Oh, Astoria...

Ask me why I live in Astoria.

Go on, ask.

OK, since you've asked.

It's cheap. It's cheap, it's convenient, it's safe, it's easy to get to, and well, it's cheap. Did I mention it's cheap?

When I spent my childhood and most of my teen and college years daydreaming about someday living in THE city, I never imagined I would live in Queens. My career choice, the outrageous cost of this city and my personal desire to put money into my savings account landed me in Astoria. And nearly two years later I'm still here.

I'd be lying if I told you economics is not what has kept me here, but still, there is something magical about this neighborhood. And something even more magical about the diversity of this borough. The most diverse county in America.

Last Saturday I left my apartment with 2 tasks set out to be accomplished: eat lunch and go to Rite Aid. It was a warm afternoon and the sun was shining, so I diverted part of my plan for the park. I grabbed a bagel and sat in the concrete-filled park around the corner from my apartment, "Athens Square."

Half of the park is filled with basketball courts and the other half is an homage to Greece, in the eyes of an ignorant outsider, like myself. The center of this half is built with a mini ampitheater with Parthenon-like pillars outlining the curve. A statue of Socrates stands next to the Parthenon pillars. Astoria is known as a Greek neighborhood, but it's ever-changing.

As I lose myself in a daydream and a fluffy bagel, I hear, "Excuse me, Miss, what time is it?"

"3:05"

A question from a group of Hispanic boys playing soccer in the center of the ampitheater. They call out plays in Spanish and narrowly miss hitting the other children running around the ampitheater.

Another conversation begins on the bench next to me. An outrageously loud conversation. A man speaks in Arabic on his ear piece.

The neighborhood Greek men convene at a chess table behind me. Mid-game there is some argument. Or perhaps a passionate discussion.

I finish my bagel, take a deep breath and wonder.

Where else in the world could I hear Spanish, Arabic and Greek being spoken simultaneously? Would this happen in Manhattan? Regardless it does happen in THE city, just maybe not in the location of my original daydream.

Maybe I am Italian

"Are you Italian?" a random 40-something on the subway blurts in my direction.

"Oh, geez, not again." I think. I'm about as stereotypically Jewish as it gets, but I get the Italian question a lot. What is it about me? My dark features? My pasty white skin? My high cheek bones? Other features...?

Is this an appropriate question to ask?

When is it appropriate to ask a total stranger his or her nationality? You wouldn't ask your random Jose on the subway if he prayed with a rosary or if he fasted during daylight for a month or if he avoided animal products, right? You wouldn't flat-out say, are you a Buddhist? The crazy proselytizers handing out Jesus flyers aside, religion, ethnicity, nationality are all very private and personal matters in this country, no?

I'm not saying I get offended when someone asks me if I am Italian. I take it as a compliment. I love Italian culture, art, jewelry, food, and the people, but, honestly?

To the contrary, I usually engage in conversation and offer where my grandparents and great-grandparents came from: Poland, Austria, Lithuania, Russia, Romania. Pale of Settlement Eastern Europe. Places I am the least bit proud of and feel no connection to whatsoever. "Are you Jewish?" I do get after a little conversation. "Yes." They've found me out. I'm a little uncomfortable but a little relieved a piece of my Jew-iness has found the light.

Where's the line? Can we be Americans and denude ourselves of origins and identity? Do we want no marking features but want them at the same time?

Why is someone getting rich off of my diseased Ileum?

Half asleep, I clutch my overstuffed purse, full of breakfast, lunch, book, ipod and heels as I climb up the subway steps already 20 minutes late for work. As I reach the top of the grueling climb up the subway steps, I can't help but see a purple advertisement smushed onto the concrete walkway. I see the word "Crohn's" on this ad.

Huh?

Did I really see "Crohn's?"

A metro swipe and and another flight later, I reach the platform. I see more purple ads flattened and trampled into the concrete of the platform. "Crohn's control"

I pick a dirty ad off the ground. It's an insert. An insert from the Metro or the AM, a free paper available every weekday morning. The insert is an ad for Humira, a biologic treatment approved for Multiple Sclerosis and Crohn's Disease, and perhaps others. I've only heard of it because since experiening my first sigificant flare-up with Crohn's Disease in 2004, I've become obsessed with learning everything there is to know about the Disease. I read about Humira when the FDA approved it last year.

The ad boasts that Humira would allow the user to go out to dinner again. The ad boasted control. Ask your doctor, it said. It said all the right things. As someone who lives each meal and every moment in between with this disease, this ad spoke to me. It knew its audience.

But, I wondered.

How many people who read "Metro" or "AM" have any connection to Crohn's Disease? 1.4 million Americans have been diagnosed with Crohn's Disease and/or Ulcerative Colitis, with about half suffering from Crohn's, so how many of those 700,000 ride a New York subway or walk the New York city streets? Is this ad duplicated elsewhere? How many are candidates for Humira? How many suffer from this moderate to severe Crohn's Disease that this ad suggests?

Every 8 weeks I receive a similar biologic treatment to Humira. Remicade. Remicade has changed my life forever. Remicade makes it so I can wake up each morning, go to work, eat real food, go to the bathroom, hang out with my friends, and bottom line: live my life.

Remicade allows me to be healthy enough to eat dinner at a restaurant without the anxiety that one menu item over another will decide whether I can leave the house or not. Remicade does everything the Humira ad suggests. Remicade and Humira are similar drugs; Humira is a more advanced biologic treatment, though.

What concerns me is this obsessive advertising. Is it necessary? Is it cost-effective? The ad hits me - these drugs are my lifeline and I would not be a functioning person without them. But at the same time, this lifeline has become my chain.

In order to receive Remicade every 8 weeks, I must have health insurance. Remicade is patented and my Doctor's office bills out over $9,000 in charges to the insurance company. Yes, $9,000.

My insurance company usually only pays out around $3,000, but still. $3,000? Yes, these treatments are ground-breaking and have prevented me from having surgery that would remove part or all of my colon and God-forbid, an infinite number of other serious health complications. $3,000 is indefinitely less than the suffering those experiences would bring.

Although, I still wonder.

Why are they advertising? With this small group of people living with the disease and their circles of family and friends who may hand this ad over to them, they seem to be spending so much money.

And who ultimately pays?

I do. I pay.

And you do, too. Regardless of whether you have Crohn's Disease or know someone who does or have even heard of this taboo disease, you pay. Because you have health insurance. Because you have a job that pays for your health insurance. Or because someone pays for your insurance. Or because you don't have insurance, which in that case, you pay the greatest price.

The advertising costs drive up the price of the drug. And I become a slave to it because I need it just to live my life.

We have a serious problem in this country when necessities become fodder for advertisement the same as candy or a car is advertised.

I've done no academic research on this topic. I'm purely a consumer and observer of how my life choices have become chained to the pharmaceutical, insurance and health care industry. I can only report what I've experienced.

Why can't a Crohn's patient's doctor be the first to tell him or her about Humira? Why does he or she have to hear about it from a glossy full-color insert in the free subway newspaper?

Why is someone getting rich off of my diseased ileum?




Crohn's Disease is an autoimmune disorder, causing inflammation of the digestive tract and other serious complications. To learn more about Crohn's Disease, Remicade or Humira, visit: www.ccfa.org