The Arithmetic of Survival

The Weight of What Cannot Be

The landlord’s letter arrived on a Tuesday, which seemed important at the time though I could not have said why. The envelope was thin, the kind that suggests its contents require no discussion, no negotiation, no response beyond compliance. Rent would increase by two hundred and seventy-five dollars beginning the first of next month. The language was almost apologetic,rising property taxes, maintenance costs, the market,but the number remained: $275. I held the letter for a long time, standing in the kitchen where the morning light fell across the Formica counter in a way that might have seemed hopeful in a different season of my life.

The market, I thought. As if the market were weather, something that happened to you rather than something made by people making decisions. Property taxes rose because someone voted to cut funding somewhere else. Maintenance costs were real but so was profit. The letter didn’t mention profit. It never did.

I had been doing the arithmetic for years by then. Not the arithmetic they taught in school, with its clean variables and reliable solutions, but the other kind, the kind where you subtract groceries from the paycheck and add the gas bill and divide what remains by the number of days until the next deposit appears, spectral and insufficient, in your account. This new number,$275,required recalculation. I would need to run the figures again.

The apartment was not much. Two rooms and a bathroom with tiles that had been white once, in some previous decade, under some previous tenant’s regime of care. The carpet was brown or had become brown; I no longer remembered. But the place was mine in the way that anything you pay for each month becomes yours, which is to say not really, not in any permanent sense, but enough that you arrange your few possessions in it and call it home when people ask where you live. The neighborhood was what real estate people called “transitional,” which meant it was not quite dangerous enough to abandon but not safe enough to cost more. It was the kind of place where car alarms went off at three in the morning and no one called the police.

Transitional. I had looked up what happened to neighborhoods like this one, how the pattern worked. First the rent went up slowly, just a little more than people could manage. Then the people who couldn’t manage left, and new people came in, people with slightly more money, and then the rent went up again. It wasn’t personal. It was mechanics. Someone somewhere was making decisions about what this neighborhood should become, and those decisions required that people like me eventually go somewhere else. Except there was nowhere else that cost less. That was the point.

I had been working at the clinic for four years. Medical billing. The work required precision, attention to detail, an ability to navigate systems that changed constantly and made no sense. I was good at it. I had always been good at learning systems, at understanding how things worked even when they seemed designed to be incomprehensible. The job offered health insurance and a predictable paycheck every other Friday, and these things were not nothing. My mother had taught me that you do not leave a job with benefits for no reason, that you show up even when you are tired, especially when you are tired, that reliability is its own form of currency. She had worked for thirty years at the telephone company, back when there was a telephone company to work for, and had believed absolutely in the promise that loyalty would be rewarded. Then they downsized her department and she found herself at fifty-eight with a pension that covered almost nothing.

She had believed in the promise. That was the difference between her generation and mine. I had never believed in it. I had watched it break for people like her, had understood early that the rules had changed but the language hadn’t. They still talked about hard work and loyalty and ladders you could climb, but the ladders were gone. What was left was the arithmetic, the constant calculation of not enough, and if you were good at it you survived and if you weren’t you didn’t. I had gotten very good at it. That was something. Not much, but something.

The clinic had changed in recent months. There was a new tension in the waiting room, in the way patients spoke to staff, in the way staff spoke to each other. People were angry about things that had nothing to do with their appointments,about immigrants, about handouts, about people getting things they didn’t deserve. A woman had screamed at Maria, one of the intake nurses, telling her to go back where she came from. Maria had been born in Tucson. The administration sent an email about maintaining professional conduct, about not engaging with political discussions, as if silence could smooth over the atmosphere that had settled over everything like a fine, corrosive dust.

I understood what was happening. It wasn’t complicated. People were suffering and someone had convinced them it was because of other people who were also suffering. Look at them, getting handouts. Look at them, taking your jobs. Never mind that the jobs paid less each year, that the handouts barely covered rent, that the real money was moving in directions none of us in the waiting room would ever see. The anger needed a target and the target needed to be someone powerless. Someone like Maria. Someone like the people waiting for healthcare they couldn’t afford. Someone, eventually, like me.

My mother called on Wednesday. I knew before I answered that something was wrong because she never called in the middle of the week, as if the minutes cost more on workdays, which perhaps in her mind they did. Her voice had the thin quality it got when she was trying not to worry me.

“I’m fine,” she said, which meant she wasn’t.

The prescription had gotten more expensive. The pharmacy had explained something about her insurance changing, about formularies and prior authorizations, about generic alternatives that her doctor said wouldn’t work as well. The new cost was four hundred and twelve dollars. She had been stretching the old prescription, taking pills every other day instead of daily, but she was running out. She wanted to know if I might be able to help.

I did not tell her about the rent increase. I said of course, I would figure something out, it was not a problem. This was not lying. This was protecting her from worry she couldn’t fix. This was what we did for each other, what we had always done. My mother had never asked me for anything she didn’t absolutely need. I would not let her go without her medication. That was not negotiable. I would find the money because that was what you did for the people you loved.

Her insurance hadn’t changed randomly. Someone had decided that profit mattered more than whether she could afford her heart medication. It was a simple equation: more cost to her meant more profit somewhere else. They called it market forces. They called it sustainability. They never called it what it was, which was a choice about who deserved to live comfortably and who deserved to ration pills and hope.

After we hung up I sat at the kitchen table and made lists. This was something I did, the making of lists, as if organization itself could solve the fundamental problem of not having enough. On one side I wrote what I owed: rent, utilities, car insurance, the minimum payment on the credit card I had promised myself I would pay off but kept using for emergencies, which came often enough that the balance only climbed. On the other side I wrote what I had: the paycheck, which after taxes was never as much as the number they said when they hired you. The gap between the two columns had always been there, a permanent feature of the landscape, but it was wider now.

Every line item on my list was a decision someone else had made. The wage that hadn’t increased in three years. The healthcare that cost more each month. The interest rate on the credit card that made the balance grow even when I paid on time. These weren’t accidents. These were choices, and I was living inside of them.

The car had been making a noise for weeks, a grinding sound when I braked that I had been ignoring in the way you ignore anything you cannot afford to acknowledge. On Thursday it got worse. Louder. Harder to ignore. I drove to work with the windows down so I wouldn’t have to hear it as clearly, but at stop lights the grinding became a shrieking and other drivers looked over.

That morning I had been sick again. The nausea came in waves, predictable now in its unpredictability. I told myself it was stress. The body did strange things under pressure. But I had been counting days in the back of my mind, the way you count anything you’re afraid to acknowledge directly. My period was late. Not a little late. Late enough that the counting had become its own form of arithmetic, days adding up to a number I didn’t want to consider.

There were pregnancy tests at the dollar store, but even a dollar felt like too much to spend on confirming what I suspected I already knew. And if I knew for certain, then I would have to decide something, and decisions required money I didn’t have. The clinic where I worked didn’t provide those services anymore,new regulations, state mandates, things the administration discussed in careful language that revealed nothing. Women were driving to other states now, if they could afford to. If they had cars that worked and gas money and the ability to take time off work.

The timing was almost perfect, in the way disasters have their own logic. New regulations that closed clinics and forced women to travel. New policies that made healthcare more expensive. New rhetoric that convinced people the problem was immigrants and welfare recipients rather than the people writing the policies. And all of it happening while I was trying to figure out how to afford brake pads and my mother’s medication and now, possibly, this.

I thought about the politicians who had written these regulations. They talked about life, about protecting the unborn, about family values. But they voted against healthcare and childcare and food assistance. They voted against everything that might actually help a child survive once it was born. The contradiction didn’t bother them. The cruelty was the point. Keep people desperate enough and they’ll work for less, accept worse conditions, be grateful for whatever scraps they’re given.

Friday I took the car to the mechanic, the one whose shop was under the freeway overpass, who charged less than the dealership and never suggested repairs you didn’t need. He was the kind of man who wiped his hands on the same rag all day and whose competence was evident in his efficiency of movement. He drove the car around the block and when he came back his face had the expression mechanics get when they are about to tell you something expensive.

“Brake pads are shot,” he said. “Rotors are damaged. You’ve been driving on them too long.”

I had been driving on them exactly as long as I could, which was the point, but I didn’t say this. He wrote up an estimate: one thousand and forty dollars. He could do it for less if I wanted to risk it, but he wouldn’t recommend that. The brakes were safety. You didn’t compromise on safety.

Except that everything was a compromise when you didn’t have enough. Safety was a luxury. So was health. So was the ability to choose what happened to your own body. These were things people with money took for granted, things that seemed like basic rights until you couldn’t afford them and realized they were just commodities like anything else.

I told him I needed to think about it. He said okay, but don’t think too long. I drove home with the windows down again, the nausea rising in my throat at every stop light.

The arithmetic that night took longer. I had nine hundred and eighteen dollars in checking after the paycheck cleared. Rent was due in eleven days. I had stretched the groceries as far as they would go, which was not quite to the end of the month. The credit card was nearly maxed. I called the clinic and asked about overtime, but they were cutting hours, not adding them. Healthcare costs were up, reimbursements were down, something about new policies from Washington that meant less funding for clinics like ours. I looked at the balance in my savings account, which was sixty-three dollars, an amount that felt aspirational when I opened it, as if calling something “savings” made it substantial.

My mother’s medication cost four hundred and twelve dollars. The car repair cost one thousand and forty. The rent increase started next month. And there was the other thing, the possibility I was carrying, that would cost more than all of it combined. The numbers did not add up no matter how many times I rearranged them.

There is a particular kind of tiredness that comes from this arithmetic, from the endless calculation of not enough. It lives in your shoulders and in the small of your back and in the space behind your eyes. You carry it everywhere. People at work ask if you’re feeling okay and you say you didn’t sleep well, which is true but not in the way they think. You were not awake because of noise or anxiety in the conventional sense. You were awake because you were running the numbers again, trying to find some combination that worked, some sequence where everything got paid and there was enough left over to eat and put gas in the car and maybe, possibly, deal with the other thing.

Saturday I worked a shift at the restaurant. This was something I did sometimes, when the arithmetic got particularly bad,picked up hours waiting tables at a place downtown where the tips were good if you worked the right shifts. The work was hard in a different way than the clinic, required different skills. I was good at reading people, at understanding what they needed before they asked for it. You had to be present, attentive, efficient. I moved through the dining room with purpose, carrying trays that weighed more than they looked like they should, remembering orders without writing them down, keeping six tables running smoothly in my head at once. It was a kind of competence I took satisfaction in, even when my feet hurt, even when I was tired.

The nausea hit during the dinner rush. I made it to the bathroom and stood there breathing carefully, willing my body to cooperate for just a few more hours. In the mirror my face looked pale, drawn, but I straightened my shoulders and went back out to the floor. You didn’t let people see you struggling. That was something else my mother had taught me.

A table of men in their fifties talked loudly about the news, about how the president was finally doing something about the freeloaders, about how people needed to work for what they got instead of expecting handouts. One of them looked at me and said something about lazy people always having their hands out. I smiled and asked if they needed anything else. My voice was steady, professional. I had been working since I was fifteen years old. I was working two jobs now, had been for two years. I had not taken a sick day since I started at the clinic. I knew what hard work looked like, and I knew these men had no idea what my life required of me. But I also knew that saying any of this would cost me the tip, and I needed the tip more than I needed to educate them.

The shift was long. My feet hurt. At the end of the night I counted my tips: one hundred and sixty-three dollars. It was more than I expected and less than I needed. But it was something. I had earned it. That mattered.

Sunday I bought the pregnancy test. Not at the dollar store but at the pharmacy, where it cost twelve dollars, which felt obscene but I needed to know. I took it in the bathroom of my apartment, the one with the tiles that had been white once, and watched the second line appear. There it was, then. Another number in the arithmetic. Another problem to solve.

I sat on the bathroom floor for a long time, but not because I was falling apart. I was thinking. That was what you did when you faced something difficult,you thought it through, you looked at the options, you made a plan. I thought about driving to another state, about the cost of gas and a hotel and the procedure itself. I thought about having it, about childcare and diapers and how I could barely feed myself. I thought about the new regulations, about how the options were narrowing, about politicians who talked about the sanctity of life while voting against healthcare and food assistance and everything that might actually help a child survive.

I had faced difficult things before. I would face this one too. Not because I had some special strength, but because giving up had never been an option. My mother hadn’t raised me to give up. She had raised me to work, to persist, to find a way. And I would find a way, even if I didn’t know what it was yet.

The system worked by making everything just difficult enough that most people gave up or learned to accept less. Want an abortion? Drive eight hours. Take two days off work. Find six hundred dollars. Want healthcare? Pay premiums that consume a quarter of your paycheck. Want housing? Compete with people who have more. Want childcare? Pay more than you make. Want a better job? Get a degree you can’t afford. The obstacles weren’t accidental. They were designed. If enough people gave up, the system could call it choice. See, we offered options. Not our fault if you couldn’t manage.

I called my mother and told her I would send the money for her medication. She asked if I was sure, if I could really afford it. I said yes, and I meant it. I would make it work because that was what I did. She thanked me and I said it was nothing, and we both understood that it wasn’t nothing, that it was everything, that this was how we showed love,by taking care of each other, by shouldering what needed to be shouldered, by not breaking even when it would have been easier to break.

Monday morning the car made the noise again, worse now. I thought about the mechanic’s face, about safety and compromise. I thought about my mother taking her medication every other day, stretching it, making it last. I thought about the credit card statement I hadn’t opened yet, about the minimum payment that was due, about the late fee if I missed it. I thought about the pregnancy test in the bathroom trash.

At work I stared at the computer screen where insurance codes appeared in rows, each one representing someone else’s medical crisis, someone else’s arithmetic. The numbers blurred. I blinked and they resolved again: diagnosis codes, procedure codes, payments and denials and appeals. Other people’s emergencies, reduced to data. A woman came to the window crying because her husband’s insulin wasn’t covered anymore, something about the formulary changing. I gave her the phone number for patient assistance programs, knowing they wouldn’t be enough, that nothing was ever enough.

I saw it clearly then, the whole system. The clinic got reimbursed less, so it cut staff and services. The insurance companies paid out less, so premiums went up. The pharmaceutical companies raised prices because they could, because profit was the only metric that mattered, because people would pay anything to stay alive and they knew it. And somewhere, far away from this waiting room, people were making money from all of it. From every denied claim, every raised premium, every desperate choice.

During my lunch break I sat in my car and searched for clinics in other states. The nearest one that provided the services I needed was four hundred miles away. They required a consultation visit and then a waiting period and then the procedure itself. Two trips. Two days off work I couldn’t afford to take. Gas money. Hotel money. The procedure itself was six hundred and fifty dollars, which might as well have been six thousand. I closed the browser and stared at the dashboard.

The waiting period was the cruelest part. They called it informed consent, as if you hadn’t already thought about it, as if the decision wasn’t already hard enough. But it wasn’t about consent. It was about making it just difficult enough that some women would give up. Would run out of time. Would run out of money. Would accept what they couldn’t afford to choose against. It was policy designed to look like choice while removing every practical option.

That night I called the credit card company. I asked about hardship programs, about reduced interest rates, about payment plans. The woman on the phone was kind but firm. She could offer me a slightly lower minimum payment for three months, but the interest would continue accruing. I did the math while she talked. The slightly lower payment would save me thirty-four dollars a month. This seemed both significant and meaningless.

I made a new list. This one was different. It was not about what I owed or what I had but about what I might be able to eliminate, what I might be able to sacrifice or postpone or simply not have. I looked at the streaming service I paid for, the phone plan, the occasional coffee on the way to work. The numbers were small, five dollars here, twelve dollars there, but I added them up anyway. They totaled sixty-eight dollars a month. This was not enough to cover anything that mattered, but it was something.

I thought about what else I could cut. Groceries were already minimal. I had learned to cook rice in quantity, to make vegetables stretch across multiple meals, to pretend that eating the same thing five nights in a row was a choice rather than a necessity. Heat in winter was not optional. Neither was electricity. The car insurance couldn’t be canceled without losing the car, and losing the car meant losing the job. Everything was connected, every cut created a new problem.

The pregnancy added a new dimension to the arithmetic. I had perhaps eight weeks to decide, to find the money, to make the trip. Or I had nine months to prepare for something else entirely impossible. Both timelines felt equally unreal.

Tuesday I sent my mother the money for her medication. I watched the balance in my checking account drop: from nine hundred and eighteen to five hundred and six. Rent was due in eight days. The car still made the noise. And I was still pregnant, though I tried not to think about it directly, as if looking away might make it less real.

Wednesday I called the mechanic and asked if he could do a payment plan. He said he didn’t usually, but his voice was kind. We worked it out: three hundred now, the rest over three months. It wasn’t ideal, he said, but he understood. People had to work. People had to drive. The car would be ready Thursday.

I paid him with the credit card, which meant the balance went up again, which meant the minimum payment would go up, which meant next month’s arithmetic would be worse. But I would have brakes. I would be safe, at least in that one way.

At work, Maria was training a new hire, explaining the intake procedures, the insurance verification, the careful documentation required. The new girl asked why we didn’t offer certain services anymore and Maria’s face went careful. “Policy changes,” she said. “Above our pay grade.” The new girl nodded but looked confused. She would learn soon enough. We all learned eventually.

The rent came due. I paid it. The balance in my checking account after was one hundred and fourteen dollars. I had eleven days until the next paycheck. The groceries were low. The gas tank was half full. And I was still pregnant, the cells dividing and multiplying according to their own arithmetic, one that had nothing to do with what I could afford.

My mother called to say the medication was working, that she felt better, that she was so grateful. I told her I was glad. I did not tell her about the credit card or the car or the rent increase or the pregnancy or the new arithmetic I was running. These were things we did not discuss, the costs of survival, the prices we paid for each other, the choices that weren’t really choices at all.

Thursday I picked up the car. The brakes worked. It felt almost luxurious, the smooth stop at red lights, the absence of that grinding shriek. Small victories. I drove home and the nausea hit again at a stop sign and I breathed through it and kept going.

Friday the paycheck came. I sat at the kitchen table and divided it by the number of days until the next one. I subtracted rent and utilities and the credit card payment and groceries and gas. I looked at what remained and knew it wouldn’t be enough, that something unexpected would happen, that the arithmetic would shift again. This was not pessimism. This was just accuracy, the clear-eyed acknowledgment of how the numbers worked.

The pregnancy test was still in the bathroom trash. I would have to decide something soon. But every option required resources I didn’t have.

I thought about the people who designed this system, who wrote the policies and passed the regulations and cut the funding. They weren’t evil, probably. They were just comfortable enough that four hundred and twelve dollars didn’t sound like an impossible amount. Comfortable enough that driving eight hours seemed like a minor inconvenience rather than an insurmountable barrier. Comfortable enough that they could talk about personal responsibility and market forces and never have to run the arithmetic themselves, never have to sit at a kitchen table at midnight trying to figure out which necessity to sacrifice.

But I would figure it out. I always did. Not because I was particularly resilient or strong or any of the words people used for this kind of survival, but because giving up was not in my vocabulary. My mother had raised me to work, to persist, to hold my head up no matter what. I had been doing that my entire life. The car would run. My mother would have her medication. The rent would be paid. I would show up at the clinic and do my job well, the way I always did. And I would run the numbers again, looking for some sequence where everything worked, where the gap between the two columns closed, even though I knew it wouldn’t, not really, not in any permanent way.

But I would keep looking. That was the thing about people like me, people like my mother. We didn’t stop trying. We didn’t accept that things had to be this way. We saw the system clearly, understood how it worked, and we kept going anyway. Not because we were naive, but because we had dignity, and dignity required that you not give up on yourself or the people you loved.

The landlord’s letter was still on the counter where I’d left it. I picked it up and read it again, the apologetic language about market conditions and costs, the number that remained unchanged: $275. Next month I would pay it. I would find a way because that was what you did. You made it work. You stretched and compromised and calculated and survived. And you did it without complaint, without self-pity, because complaining didn’t pay the bills and self-pity was a luxury I couldn’t afford.

And if the system was designed to keep you here, in this place of constant calculation, constant compromise, then you at least had the clarity of seeing it for what it was. That was something. Not enough to change it, maybe, but enough to know that your struggle wasn’t failure. It was the system working exactly as it was designed to work, extracting everything it could from people who had the least to give, calling it personal responsibility, calling it the market, calling it anything but what it was. I understood that. And understanding it meant I would not be ashamed. I was working as hard as anyone could work. I was taking care of the people I loved. I was doing everything right, and if that still wasn’t enough, that was not my failure. That was the system’s design.

The morning light fell across the Formica in that same way, neither hopeful nor hopeless, just light doing what light does. I folded the letter and put it away. Outside, the neighborhood was waking up, car alarms silent for now, people leaving for jobs that paid almost enough, living in apartments they could barely afford. All of us running our own arithmetic, making it work, day by day, paycheck to paycheck, refusing to give up.

I poured coffee and looked at my list. Tomorrow I would start again. The pregnancy would still be there. The bills would still be there. The system would still be there. And I would still be doing the arithmetic, calculating what I could afford and what I couldn’t, what was possible and what wasn’t, what the cost of surviving another month would be. But I would be doing it with my head up, with the same competence and determination I brought to everything else. That was who I was. That was who my mother had raised me to be.

The numbers never changed enough to matter. But you did them anyway. That was what survival looked like now. And if survival required everything you had, then you gave everything you had. That was dignity. That was pride. That was enough.

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