{"id":9851,"date":"2025-03-02T11:41:14","date_gmt":"2025-03-02T11:41:14","guid":{"rendered":"https:\/\/site.itshrt.com\/worldnews\/shes-a-foot-soldier-in-americas-losing-war-with-chronic-disease\/"},"modified":"2025-03-02T11:41:14","modified_gmt":"2025-03-02T11:41:14","slug":"shes-a-foot-soldier-in-americas-losing-war-with-chronic-disease","status":"publish","type":"post","link":"https:\/\/site.itshrt.com\/worldnews\/shes-a-foot-soldier-in-americas-losing-war-with-chronic-disease\/","title":{"rendered":"She\u2019s a Foot Soldier in America\u2019s Losing War With Chronic Disease"},"content":{"rendered":"<p> <script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-6606220950177433\"\r\n     crossorigin=\"anonymous\"><\/script>\r\n<!-- ItShrt World News -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-6606220950177433\"\r\n     data-ad-slot=\"1882483372\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\r\n<br \/>\n<\/p>\n<div data-testid=\"companionColumn-0\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">Sam Runyon navigated to the house by memory as she reviewed her patient\u2019s file, a \u201cproblem list\u201d of medications and chronic diseases that went on for several pages. Sam, a 45-year-old nurse, had already seen Cora Perkins survive two types of cancer. During previous appointments, she had found Cora\u2019s arms turning blue from diabetes, or her ankles swollen from congestive heart failure, or her stomach cramping from hunger with no fresh food left in the house. It had been a week since Sam\u2019s last visit, and she wondered if anyone had come or gone through the front door since.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-1\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">She knocked, but nobody answered. She walked across the porch to a hole in the window and called into the house. \u201cCora, honey? Are you OK?\u201d A light flickered inside. A dog began to bark. Sam pushed open the door and walked into the living room, where she found Cora wrapped under a blanket.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cSam. Thank God you\u2019re here,\u201d said Cora, 64. She tried to stand, but she lost her balance and sat back down in a recliner.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-2\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">\u201cIt looks like you\u2019re wobbly this morning,\u201d Sam said. \u201cAre you feeling really bad or just normal bad?\u201d<\/p>\n<p class=\"css-at9mc1 evys1bk0\">It was the same question she asked her patients dozens of times each week as she made home visits across West Virginia, traveling from one impending emergency to the next in a country where feeling bad had become the new normal. All 31 patients in her caseload for the Williamson Health and Wellness Center were under 65 years old, and yet each had at least one of the chronic diseases that had become endemic in the United States over the last two decades: death rates up 25 percent nationally from diabetes, 40 percent from liver disease, 60 percent from kidney disease, 80 percent from hypertension and more than 95 percent from obesity, according to data from the Centers for Disease Control and Prevention.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-3\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">Americans now spend more years living with chronic disease than people in 183 other countries in the World Health Organization \u2014 a reality that Robert F. Kennedy Jr. framed as a \u201cnational crisis\u201d in his first weeks as health secretary. \u201cWe will reverse the chronic disease epidemic and make America healthy again,\u201d he was promising members of Congress that same morning, while Sam confronted the challenges of that work in Mingo County, where the average life expectancy had been dropping steadily for a decade to 67 years old.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cAre we calling that your breakfast?\u201d Sam asked, pointing to Cora\u2019s side table, where two bottles of sugar-free Dr Pepper sat next to a bag of pepperoni-flavored Combos.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-4\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">\u201cIt\u2019s the end of the month,\u201d Cora said. \u201cIt\u2019s whatever\u2019s left. I got the pops on sale at Dollar Tree.\u201d<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cYou know Dollar Tree isn\u2019t a good place to buy real groceries,\u201d Sam said.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cHow am I supposed to get to the grocery store if I don\u2019t have a car?\u201d Cora said.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Sam had been visiting Cora every week for almost two years, helping her to lose 40 pounds, stabilize her blood sugar levels and lower her cholesterol back into the normal range, but each problem they solved revealed another. Cora and her live-in boyfriend regularly had less than $100 in their joint bank account, so she needed help applying for government assistance. She finally qualified for food stamps, but she had no way to go shopping. She occasionally managed to buy meat and vegetables, but her oven was usually broken, so instead she relied on the cheap, ultraprocessed foods that make up 73 percent of the U.S. food supply. Those foods made her sick. Her illnesses made her anxious and depressed. Anxiety raised her blood pressure and complicated her ability to manage diabetes.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-5\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">\u201cI don\u2019t mean to nag you,\u201d Sam said. \u201cI know it feels impossible. I can see how hard you\u2019re trying.\u201d<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-6\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">She took out a blood pressure cuff and started her examination while two dogs crawled over her lap and nipped at her neck. She had been offered an extra $8 an hour to work as a nurse at a nearby hospital, with a sterile office and a support staff, but she preferred the messy intimacy of home visits, where she could spend an hour with her patients and see the systemic decay behind their conditions. She\u2019d grown up nearby in another drafty rental home, and she knew how to spot the empty jar of cooking oil in Cora\u2019s kitchen, the collection notice on the refrigerator for an electric bill of $766, and the pill box on the counter with several outdated prescription medications.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Many of Sam\u2019s patients stabilized and even got well. They were more likely to take their medications and less likely to visit the emergency room while under her care. More than half lowered their average blood sugar levels or improved their kidney function. But in other cases, no amount of intervention was enough to stop the progression of chronic disease, and Sam ended up listed among the survivors in her patients\u2019 obituaries.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cWe\u2019ve still got work to do,\u201d she told Cora. Her blood pressure was high. Her resting pulse rate was 93. Her legs were swollen from eating too much salt. Sam went back to her car and brought in a box from a nearby pantry that had some canned goods, noodles and a bag of potatoes.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cI\u2019m sorry it\u2019s not more nutritious,\u201d Sam said, as she packed her nursing bag and gave Cora a hug.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cI\u2019m pretty much used to the junk,\u201d Cora said.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-7\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">\u201cYou and everyone else,\u201d Sam said.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-8\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\"><strong class=\"css-8qgvsz ebyp5n10\">She had worn out five cars<\/strong> while visiting patients on the back roads of Mingo County, and over time she had come to recognize every pothole, every scar on the hillsides left from logging, deep mining and mountaintop removal. It was a place where every resource, including the residents, had been exploited for a profit. Sam turned into Williamson, population 3,042, where two local pharmacies had distributed more than 20 million opioid painkillers over the course of a decade, though the drugs didn\u2019t so much numb people\u2019s pain as exacerbate it. Now the downtown was largely vacant except for rehab centers, budget law offices and a methadone clinic. She drove by a liquor store offering three-for-one shooters of vodka and a gas station advertising two-liter bottles of soda for a dollar each. \u201cEvery business is either trying to kill you or selling a cure,\u201d she said.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">She pulled up to a house on the edge of downtown to check on another diabetic patient, Joe Miller, 48, who was lying shirtless on his bed, immobilized from hip pain as his pit bull chewed his socks. On his night stand was a bowl of Kraft macaroni and cheese, a box of salt and a photograph of him from a few years earlier \u2014 thin and smiling in a button-down shirt, his arm wrapped around his wife. Now she was dead of a heart attack in her 40s, and he was struggling with depression and closing in on 300 pounds with dangerously high cholesterol. He told Sam he\u2019d kept having a recurring nightmare in which he found dynamite stuffed inside his chest.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">She reached for his wrist to take his pulse and measured his heart rate at 130 beats per minute.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cGeez, Joe,\u201d she said. \u201cAre you sneaking out to ride roller coasters on me?\u201d<\/p>\n<p class=\"css-at9mc1 evys1bk0\">He pointed to a portable toilet in the corner of the room. \u201cThat\u2019s about as far as I\u2019ve moved from this bed in two weeks,\u201d he said. \u201cIt\u2019s so sad I can\u2019t help but laugh.\u201d<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cWell, we might as well try to bring some light to the situation,\u201d Sam said. \u201cBut I can tell you\u2019re in pain, and I hate that. Let\u2019s set you up to talk with a counselor.\u201d<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-9\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">She got back into her car and followed the Tug River into the mountains as she opened her second energy drink of the day. \u201cYou have to cope with the stress somehow,\u201d she said. \u201cIf there are any saints around here, I haven\u2019t found them.\u201d About half of the county\u2019s 22,000 residents were obese, a quarter of them smoked cigarettes and almost 20 percent were diabetic \u2014 numbers that had become increasingly typical in rural America, where working-age adults were dying at higher rates than they were 20 years earlier, according to data from the C.D.C. People in the country\u2019s poorest places were now almost twice as likely to develop chronic disease as those who lived in wealthy, urban centers on the coasts, helping to create a political climate of resentment. Mingo County had been solidly Democratic for much of its history, but more than 85 percent of voters supported Donald J. Trump in the 2024 presidential election.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Sam passed one of the only fresh grocery stores within 30 miles, where inflation had driven up the cost of produce. She slowed next to a roadside stand and saw a couple reselling off-brand soda, charging $3 for 12-packs containing 500 grams of sugar each. \u201cFill up for cheap,\u201d their sign read.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">The road twisted up a creek bed, and Sam stopped to check on a 43-year-old patient. She had cut her average blood sugar in half with Sam\u2019s help, but her diabetes was still causing hemorrhaging in her eyes. \u201cI brought you some exercise bands,\u201d Sam said. \u201cWe\u2019re going to get all Jane Fonda up in here.\u201d<\/p>\n<p class=\"css-at9mc1 evys1bk0\">She went back to her car and opened another energy drink. \u201cThis job is like fighting gravity,\u201d she said. Her younger brother had died in his early 40s of heart and liver failure. Her father was a diabetic who loved Wendy\u2019s and drank several sodas a day. The father of Sam\u2019s two children was prescribed opioids after a work injury, and then he spiraled into addiction. Sam had raised the children mostly by herself, worked three jobs and put herself through nursing school at night while driving her relatives back and forth to the methadone clinic. \u201cI keep thinking I can fix people,\u201d she said.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-10\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">She pulled up to see her last patient of the day, Harry Ray, who lived with his brother in a single-wide trailer tucked against an icy hillside. Next to the house were two gravestones: one for their mother, who died from kidney disease at 56; the other for their father, killed by diabetes at 61. Harry had lost his leg to diabetes in 2009, but with Sam\u2019s help, he\u2019d dropped almost 75 pounds in the last two years. She taught him how to organize his medications and manage his diseases. He took notes during each of their meetings and tacked them up on the trailer walls. \u201cYou are what you eat, big boy,\u201d one of them read.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Sam checked his blood pressure and bandaged a wound on his skin. The house smelled of unkempt cats, but she brushed a bug off the couch and sat down to visit for an hour before saying her goodbyes.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cNow hold on a minute,\u201d Harry said. \u201cYou\u2019re not leaving empty-handed.\u201d<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Sam tried to protest, but he disappeared into the kitchen and returned with a small bag.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cI wouldn\u2019t be alive without you,\u201d he said. \u201cI\u2019m sorry it\u2019s not much, but it\u2019s what we\u2019ve got.\u201d<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Sam gave him a hug and went back to the car. She opened the bag and found a single can of Sprite, a pack of Fritos and eight pieces of hard candy. She closed her eyes for a moment and then drove in silence out of the mountains, until she made it back into cell range and her phone started to ring. One patient had a temperature of 101.6. Another couldn\u2019t seem to pee. Cora called to say she was experiencing chest pain.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-11\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">\u201cWhy does it feel like somebody keeps stabbing me?\u201d she asked.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Sam listened to Cora describe her symptoms as she squeezed the wheel. \u201cWhen was the last time you ate a real meal?\u201d she asked.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-12\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\"><strong class=\"css-8qgvsz ebyp5n10\">Lunch had been a package<\/strong> of ramen noodle soup. So had dinner the previous night and lunch the day before. Cora hung up with Sam, checked her blood sugar and saw that it was 255, which was dangerously high. Sam had given her a pamphlet on heart-healthy foods, and Cora glanced at the list: avocados, pumpernickel bread, fish, blueberries, broccoli. She called out to her boyfriend, John Ratcliff, who was in the kitchen.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cDo we have any vegetables left?\u201d she asked<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cI doubt it,\u201d he said, but he started to search the pantry and refrigerator. They had a bottle of mustard, a half-eaten microwave meal, a package of American cheese, a box of cornflakes and a bag of flour. This was what their kitchen often looked like at the end of each month, after they had used up their $380 in food stamps. The only accessible food within walking distance was at Pizza Hut, KFC, Taco Bell, Little Caesars, a dollar store and a tiny convenience mart where avocados sold for $2.99 each and a 12-pack of ramen noodles cost $2.50.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Cora turned on the television and saw an advertisement with close-up images of fried hash browns, steaming sausage patties and melting cheese, all on sale for a dollar. \u201cBoy, doesn\u2019t that look good?\u201d she said. She muted the television and called into the kitchen. \u201cAny luck?\u201d she asked.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-13\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">John came out holding a package of beef-flavored ramen. \u201cHonestly, I\u2019d rather starve,\u201d Cora said.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-14\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">He searched again and found a leftover bag of potatoes in the back of the pantry. He sliced them into cubes and doused them with salt. Sam had told him once that potatoes could cause a spike in blood pressure for diabetics, and that they were healthier when they were baked, but the oven was still broken. He filled a pan with oil and turned on a burner. \u201cI found you some vegetables,\u201d he called out to Cora.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">They had been together for more than 20 years, and had taken turns as each other\u2019s care givers. He suffered from seizures and had survived a quadruple bypass surgery. For the last decade, they had been measuring out their days to the relentless rhythm of her chronic disease: checking her blood sugar every few hours, decoding nutrition labels, taking six medications in the morning and five more with dinner.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">He finished cooking the potatoes and stirred flour and milk together in a bowl. He dropped the mixture into the leftover oil to make what he called fry bread, Cora\u2019s favorite. A few minutes later, he walked into the living room with two plates of fried carbs and a couple of Dr Peppers.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cThis is so good,\u201d Cora said. \u201cThank you. It\u2019s exactly what I needed.\u201d<\/p>\n<p class=\"css-at9mc1 evys1bk0\">They played a game of gin rummy and started to watch \u201cLittle House on the Prairie,\u201d but Cora kept dozing off in her chair. She checked her blood sugar, and it was up to 270. Her mouth felt dry. She could feel the beginning of a headache. She tried to distract herself by playing a game on her phone, but her hands started tingling. \u201cIt never ends,\u201d she said.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-15\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">Her mother was diabetic. Her brother had died of complications from diabetes before he turned 60. Her daughter, 37, was already one of Sam\u2019s patients. Her grandchildren were surviving mostly on processed school meals.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-16\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">\u201cI can\u2019t remember the last time I felt decent,\u201d Cora said.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cMaybe you should call Sam,\u201d John said. Cora usually checked in with Sam at least once or twice a day, sometimes just to say good night, but now it was already close to 10 p.m.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cI don\u2019t want to bother her,\u201d she said.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">The tingling persisted. Her headache got worse. A chill spread into her hands and then her arms. She slept for a few hours and then awoke to another day of Dr Pepper and ramen. By the next afternoon, her ankles were swollen, and her lips had gone numb. She called Sam, who was driving into the mountains to see another patient.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cI\u2019ve got problems,\u201d Cora said. \u201cMy lips keep going numb.\u201d<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cYour lips? Uh-oh. What\u2019s your blood pressure?\u201d<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-17\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">\u201cI don\u2019t know.\u201d<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cThat isn\u2019t good, Cora. I\u2019ll be there in a few minutes.\u201d<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Sam drove out of the hills and back into Williamson, remembering the previous calamities that had brought her to Cora\u2019s house and filled her patient file: \u201cPain in spine.\u201d \u201cChronic pain.\u201d \u201cNeuropathy.\u201d \u201cLower respiratory infection.\u201d \u201cDepressive disorder.\u201d \u201cHypertension.\u201d \u201cTransportation insecurity.\u201d \u201cObesity due to diet.\u201d \u201cNoncompliance with dietary regimen due to financial hardship.\u201d<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-18\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">But lip numbness was something new, and Sam ran through the possibilities in her head. Cora\u2019s lips could have gone numb from eating too much salt, since one package of ramen included almost a full daily serving of sodium. Or maybe she was freezing cold and losing feeling in her face \u2014 especially if the power company had made good on its threat to cut off the heat for nonpayment. Or the numbness could be a sign of anxiety, an allergic reaction or even an oncoming stroke. \u201cI might have to transport her to the ER,\u201d Sam said, as she parked out front and walked up to the house.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Inside, the dogs were barking and half a dozen relatives were gathered in the living room. It was the first day of the month, and Cora\u2019s extended family had loaded up two cars to drive with her to the grocery store. Sam gently pushed away the dogs and made her way to Cora\u2019s recliner. \u201cI\u2019m so sorry about all this, girl,\u201d Sam said, as she took out a blood pressure cuff and reached for Cora\u2019s hand.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Her blood pressure reading was 146 over 80 \u2014 high, but not an emergency. Her pulse was normal. Her blood sugar was in the typical range. Cora said she was feeling a little better, and she wanted to go shopping with her children and her grandchildren. None of them had groceries. She finally had a little money to spend. If she didn\u2019t take the ride now, it could be days before she had transportation to the store again.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-19\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">\u201cCora, listen to me,\u201d Sam said. \u201cYou have to take care of yourself first.\u201d She told Cora that she should consider going to an urgent care clinic or at least resting until she felt more stable.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cThey could take me around the store in a motorized cart,\u201d Cora said.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cIt\u2019s up to you,\u201d Sam said. She packed her nursing bag as Cora weighed another impossible choice in a country where one urgent need was sometimes eclipsed by another.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cI have to get us some food,\u201d she said.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-20\">\n<div class=\"css-53u6y8\">\n<hr class=\"css-7ad88g e1mu4ftr0\"\/>\n<p class=\"css-798hid etfikam0\">Audio produced by <!-- -->Tally Abecassis<!-- -->.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<p><script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-6606220950177433\"\r\n     crossorigin=\"anonymous\"><\/script>\r\n<!-- ItShrt World News -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-6606220950177433\"\r\n     data-ad-slot=\"1882483372\"\r\n     data-ad-format=\"auto\"\r\n     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and<\/p>\n","protected":false},"author":1,"featured_media":9852,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[36],"tags":[2565,2720,1100,929,3435,3436,141,1098,1418,3437],"class_list":["post-9851","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-2","tag-audio-negative-sad","tag-audio-neutral-immersive","tag-chronic-condition-health","tag-diabetes","tag-hypertension","tag-mingo-county","tag-obesity","tag-processed-and-ultraprocessed-foods","tag-vis-photo","tag-w-va"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.2 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>She\u2019s a Foot Soldier in America\u2019s Losing War With Chronic Disease - World News<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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