My mother’s father died when she was sixteen; I never met him. He was a doctor in Roodhouse, the small town in downstate Illinois where he grew up. During World War I, he was sent to the Rockefeller Institute in New York to do war work–what, exactly, I’ve never known. After the war, he returned to Roodhouse. As the Depression struck and unemployment rose, his patients became unable to pay him; he took payment in canned goods, or in the occasional duck or chicken, but he never turned anyone away because they had no insurance.

In 1935, he Mayo Clinic invited him to join them in Minnesota; he was apparently a very good doctor indeed. He turned them down because that would have left his small town without medical care.

In 1937, he had gallbladder surgery. Three days afterward, an old man in town slipped and fell on the ice. My grandfather went out to look after the old man, couldn’t find anyone to help  lift him, and carried him into his home himself. The strain so soon after abdominal surgery was too much for my grandfather’s heart. He died the following week. He was 49 years old.

I thought about him recently. I turned sixty-five earlier this month and have learned to my chagrin that the doctors I see for a thyroid disorder, the mammographer who looks at the lumps in my breast, and the gynecologist who discusses them with me, do not accept Medicare. If you opt out of Medicare, your patients are responsible for the whole bill–the patient, or customer as we prefer to call them–can’t submit the bills to Medicare herself. My gynecologist explained that medicine was a business these days, not a service. No one’s asking her to accept a jar of tomatoes in lieu of payment, but then, that would be ludicrous when you’re running a business, not providing a service.

Maybe if my grandfather had realized that, he’d have lived to see my mother graduate from college. But I don’t think we’d feel quite as honored to be living in his shadow.