04/10/2026
They Deserve It
by Jess Piper
I have visited the doctor more in the last two years than I have in my entire life. Turning 50 and the years leading up to my half-century were tough on me — tougher than they should have been.
You can imagine I live with a lot of stress because of my profession, but I have also had so many odd health issues that I imagined the rest of my life was just going to be rough. I guess this is what growing older is like?
I travel the country to speak on rural issues. I write about them. I ran for office because of them. And then I fell prey to those issues.
I am the rural person I always speak about.
For years, I have shown up to speaking events with extreme nausea. I often took the stage feeling faint. I had headaches and constant blurred vision. My hair was getting thinner, and my skin looked awful. I was gaining weight in my midsection, while my limbs were growing thin.
I stayed up night after night with insomnia and the need to drink cup after cup of water…I was always so thirsty.
But the worst symptom was an inflamed nerve in my back that sent sharp burning sensations down my leg into my calf and foot.
You should know that I have delivered a baby completely unmedicated, and even that could not compare to the pain shooting down my leg 24 hours a day.
I was sent to a pain clinic to manage the unbearable pain. I started spinal injections to numb the pain a few weeks at a time. It worked until it didn’t, and the pain doctor finally told me that he couldn’t do any more for me and discharged me.
When I asked for a pain medication to help me get through my day and my work, the doctor said, “I am an anesthesiologist.” I’m still not sure what that means, but I knew I was on my own.
A quick shoutout to the Sackler family for creating an opioid epidemic in rural America that has led to a nightmarish situation for people in pain seeking to mitigate that pain. It is nearly impossible to get any pain relief without being treated like a habitual user.
I was finally referred to a surgeon. We decided on a date, and the week before the surgery, my Marketplace health insurance, Ambetter, denied my surgery.
I canceled the surgery. Suck it up, Buttercup.
As a last-ditch effort, I made an appointment with a Nurse Practitioner, and she ordered blood work. I went in at 6 AM the next day, and I received a call from the NP within hours…
“Jess, you’re a rampant diabetic.”
My A1C was 11.8.
If anything, I felt relief and validation with the diagnosis. I wasn’t crazy. I wasn’t making up symptoms for medication. Everything from my nerve pain to my blurred vision issues to my weight and thinning hair and constant nausea and thirst was a symptom of diabetes.
I can’t say that I was surprised. I had gestational diabetes with all of my pregnancies. My grandparents were diabetics. My dad was a diabetic. And my dad’s sister, my aunt, who was one of my best friends, died at 50 from complications of diabetes.
I guess I have quite the family history, but my diabetes was missed. Over and over again. For years.
I went to the doctor when I could afford it, and I pieced together my own care. This is rural healthcare.
I was hesitant to write this essay because many folks consider Type 2 Diabetes a moral failing.
You did this to yourself. You shouldn’t eat the way you do. You should just exercise. You’re the problem. You should do better.
And part of that is true. Diabetes is part environment and part genetic. But my diagnosis reminds me of the way we treat rural people in general. Rural folks “deserve” what they get because of the way they vote, even if they’ve never had a choice.
It’s their problem. They did this to themselves. They deserve everything they get.
I read an article from Missouri Independent on the topic of rural healthcare yesterday:
"According to the Center for Healthcare Quality and Payment Reform, 50% of Missouri’s 58 remaining rural hospitals are at risk of closure. Another 21% are considered at immediate risk of closure."
I have been writing and speaking about this issue for years. I have taken my Representatives to task for allowing the closure of rural hospitals. For hastening it by refusing to expand Medicaid. And even after Missourians voted to expand Medicaid, our lawmakers refused to fund it for a year.
Those decisions have closed over 20 rural hospitals in the last two decades — the decades the GOP has had a supermajority.
When I post or speak on the problem with rural healthcare, almost every comment is something like, “Rural people voted for this. They deserve it.”
When I ran for office in 2022, over 40% of the legislative seats in Missouri were uncontested by a Democrat. I haven’t been able to vote for a county official in I don’t know how long because there are only Republicans on my ballot.
I am rural, and I didn’t vote for any of this, but it’s kind of like the chronic disease I struggle with…it must be my fault somehow, right? I must have done something to deserve this. If I didn’t want this, I would do better.
That’s not how any of this works, and things can change when the conditions and environment change. Knowing what we are struggling with is a big part of the way we can change. A diagnosis is actually a light at the end of the tunnel.
Progress is made with the right tools.
I finally got a diagnosis because someone listened to me and ran tests to get to the bottom of it. Rural America needs the same.
We need policymakers and lawmakers who look past the blame and see the cause — decades of disinvestment and indifference.
The best news is that Missouri Democrats are contesting almost every single race in the Statehouse and the State Senate this cycle. We did it.
The prognosis is so much better when we say the problem out loud and present a solution. I can’t force folks to vote in their self-interest any more than someone can force me to quit sweets and take my health seriously.
But I have done better. I feel like a different person.
I didn’t know what was wrong with me, but now I do, and I am making huge strides in getting better. I am healthier every single day because I know what was making me sick and how to make myself better.
This essay isn’t just about blood sugar and nerves. It’s about what happens when a whole region’s pain goes untreated. And it’s about what can happen when we finally decide to heal it.
Rural America deserves that same chance. A diagnosis and attention and care. We are not beyond saving.
We have just been waiting for someone to take our symptoms seriously.
~Jess
