Universal healthcare may be a controversial issue for some, but not for author Deborah Copaken. In her new memoir, Ladyparts, Deborah shares how her personal and medical history were only made more challenging by the fact that she did not consistently have insurance, despite being a New York Times bestselling author with an illustrious career. Using her own body as a metaphor for how women are treated in the American healthcare system, Deborah takes an unflinching look at the industry’s often insurmountable hurdles and the physical toll they take.

Transcript:

Zibby Owens: Welcome, Deb. Thanks so much for coming on “Moms Don’t Have Time to Read Books” to discuss Ladyparts.

Deborah Copaken: Thank you, Zibby. You read this early, remember?

Zibby: I know. I did. It was so exciting. I was on a plane. I was opening your Word document and being like, this is the coolest thing ever.

Deb: That was really fun. We did the Modern Love thing. I was trying to remember the course of events. I think we did the Modern Love podcast. Then I gave you the Word document. You’re like, “I need more.” That actually was a good incentive to keep writing more, so thank you.

Zibby: It was great. It was so good. You had only had two or three chapters, I feel like, at that point. It was right in the beginning.

Deb: I think I just had the uterus chapter, and the vagina.

Zibby: Thank you for putting me in the acknowledgments. That was very sweet of you. I saw that at the end. Thank you. Why don’t you tell everybody what Ladyparts is about and how you came up with this, as I know you describe in here, but how you came up with this as a device for how to tell your story?

Deb: This is one of my first interviews, so I’m going to have to do this on the fly. I don’t have my elevator pitch down.

Zibby: You don’t need a pitch. Just tell it to me like it happened.

Deb: In 2018, so three years ago, I was standing in the shower. I was looking down at my stomach at all of the various scars on it. I’ve had a hysterectomy. I had a trachelectomy. I had a vaginal cuff dehiscence. My body is covered with scars. They’re not big. They’re not annoying. They’re there. Every day, I soap them up. I was looking at them and I thought, oh, my god, this is the outline of a book. They weren’t just my scars. They were scars that America had given to me. There was a useful way to use each body part that had been either excised or went on the fritz as metaphor and narrative construct. Just for an example, uterus, my uterus was taken out the same day that my teenage daughter got her period and the same day that my mentor and sort of surrogate mother figure in New York was dying. What is a uterus other than a symbol of fertility, of motherhood? It was one of the things that I was afraid of, getting rid of my uterus. Who was I without a uterus? I thought, okay, that’s a chapter. Then I went further. I thought, my heart went on the fritz just as I was starting to date again. Literally as I was going on my first Tinder dates, I was wearing a Holter monitor. There’s little sticky things all over you. You have a little buzzy thing here that bleeps and buzzes when your heart goes too fast. That was interesting. Literally, every body part that was broken or excised had a perfect narrative structure. It was just one of those lightning bolt moments in the shower. I came out and I just really pounded it out, the outline. I called Lisa Leshne, my agent. I was like, “I got a book. I got a book I want to write.”

Zibby: That’s amazing, oh, my gosh. All of your stories, you link back to the bigger picture. I feel like you always have a, okay, this isn’t just — you’re using your story to tell a much bigger story of what it’s like in America, what it’s like with the shrinking middle class or the pressures on that, the healthcare system here versus healthcare systems everywhere else. You scatter in — maybe that’s the wrong word. You intersperse all sorts of statistics to make your point and show, look, I am a hardworking author doing my best, and this is what you’re giving me back? Come on.

Deb: I am a hardworking author doing my best, and I can’t fucking make it. Am I allowed to curse on this podcast?

Zibby: You are now.

Deb: Sorry, folks.

Zibby: You can. It’s fine. I’ll put a little label on it.

Deb: What, in essence, I’m doing, and I’m thinking of this as I’m talking to you, is I’m using my body as a megaphone. This is not just my body. My body stands for all female American bodies that don’t get maternity leave. They don’t get healthcare. They pay nine thousand dollars per baby. That’s a lot of money for someone in my economic situation. That’s a lot of money. Babysitters are ridiculously expensive. We don’t have a system. Our science is behind the times. We don’t look at female bodies, per se. We don’t look at the effects of estrogen. I could go on and on and on. The book does go on and on and on for nearly five hundred pages, but I hope they go fast. What I’m trying to do is to use my body as an example. I just had such a cascade of bad luck that I could’ve either crawled into a ball and cried or I could say, okay, this is an opportunity to use my own situation, my own body as a way for talking about issues that get swept under the rug that we’re not talking about. Being a female body in America is really, really hard, particularly being a female, middle-class body. You said, you’re a hardworking writer, you can’t make it work. I’m a New York Times best-selling author, but I can’t do that job because I need healthcare. I’m always having to go get other jobs, like corporate jobs with health insurance, to make my life work. If I had health insurance or universal healthcare like any other country, France, Sweden, Norway, Denmark, all these countries that have — Israel — have socialized medicine where healthcare is a right, not a privilege, I could be a more productive writer. I could be a less stressed-out woman. I could be a better mother. There are so many implications to tying health insurance to corporate jobs.

Zibby: I couldn’t believe when you had found the lump in your breast and you had to wait. First of all, you were at the Harlem free clinic. There was a cancellation. You got in. Then they were like, “You have to come right back for tests.” You were like, “No, no, I can’t. I have to wait for my health insurance.” The doctor’s like, “No, you have to come.” You were like, “No, I’m not going to. I can’t. I can’t pay for this. I have to wait.” Then that they so flippantly at work were like, “We’re going to push this back a little bit,” and so you had to push back the appointment again. The ramifications of this are so vast when you think about it multiplied by a zillion with everybody with healthcare and work and all of this and what is not being diagnosed and then the implications of the — you point out how vast a problem it is for everyone.

Deb: Then also, at that same job, which was, by the way, an online health magazine which shall remain unnamed, an online health magazine, I was fired for spending too much time at Sloan Kettering. I was fired because I was absent too often. I showed the HR person, on my calendar, each absence mapped out. There was one absence a week. I was going to Sloan Kettering. Each of those absences was related to my breast. It was related to my stage zero breast cancer diagnosis. I’m fine. I didn’t have to go through chemotherapy. I didn’t have to go through radiation. Mine was a really simple, one-and-done situation of breast cancer, but I got fired for getting breast cancer, essentially.

Zibby: It’s so crazy. It’s so unfair. Even the fact, as you point out, that you were working at that healthcare place and you had all these ideas coming in of what you were going to do to mix things up, and you quickly realized that, wait a minute, this is really just a fodder for advertising. It was backwards, like wagging the dog.

Deb: Right. It was a “healthcare magazine.” I put it in quotes. It really was about getting healthcare pharmaceutical dollars. They made a lot of money. They went public. They did well. The people that were at the top did well in that. I was hired to get the stable of bloggers writing better prose, to edit because there was often misspellings. I kept saying to my bosses, “When are we going to pay these people? You told them you were going to pay them. They were promised if they start –” These were sick people. This was somebody with diabetes, with cancer, with breast cancer, with skin cancer. They got all the diseases. By the way, none of the diseases that didn’t have pharmaceutical ads that they could sell. Type one diabetes, no. Type two, yes, because there’s lots of ads you can sell for that. I didn’t have a type one diabetes blogger. I had a type two diabetes blogger. They told me, each of them, they’d been promised payment. Here I was asking sick people who had bills to pay, medical bills to pay, to write for me for free so that we could sell ads to make my bosses rich. In a nutshell, I hate to say it, that’s corporate America.

Zibby: Wow. This book, in addition to taking all of that on, which you did really well — I felt like I was watching, not a political candidate, but somebody who just had all their facts together and was up there making a case. You have that whole thing. Then you take us deep into your marriage and how lonely you were being married to someone who you didn’t even know was on the spectrum and then having to bring that into reshuffling all your thoughts when you learned that. Did it really make things better? Having to go through the extrication of that, that was a lot. You continued to use that as an example of how hard it is for women to get divorced and what happens when you don’t have the spouse helping out. Your 9/11 story was insane when you couldn’t even pick up both your kids. Oh, my gosh, it’s not even a question. I’m just like, wow.

Deb: The 9/11 scene, my ex-husband was stuck downtown, but it was more of a metaphor for being the mother alone. I had to pick up two kids from two different schools. I only had one bike. One of them was a toddler. I don’t have a car. Even if I had a car that day, I’m not sure you were allowed to use them. I don’t remember. My ex-husband and I are actually good friends now. We’ve reached a place where for my son’s birthday this year, me and my new partner and him and his new partner, we all met at a sushi place with the big kids and my son. Everybody’s fine. It’s really kind of pleasant. Back in those moments of my lonely marriage before we got the diagnosis of Asperger’s, which is now called being on the spectrum, I just couldn’t understand why I wasn’t getting empathy from the man who claimed to love me. I do have no doubt that he loved me, no doubt, but love without empathy was really, really difficult for me to deal with. Particularly, when we took the empathy scale test — it goes from zero to eighty. I scored sixty-eight, which is really high up on the empathy scale. My ex scored an eight. We were just at two different ends of the scale, which by the way, is very common as well. Usually, someone on the bottom of the scale tries to find someone at the top of the scale to mesh their lives together, to be that person that can navigate social situations for them. All of my kids say we’re all better off with us not being married to one another. As my body was falling apart, so was my marriage. That gets thrown in there as well.

Zibby: You even reached a point where you were looking over your window in your office and debating jumping and what that would feel like. I was like, I cannot believe she got that low. Tell me about that moment.

Deb: I had dropped off my son at college, my first child at college, on the same day my marriage ended, but I wasn’t allowed to tell him that my marriage had ended because my ex didn’t want us to talk about it yet. He was trying to figure out how he wanted to do this, which was fine, but it stretched on and on and on. I’m trying to be peppy and drive my son to — ooh, this is fun — drive him to college, be up and happy and driving him there, dropping him off at his dorm. Then I come back. I’d left my little one with friends because I can’t pay a babysitter overnight. I don’t have that kind of money. I’d left my little one with friends. I had to go pick him up. I brought him back, made dinner for my kids. Then I got my little one to school the next day on the subway. No, it wasn’t preschool. It was elementary school at that time. Came back, walked into my home. It was the first time in three days since my marriage had ended that I was allowed to cry, that I could let myself go. I didn’t even make it up the stairs. We lived in Harlem at the time. There’s a staircase between the bottom apartment and our apartment up top. I fell on the stairs unable to move, and just this gross wailing, this heaving wailing and crying. The stairs started hurting my ribs. I just was like, I got to get out of the stairs.

I went into my office. I was like, I can’t afford my apartment. I’ve lost my marriage. I don’t know which way is up. I don’t know how I’m going to pay for anything. Oh, by the way, the day that I drove my son to college, I found the breast lump. What had happened was I was starting to try to figure out, how am I going to deal with this breast lump without health insurance? My ex had lost his job and had no health insurance. I had been relying on his health insurance. I didn’t see a point in living. I didn’t see it. Then across the way — I lived in Harlem on St. Nicholas Avenue, so my apartment looked over, I think it was Edgecombe Avenue. A lot of musicians live in Edgecombe Avenue, and so you can hear their music playing. One of them started playing “Sounds of Silence,” which is my dad’s favorite song and the song that he asked my son to play at his funeral. I know this sounds weird, but I just kind of felt like it was my dad speaking to me from beyond the grave saying, don’t do it. Don’t do it. I pulled my head in. I had my head halfway out the window. It’s hard to relive that period. Now that I’ve put it down on paper, actually, as I’m talking to you right now, my heart’s not beating at the same hideous rate that it would have had I told the story fresh.

Zibby: I believe too. I believe you that it was your dad. I believe in all that stuff. I’m so sorry you got to that point. The way you wrote about it, you really made the reader completely understand. Even the logistics you were facing of getting to the Brooklyn Book Festival and all these little things, you basically were just like, let me immerse you in this and show you how impossible it felt. You get it. I felt like I went along with you on the whole thing. You just had all of the stress and all of that. Then you added the lung chapter that you didn’t even have planned. Tell me a little bit about the lung chapter. Then I want the PS since the book was written. Are you okay?

Deb: I pitched this book in 2018. We sold it. I think it was December of 2018. I started writing in January of 2019. Obviously, we didn’t know COVID was on the horizon. Who did? Each chapter was the name of a body part that had failed me. Of course, March 18th, 2020, I get one of the first cases of COVID. I get it, by the way, because I had to go for a second time to an urgent care to get treated for a urinary tract infection, which I wouldn’t have if I had known that you could — by the way, all readers, all listeners right now, if you are a middle-aged woman, go talk to your doctor right now. Estrogen will cure your urinary tract infections. It will cure it. I’ve talked to two experts right now. I’m about to write a piece about this for The New York Times. Estrogen therapy, which is now called menopausal hormone treatment, for UTIs is key. I had to go to an urgent care for a second time because the urgent care doctor gave me the wrong prescription for my UTI, which I told him was wrong, but he said, “I know better. You don’t know better,” which is the problem we have in healthcare over and over again, being minimized, our knowledge being minimized of our own bodies. I got COVID in that room. I’m sure of it because there were people coming in saying, “I can’t breathe.” They were screaming. There were no masks. Nobody had masks at the time. Everybody was coughing in the waiting room. Where else could I have gotten it? It was clear to me that’s where I got it.

I had to add in the lung chapter. Also, during this whole COVID period — I got COVID in March. I got long-haul COVID, which means that I’m still — I just had a POTS episode this last week. I have postural orthostatic tachycardia syndrome, which is initiated by COVID. In the middle of all this, I get fired from my well-paying job, the one with health insurance, because they had COVID layoffs. I’m not the only one, obviously. There was a statistic. 140,000 jobs were lost. All of them were women. That was a headline in January of 2021. 140,000 jobs were lost. All of them were women. I lose my job. I lose my health insurance. Suddenly, I’m on the hook for $2,400 a month for family health insurance again. You want to know the upshot of all this? I’m still on unemployment. Luckily, because of Biden, I’m not paying for COBRA. He has it so that we’re not paying between April and September, which is a godsend. We just started getting three hundred dollars a month for children. Thank god. I am living on public assistance right now. I sold Ladyparts to TV. Hopefully, that will be my new job. Because of COVID, we haven’t had a chance to actually get together and work on this and pitch. Everything has stalled because of this disease. I got super sick. I couldn’t breathe. There were three nights that I thought I was going to die. At the time, they didn’t know to turn you on your stomach. I learned that on my own because it was the only way I could breathe. There were no monoclonal antibodies. Weirdly, I have a medication for, it’s called Aimovig, for migraines, which is a monoclonal antibody. I take it every month on the 28th. I got sick on the 18th. On the 28th, I took my Aimovig. I don’t know if it was just that I was getting better from the COVID or it was the monoclonal antibody somehow hitting my bloodstream, but I was better after that. I know it’s a different monoclonal antibody. I know that this makes no sense at all. After taking my monthly Aimovig shot, you shoot yourself in the stomach, I got a little better.

Zibby: Oh, my lord. Deb, it’s just crazy to me. You’re such a gifted writer. You’ve written amazing books. You should not be in this situation.

Deb: Well, books don’t pay that well. You know that.

Zibby: I know, but still.

Deb: It’s not enough to earn a living, really. I wish they were. Also, by the way, in the middle of all this — I end the book at a scene in July of 2020 on the roof with my son watching fireworks trying to convince this young boy who has no hope for America that he should have hope for America, that there’s hope, that we’re going to be okay. I have one line that I wrote in there saying, I looked down at my roof thinking this is all impermanent. It was really impermanent because two months later, my landlord says he wanted his apartment back. All of a sudden in the middle of a global pandemic, my new partner, my son, and I, and my daughter who was living with us, all had to move. My daughter moved to her own place in Williamsburg. We had to move out here to Red Hook. We’re thirty-five minutes from the closest subway. It’s the only apartment I could find in the middle of the pandemic. It’s fine. I love it. I love my new neighborhood, but we had to move in a global pandemic and had to, by the way, look for an apartment in a pandemic. If any of your readers or listeners have done that, you’re wearing a mask. You can only come one at a time. It was not easy to find an apartment during a time when nobody’s really moving around.

Zibby: Oh, my gosh. When did you find time? When did you write this? I think you said that you write it at five in the morning before you go to work.

Deb: I had, at one point, two full-time jobs, and a third. In January of 2019 when I started writing this, I was head writer at a company called Neurotrack. That was my main job. I was a staff writer on Emily in Paris, the TV show. I was in LA. Luckily, my partner really watched my son, with my ex-husband, or else I would not have been able to go. I also am a contributing writer for The Atlantic. I had these three main jobs plus the book. I really mapped out a very specific schedule. Normally, I get up at five. In LA, I got up at four. I get up at four, had my coffee, start writing by five. I would write from five to eight. Then I would take a shower. Then I would walk to work so that I’d get some exercise in. That was the only way I could fit in exercise. I was the only crazy person in LA walking to work. It was a half hour walk. I figured, whatever, walking along Sunset Boulevard. I walked to work. We spent from ten AM until around four PM in the office pounding out the show. Then I would walk back on Sunset Boulevard back to my place in the Hollywood Hills, which is a tiny, little studio, by the way, tiny, teeny tiny. That’s all I could afford with an Airbnb. Then around five o’clock, I would sit down and start doing my other job, which is the head writer at Neurotrack. I would also sometimes take Zoom — not Zoom breaks, but little breaks during — we had, not a Zoom thing, but a — what is it called when you have — FaceTime calls with my team there. From five until around ten, I would do my Neurotrack work. I would order in dinner. Then I’d go to sleep and start all over again. That too is stressful. That’s not good for the heart. I think we need to start talking more and more about the role of stress in all of our lives and how stress plays out on the body.

Zibby: Wow, what a story. Unbelievable. What advice would you have for aspiring authors both in terms of how to survive life and in terms of the writing itself?

Deb: Move to France. I’m sorry. No, seriously, during this whole period, I was like, why am I living in the United States where I don’t have health insurance? That’s the main thing. How are you going to survive without health insurance? Writing books, you don’t get paid in health insurance. I would say to an aspiring author that if you think you don’t have time to write, you’re wrong. There is always time to write. I wrote my Modern Love that became an episode of the Modern Love TV series on the A train to work. I was living in Inwood, which is the northern tip of Manhattan, 207th Street, last stop on the A train, so I always got a seat on the subway, which was key for me for my writing session. It was like my writing retreat on the subway. I’d get my seat. I’d open my laptop. I would write. Then I literally wrote the first draft of that Modern Love from the moment I sat down to the moment I got to my office in SoHo. There’s always time and space to write. If you’re a mom in a car and you’re waiting for your kid to get out of baseball, soccer, whatever, get out your laptop. If you’re working full time and have no childcare and all that, there are a few moments before you fall asleep where you can get in a few hours of work, especially if you have young kids. They have to be in bed by seven or eight. Use that time afterwards.

I am a big, big believer, when you’re looking for time to write, in the early morning hours just because the brain is fresh. You’re still in an oneiric state from your dream. You’ve still got the stuff going on where you’ve just had these weird dreams. That fuels writing. I really am a big proponent of the early, early, pre-dawn write. I also believe that walking is key, showers and walking. I get my best ideas in showers, so take a lot of showers. Go on a twenty-five-minute walk, thirty-minute walk every day if you can. Don’t listen to podcasts. I’m sorry. Don’t listen to podcasts. Don’t listen to music. Clear your head. Let your brain do the work of connection. It will. Your brain will work. If you just give it time, your brain will come up with ideas. Also, like Anne Lamott says, shitty first drafts, always. Just write your shitty first draft. When you sit down to write the next day, you’re allowed to tinker with the previous paragraph, but do not tinker with anything else. Just keep moving forward. Then you have all your pages. I know you’re going through this right now, so I’m speaking to you as well as to your audience. Get your shitty first draft out. Then, as we all say, writing is rewriting.

Zibby: Thank you. Thanks for tips. Wow, Deb, I feel like this book is an accomplishment. There’s a lot of heart and soul and fact and fury all mixed in. It was just really powerful.

Deb: Thank you. I really appreciate it. How are you doing? Are you doing okay? How’s your writing going?

Zibby: It’s good. I did my shitty first draft. Thank you very much. I’m on my second draft. Now my editor has it.

Deb: Wait, wait, wait, you’ve already finished your shitty first draft?

Zibby: Yeah.

Deb: When did you start? You started like a month ago. No, wait, let’s get down to the nitty-gritty. How did you get that done?

Zibby: I didn’t start a month ago. I started in March. There was a chunk of it that I had already. That was probably thirty pages. I don’t know. I just did it really fast.

Deb: Mazel tov. I’m truly proud of you.

Zibby: Thank you.

Deb: That’s a huge accomplishment. You’ve gotten the first draft done.

Zibby: The whole thing’s due, finished, in September, so I didn’t really have a choice. I’m getting my edits back in two weeks. Then I have that time.

Deb: If you want to send it to another person, I’m offering here in front of your entire audience to do an edit if you’d like.

Zibby: You’re so nice.

Deb: When I finish an edit of a book, I send it to Tad Friend, always, who’s a writer on The New Yorker who’s been my friend since college. He’s always my first reader. It’s good to have a few other friends with their hands in the book because if three people notice something, then you know that there’s a problem. If one person notices something but the other two don’t, you triangulate. Don’t be afraid. I can do it. I know other people who can do it. You’ve got a million writers on your podcast that you’ve already spoken to who would probably be like, sure, Zibby, send it to me. Don’t be afraid to ask the writing community for help.

Zibby: Oh, my goodness, thank you so much. I might. I don’t know. Then if you think it’s really bad, I have to start over, and I don’t want to deal with that.

Deb: I’m sure it’s not bad because you’re brilliant, first of all.

Zibby: Thank you.

Deb: I had a friend try to submit a Modern Love. It didn’t work. Lisa, my agent, asked me to work on her Modern Love. I worked on it. I showed her what was missing, that there was key elements of transition that were missing, that the ending wasn’t satisfying. She submitted it, and it got accepted. Don’t be afraid. I’m offering this to you gratis. Let me help you out.

Zibby: I would never accept that gratis, but thank you. Thank you, Deb. Thank you. Thanks for coming on “Moms Don’t Have Time to Read Books.” I’ll be in touch on email. I have an idea for you. We’ll stay in close touch.

Deb: Thank you. Bye, Zibby.

Zibby: Bye.

LADYPARTS by Deborah Copaken

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