In April 1984 I quit my job, took a year off and explored the continent of Asia as well as parts of the South Pacific. When I returned to Los Angeles in April 1985, it was discovered that I had a malignant melanoma, a cancerous mole on my chest.

Incredible as it may seem, in a country that boasts the most advanced medicine and technology, medical treatment was not accessible to me because I had no health insurance and very little money. Although this type of cancer is curable, it is fatal if left untreated, so I was urged to have immediate surgery.

In my case, nine centimeters around the tumor needed to be excised in case the cancer cells had jumped beyond the original site, which would require skin grafting from the thigh. I was 33 years old, and although not easily frightened, the thought of being left to face cancer to its bitter end chilled me. I had no choice.

My parents offered to take a loan out on my behalf since I could not obtain one on my own. I was broke from the trip. I hoped, though, to seek medical assistance for the first time in my life.

My cousin, a doctor, was required to sign a form for the hospital making him liable for expenses. Because I lacked the money to obtain the services of a plastic surgeon, a general surgeon who never had done this procedure in the chest area performed the operation. When asked how it would look, he could give me no real answer, which was not reassuring.

Even though this was a major operation and required hospitalization, especially since my left side was immobilized because of the grafting (I am left-handed), I could not afford to stay in the hospital and left immediately after the operation.

I stayed with a relative who worked all day, and I found it hard to cope. The day after the surgery found me sprawled out on the floor, dizzy with weakness after trying to prepare a meal. It was a frustrating and depressing time -- trying to deal with the emotions of having cancer, the pain and taking care of myself. I longed to go home and be with my family, who could not afford to take the time off from work to be with me.

My skin graft healed slowly and, according to the surgeon, did not look right. I could not bear to look at the wound and kept it covered at all times. Even now, when it's not hidden by my clothes, I see people stare, unable to mask their true feelings.

I tried to obtain medical assistance from the state of California, where I had the operation, but was told I must possess a California driver's license. However, I was unable to drive a car because of the surgery, and besides, my car was in Maryland.

When I applied for medical assistance from Maryland, they claimed I was no longer a resident (even after paying Maryland taxes for the year I was abroad and after living in the area for 20 years). Maryland insisted I ask California to reimburse me for the operation. My appeal to the Maryland Social Services Agency reversed the decision, but because the ordeal had dragged on for so long, I had already paid for the operation out of borrowed funds. Also, reciprocity of payment from Maryland to California did not seem to work, as I later found out with my anesthesiologist bill.

I am now considered "potentially" cured, but must be checked every three months, so I am enrolled in a cancer follow-up program at Georgetown University Hospital. I have tried to obtain health insurance for future treatment but have been told that any cancer-related services would not be covered. One company told me there must be a 10-month period of waiting before I could be considered for health insurance for my pre-existing condition, if I am accepted for coverage after review of my case. The monthly rates were quite high. I have opted for no health insurance.

My skin graft, unfortunately, is a ghastly sight, and recently I consulted a plastic surgeon who does cancer reconstruction. He said that the skin graft did not take well and did not know why. He recommended that it be removed and a biopsy done. A large incision, the length of my chest, would have to be made and then sewn together. This, he felt, required two operations.

Of course, without access to funds, and given my lack of health insurance, I would have to forgo the costly procedure in an operating room and would have the surgery in his office. I had scheduled the operation for the winter, but recently canceled it because I could not save the money in time; also, the memory of pain is still too clear in my mind and I cannot face it at the moment.

I find it shocking that people can die in this country from lack of medical aid if not properly insured or financially set.

While I was traveling in the mountainous jungles of Thailand, I burned an entire buttock when I upset a tea kettle full of boiling water, and walked for two days with blisters the size of my hand. Upon arrival in a town, I went to the emergency ward of a local hospital, where they scraped the burn and gave me morphine and pain medicine. Every day for two weeks I went to the hospital to have the wound changed and dressed without charge.

People were never turned away from this hospital, and the majority of the patients were very poor. Although the facilities lacked the sophistication and standards of the West, it was reassuring to know that I could seek medical aid in an emergency. Somewhere, I think, this country has lost sight of what medical facilities should provide; they have become a business accessible only to those who meet certain critieria.

At times now, I shudder to think what would happen if complications were to arise in my case, as I would not be able to seek medical aid. It is a frightening thought that has kept me awake many nights. I am currently working at temporary jobs to pay off my last operation and, I hope, gather funds for the next two. After cancer, the future is the present, since the ominous prospect of death seems less remote.