Chemo Limo

There are lots of great, in-depth analyses of this song, but I don't think anyone has addressed the larger social issue that pervades it. Although it's a personal story of one woman's battle with cancer, she represents all the working poor who've been failed by the privatized American health care system.

The (probably single) mom of this song obviously works very hard ("I plan to retire someday" and "go out in style," she sings proudly) but has trouble making ends meet. Her concern with cash is introduced immediately, when she dreams that "crispy, crispy Benjamin Franklin" babysits her kids. Franklin had many other incarnations--as a founding father, an inventor, an essayist--but, significantly, the one she associates him with is his image on a $100 bill. Money is on her mind, especially when it comes to her kids. She probably struggles to provide for them, and a babysitter is a luxury, something to be dreamt about.

Despite how hard this woman works, she doesn't have adequate insurance coverage. A number of people interpret her attitude as a "f*** you" to the medical establishment and an active choice to let the disease take its natural course, but that's not what I see going on here. The lyrics tell us candidly that she's been in treatment with chemo, radiation, or both ("this shit is making me tired") but that her insurance has now run out. Hence she dreams that her doctor consults her employer about her insurance policy and, when he finds out it won't cover further medical care, dismisses her with the condescending assurance that everything is just fine. The image of her waiting for the verdict of their secret conference only to be given a pat on the head and sent home perfectly captures the powerlessness that many working class citizens experience in their encounters with the health care system. To regain a sense of dignity and control over her own life, the singer rationalizes the choice that has been made for her as her own, and certainly there is some amount of denial ("I smiled 'cause I'd known it all along") and relief in giving up the fight and living out her last days in peace ("on any given day, I'd rather ride a limousine"). But make no mistake about it--this mom doesn't CHOOSE to succumb to cancer and leave her kids alone. She simply "can afford chemo like...a limo." In other words, she can't. It's money (or lack thereof) that chooses for her.

Whether the singer really uses the last of her savings to rent a limo or not doesn't really matter. The whole song is surreal and dreamlike, including the limo ride, in which the doctor is the chauffeur and they symbolically head west into the dying day. The meaning is far more important here than a dissection of which words should be taken literally and which are metaphorical. However, I DO believe that the children are really kids. After all, isn't that what makes this song so poignant? That not only has this woman been victimized by a health care system that won't treat her cancer but that her kids are about to become victims by proxy? The sequence in the limo is so heartbreaking not just because the singer realizes what she is losing but because she (and we) realize what her children are about to lose. Who will foster Sophie's love of learning? Who will protect Michael from the school bulllies? And Jacqueline, already trying to be so mature about this, is losing her innocence.

All of this seems to hit home at once as the singer notices, perhaps for the first time, how much Barbara resembles her own mother. Although we can't be sure if her mother is living or dead, the reference is a jolting, physical reminder of the mother-daughter bond that will soon be severed. The singer's realization triggers a dual outpouring of grief for her own loss of her daughter's childhood and for her daughter's loss of her mom, a loss that perhaps the singer understands firsthand if her own mother has already passed on.

As the last note fades away, we are left with that image of Barbara, who is the spitting image of her grandma, and wonder what now will become of these four children. Who will raise them and impart the values and family traditions that the singer's mom instilled in her?

Well, when you go back to the beginning, you have your answer, and in fact, Spektor reminds us of it in the last verse: "Crispy, crispy Benjamin Franklin," this time in his incarnation as a federal official, takes care of her kids. It's a single parent's worst nightmare that, in the event of her death, her children might grow up schlepping through foster care homes or state institutions. And yet that is too often the reality for the littlest victims of a health care system that treats some people as second-class citizens.

A heartbreaking and musically intricate cautionary tale about one of those ills of society we just don't like to face. And yet it happens every day.