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the sidebar » Blog Archive » Essay: We Die
Essay: We Die
By Adam Gnade
Wednesday, February 10th, 2010

The big blond one with the white baseball cap hit me square on the jaw and I went down. As I lay on the ground he and his friend kicked me and the kicks didn’t do much but when they began to stomp on my chest I knew the fight had changed.

After they left me, I lay in the grass under the moon and had a conversation with myself. Broken nose? No. Teeth? Nothing loose. Good. Jaw? Fine. Arms, legs. Fine. Ribs? Yeah, they did the ribs. The ribs again...

The first time I fractured my ribs I was on tour in England. How they were busted isn’t important but the pain built all week and by Bristol it was bad. We had left the venue and were at the after-party when the combination of booze and pain and no sleep joined forces and a panic attack came on. As it got worse, I was sure I was done. I knew without a doubt that my cracked ribs were poking into my organs and that it was only a matter of time before one of them burst and filled my body cavity with bacteria and toxins and bile. Then, naturally, death, and a bad one.

This, of course, was the panic attack talking but that didn’t matter. I made the fatal mistake of believing the voice. Of course I’m dying. Of course my organs are popping like water balloons and poisoning my bloodstream. Of course.

In the ambulance, they put me on oxygen and my panic attack passed but the pain didn’t. At the hospital I was taken to a room where they ran X-rays and blood tests and gave me an EKG. Beyond that, everything was blurry. I was in the warm, loose, post-panic attack haze, my mind still a jumble of paranoia cycles and memory holes and wormy logic. I knew I wasn’t having a panic attack anymore and I knew I wasn’t going to die but that was all I was sure of.

Three hours later the diagnosis came and I tried to listen to the doctor as he gave it to me. His voice faded in and out, “… full set of fractured ribs, left side… they’ll heal on their own but it will be slow… a year, year and a half … very gradual… try not to exert yourself… try not to cough, sneeze, lift anything heavy, run, walk fast, bend over quickly, sleep in unnatural positions or breathe harder than usual.”

Walking back to the waiting room, a nurse stopped me. Tall. Middle-aged. Swirls of gray and black hair pulled up into a bun. She had the face of a cop, the bulldog jowls, authority and poise.

Okay, I know this part, I thought. Let the hammer fall…

“Wait,” she said, looking down at her clipboard. “I believe we haven’t taken your name.”

“Uh, Adam.” It was a gamble. Act confused. Give your first name. Nothing to trace. I hadn’t filled out any paperwork yet. I’d been wheeled in, worked on, and excused. They hadn’t so much as looked at my passport.

“Alright, Adam. Hope you heal well.”

“Oh, okay, thanks. That’s all?”

“That’s all. Enjoy the rest of your stay in England.”

A few days later the promoter of that night’s show drove me to his house where his friends made me supper.

There was an American girl there. She had been living in the UK long enough to adopt a vaguely British tone but she was still American and she had a nice face and it felt good to talk to someone from home. We sat around the kitchen table and ate penne pasta with tomato sauce.

“Yeah, just like that,” I said. “They asked me my name and I left. I didn’t even give my last name. No paperwork. No questions. Didn’t pay a cent.” I took a forkful of pasta and shoved it in my mouth.

“Back home you would’ve paid … wow, I don’t even remember.

“For the ambulance ride and hospital visit? Ten, fifteen thousand?”

“Totally. God. Have you seen Sicko?” she asked.


“The new Michael Moore.”


“I cried,” she said. “I watched it twice at the cinema and cried both times. You’d think a country would … I don’t know, at least try to keep its people in good shape. Sick people, sick country. It’s bad business. You wouldn’t do that if you were managing a sports team. You’d want everyone healthy so you could win.” She tore the end off a baguette and mopped up the rest of the sauce from her plate. “Money, pharmaceutical companies… it’s such… it’s a rich man’s game.”

We sat in silence finishing our food.

The promoter came in the room with a bottle of red wine and set it in front of us.

“Hiya! Y’alright?” he asked cheerfully.

“I’m good,” I said. “Thank you for dinner. It was really good.”



The girl turned to him. “We were talking about Sicko.”

“Oh, man. I like visiting America but I couldn’t imagine living there. I’d be terrified to do anything,” he said as he struggled with the cork.

“Here, let me,” the girl said and he handed her the bottle. “I still remember how it was when I lived there,” she said as she pulled out the cork and set the opener aside. “You can’t live in fear but it’s always in the back of your mind. Like, what if I just took the wrong step.”

“Does anyone you know in America have health insurance?” the guy asked, sitting down across from me.

“None of my friends,” I said. The girl poured three coffee mugs of wine. I took mine and drank half of it and my face went warm. “Yeah, nobody.”

“That’s crazy, man,” the guy said. “Health care isn’t even something we think about here. I mean I’m well chuffed with NHS but we don’t think about it. It just is.”

“My new plan,” I started to say, and then cleared my throat, “my new plan after what happened in Bristol is if I get hurt in America my friends will put me on a plane, send me to London Heathrow and I’ll take the first cab to the ER. The plane ticket would be expensive of course but I’d save thousands in hospital bills.”

“What happens to people in America without health insurance when they get, y’know, really sick?” the guy asked.

“We die.”

Naw, mate. Really… ” he said.

We die.”

The girl got up and carried her plate to the sink. She ran the tap water but she didn’t rinse the plate. She held it in her hands and the water ran and she stared out the window. She looked back at us and then turned away again. Her shoulders began to shake and I knew she was crying.

BIO: Adam Gnade's (guh nah dee) work is released as a series of books and records that share characters and themes; the fiction writing continuing plot-lines left open by the self-described "talking songs" in an attempt to compile a vast, detailed, interconnected, personal history of contemporary American life. Check out recent writing here and songs here. Contact: adam@asthmatickitty.com

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