My health insurance policy, a COBRA plan from my previous employer, expired on February 29. Owing to my lameness, the replacement policy takes effect on March 2, leaving me for one day twisting in the socioeconomic wind of zero health coverage. I vowed to spend the day indoors, in bed if possible. But greed called, so I picked my way up the stairs to the office, where I hunkered down before the computer, not making any sudden moves. At lunch, I chewed my food carefully, insuring that I would not choke on any large lumps. Unfortunately, the fax machine chose this day to assert its collective bargaining power by going on strike. I became clear that I would have to venture out of the house and walk several blocks to the local office-service store, where I could send a client a much-needed fax.

This is not the first time I have spent time in such perilous conditions. For months while working on the ambulance in Ohio, I had no health coverage. While I spent every day rushing people to the hospital for traumatic injuries and illnesses, I developed an enormous mental blind spot that obscured any contemplation of what a pickle I'd be in if I ever got into similar circumstances. The ambulance crew was the one division of the hospital where employees were not offered medical insurance, despite the fact that many of us worked there 60+ hours each week. I simply hoped that if something awful happened to me, it would happen while I was on duty, thus making me eligible for workman's comp. Of course, the evil beancounters who ran the whole show would probably have contested that as well, but this scenario was also located in my blind spot, and I didn't dwell on it.

It was that kind of official neglect that eventually persuaded the ambulance crew to vote to join the nurses' union in the hospital. The suits were dumbfounded at our cheek for demanding such privilege. I was one of three members of the negotiating team that sat down over endless days in the odious presence of the hospital administrators and tried to hammer out a deal from the steaming heaps of crap that they presented to us. By the time the administrators locked out the employees and hired scabs to run on the ambulance, I was on my way. I joined the Peace Corps, which offered a generous medical plan that included free treatment for malaria, lice, hideous infections, and other ghastly conditions which I encountered in the performance of my duties.

My friends on the ambulance wrote to say that after a lengthy and nasty labor dispute, they finally triumphed and were begrudgingly given their jobs back. Many had already moved on to other ambulance services in the area, but some came back for the sheer pleasure of being a persistent irritating presence to the administrators who had tried to fire them.

So today I rejoined the ranks of uninsured Americans. My first act in this condition was, some time after midnight, to leave one of the gas jets on the stove running while I went upstairs and amused myself with the accoutrements of the communications age. I thought I had turned off the burner, when in fact I had merely extinguished the flame and allowed the gas to squirt gleefully out into the house. After a while, I smelled something odd and went downstairs to investigate. A frenzy of window-opening ensued. Having averted disaster, I crawled back up to bed and resolved to live with particular care for the next twenty-four hours.

In the afternoon, I walked carefully out of the house toward the office-service center. Here in Washington DC, there is an ongoing battle between pedestrians and motorists over who really deserves use of the road. Usually I play along, standing out in traffic and daring cars to clobber me like everyone else. The underlying presumption is that determination of fault is more important than who would suffer catastrophic injuries in a collision. Today I played a safer game. I crossed only on red lights, gazing furtively around, prepared to defend myself instantly against vehicles, falling safes, and gangs of armed toughs. None manifested themselves. Having accomplished my mission, I resisted the urge to run back to the house, and returned slowly, with extreme deliberation and care.

I have five hours and forty-five minutes to go.

Insurance is such a Western ideal, the product of our cultural predisposition to anticipate and control the swirling potentials of the future. No one I knew in my village in Senegal had even the slightest concept of, or access to, medical insurance. If it had been available, I doubt they would have been inclined to spend precious money on it. Resources couldn't be squandered on things that hadn't even happened yet. God was great, and He would deal out both trials and solutions with all the capriciousness that is the hallmark of the all-powerful. Even preventive health care, like taking drugs to prevent malaria, was something of a stretch for many folks. The Wolofs, including my family, tended to live in the Now.

Right in my own village, I saw a fascinating demonstration of different cultures' prioritization of the present or the future. My village was mostly comprised of Wolofs, but there was a small Pulaar village nearby. Every year, at the end of rainy season, the Wolofs would harvest their crops from the grim face of the lightly-dampened desert. They would keep what they needed to eat, and immediately sell the rest for money. The Pulaar, who were mostly animal-herders, bought huge quantities of beans from the Wolofs, and stored them away. Pulaar tended to sell livestock for money, and grew little more than they intended to eat. At the beginning of the next growing season, they would sell the Wolofs back their own beans for use as seeds, at significantly inflated prices. Come harvest time, the cycle repeated again. I had a bit of a laugh with Pulaar friends over it; they coulnd't really understand why Wolofs would do this. Everyone was aware of this, but I knew few Wolofs who would bother holding on to their own seeds until the following year.

It's no coincidence, I believe, that the Pulaar had a much more clearly defined sense of their ethnic group's history and heritage. They knew that their people once ruled the entire region, governing a kingdom that had schools, roads, and trade relations with other states throughout West Africa. No one is even sure where the Wolof come from -- some theorize that they are an amalgam of other groups that settled in the same region and gradually formed a distinct identity and language. Although they are the politically dominant ethnic group in Senegal, few have the same sense of cultural identity and pride that other groups hold. While they control the country, they are still a bit like refugees, upstarts, nouveau-riche, the colonized. Denied a past, they seldom look long and hard at the future. There can be no insurance for them -- the present is too new, too precarious and too enormous to be overcome.

(At some point, all this becomes stereotype. Categories are wonderful sacks in which to carry around big ideas, but individuals tend to fall out of the holes in them.)