Profile: Brian McTear

When he was very young, Brian McTear knew two things about himself: He was a musician, and he had cystic fibrosis.

by Daniel Scully

Photo By: Michael T. Regan

When he was very young, Brian McTear knew two things about himself: He was a musician, and he had cystic fibrosis.

The first fact remains today. Under the moniker Bitter, Bitter Weeks, McTear has recorded two solo albums and a full band record. The band headlines venues like the North Star and Johnny Brenda's, and is playing this year's XPoNential Music Festival. McTear is a highly regarded local producer, and co-owner of Fishtown's Miner Street Recordings studio.

Unfortunately, the second fact remains, as well.

Cystic fibrosis is a hereditary disease, with symptoms including difficulty with breathing and frequent lung infections. As a self-employed musician, McTear, 34, is responsible for his own health insurance. And he can't afford it. The premium for someone with his condition, which requires constant care, would be about $1,300 a month.

"I start my day inhaling a bronchodilator for around 15 minutes; then I spend about 20 minutes inhaling a saline solution to break up the stuff in my lungs," he says. He is constantly two weeks on, two weeks off a nebulized antibiotic, and he takes extra enzymes before every meal because his pancreas doesn't produce enough to digest food. "Basically [they] digest my food for me."

The antibiotic costs about $2,800 a month; the enzymes, $600. McTear gets them free through patient assistance programs run by the drug manufacturers. But there are no such programs for doctor visits, so has to carefully consider the cost of any medical care he seeks. Still, he emphasizes that his doctors at University of Pennsylvania's Presbyterian Hospital have never denied him treatment because of his insurance status.

"If anything, they encourage me to see them more often and get more tests done," McTear says. Not that he can afford it.

A normal patient with cystic fibrosis would see a specialist every two to three months; McTear goes only once a year, sometimes less, and often finds himself vetoing his doctors' desires to run tests. "About two years ago, my doctor noticed I had a heart murmur, and wanted it checked out. So I had to have a sonogram," he recalls. "Since it was in a different department, it didn't really get worked out and I ended up having to pay $3,400 for it. If I would have known, I would have said, 'I'll come back in a couple months when I can afford this.'"

One Friday this April, after a full day in the studio, McTear got an intense pain in his stomach. Figuring the trouble would pass, he went out to see a band called Canadian Invasion at The Fire. "I was really excited about seeing them, so I toughed it out until about 11:30," he says. But the pain finally overwhelmed him, so he went home and went to sleep. But he woke an hour and a half later.

"I thought I was fine until I stood up," he says.

Realizing that whatever was happening was serious, McTear roused business partner and girlfriend Amy Morrissey, who was sleeping on the couch, and they went to Temple University Hospital's emergency room. There, he was given a painkiller, and was advised that he should be admitted. He waited eight hours for a room, but says he was not treated differently on account of his lack of insurance. The Temple doctors discovered that McTear had a blockage in his large intestines — a condition that possibly could have been prevented by the chest X-rays and other procedures McTear hasn't be able to afford.

As the following day progressed, his condition worsened. By 2 p.m., he says, "I was in such intense pain that I was vomiting." The doctors "put a centimeter-in-diameter tube up my nose and down my throat. That was really painful, particularly in my nose." The tube sucked up the bile and juices from his stomach.

With Morrissey by his side, McTear sat in the hospital for four days straight, having his stomach pumped and his entire digestive tract cleaned out. Finally, the blockage cleared and the doctors pulled the tube out of his stomach. He left the hospital in good health — and with more than $80,000 in medical bills.

Though he's working with Temple's patient assistance program on getting a large portion of the cost forgiven, McTear still doesn't "know what I'm gonna do about that one."

My lack of insurance "is not the primary focus of my life. It should be, perhaps, but it just isn't. ... My life would be better if I could afford health insurance, and if I could maintain my condition more regularly. But right now, that is a future goal, not a current process."