24 May 2008

catch-up: talking shop

so a friend emailed me recently and said hey, how have you been doing by the way, i don't really know what you're up to.

good point.

since january i've been working at a national pro-choice organization. it's a professional organization for providers, a policy and lobbying group, a coordinator of research and medical education, and a resource for women seeking information about abortion, sexual health, and a good variety of related things.

the latter function is under the scope of an assistance hotline, where i work as a case manager. my department recently received a significant gift of money, all earmarked for helping women pay for abortion care. this is why i was hired. it used to be that one case manager was sufficient for the tasks of (a) usually telling people "no, funding isn't really what we do", (b) determining who was most needy of a "yes", and (c) administering the very small amount of money we had. but the hotline has become a real funding resource since then, and as of next week we will have a total of five case managers to manage the demand (i was the third).

it's great to be able to say "yes" so often. it makes me wonder about all the women who called for prices when i worked at the clinic; how many of them simply gave up? when people inquired about financial help, we had to begin with the shitty stuff -- "have you asked your church group for help? can you go see a loan shark? do you have anything you can pawn?", knowing that some women might already be selling their food stamps or selling sex -- and then tack on, "and if you get pretty close to your goal, there are organizations that may then be able to give $50 or $75, but they can only do that a couple times a month, so call back and talk to our manager and maybe she can talk to them for you". now that shitty stuff is the last resort, for after we've promised as much money as we're allowed to. it's still not a perfect system, but i'll certainly take that over "no, we can't do payment plans. but we do accept credit cards...".

in fact, we say "yes" so often to so many women that we've delegated a lot of that to the hotline operators, so that case managers can spend more time on people who need more support than just the money. in a way that makes it harder, of course; you feel like you fail more often, because there are still people that, no matter how hard you try for them, don't make it to their bus ride across the country or have too complicated a medical history to be seen by anyone at this stage in the pregnancy, etc. i had to give up on a woman with paranoid-schizophrenia and a pregnancy that may or may not have been the product of incestuous assault because she would only contact me, via payphone, every two weeks, was unwilling to fax the clinic the police report or the medical report that would have established legal grounds for the procedure (or even her previous sonogram so they could tell her the length of pregnancy and the cost and set her an appointment), and had been sent home from a previous appointment elsewhere after having a freakout and making a nurse there feel unsafe. one of my colleagues had been working with her as early as january, and by the time she was too far along to have an abortion she still hadn't gotten it together.

of course these are the people that you want to work hardest for, because they're having the most trouble getting what they need. but there's a certain point where i can't do more -- can't go to her state and get her out of her father's house and drive her to colorado and escort her through the weeklong appointment -- and even if i could, maybe i shouldn't. the hardest thing for me has been sussing out whether a woman really wants to go ahead with an abortion and is just encountering obstacle after obstacle, or is inwardly ambivalent and hoping that one of those obstacles might stop the events in motion. it happens. i've done that myself, about mundane things like going to a movie i didn't really want to see, or accepting a job i didn't really want to do: "i'm so disappointed, i was all set to do it but then i got sick / had a plumbing emergency / had conflicting family plans", whatever. it's important that women still be able to own their decision, such as it is -- if you can help it, you should avoid being in a position to blame something important, like having or not having a child, on things beyond your control -- and i am struggling to find the best way to support that. once someone apologized to me when she said she wouldn't need financial assistance anymore because she had decided to carry to term. i don't want you to be sorry. i just want you to to be able to do what's best for you, and you know best what that is.

i'm glad that i am still working with a client population, even if it's only over the phone; i know i quit my job at the clinic saying i wanted to do lobbying or communications or something of the sort, but this job offer came right at the time where i was starting to question that, and i think it's mostly been a good thing. i'm still thinking i'd like to do policy research sometime soon, but it makes me sad to think about sitting alone in an office not actually talking to the people i'm hoping to be useful to. how can you know you're on the right track if you don't listen to your clients? but anyway, there are so many things i want to do sometime soon that i don't know which one will be soonest. go to school so i can just get a masters' out of the way, travel, live in my hometown for a spell, change jobs four hundred times, write some kind of food book? sure.

anyway, so that's what i do, sort of. i'll try to update more soon.


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