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There is a Japanese art and technique called kintsukuroi, or the mending of broken ceramics with gold and/or silver powder. It is a difficult and intensive process requiring no small amount of skill, but when the broken item is fixed, it is adorned with veins of precious metal and is thus made even more beautiful than it was originally. Such ceramics hold a special place in Japanese tea ceremony tradition, and take on a special significance during tea ceremonies conducted in late autumn, when utensils damaged or worn down by long use are seen as all the more precious; that they have been used so often speaks to their intrinsic worth, whatever their current state may be. During these late autumn tea ceremonies, the year’s supply of tea itself may be running low. In a catalog for a 2008 exhibition at the Lacquer Museum in Muenster, Germany, tea ceremony expert Christy Bartlett wrote that at these late-autumn ceremonies, when there would be enough tea for three people, five would be invited, so that all may better cherish and share that which remains.

Not long ago, an image of a mended bowl and the definition of kintsukuroi went viral across social media and various image blogs. It is not hard to see why the image caught on; in times of difficulty, everybody either picks up a few more physical, mental and metaphorical scars or they remember the ones they are already living with. Nobody likes to think of themselves as scarred. But everybody appreciates having survived the scarring process. That’s why I forwarded the kintsukuroi note along to my own inner circle; more than a few of my friends and family have gone through some significant health challenges recently. Those who survived came away less than physically whole. Some have fully recovered, more or less. Others are still recovering. All have shown the indomitable spirit that is needed to face their own mortality and to decide: no, not today. Not any time soon, in fact.

One of these friends—we’ll call her by the pseudonym of Amy—recently underwent a double mastectomy after being diagnosed with breast cancer. Her mother had died from cancer, and Amy decided that she was taking no chances on her own cancer coming back on her. I think she showed extraordinary courage doing that. There are people who would have taken the risk, even with their own life, just to spare themselves certain pain. Amy did not, even though it has cost her a portion of her body. She underwent her own form of kintsukuroi. She is more beautiful for having been broken.

Amy is also quite lucky. A little more than 20 years ago, her mother was diagnosed with breast cancer at almost the same age Amy is now. Amy’s mother, however, never lived to 41. Her cancer was caught too late, and spread to her brain. I remember driving home overnight to attend the funeral. Because of Amy’s mother’s early death, that made Amy herself a good candidate for BRCA testing, to see if she had a genetic predisposition for breast cancer. For the better part of two decades, however, Amy was unwilling to take the BRCA test for fear of what the test would reveal. If she came up positive, her health insurer could use her genetic status against her and exclude coverage, even if she did not have cancer. She could find herself without health insurance and then discover she has cancer. Then came health care reform.

With her concern about pre-existing conditions behind her, Amy got BRCA tested (which she paid for out of her own pocket; her insurance would not cover it). The tests came back positive, unlocking pre-emptive MRI screenings. It was those screenings that discovered Amy’s cancer, which was so early it could not have been detected by mammography. As far as Amy is concerned, the Patient Protection and Affordable Care Act literally saved her life.

We have spent much time covering PPACA on these pages, and many of our readers have complained loudly at the law’s mandates, restrictions and impact on the business of insuring health. And yet, at least in this one case, the law has saved someone. A business owner. A job creator. And a dear friend. If PPACA has broken the health insurance system, then stories like Amy’s have proven that, like Amy herself, health insurance is currently more beautiful for having been broken.


Mended ceramic