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Linked by Paul Ciano on April 14, 2019

His guts roiled. He had never been more angry at Lacey in their eight years of marriage. She knew that he had this meeting. It was all he’d talked about, when he’d talked at all, when he wasn’t sitting at the kitchen table with his laptop working on his proposal. Jesus fucking Christ, couldn’t she handle the stupid restaurant reservation or guest list or whatever on her own? She was a grown woman. It was his birthday. Some birthday present.

“Sounds like you need to get that,” the VP said. He sounded jocular but there was also a sardonic eye roll in there that Joe couldn’t miss. “Have Gloria set up another time, OK?”

Gloria gave him a sympathetic look as he hustled out of the office, out into the parking lot, where it was blazing hot and blindingly sunny. He took out his cell phone and unlocked it and called Lacey.

“Lacey, honey—” He only called her honey when he was furious with her. “Joe—” was all she got out, and then she was sobbing.

His emotions whipsawed. Lacey was not a crier. His mother had been a crier, and he’d dated some girls who felt everything so keenly that tears were never far beneath the surface, but Lacey wasn’t like that at all. He was suddenly scared, the anger roiling around, too, but unattached.

“What is it?”

More sobbing. Then a deep breath. “I saw the doctor.” A long pause. Joe wanted to hang up. More than anything. Because he knew that he was about to go through a door that led out of his life as it was and into a new, worse life. It was a door that only swung one way and once you went through it, you could never go back. There was a split second when he actually almost hung up on Lacey, but of course he didn’t.

It was stage-four breast cancer, metastatic, nodules in her liver, pancreas, and one lung. Lacey had three months to live. Six, if they tried for the most extreme interventions. Lacey had stopped crying after the first two days and had become a laser-focused, stoic self-advocate who had read everything and even found a Dying with Dignity Facebook group that she had become the queen bee of. She’d had all these picture books about kids whose parents were dying, and she read them regularly to Madison, snugging Maddie up on her lap and reading in the same quiet, sing-song storytime cadence she’d always used at storytime, as though she wasn’t preparing their six-year-old for a life without a mother.

The doctor laid out all the ways that her three months could be lengthened to six, and Lacey looked her straight in the eye and said, “If you had what I had, would you try any of those therapies?”

The doctor pursed her lips. “Honestly? No. I don’t think any doctor would.”

“Thank you for your honesty,” is what Lacey said, and Joe knew then she wouldn’t be doing anything else.

Lacey’s mom found the link to adoptive cell transfer therapy. It wasn’t woo: the US National Cancer Institute was part of the NIH, and they had gotten multiple papers on the therapy published in Nature, with huge numbers of citations. Joe and Lacey read the papers as best as they could, and Lacey talked about them with her dying Facebook friends, and they all decided that maybe this was worth a shot.

The way it worked was, they sequenced the genome of your tumor and looked for traits that your own white blood cells could target, then they sorted out your own white blood cells until they found some that targeted those traits, and grew 100 billion or so of those little soldiers in a lab and injected them into you. It was just a way of speeding up the slow and inefficient process by which your own body tuned its own white blood cell population, giving it a computational boost that could outrace even the fastest-mutating tumor.

Joe and Lacey even found a private doc, right there in Phoenix, who’d do the procedure. He had an appointment at Arizona State University, had published some good papers on the procedure himself, and all he needed was $1.5 million from their health insurer.

You know what happened next. Their insurer told Lacey that it was time for her to die now. If she wanted chemo and radiation and whatever, they’d pay it (reluctantly, and with great bureaucratic intransigence), but “experimental” therapies were not covered. Which, you know, OK, who wants to spend $1.5 mil on some charlatan’s miracle-cure juice cleanse or crystal therapy? But adaptive cell transfer wasn’t crystal healing and the NIH wasn’t the local shaman.

They underwent—Joe underwent—a weird transformation after her last call with the supervisor’s supervisor’s supervisor at their health insurer. Lacey had been so good about it all, finding peace and calm and determining to make her death a good death. She’d dragged Joe out of his anger at cancer and back into his love of her and a mutual understanding that they’d make their last days together good ones, for them and for Madison.

But after the insurer turned them down, the rage came back. Maybe the therapy wouldn’t have worked, but it was a chance, and a realistic one, not a desperate one, a real possibility that his daughter would have a mother and that he would have a wife and best friend to grow old with.

He wanted to sell the house and borrow more money from friends and family and do a GoFundMe, but Lacey wouldn’t hear it. She pointed out that everything they—and all their immediate families—could spare wouldn’t touch that $1.5-mil ticket, and the only thing worse than a family losing its wife and mother was that same family losing its house and savings, too. She was much smarter and much calmer than Joe.

Joe was furious. Joe couldn’t be angry at cancer, but he could be coldly, murderously enraged at an insurance company and the people who worked there. He worked for a blue-chip, Fortune 100 company, and he’d bought the top tier of insurance, and they took more than $1,500 out of his paycheck every month for that coverage, and some faceless, evil fucker had just decided that they wouldn’t even try to save his wife from a painful, grotesque death.

He had eight tabs’ worth of Yelp reviews for local shrinks open when he found the forum. Ostensibly, it was for fathers whose wives were dying of breast cancer (there are enough people dying of enough cancer that the forums had become that specialized) but actually it was for fathers whose wives were dying of treatable breast cancer who had been denied coverage by their insurers.

Joe read for hours, long past the point when his butt went numb and he got a crick in his neck. The words on his screen seemed to come straight out of his own head. They were secret things, things he’d never dared say to any other human, because Lacey was right, they were the kinds of things that you couldn’t say aloud without risking incarceration or involuntary commitment.

Here were men saying those things. And other men who heard them and told them that they understood, that they had felt the same unspeakable feelings and they understood those feelings. Even before he posted his first message to the forum, it had soothed something raw inside him, and maybe someday it could even heal the wounds that had been widening since his thirty-sixth birthday.

He never bothered to find a shrink. He didn’t need one. The fathers of the Fuck Cancer Right In Its Fucking Face forum were all the therapist he needed.

Only an idiot really believes in spontaneous remission, which is doctor for “Your cancer went away and we don’t know why.” Oh, it happens, but so do lightning strikes and lottery jackpots. Spontaneous remission isn’t a plan, it’s an unrealistic daydream.

Some people do get hit by lightning, though. And some people win the lottery.

And Lacey got spontaneous remission.

Three months to live became four, then five, and her doctor started to make the most cautious, preliminary noises about the nodules shrinking, and new tests, and then, one day, the doc summoned Lacey to her office, and Joe went along, because when your doctor wants to discuss test results in person, it’s better not to face that on your own.

The doctor was running late, and that made Lacey and Joe run nervous, the tension stretching. It was an oncology practice, so the waiting room was full of bald, sunk-eyed, dying people and their haunted loved ones, and they were actually in better shape than the people who still looked well, because those people had just been diagnosed and were coming to the doctor to find out what happened next. Those people were wrecks.

The nurse didn’t bother taking Lacey’s vitals, so she and Joe just waited in the exam room on a pair of orange waiting-room chairs, holding hands tightly.

The doctor came in and closed the door and apologized for making them wait and made a joke about it being one of those days and sat in her padded roller chair and squared up some papers on her desk. Then she looked at them both for a long moment, and, unexpectedly, beamed at them.

“Lacey, Joe, I’ve been in practice for fourteen years and I’ve given out a lot of bad news. I don’t mind; it comes with the job. But it gets to you. Even when I have good news, it’s still not happy news: we took out half your organs, removed your breasts, poisoned you, irradiated you, and now, we think, you are better. Sorry.

“But once in a very, very long while—a very long while—a doctor in my job gets to give out good news. This is one of those days.”

Joe never did stop visiting Fuck Cancer Right In Its Fucking Face, which surprised him. That night, he and Lacey made the slowest, tenderest love in their entire relationship, fucking so slowly that they barely moved. Joe handled Lacey like she was made out of brittle china, and Lacey clung to Joe like he was the only thing keeping her from falling off the world’s tallest building. Afterwards, they clung to each other, then moved apart, fingers twined. Before long, Lacey was sleeping, softly snoring, hogging the blankets, and Joe slipped out of bed and went back to the forum.

There are lots of support forums online and the best ones perform an incredible, nearly magical service for their participants, proving the aphorism that “shared pain is lessened, shared joy is increased,” and making the lives of everyone who contributes to them better.

Fuck Cancer Right In Its Fucking Face was not one of those forums.

When Lacey was pronounced well, Joe’s anger drained out in an instant. The insurance flunkies who’d sentenced Lacey to die could stew in their juices and look themselves in the mirror every morning, and Joe would have his beautiful, brilliant wife and his amazing, sweet daughter, and that was all that mattered.

He was ready to quit FCRIIFF—which old-timers like him called Fuckriff, or Ruck Fiff when they wanted to sound polite—when LisasDad1990 joined. His first message:

Lisa is six years old. This is what she looks like. I have put her to bed every night since she stopped breast feeding. I used to read her Hand, Hand, Fingers, Thumb and then we graduated to Green Eggs and now we’re reading Harry Potter. That’s right, a six-year-old. She’s SMART.

Last year, Lisa started falling down a lot, bumping into things. Her teachers said she wasn’t concentrating in school and I saw it too. Her mom’s not in the picture. I took her to the doc’s and they said she had a brain tumor. I can go into details later, but it’s not a good brain tumor. It’s not little or cute. It’s an aggressive little fucker, and it’s growing.

Lisa can only see out of one eye now, and she walks with a walker, or I wheel her in her chair.

But the good news is that it’s treatable. Not like 100% but the oncologist says he can whack that bastard straight out of there and blast her with some rads and give her some poison and she’ll live. She’ll always have some problems, but she’s young and she’s full of life and she’ll figure that shit out.

But our insurance? Not so much. I was working for a customs broker when it hit, my first real full time job, with insurance and everything. Paid so much into that insurance. SO MUCH. But they say that the kind of surgery the doc wants to do, it’s experimental. They say it’s not covered.

Guys, I’m 28 years old, a single dad. My parents haven’t given me a dime since I told them to go fuck themselves and moved out at 17. If my ex had a dollar to spare, it’d go to oxys, before the student-debt collectors could get it.

I have a GoFundMe, but that only works if you know a million people or one millionaire. My kid is the greatest thing in the world, but everyone thinks that about their kid, and from all the evidence so far, I’m the only one who can see it.

The thing is, my daughter Lisa is going to die.

I mean, I can kid myself about it, but that’s what it’s about. My six-year-old kid is going to die even though she doesn’t have to (or at least she has a chance she won’t get to take).

It’s because some random asshole earning half a million dollars in an office at the top of a tower full of random assholes earning less than me decided she should die. He doesn’t know her and he won’t ever know her but he knows that there are so many kids like Lisa that are going to die because of his choices.

I’ve been sad, I’ve been angry, I’ve been worried. I hold Lisa so much that she tells me, dad stop it, but some day I’m going to hold her and she won’t say anything because she’ll be dead. That’s my truth and my life and I live that truth every day.

When Lisa goes, I’m going to go too. I never said that out loud but I’ll write it here because you guys know what I’m going through. I’m dead fucking serious. With Lisa I had everything to live for. Now I got nothing. Can’t even afford to bury her, not after all the out of pockets. Red bills every day, every credit card wants to send a guy around with a bat to break my knees. Maybe I’ll buy a gun and shoot the first one that comes to the door, then stick it in my mouth …

Joe settled into his cubicle and did exactly the things in his job description and clocked out at 5:00 P.M. every single day. He had a work phone and a personal phone, and he’d had lots of training about the fact that the work phone’s traffic was all logged, even the “secure” traffic, because the company had done something to its operating system so that everything he did with it would be visible to the compliance team. They had to do it, they said, for their insurance. It was important, therefore, that he strictly segregate his personal activities and work-related activities. No one wanted to read his sexts or eavesdrop on his search history when he was coping with an embarrassing itch.

This had been a real struggle with Joe at first, because he was the kind of guy who liked to pull the handle on his work-email slot machine, checking to see whether his boss wanted him to do stuff after hours. That meant that the phone he was most likely to have in his hand at any given moment was that work phone. Sometimes he even forgot to charge his personal phone.

But then, after his company’s HR department told him it wasn’t their job to stop his wife from being murdered by their health insurer, he got demotivated. Now it was his work phone that was usually out of battery.

LisasDad1990 was a soft-spoken, slightly heavyset man with sad eyes and a three-day beard. In the video, he spoke in a monotone, staring straight into the camera with red-rimmed eyes. His hair was limp and greasy and the kitchen behind him was in chaos, with empty pharmacy packaging and pizza boxes. In a quiet, calm, gentlemanly Southern voice, he talked about the decision that BlueCross BlueShield had made to deny his daughter’s coverage, and what that had meant. He held up a photo of a smiling little girl, brown pixie-cut, missing tooth, a dusting of freckles on a little upturned nose. He talked about Lisa’s stories, the drawings she’d do to accompany them, the kitten she’d rescued and nursed to health, her inconsolable grief when the cat was hit by a car. He talked about her illness and her bravery, and her pain, and her promise.

He spoke extemporaneously, no notes in evidence, and when he was done, he stopped for a long time, then wiped his eyes with his thumbs, opened and shut his mouth a few times without being able to speak, drew in a deep, shuddering breath, and composed himself. “So that’s why I’m doing this. It’s not vengeance. I don’t have a vengeful bone in my body. Nothing I do will bring Lisa back, so why would I want revenge?

“This is a public service. There’s another dad just like me and another little girl just like—” Another moment to compose himself. “Just like Lisa. And right now, that dad is talking to someone at Cigna, or Humana, or BlueCross BlueShield, and the person on the phone is telling that dad that his little girl has. To. Die.

“Someone in that building made the decision to kill my little girl, and everyone else in that building went along with it. Not one of them is innocent, and not one of them is afraid. They’re going to be afraid, after this. After today, every one of those people is going to spend the rest of their lives looking over their shoulders for a man like me. Ordinary looking. Harmless. A little sad, maybe.

“Because they must know in their hearts. Them, their lobbyists, the men in Congress who enabled them. They’re parents. They know. Anyone who hurt their precious children, they’d hunt that person down like a dog. The only amazing thing about any of this is that no one has done it yet.

“I’m going to make a prediction right now, that even though I’m the first, I sure as hell will not be the last. There’s more to come. To those fathers and husbands, mothers and wives, grandparents and lovers, the ones who’ll come after me, I want to salute you. We are going to scare them, we’re going to make them so scared that they will never get a night’s sleep again. They will right this wrong, this stain on our country, not because they love your kids as much as you love your kids, but because we will scare them into it.”

He stared into the camera for a while longer, his eyes burning and glittering. Then he nodded to himself, stood up, and walked out of the frame. When he came back a moment later, he had a duct-taped package the size of a pot roast that he carefully lifted and placed into a backpack. He nodded once more, shrugged into the backpack, and clicked the video off.

The second bomber went after a Tennessee Republican state senator who’d voted down the Medicare expansion, despite his campaign promise to make sure that “every Tennessean who wants insurance will get insurance.”

The bomber was named Logan Lents, and his people had been in Tennessee since it became a state in 1796. Though his background was wealthy, he was broke—his parents had lost the family fortune when he was a boy and he’d been a scholarship case at TSU, where six generations of his ancestors had matriculated, and he’d been the president of Phi Beta Sigma, like his father, grandfather, and great-grandfather had been.

Logan Lents was the widower of Patricia Lents, another Tennessean of long and fallen lineage, whose uterine cancer was treatable (according to her OB/GYN) or not (according to Cigna’s insurance underwriters). Patricia lost a baby early in the cancer, which everyone secretly counted as a blessing, what with her illness and all, and when she died a year later, at the age of twenty-six, Logan had been shattered.

Logan bombed Senator William Blount’s office on a fine Saturday, after a day’s worth of constituency meetings during the spring recess. Logan was considerate enough to wait for all the voters and staffers who’d been there for the day’s business to clear out and only killed himself, the senator, and a Tennessee state trooper. Another trooper and a cleaner were maimed, but they survived.

The men of Dark Fuckriff declared it a “surgical” mission and praised its “clean” execution.

Logan’s video was really well done, eloquent in the way of someone from a fine old family who’d once talked his way into the presidency of an exclusive frat. He had that American Brahmin thing, like a southern Kennedy, and it was easy to forget that he was about to blow himself up along with anyone standing nearby to make his point, which was that health care was a human right and that evil men had conspired to take it away from many Americans, which meant that they would die.

The third bomber was DeathEater.

…Joe’s phone rang, at 6:00 A.M., and he said, “Hello, hello?” until he worked out that the noises in the background were a wheelchair and someone setting up a laptop to record a video straight to camera. The voice was wheezy but strong with emotion.

“I’m going to make a bunch of men and women miserable today, make them grieve for the rest of their lives for the husbands and wives they’re going to lose. A lot of kids will never see their moms and dads again.

“I’m not proud of that. I truly grieve for you. But I have to do this. Enough is enough. The people I’m going to kill today are part of a machine that every day, every year, cost so many of us our wives, husbands, parents, and children. We watch them die bad, slow, painful deaths, and why? Because it’s always someone’s job to watch the money, and no one’s job to keep those people alive, who don’t have to die yet.

“Somewhere along the way, there have to be consequences. There’s plenty of good people working for meth dealers, just trying to scrape by. I expect there are good people who just need to earn a living, who work for human traffickers, too. We arrest those people, send them to jail for the rest of their lives, even though they’re just trying to get by like the rest of us. Why should working for a legal murderer mean you’re innocent? That you get off scot-free?

“If you work for a health insurance company, or their lobbyists, or a senator or congressman who votes against health care for everyone, I want you to be afraid. Scared to leave home. Too scared to sleep. I want you lying awake at night, feeling a rush of fear every time you hear a creak. I want you to have a concealed carry permit, a shotgun by the bed, and still find yourself wondering every morning whether today’s going to be the day.

“If you can’t take that, quit your job. Tell your boss you didn’t sign up to get blown to pieces by some grief-crazed suicide bomber. Eventually, those insurance executives and lobbyists and politicians will have to move on to Plan B. Which is health care for everyone.

“They say violence never solves anything, but to quote The Onion: ‘That’s only true so long as you ignore all of human history.’ Violence is the only way to get some people’s attention. You know which ones I mean.

“Brady, I’m sorry, son. You deserve a better legacy than this. Marla, you too. You both deserve better, but this is all I got. I love you. I’ll see you soon.” DeathEater clicked on something and the video ended, but he kept talking to Joe, monologuing as he rolled his chair around his cramped home, getting ready to blow himself up.

DeathEater had wheeled himself into a health insurance conference at a Sheraton, a big trade show that had put on extra security because the people who went were already a little afraid. But DeathEater had booked a room weeks before, and he paid for valet parking and had a bellman help lift him into his chair and hang his pack on the chair back, then wheeled himself in, checked in, and wheeled toward the elevator bank, flashing his room key at the private security guards who were stopping everyone who tried to go past the ballrooms. No one wanted to pat down an old white man with a room key, wearing a gaily colored aloha shirt and a battered straw hat, pale skinny legs sticking out of baggy shorts.

He had timed his arrival for ten minutes before the morning plenary, when all the conference-goers were milling around out front of the big ballroom, drinking coffee and eating muffins and chattering. He wheeled himself dead center of the crowd and—

The death toll was spectacular.

On the drive to school, Maddy wanted to talk about when mommy got sick, which was a topic that came up a lot. Neither Joe nor Lacey were religious, but inevitably, Maddy had a friend at school who wanted her to know that God had saved her mommy and that she should be giving thanks to God. She kept bringing this up and was obviously, visibly anxious that they weren’t doing enough on that score and maybe God would change His mind.

“So you know that I don’t believe in God, right, kiddo?”

He snuck a glance away from the slow-moving traffic and looked at her. She was nodding solemnly.

“I think that Mommy just got really, really, super lucky. Like rolling two sixes in Monopoly, ten times in a row. But that doesn’t mean we shouldn’t be grateful and thankful that we get to have her with us. I wake up every day and I’m thankful. Aren’t you?”

“Yeah.” Her voice was tiny.

“Yeah. So if there is a God, then She or He”—She or He was a phrase Lacey insisted on when they talked about God with Maddy—“knows how you feel.”

He heard her crying in the back seat and pulled the car over. “What is it, baby? Why are you crying?”

She snuffled and he gave her a tissue. “Sometimes I’m not grateful. Sometimes I get mad at her because she won’t let me wear what I want or she says I didn’t brush my teeth right. What if God sees that I’m not grateful and takes her away?”

For the ten-millionth time, Joe cursed the little evangelical kid in Maddy’s class who’d put all this crapola inside her innocent, traumatized head.

“Well, kiddo, I’m the wrong guy to answer that one, because you know I don’t believe there is a God. But I don’t expect you not to get upset with Mommy. I get upset with her sometimes, too. That happens even when people love each other. Especially when people love each other! It’s hard work, loving someone. All that matters is that you talk about things when you’re upset and work them out. You know that even when we get really angry with each other it always works out and we always end up loving each other again, right? So what we need to do is just concentrate on getting past the mad part and getting back to the happy part. I’m sure if there is a God, that’s all She or He expects from you.”

Maddy seemed satisfied with that answer, so Joe put the car back into gear and pulled out into traffic.

…Fuckriff was gone: both the light and dark versions were 404, page not found.

And that set him off again.

Because—he realized—the Fuckriffers were his people. They were his community. Some of them scared the shit out of him and some of them made him want to punch a wall, but it was his place in the digital world, a place where a truth he’d come to feel deep in his bones was universally acknowledged. Most Americans knew that the health-care system was fucked up, and they even knew that health industry execs and the politicians they purchased on the cheap were behind it. But the Fuckriffers alone understood how central those two facts were, and how evil they were. Joe didn’t want to kill anyone, but deep inside, he knew that there were plenty of people who warranted killing.

“Why are those men killing those people?” Maddy asked over breakfast. Another classmate had been telling her that she shouldn’t go to the doctor because crazy men were killing anyone near a hospital.

“They’re crazy,” Lacey said, shoving a bowl of berries and yogurt under her nose. “Sick in the head.”

“But why?”

“Because some people just go crazy, honey.”

“But why?”

“Joe?” Lacey threw a dishwasher tablet into the machine and headed to the bathroom, scooping up the laundry as she went.


“How come I get the hard ones?”

“Because you’re so good at them,” Lacey called down from the bathroom.

Joe smiled and that made Maddy smile, but she hadn’t forgotten. “How come, Daddy?”

“Because,” he said, and shook his head. “There are some very bad men who decided that they could be rich if they made it so going to the doctor was very expensive. They made it so expensive that people are dying because they can’t afford it. That’s what nearly happened to Mommy.” Madison’s face clouded over, the way it always did when this subject came up. “So there are other men who’ve had to see their babies and their wives and their friends die, and it makes them go crazy, and so they go and kill people who work for the bad guys who made the doctor so expensive.”

Maddy looked frustrated. “But why?”

He broke it down into smaller pieces, hearing himself use terms like “bad guys” and “good guys” and thinking about how Lacey would not approve of this framing, but that the Fuckriffers surely would.

“I don’t think killing people is good.”

“It’s not, sweetie.”

“You said that the bad guys killed people by not letting them see the doctor, though.”

“Yes, that’s right.”

“So they’re killing people.”


“So they’re the same as the people who are shooting people.”

“Not really.”

It was time to get dressed and get into the car. Maddy wouldn’t let him put music on during the drive. She wanted to shout more morally fraught questions from the back seat. This was a “teachable moment,” Joe knew, and his responsibility as an adult was to follow Maddy where she wanted to lead.

“Why do the bad guys want to kill people?”

“They don’t want to—” He stopped himself. Keep it simple, stupid. “Because they get rich and they can buy nice houses and cars and vacations if doctors are expensive.”

“Why do the guys with the bombs want to kill people?”

“Because they’re angry at the bad guys.”

A long pause from the back seat. He swung into the school drop-off horseshoe. “All right, kiddo, we’ll pick this up tonight after school.”

Standing on the sidewalk with her lunch and her schoolbag, she tapped on the passenger window and he rolled it down. “I think the bad guys are worse than the guys with the bombs. The guys with the bombs are just punishing the bad guys for killing their kids.”

And a future Fuckriffer is born. Joe tried to imagine the conversations that Maddy’s friends would have with their parents that night, after Maddy got through with them.

The FBI staged coordinated raids on four private homes and two data centers, claiming that they had seized three different message boards where the “deranged killers” had planned their attacks and arrested the owners of those boards.

Joe watched the perp-walks on social media, four white guys in middle age in their pajamas, cuffed hands behind their backs, terrified looks and curious neighbors. The cops had served no-knock warrants on all four, gone in with guns drawn and SWAT backup—but had somehow managed to fail to shoot any of them in the process. Joe took some comfort in that.

Social media exploded with the personal lives of these four guys, who were, to put it mildly, basic as fuck. They had bullshit jobs: jobs that no one, not even them, thought worth doing. One was a management consultant. One was a customer service manager for a call center. One was an ad-tech programmer. One was a marketing specialist for cryptocurrency startups. All shared one trait: they’d watched the slow death of an insured loved one who’d been denied coverage.

One of them—the management consultant—was a Canadian expat, and his Twitter was full of comparisons between US health care and the Canadian system, and that kicked off a whole other social media storm about Canada and what America could learn from it, and also whether Canadians were secretly terrorists, which was jokey but not entirely. The South Park memes were epic and late-night comedy had a ball with it.

The Canadian prime minister weighed in on the subject and said that even though she was a conservative, she understood that there were some places where markets couldn’t do the job, and health care was one of them. It won her a lot of points with her base, and it also played really well with the undecided Canadian voters who generally held the Tories in bad odor, but who were swayed enough by this demonstration of compassionate conservatism that they elected Quebec’s first-ever Conservative provincial government later that month. If there was one thing that would motivate Canadians, it was the sense that American politics were so screwed up that they made Canada shine by comparison.

None of the four got bail.

The doc listened attentively, if impersonally, then shook his head.

“Sounds like you’re having a hard time, Joe.”

Joe felt tears well up. “Yeah,” he said, barely a whisper.

“How is everyone else in your family?” The doctor looked at his screen. “How’s Lacey?”

Joe had talked extensively with the doc about Lacey’s health, back when everything had been so scary. He remembered the doc commiserating about the bastards at the insurance company who’d turned down her therapy. From the doc’s expression—startlement, mistrust—he’d just remembered it, too.

“Lacey’s great.” He felt the tears slipping down his cheeks, but he didn’t know what they were for. “Full recovery. Her hair’s down to here now.” He touched his shoulders.

The doc handed him a Kleenex box. “That’s great news, really great.” He shifted in his chair. “A miracle, really.”

Joe was really crying now.

The doc tapped at his computer for a while. “Look, I want to refer you for psychiatric care but it looks like you only get twenty-five percent coverage. There’s a woman I really like, she used to be an ER doc and then became a psychiatrist. You’ll really like her, I think. She’s not afraid to prescribe mood-stabilizers but they’re not her first choice, either. But she’s not cheap. I know this is a hard question, but do you think you can afford it?”

Joe started to laugh, still crying, then sobbing. The doc looked uncomfortable, then alarmed. Joe didn’t know exactly how much time they had for the appointment, but he was pretty sure he’d run over and there would be other patients waiting. He pulled himself together, blew his nose, and wiped his eyes.

“I’m sorry,” he said. “It’s just…” He waved his hands and dropped some snotty Kleenexes. He picked them up. “My insurance won’t pay for me to go to a shrink to talk about how screwed up my insurance is.”

“Yeah,” the doc said. “Look, we doctors hate this even more than you do. You only have to deal with them when you’re sick. We have to deal with them every damned day. I have two admin people out there whose only job is chasing payment from them.”

“I’d heard about that.”

“You haven’t heard half of it, believe me.” The doc pushed the cart with the computer away, started to rub his eyes, then took his hands away from his face and reached for a pump of hand sanitizer from the wall-mounted receptacle. He looked at Joe. “You’ve been through a lot, Joe. Nearly losing your wife, it’s hard stuff. It’s a miracle that she survived, but it also means that you didn’t get any counseling or care, the kind of thing that would have kicked in automatically if she hadn’t made it. So you’re just hanging out there. I had an insurance rep on the phone yesterday, telling me that I could refer for unlimited psych care for anyone who’s lost someone—they’ve figured out that the cheapest way to keep from having their heads blown off is to remove barriers to psych treatment.” He smiled mirthlessly.

“I’m not a psychiatric professional, Joe, but I’ve seen enough PTSD cases to know one when I see one. You need treatment. For the sake of your family, and for your own sake. I know you want to be the dad your daughter needs.

“There’s a reason there’s so much medical debt in this country: your health is just that important. More important than your credit-card balance or your credit rating or even your mortgage. If I write you a referral to Dr. Haddid, will you find a way to see her? You can try discussing all-cash payments. A lot of doctors offer discounts for cash up front.”

Joe blew his nose. “Yeah,” he said, “thanks.”

…before he could stop himself or even remember that the site had gone down, he was logging in.

The login banner informed him that the site was back up, with all the accounts intact but all the archives securely deleted. It asked him to delete any screengrabs or saved messages he might have stashed away himself, and welcomed him back on behalf of the new manager, someone called Deadzone874755, who he couldn’t ever recall working with.

For the first time in more than a month, he felt relaxed. All the tension drained out of him as he skimmed the boards, laughing at the bullshit sessions and bon mots, reading updates from old friends. Like it or not, these were his people, this was his place. His spiritual home. And if there were fringe elements in his community who did bad things, unconscionable things, well, what of it? No one faulted soldiers for staying in the army just because someone wearing the same uniform shot up a village or waterboarded a prisoner. The camaraderie and understanding he got from the Fuckriffers, the bond of shared experience—it was irreplaceable. He had a right to that, and no one had the right to make him stop. He never egged anyone on to an act of violence. In fact, he’d done everything he could to stop violence.

Not to mention: the cause was just. The most just one. Letting people die because saving their lives would erode profits was a wicked act, and people who endorsed that act were wicked people. Blowing them up or shooting them wasn’t right, but a world in which the wicked went about their days frightened of retribution was a more just one than a world where the wicked held their heads high.

DamFool was the newest Fuckriffer. Fuckriff was a lot harder to find than it used to be, and new recruits were brought in by old hands, vouched for. His son, Tommy, was fourteen years old, track star, accelerated math, Eagle Scout.

Non-Hodgkin’s lymphoma.

Tommy’s cancer had not responded to two rounds of chemo. He was strong and young and vital, and the same youth that gave him the strength to withstand all that terrible medicine also caused his cells to divide with terrible, regular rapidity, even the cancerous ones.

His doc thought that Tommy was a good candidate for chimeric antigen receptor T-cell therapy, a therapy that was experimental by anyone’s lights. But if anyone could survive it, it was Tommy. People who survived that therapy had a good chance of making it three years cancer free, and then the sky was the limit. Tommy was up for it. He even wanted to freeze some sperm in case he decided to have kids later in life. That was the kind of life choice that people who were planning on surviving made.

The insurer—Cigna—had other ideas.

The bottom line: they would not spend three quarters of a million (table stakes, the total could be much higher) to kill Tommy with an experimental therapy. Not even if Tommy was a fighter and an optimist and young and healthy (except for dying of cancer) and wanted to freeze his sperm.

DamFool’s wife was inconsolable. His older son, Rhett, had died of an opioid overdose in his senior year, five years ago, and the two of them had put everything they had into Tommy, throwing themselves into his life and upbringing with a vigor that Tommy seemed to embrace. They’d all been hurt by what happened to Rhett.

For his part, DamFool was barely holding it together. He spent as much time away from Tommy as he could bear to, not wanting to overshadow the boy, and when he wasn’t with Tommy, he was trying to console his wife, who was in no mood for consolation, or trying not to drink all the beer in the fridge. Tommy was in a lot of pain, partly because he resisted the painkillers because they were the same ones that Rhett had been addicted to. It was a bad situation.

The Great Old Ones were good at this pitch. They were just hinting now, not giving DamFool the hard sell. That would come after Tommy’s demise. Right now, they were just getting him in position. Joe had seen the playbook before. It was his cue to dive in with a highly symbolic and largely ornamental bid to save his soul.

Joe just couldn’t. He’d been reading these op-eds by Black Lives Matter activists about the official neglect that people with sickle cell anemia endured, stories about agonized teenagers being tied to hospital beds and told to stop shouting if they wanted to get untied. The general tenor was that the whites who’d suddenly decided that the health-care system was too sick to live were late to the party, and by the way, let me tell you a little story about the Tuskegee airmen.

Joe found himself imagining what his life would have been like if Lacey had died. If he’d been alone with Maddy, a huge hole in both their hearts. He imagined what life must be like for a parent going through that themselves, watching their kids go through it, watching their nieces and nephews and their friends go through it. He couldn’t imagine it. Couldn’t imagine tolerating it. How could they tolerate it? He wasn’t stupid. He’d heard of white privilege. It was a thing. He got it.

The more he thought about this, though—what if Lacey died, what about all those people who’ve tolerated that and worse, what about everything he could get away with that all those people couldn’t?

When you thought about it that way, he practically had a duty to kill a health-care executive or two.

DamFool didn’t answer Joe’s messages, but the next morning, he was walking fuzzy-headed to the toilet in a pair of boxers, holding his phone and thinking about his first cup of coffee, when he saw something out the window. He stopped and peered at the shape, trying to make sense of what appeared to be a futuristic robot, at least in the brief instant it took him to realize that it was a man in SWAT armor with a visor and a very large gun, which he was swinging around to point at Joe.

Joe opened his mouth to say something—“no” or maybe “what the fuck?”—when he discovered that he was lying on the floor and he couldn’t breathe. He tried to get up, because something was on his chest and he had to get out from under it, but it wasn’t just his lungs that weren’t working—he couldn’t make his legs or arms move, either. It was very noisy all of a sudden, too, and eventually, as he was surrounded by more robot-men in body armor with very, very large guns, he realized that he had been shot in the chest.

The officer who shot Joe was a SWAT veteran with twenty-two years on the Tempe PD, during which time he had shot a total of nineteen suspects, but Joe was the first white person Officer Connor had shot. Joe was also the first one who survived, and there were social media pundits who hypothesized that Connor’s latent white supremacy—the same force that had animated his trigger finger all those times before—had spoiled his aim, sparing Joe’s life. He had been hit “center mass” but had only suffered a collapsed lung and no damage to his heart.

The officer said he’d mistaken Joe’s phone for a gun.

Joe was very groggy. The anesthetic was still in his blood and then there was the fantastic calamity of sensations from his chest cavity, bones, and swollen, stitched skin.

A muffled voice in the back of his mind was chattering intensely at him, telling him he needed to talk to Lacey ASAP because she’d be out of her mind, telling him he should not talk to this cop without a lawyer present.

Joe listened to the cop talking. Agent Sebold was good: calm, reassuring, friendly. He only wanted the same things Joe wanted. He wanted to help Joe. He knew Joe wanted to help, too.

Joe tried to speak but couldn’t. His mouth was gummed shut with thick, dried saliva, his tongue was as thick as his fist. Agent Sebold clearly knew his business: gently, he dipped a large cotton swab in water and swabbed at Joe’s lips, then the front of his teeth. A trickle of the flat, room-temperature water moistened Joe’s tongue. It felt incredible.

“Lawyer,” Joe said. The agent looked angry for a second, then he mastered himself and switched to disappointed. “Sorry,” Joe added. Then, “Lawyer.” It was all he managed before his tongue dried out again. The FBI agent left.

He almost broke down every day. But he didn’t.

You know what kept him going? The visit from the guy from hospital billing.

His insurance wasn’t covering his stay. There was an exemption in his policy for “acts of terrorism” and they were invoking it. The hospital’s accounting department wanted to know about his assets. They were the only ones who would talk to him about Lacey, and what they wanted to know was whether she had separate finances from his.

The billing guy seemed like a decent fellow stuck with a shitty job. Joe knew, somehow, that he made less money than Joe. It was the cheap shoes, and the seven-dollar haircut. He was embarrassed and apologetic, but he had a job to do. It wasn’t his fault the system was so totally fucked up. There was nothing that one guy could do about it. When the billing guy visited for the third time, Joe decided that he’d go to jail for a hundred years before he betrayed Fuckriff and all who sailed in her.

Agent Sebold visited just ahead of the lawyer, looking pissed and harried. The last time, he’d gently persuaded, but this time he wheedled and it tipped Joe off that things weren’t going the way he’d hoped.

The last verified #YouShouldBeAfraid killing took place a year and a half later, while Joe was in solitary in the Tucson supermax pen, having been transferred after he caught a beating at the Maricopa County pen while waiting for a hearing on Leonard’s appeal on his bail. The Tucson warden took one look at Joe’s beat-up face and taped ribs and ordered him into “protective solitary.” It had been a week.

The killer had been a Jacksonville, Missouri, fireman whose BlueCross BlueShield refused to cover treatment for dialysis after an acute kidney injury he experienced on the job when a ceiling joist fell on him. They disagreed with the doctor’s analysis of his condition. His doctor privately told him that he had better scrape together the cash for the dialysis or he could expect a short and unhappy life ahead of him.

The fireman had no wife and no child, which made him different from the others. He’d had elderly parents and he’d gone into deep debt paying for their home care in the years before. Now that they were gone, all he had was his job and his health, neither of which he had anymore.

The insurer reported the fireman to the sheriff, as was standard procedure now when denying a claim like this one, but the sheriff had a lot to do and not many deputies to do it with, and the deputy who was supposed to look in on the fireman had pushed it to a later date twice while he got caught up in more urgent matters.

Firemen know a fair bit about explosives, as it turns out.

“They passed Americare,” Lacey said. She looked terrible, exhausted and emotionally wrung out, her rosacea hectic, the way it got when she got stressed. Joe was acutely aware of the paunch he’d watched develop around his waistline, the six days that had passed since his weekly shower.

He wanted to say something like, “It’s been three months and all you want to talk about is Americare,” but he also recognized that safe subjects were few and far between for them, and Maddy’s eyes were red and big as saucers and everyone was just doing their best.

“That’s good news.”

“It didn’t have everything we wanted, but it’s still pretty amazing. No one believed it would pass. No one believed the president would sign it. The lawsuit was dead on arrival, too, even though they got to choose their venue. The Federal Circuit appeals judges took about ten seconds to tell ’em to go fuck themselves. No one seriously believes the Supremes will take the case, and the share prices are—”

“I’ve missed you, Lacey.”

She stopped. Her eyes were bright with tears.

“Are you OK?”

He looked at Maddy. “Yes,” he said. When Maddy looked away, he mouthed “no.” Lacey put her hand on the glass and he did the same, conscious that it was such a cliché, but also feeling the psychosomatic ghost of the warmth of her skin through the thick Plexi like a space heater radiating directly into his own palm.

Lacey was crying now. So was he.

“They really passed it, huh?” he said through the snot.

“Who says violence doesn’t solve anything?” she said.

Radicalized by Cory Doctorow

Paul Ciano

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