Ellen Tinsman was an early supporter of The Williamsport Guardian and wrote for the paper under her blog name, JoanBeach4, until she turned all her writing energies to the blog (an excerpt is below), where she could express her strong opinions more freely. She was also an early supporter of President Obama and volunteered at his Williamsport campaign office almost every day before the presidential primary, until a long-scheduled trip to France and Greece, where she spent a blissful week on one of the Greek Isles just before election day. (Who knew the PA primary would actually turn out to be important?)

After she returned to her home on Rose Lake, she spent a good deal of time cutting firewood, in preparation for winter. (Ellen’s family home didn’t have any heat except wood, and she took pride in not using fossil fuels in her home.) She began having back pains, which at first she blamed on her woodcutting, but then she developed other symptoms and was diagnosed with pancreatic cancer. She died earlier this year. We at the Guardian will miss her but are glad to have had her with us, glad she had her wonderful time in Greece, and glad she lived to see Obama elected president.

A few days before last November’s election, our friend Ellen Tinsman sent this email to her Democratic friends to explain why she hadn’t been able to do her usual volunteering: "I’ve been horribly absent in this election, and you need to know why. Started having a lot of back and stomach pain in August; worsened in September/October. Had a really horrible doctor who acted as if I were making it up, and dragged his feet for six weeks. Got a new doctor yesterday, who took one look at my recent cat scan, found a tumor on my pancreas, and in four hours had arranged for a biopsy and possible surgery at Sloan-Kettering. Obviously, this is the worst-case scenario, and it is more likely than not benign. However, please believe me when I say my pain—and also the stupid pain medication—has prevented me from pulling my fair share, and I feel awful about the timing, but it can’t be helped. Obviously, I won’t be able to poll-watch or do much of anything on Tuesday, even if I’m still here and not in NYC. One thing that worries me is that, in the worst case, they’ll send me to NYC on Monday, and I won’t be able to vote. I’m going to stop by the voter’s bureau today to see if there’s anything I can do. If not, I’ll raise hell with the doctor, and try to get everything put off for a day. Anyway, don’t cry for me Argentina, I’ll be okay. Just wanted to make sure you weren’t under the assumption I’d slacked off for no reason."

Three months later, Ellen was dead. The cause was pancreatic cancer, which is fatal unless caught at a very early stage, but Ellen’s death was hastened and made more painful by a broken healthcare system. Lack of communication among doctors, and between doctors and hospital staff, plus bureaucratic decisions by the insurance company – all of these factors made Ellen’s final months far more miserable than they should have been.

First, her family physician, on the verge of retiring, passed her off to a new partner she’d never met before. Like many female patients, she soon came to realize that he wasn’t taking her pain very seriously. He diagnosed an ulcer and didn’t seem to believe her when she said the medication he gave her wasn’t working. When a doctor finally went to order tests, the insurance company told him which test he had to do first—a test that required her to swallow a large barium cocktail, at a time when she couldn’t swallow more than a few sips of anything.

After the biopsy, Ellen went home, but within a few hours the pain was so terrible that she called an ambulance. After she was back at the hospital, the doctors said that during the procedure her liver had been bruised. They gave her painkillers and said their office had made arrangements for her to be seen at New York’s Sloan Kettering, the premier hospital for cancer patients. Ellen went to stay with a friend in New York, but when she went for her appointment at Sloan Kettering, they told her that she needed a referral from her insurance company before she made the appointment. A retroactive referral was invalid.

After a couple of weeks staying with a friend in New York, and futile efforts to negotiate with the insurance company and hospital, Ellen returned to Williamsport and was admitted to Williamsport Hospital. She was in intense pain and agitated, and doctors put her on large doses of the anti-psychotic drug haldol, which she reacted badly to. Unable to get the insurance company to approve an out-ofstate hospital, Ellen finally agreed to go to the Hospital a the University of Pennsylvania. But by that time, it was too late. The cancer was too advanced for surgery. Ellen’s friends took her from the hospital, where she had endured so much unnecessary pain, and put her in hospice care, where her pain was managed much more effectively and humanely.

A few months ago, Supreme Court Justice Ruth Bader Ginsberg had surgery for early stage cancer at Sloan Kettering. It appears to have been successful, and she has been able to consider serving on the bench. Of course, as a federal judge, Ginsberg has access to excellent medical insurance, as do members of Congress. The contrast with Ellen’s private insurance could not be clearer.

In recent years, Ellen was an advocate for universal, single-payer healthcare, and I can only hope that this story of how she died can continue her advocacy. We need major healthcare reform, to get medical decisions out of the hands of insurance companies whose main goal is profit, not people. Real healthcare reform would be a fitting memorial to Ellen—and many more who have died needlessly.