The True American: Murder and Mercy in Texas by Anand Giridharadas Page A

began to hear from all manner of people employed in the collection of debt.
    Less than a week after the first surgery, he received a letter from a company that called itself a reimbursement specialist, signed by a so-called Financial Assistance Representative who didn’t seem all that interested in assisting:
    Dear RAIS BHUIYAN
    We have attempted contacting you by mail and telephone but our efforts have proven unsuccessful. We understand that your time is valuable, and, therefore; will take only a moment to ask you to consider your hospital bill and the advantages of resolving it.
    We feel certain you will be greatly relieved when this financial obligation is behind you. Also, taking care of these charges will prevent your account from being submitted to collections.
    We hope you will take a moment of your time to respond to this letter. Your efforts could bring you financial assistance for your medical bill which is $12611.02.
    I would appreciate a call as soon as possible at 972——. Thank you in advance for your cooperation.
    Twelve thousand six hundred eleven dollars and two cents was close to $12,611.02 more than Rais possessed. He had a tiny reservoir of savings—barely enough for medicine, groceries, and calling cards—and no other assets. He wondered what happened in America to patients like him. Maybe the bills were somewhat for show, and the doctors kept treating you regardless—sending the bills as a formality, as Dr. Spencer did, but caring for you whether or not you could pay. Or maybe they did just cut you off. What in God’s name would he do if they did that? What if, worse, they came after him? It was not a good time to be Muslim. Imagine being a Muslim who lived in Texas and refused to pay his debts to a Christian hospital.

    T O RAIS IT was evident that the man who shot him was not a crazed loner, because inscribed across his body were the symbols of some sad, deranged tribe. He had to belong to something to do this—had to have some cause. Indeed, if an untrained newcomer went looking for fellow members of this tribe, they could seem to be everywhere in Dallas: bald heads, big arms and thick fingers, tattoos, sleeveless shirts, sports team jackets.
    Rais decided to confine himself to Salim’s three-bedroom house as much as possible. There whole days passed in worry and self-questioning. Should he leave home? Was it safe? Were they, whoever they were, still after him? They could strike at any time. Rais figured, “If I go outside, somebody from Mark Stroman’s association will try to kill me, because I’m the only survivor.”
    Nightmares devoured his sleep. They made the attack happen to him again and again—that man with those searing eyes walking in, pointing the twin-barreled gun, asking where he was from, and then the stings. The days weren’t much better, filled with flashbacks. He sank into an abysmal depression and knew he needed what the Americans called “help,” even though he came from a place where people could be suspicious of such things. And yet help would cost so much. He was no longer simply an invalid; he was becoming a debtor. Bank of America, when it got wind of his situation, would close his account, compelling him to borrow money from friends and open an account in a community institution called Inwood National Bank. No therapy for Rais, then: “I said, ‘Forget about that, going to a psychiatric, going to a psychological evaluation. Pray to the biggest psychiatrist in the world, which is God. Keep on praying to God.’ He is my psychologist.”
    It must have crossed his mind from time to time how different it would be back in Dhaka. People spoke less of needing “help” there, because it was taboo, of course, but also because you had people. Rais grew up in that vast quarter of the world where you can ask friends you haven’t seen in years to do some giant task for you, and they will be offended if you cheapen the situation by thanking them. In Dallas it wasn’t