At another time in America, Pierrette’s story might have been a hard pill for most Americans to swallow. A doctor - unemployed and on Medicaid? Going to soup kitchens? But in today’s economic climate, such tragedies seem all too possible to fathom.

Since the housing bubble burst two years ago and its domino effect on the entire economy is now being felt, a glaring spotlight has been shone on America’s middle class. About 70% of Americans polled say they live paycheck to paycheck; nearly 47 million Americans, or 18%, have no health insurance; over two million houses went into foreclosure since the bubble burst; nearly ten and a half million Americans are now unemployed. In plain terms, America’s middle class is barely getting by, and most are merely an accident, an illness or a missed paycheck away from poverty.

As a single mother and a pediatrician with her own practice, life for Pierrette was already challenging. Then everything got harder. Her son, Joshua, was only nine when he was diagnosed with bi-polar disorder. In less than three years, he was admitted five times to the hospital after having mental “blow outs,” which resulted in him breaking Pierrette’s nose and injuring her wrist. “Meltdowns,” she says, “included trying to destroy my bifocals that I need to drive, hitting me and throwing all sorts of stuff around.” Joshua also had suicidal thoughts.

“He was admitted to a child unit 65 miles away,” Pierrette writes in her blog, “since there are none in my county. (He received) twelve days of stabilization and anger management in milieu of therapy and they added a diagnosis of Tourette's disorder—he has mega vocal and facial tics without the medication. I was told repeatedly by the staff that Joshua needs residential (in-patient) treatment.”

But Joshua’s mental health problems were not considered an “emergency” by officials in Sonoma County, California, where they now live, says Pierrette. Last year in June, Pierrette was told that she could only apply for assistance for a “severe emotional disturbance” during the school calendar year (August-May), and even that process takes 60 days, pending an assessment by a mental health professional.

With the demands of supporting her son alone, Pierrette lost one contract job after the next, sinking deeper and deeper into financial debt. “Employers aren’t happy when I have to leave work because my son has been suspended or is having a medical crisis.”

Over 27% of parents who have children with disabilities lose their jobs according to research by Dr. Julie Rosenzweig, a professor in the School of Social Work at Portland State University. “Nearly half (48%) of these parents had to quit their jobs in order to take care of their children. There are exceptional care responsibilities for children with mental disabilities,” she explains, “and very few childcare resources.”

Once Pierrette lost her job, she lost her health insurance. She was also forced to sell her house. Like many struggling homeowners, she lost almost $100,000 in equity in a short sale - money that she needed to pay off thousands of dollars of debt for the healthcare she was paying for out of pocket.

Having spoken to Pierrette via telephone from Germany, I realized just how lucky I have been to raise children in a social democracy. I recall the fear-based backlash at Barack Obama’s plan to “spread the wealth” during his election campaign, and wondered if most middle and working Americans really understood what that actually means?

For me here in Germany, it means that my kids will always have health insurance. It means that I never have to pay for medicine for my children, even alternative and homeopathic treatments. It means that if one of my children were to have special needs, I wouldn’t have to choose between working and taking care of him.

“We talk to professionals all the time who will step out of their career track, turn down promotions, turn down travel to take care of their kids,” says Rosenzweig. Pierrette points out, “It’s hard to keep a child care person when your child is assaultive.”

In many ways Pierrette made her own social investments in the community from as early on as childhood. “My idea of fun was going to the local A + P (grocery story) to participate in a boycott to change discriminatory hiring practices and marching in Chicago and Mississippi. I was old enough to meet many of the powerhouses of the (civil rights) movement in my parents’ living room.” As a doctor, Pierrette worked for three years in the National Health Service Corps in Nevada and the Central Valley of California, providing basic healthcare for communities in need.

Forgoing lucrative jobs to service a poor community, Pierrete discovered, has its returns as well. During the hard times, former patients gave her clothes and food. “And here in Petaluma people really take care of those in need - there are community gardens and transitional housing,” says Pierrette. “I’m not afraid of being embarrassed anymore.” While she has never made Joshua stand in line with her at a food pantry, she is grateful that services she has long advocated for were around when she needed them herself.

When I first got in touch with Pierrette in early October she said, “Even though I am not living high on the hog, I am still more privileged than many other single moms in the same circumstances. No one can take away one's skills, intellect and hope.”

Eventually she found flexible work at a coffee shop that offers health insurance once she accrues enough hours. She relied on the support of friends and family for childcare. She gave away old clothes to charity as she couldn’t possibly fit anything more into her car, where she once kept her and Joshua’s possessions. She pushed for adequate services for her son (being a pediatrician, she knew the avenues to explore) and Joshua has finally started receiving therapy and case management through the county. He also gets therapeutic behavioral services at home. In his new private school, Pierrette proudly announces, “He is now reading above grade level, making leaps and bounds in math. He has decided he wants to be a biophysicist and work for NASA.”

Last month they moved into a rental and although life isn’t easy - Pierrette recently had to hock her flute and Joshua's soprano saxophone to pay for utilities, gas and “a tiny bit of pocket change” - she is still hopeful that her situation will change.

“Too many folks expect (Obama) to solve all,” says Pierrette. “I think more will come from his behemoth group of community volunteers who are shifting their energies away from campaigning to local projects.”

In the mean time, she continues to work at the café and has to eat “humble pie” whenever she pours coffee for her former colleagues. But she does so because she hopes to eventually earn the health insurance she and her son need, something that though possible, is difficult given her part-time status.

For her spiritual insurance, she practices her Buddhist chants, remains grateful and strives to “find joy in each day.”

Still hopeful that she’ll find a job in her field soon, Pierrette says, “I have learned to appreciate every challenge.”

Rose-Anne's article is part of this month's focus on disability issues. - Ed.

About the Author
Rose-Anne Clermont was born in New York City and first lived in Germany as a Fulbright fellow from 1998-1999. She holds a Bachelor's Degree from Sarah Lawrence College and a Master's Degree in Journalism from Columbia University. She has contributed to Spiegel Online, The International Herald Tribune and, in German, to Die Zeit. Rose-Anne is also a contributing writer to the upcoming NPR Worldwide series entitled The Berlin Stories, launched in November 2008. She currently lives in Berlin with her husband and three sons.

Visit her blog, Currents between Shores.