WHEN THE SYSTEM BREAKS, LOVE BECOMES A FORM OF RESISTANCE
Unsolicited Press announces the publication of Bone Deep: Love and Survival in a Broken Healthcare System, a searching new work of nonfiction by career journalist and former Ashland, Oregon, Mayor Julie Akins.
Akins was accustomed to asking difficult questions during the decades she spent reporting on poverty and homelessness. As mayor, she understood the public language of policy, budgets, civic responsibility, and reform. Then illness entered her own home.
After Akins’s husband, Leo, suffered a devastating stroke that was not properly diagnosed until the window for critical treatment had closed, she became his caregiver, advocate, medical researcher, and last defense against an increasingly indifferent bureaucracy. At the same time, her own body began to fail. A specialist raised the possibility of carcinoid syndrome, a rare form of cancer, but Julie was left without a confirmed diagnosis or coordinated path forward.
While caring for Leo, searching for answers, and attempting to meet the demands of public office, Akins watched the distance between the promise of American healthcare and its lived reality collapse around her.
In Bone Deep, Akins chronicles the private hours behind a public crisis: the waiting rooms, insurance battles, diagnostic dead ends, medical bills, sleepless nights, bewildering referrals, and relentless administrative labor imposed on people whose bodies and families are already under tremendous strain. Her account reveals a system that too often treats patients as disconnected symptoms rather than whole human beings, while treating caregivers as an inexhaustible source of unpaid labor.
After nearly two years of uncertainty, Akins reaches Mayo Clinic in Arizona, where a coordinated team finally rules out carcinoid syndrome, cancerous systemic mastocytosis, and terminal disease. She is diagnosed instead with a treatable mast cell disorder and given something the system had repeatedly denied her: a clear answer and a plan.
Akins writes from an unusual intersection of experience. She is a journalist trained to follow evidence, a former elected official familiar with the machinery of government, a patient confronting frightening uncertainty, and a woman trying to protect the person she loves. That perspective allows her to connect intimate experience with the larger forces shaping American health: medical debt, specialist shortages, housing insecurity, aging, poverty, and the enormous gulf between qualifying for assistance and actually receiving it.
Yet Bone Deep is more than an indictment of American healthcare. It is also a meditation on devotion and identity that can emerge when the life a person expected gets stripped away.
Drawing on Zen practice and the work of thinkers including Richard Rohr and Carl Jung, Akins searches for meaning without romanticizing the pain. She rejects the idea that suffering automatically transforms us. Transformation, she suggests, requires attention, honesty, and a willingness to remain open to love even when nearly everything else has failed.
At the center of her book is Julie and Leo’s partnership, bruised by exhaustion, forever altered by illness, and sustained by a commitment deeper than optimism. Their love cannot reverse a stroke or repair a broken institution, but it does give them a reason to continue confronting both.
Urgent, intimate, and ultimately luminous, Bone Deep speaks to people living with chronic or unresolved illness, family caregivers, healthcare workers, policy advocates, and anyone who understands how quickly a medical emergency can become a financial and existential disaster. It asks readers to reconsider healthcare not as a commodity reserved for those able to navigate its obstacles, but as a fundamental human right.
Bone Deep: Love and Survival in a Broken Healthcare System is published by Unsolicited Press and is now available!
