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Joseph Steward never had much of a chance. Born into the poor southwest Detroit neighborhood where he still resides, he has taken medication for a variety of physical ailments since he was a child.
Steward has always been unusually small. When he was a teenager, an infected batch of human growth hormone gave him a degenerative nerve disease. He has taken pills for a thyroid problem for more than 30 years. And he suffers from intermittent carpal tunnel syndrome.
Yet as he sits in his small, tidy apartment near Vernor and Central, his smile and cheery demeanor belie the pallor of his skin. Steward is clearly ailing, but he just as clearly does not pity himself.
Impoverished and the son of an alcoholic father, Steward took to the streets early in his life.
"I took a wild spin and just went nuts," says Steward, now 39. "I experimented and took everything. I stayed on the streets and didn't care about anything. Then after a while I got my act together and started to do odd jobs here and there with not much schooling."
He's worked a series of odd jobs, mostly as kitchen help. He tried his hand at electrical work, but his carpal tunnel inhibited him in that trade.
When his father was diagnosed with hepatitis C in 2003, Steward, a member of the Sault Ste. Marie Band of Chippewa, decided to have his own liver checked out at the Indian Health Services clinic in Detroit. Doctors determined that something was seriously wrong.
"They said I didn't have no hepatitis but my liver evaluated poorly and they wanted to refer me to a clinic that would take payments," Stewart says. "I said, 'No problem.'"
But when he went to the second clinic, they demanded payment up front.
"I said, 'I was told that you accept payments.' And they said 'No, we don't do that no more because people would pay one payment and don't want to pay the rest.'"
Steward, a named plaintiff in the University of Michigan Clinical Law Program lawsuit against the federal government, applied for help at the Michigan Family Independence Agency. His caseworker got him food stamps, but told him that no health care was available. She referred him to clinics that might treat him as a charity case.
"She's tried to send me to a few places," Stewart says. "They were kind of hard to get to and they just kept giving me the shuffle."
And so Steward slogs on. He is aware that his liver could give out at any time.
"It's bad enough I have short stature and all these health problems," he says. "Much less to have something where I don't even know what's going on. And it's getting to where I can barely sleep at night. It's literally like I feel all bruised up inside. It's real stressful. I'm depending on my girlfriend to support me and if it wasn't for her, I'd probably be on the street right now."
He recently applied for work at the Greektown Casino, hoping to get a job with health benefits. But he tries not to think about the future.
"Not too much, because every time I think ahead, I get set back," he says. "So the more I think ahead, it's just more of a letdown. I'd like to have an income and not depend on the state. Make my own, do my own. Nothing fancy, nothing big. All I can do is hope and pray. I don't know where I'll be. All my life I never could plan nothing. So I've always took it day by day. Day by day."
Freelancer Tom Schram is co-chair of the National Writers Union of Southeast Michigan. Send comments to firstname.lastname@example.org.