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My mom got sick when I was in high school, and she passed away when I was a junior in college. There were a lot of trips to doctors, many close calls at the ER, and many out-of-pocket medical expenses.

She had a liver disease that she found out about much too late, and combined with advanced diabetes, the last years of her life was spent scrambling to undo something she — and doctors and science — could not undo. But she was optimistic and she tried anyway. She had seen Western doctors in the States and she also consulted Eastern herbalists in China. She chased down doctors from New York to Rhode Island to California. She made friends with people over the Internet who shared her condition, and received dietary advice from buddies in Arizona.

She spent a year in China for treatment from Western practitioners and herbalists, and my extended family helped her acquire medicine from all over the country. There are certain suggested medications that aren’t readily available in Chinese hospitals, but could be acquired if you knew the right people and could pay the right money (capitalism is delicious!). I had uncles traveling from Shanghai to deliver fragile vials of interferon — proteins that play an important role against viral infections. An aunt from Hangzhou and grandparents in Guangzhou did the same.

There were the herbal treatments that required her to stay bedridden for days. There were monthlong stays at the hospital after scary outbursts of the disease. The way Chinese hospitals work is that you pay money upfront for treatment. Ten days at the hospital was, let’s say, 10,000 renminbi (about $1,641). If you stayed in the hospital for four days, you’ll be given the remaining six days’ worth of money back. If on the ninth day your doctors think you’ll probably have to stay another 10 days, you’ll have to pay another 10,000 renminbi for anticipated costs.

Insurance fell short

My dad had pretty great medical insurance in the States, all things considered. When my mom got treatment in the U.S., most of everything would be covered, but as my mom started seeking help from herbalists, those costs were paid entirely out-of-pocket. There was no cost too big, and not pursuing alternative treatment methods when there was a chance it might work was not an option. My dad was a unionized worker, so he took on overtime work every week, for months, years, to try to offset those medical costs.

Amazingly, the money we paid for hospital treatment overseas was reimbursed to us after many extended phone calls with our insurance company. But my brother, dad, and I flew back and forth to China to accompany my mom to be with her while she was there, and the airfare plus all the extraneous expenses associated with visiting another country for extended periods of time were huge.

The years that my mom was sick were tense, stressful and traumatic. Things “going well” meant that we could at least stave off the inevitable for just a little longer, even though we knew that my mom was in the final stages of her disease. Things would get bad, but they would calm down again. But after a good half decade of chasing and stressing and chasing some more, my mom succumbed to her illness.

Expenses continue after death

After she passed away, we had to take care of her post-death rites, and coming from a Buddhist Chinese family, there were many things to tend to: hiring Buddhist priests for the funeral, paying to make sure we find the “right” final resting spot, on top of all the other expenses associated with death, all of which came in spades. The costs were unavoidable too: When you’re superstitious and steeped in cultural tradition, you don’t anger those who had dealings with death. You do everything you need to, no matter the cost.

Even after all of those things were taken care of, there were the remaining medical bills. The night before she died, my mom collapsed at home alone, and firefighters had to break down the doors of our house to retrieve her. At the hospital, she had to undergo a night of intensive surgery that involved many, many surgeons. After the surgery, she made it through a couple more hours in the intensive care unit before she passed quietly.

This one traumatizing night cost us tens of thousands of dollars, some of which was covered by my dad’s insurance, some of which was not. Did you know that a short 10-minute ride on an ambulance costs somewhere in the neighborhood of $700? Did you know that firefighters busting down your door to get to your mom costs money too? Yeah, me neither, until I had to figure out how to pay for the unexpected expenses. We could have fought harder to have some of the costs waived, or fought for the insurance to cover more, but every lingering form was another reminder that my mom didn’t make it, and that we still had to monetarily appease the people who couldn’t even save her. We paid the money to wrap up the ordeal, once and for all.

Spending to cope

After my mom died, I spent a lot of money buying things because they made me feel better. It was too easy to feel like I had control over something if I was able to make a purchase and I was able to associate that purchase with being in a different, better stage in life — one where I was beyond grieving for my mom.

The spending never really got out of hand, but I knew the danger of money and debt lurked somewhere. I was fine for a few months after I graduated, but the more stuck and unemployed I was, the more money I spent. It started adding up, and I didn’t earn enough from my part-time job to pay for the things I bought quickly enough.

Going out required money, so I stopped doing that. If you stop doing that enough times, you get cranky and lonely and depressed, and in moments of anger at my state of unemployment, I would lash out by buying more things. After your debt gets up to a certain point, the mental block of it is so enormous that all money becomes a blur. What does it matter if I buy that one extra thing if I already have a giant mountain of debt from all those other things?

My debt isn’t one of those $100,000-of-credit-card-debt horror stories, but I was raised on an “any debt is bad” diet. For as long as I can remember, every year when Lunar New Year came around, my dad would ask me if I owed my friends anything, and if I did, I had to pay them back before the new year began. The anti-debt mentality continued into adulthood: If you owe money, pay it back. If you can’t afford it, don’t buy it. So the fact that I have debt feels like I failed my parents and the lessons they taught me.

Determined to dig out

After I did land a job, I became much more diligent with my money. I didn’t just cover the minimum payment on my card; I was throwing hundreds of dollars extra on top of it. I was stringent with extraneous expenses; the only thing extra I picked up was a gym membership and maybe paying for Netflix. I occasionally spent money on socializing, but I haven’t made a single “large,” frivolous purchase since I started working — despite the many dream wishlists I allowed myself to make before I was employed, fantasizing about The Things I Would Get Once I Had a Job.

My student loans all kicked in after I got a job too, so on top of helping my dad out with money, I have very little actual money to spare. If I threw the remainder of my money at my credit card (and I have only one, so at least there’s that!), I would have no fallback cushion. Meaning, nothing extraneous could come up or I’d land in trouble, and I couldn’t save at all. And if anything did come up — I had to buy a new pair of shoes for work, I had a surprise student loan payment that came in every quarter, etc. — I’d have to use my card again.

Sometimes I get angry about my mom’s sickness because it felt like the beginning of many hardships that would come upon my family. Not only was she sick, and not only were we potentially going to lose a family member, but we suddenly had to throw a lot of money in an attempt to save her life. Our safety net went out much quicker than it took for my parents to build one, and ultimately, even all that money couldn’t save her.

2 big expenses at once

During my senior year of high school, I was accepted to go to NYU, a school I really liked and a school with hideously high tuition rate and laughably bad financial aid. At one point, I actually asked my mom, “Why did you have to choose now to get sick?”

The unspoken question was, “How will we have enough money to pay for my tuition while paying for your medical bills?” It’s painful to even relive that question. She didn’t choose to get sick then because she thought it’d be fun.

I ended up going to NYU anyway, and I have all the student loans to show for it. Every semester, the day tuition bills were made available was a mini-Armageddon day for me — whether my scholarship money had made its way safely to the bursar’s office, whether I was able to get new scholarships, whether my parents’ earnings from the past year impacted our out-of-pocket expenses.

The winter before my mom died, I was in China visiting her at the hospital. On a day I stayed in because I had a cold, I got an email from the school that said that due to an error in my financial aid forms, I owed the school close to $10,000 in tuition for the school year. I panicked, because, well, why wouldn’t I panic over owing the school close to 10 grand? I was so scared of calling my mom and telling her about the email, and when I did, I cried on the phone, telling her how afraid I was that we wouldn’t be able to pay for school on top of my mom’s large, unending medical bills. She told me to not worry about it. She said we’d take out another loan if we had to and that it wasn’t the end of the world. It’s just money, she had said.

The urgency to pay off bills, to not be saddled with a “debt,” was all-consuming, and is still all-consuming. There are days and weeks when I come up with a solid plan on how to pay back my own debt and my student loans without going crazy, slowly, one month at a time. Then there are days and weeks when I panic about how my debt never, ever seems to get any smaller because I’m not allowed to have a sane relationship with my money. The panic usually wins out, and all I’m left with is the thought that I must get rid of my debt. My debt feels like an anchor to the past, and I can’t wait to be freed from money borrowed in less-than-ideal circumstances, when it was the only tangible thing that could solve a temporary problem.

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