The steel cage door slams shut.
Its metallic echo reverberates through the arena,
a warning bell for a contest already decided by those selling tickets.
Under the harsh lights stands the patient.
Thin, weary, clutching a stack of medical records
instead of weapons.
Across the cage wait towering opponents.
Corporate health systems, their muscles swollen
with profits and policies.
Government regulations, thick rulebooks
wrapped around their fists.
Pharmaceutical giants, draped in sponsorship banners,
their pockets heavy with the cost of survival.
The crowd roars.
Not for the patient.
Never for the patient.
The bell rings.
The patient enters the fight with hands tied behind his back,
a blindfold covering his eyes.
He swings anyway. Hope is a stubborn thing.
A punch lands. Denied.
Another. Not covered.
Another. Prior authorization required.
The blows rain down.
Forms. Phone trees. Billing codes. Network restrictions. Deductibles. Copays.
Each one a body slam into the unforgiving steel.
The patient staggers.
Blood trickles from wounds that cannot be seen on an MRI,
cannot be measured in a laboratory, cannot be entered neatly into
an electronic chart.
He falls to one knee.
Yet still he shouts.
“Hear me!”
A left hook from bureaucracy.
“See me!”
A knee from insurance denial.
His words become whispers lost beneath the deafening noise of shareholders,
lobbyists, executives, and politicians arguing over costs while forgetting
the cost of being human.
The crowd watches.
Some cheer the spectacle.
Others stare at glowing screens.
Most simply assume someone else will intervene.
No one notices that the patient is fighting for more than himself.
He is fighting for a mother awaiting treatment.
For a child needing medication.
For an elderly man counting pills at the table,
wondering which necessity he can afford this month.
He is fighting for everyone who has ever sat in an examination room
and felt invisible.
The rounds continue.
The patient grows weaker.
Bruised. Battered. Exhausted.
Yet somehow, he refuses to surrender.
David versus Goliath.
The odds remain terrible. The cage remains locked. The giants remain enormous.
But still he rises.
Still, he breathes. Still, he fights.
And from somewhere beyond the bloodthirsty crowd, beyond the advertisements,
the campaign donations, the quarterly reports,
a few voices begin to emerge.
Faint at first. Then louder.
“We see you.”
“We hear you.”
“Keep fighting.”
For one day, their bodies will fail them. One day, they will become patients too.
And when that day comes, they will pray that someone is still standing inside the cage,
refusing to surrender.
Michele Luckenbaugh is a patient advocate.
