a storybook, with spires and everything, that it is actually kind of frenzied. Overwhelming, even. You wonder how your mother’s maiden name could possibly be relevant to your health and wellness. You try to recall the listicle you read several months ago about identity theft. What precise information have you already provided to the interviewer? “What agency do you work for, again?”
“Sir?” the interviewer says.
“Your employer,” you say. “Who is it?”
The interviewer is silent.
The call ends the way most things end: without ceremony. It just ends. You do not even hear a click when the interviewer hangs up, since phones no longer click when people hang up. You watch as your phone switches to the home screen. The bright, neatly arranged apps have never looked less enticing. You place your forehead on the table, feeling several of the puzzle pieces adhere to your skin. You imagine the interviewer closing her laptop and calling to Bernadette. You imagine Bernadette rising from her dog bed, guileless, and meandering over, tail wagging.
Sarah Mollie Silberman’s stories have appeared in Booth, CutBank, Juked, Nashville Review, Potomac Review, and Witness. She holds an MFA from George Mason University and lives in Washington, DC. Find her online at www.sarahmolliesilberman.com.
The Boiler 