Getting cancer

Mariano Quezada has come to believe that God has a plan. As a self-described "religious man," the 64-year-old legal immigrant from the Dominican Republic has had to rely on his faith, on his belief that God won't let him down. For how else is a man sick with prostate cancer supposed to deal with the loss of his state-funded health insurance? "At first, I was depressed," confides Quezada, speaking in Spanish, explaining how he reacted to the news this past summer that state officials had cut his full-coverage Medicaid benefits. Sitting in the unadorned Lawrence apartment of his adult son, Quezada looks pale, tired, his droopy eyelids accentuating his weariness. "But," he adds, "I am a religious man, and I think God has a way."

His current predicament, of course, is not what Quezada would have chosen for himself. Indeed, he would have been content just to continue down the road he had paved by coming to the US in May 1999. Since arriving in Lawrence, where his six adult children and their families live, he has taken pride in his work ethic. For four years, he has toiled up to 60 hours a week as a "handyman" at the Andover Country Club and other local restaurants. He has washed dishes, bused tables, prepared salads - "everything but cook the meals." He has sent most of his $800 monthly income back to his hometown of Tenare, where his second wife and two daughters still reside. He has planned to bring them to this country as soon as they're approved for green cards. All in all, he has inched closer to achieving what he calls his "first objective" - a better life.

Until, that is, he got sick. Earlier this year, he began to feel ill. He grew lethargic. His face looked sunken and pale. He suffered from bouts of diarrhea. For the first time, he called in sick to work. Concerned, his children urged him to return home to see a doctor, as is the practice among many Dominican immigrants. ("We don't trust the American health-care system to treat people immediately," Quezada explains.) There, he was diagnosed with prostate cancer and an inflamed liver.

When Quezada returned to Lawrence in April, he quit his job. He enrolled in Medicaid. And because he's a sick, legal immigrant earning less than $11,952 annually, he qualified for full-coverage benefits. For four months, visits to his doctor, a trip to a cancer specialist at Tufts New England Medical Center, and two prescriptions to help him eat and sleep were taken care of. But now, after getting a biopsy to determine a treatment regimen for his cancer, he has no insurance to pay for it. Now, after discovering that his prescription drugs cost $55 per month, he has stopped using them. "I don't know what is going to happen to me," he says.

Meanwhile, he says, he's had to get "used to the sickness." He has gotten used to the overwhelming fatigue. He endures the searing pain that shoots up his spine and immobilizes him. He has even gotten used to urinating blood. As he puts it, "At least the blood is not as bad as before."

This is not to say that Quezada has accepted the loss of his health-care benefits. For him, in fact, the situation seems brutally unfair. After all, he worked hard for years; he paid his state taxes; he contributed to the Massachusetts economy. So why isn't he entitled to assistance? "I don't understand how people who never work can get welfare," he says, "and yet I cannot get health benefits." If Quezada weren't so sick, he'd go right back to his job. If anything, he hates being cooped up at home. But how, he wonders, can he be expected to work without treatment? And what is he supposed to do about getting his treatment now?

"If I knew things would have been like this," he says, "I would have stayed in my own country and just died there."