A Doctor vs. the Hospital Lobby on Medicaid
Regarding your editorial 'The Medicaid Scare Campaign' (May 27): I've dealt with this issue after having practiced emergency medicine for more than 30 years in the once Golden State of California. I work in a less affluent urban area of a generally affluent county. In my last two shifts, I saw five new immigrants, all covered by 'Emergency Medi-Cal'—the state's version of Medicaid—for nonemergent conditions. Four arrived by ambulance for drug- or alcohol-related problems, and another had dental issues, having never been seen by a dentist in her home country. One of them asked for a 'general checkup' at midnight once he sobered up.
California started by offering prenatal care to immigrant mothers many years ago, in the hope this would improve maternal and pediatric outcomes. The Democratic Legislature rapidly expanded that coverage to all for emergencies, while ignoring the high cost of care in the emergency departments vs. that of clinics. The general public doesn't comprehend the concept of true emergencies, and my state has become a magnet for people seeking all the free stuff.
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Instead of jerking my head, I would put my hand underneath the table and waggle my fingers or ball my fists repeatedly. Instead of snorting or chuffing — obvious and strange sounds — I'd click my tongue softly, like an irregular metronome. These tricks satisfied my near-constant urge to tic and kept me mostly hidden from view. I wasn't bullied or teased in school, as kids and adults with tics often are, but I probably would have been if I hadn't learned how to control my tics. I've been using these tricks ever since. When I'm out in public today, I'm keenly aware of my internal pressure to tic, but I've become adept at suppressing it, bottling it up and capping it tight. At home, where I'm free to be myself, it's a very different story. My tics come and go. Six months ago, I began squirting air from my mouth the way someone might blow hair off their face; a few weeks later, I started hocking as though to spit a loogie. 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In real life, I can't go back in time to reassure the little kid who got called out in elementary school, but I'm old enough to understand something he couldn't: 'Normal' is a highly subjective word, one laced with many assumptions. At nearly 50 years old, my tics (and the need to control them) are ingrained in the very fabric of my being. Even after publishing this essay, I will continue to hide my tics in public. Why? The stigma is a great burden. The line between dignity and humiliation is, in the end, a thin one — at least for me. I truly admire those in the younger generation, who can go on TikTok or YouTube and put themselves out there for the world to see. That's not for me. But by sharing my story here, what I can do is help normalize Tourette and other tic disorders. People like me, we're all around you. All that we ask for is what every human being deserves: to live a judgment-free life. K.E. Semmel is a writer and translator of more than a dozen novels from Danish and Norwegian. His fiction and nonfiction have appeared in Ontario Review, Literary Hub, The Writer's Chronicle, The Southern Review, The Washington Post and elsewhere. 'The World and Varvara' by Simon Fruelund is his most recent translation. His debut novel, 'The Book of Losman,' was published in October 2024 (Santa Fe Writers Project). Find him online at and on his Twitter/X page, @KESemmel. This article originally appeared on HuffPost in June 2024. Also in Goodful: This Woman Is Going Viral For Begging Women Not To Get Married Right Now, And Personally, I Couldn't Agree More Also in Goodful: People Are Sharing Their Biggest "How Doesn't Everyone Know This?" Facts, And I'm Honestly Embarrassed I Never Realized Some Of These Also in Goodful: "I Thought This Was Normal": People Are Sharing Diagnoses They Received After Someone Else Pointed Out Their Symptoms
