Editor’s note: Many caregivers know what it’s like to take on a bureaucracy. Not so many have used Google Earth, an airline website and quick-thinking to win. In this excerpt from her memoir “Ladysitting," Lorene Cary explains that because her grandmother’s Medicare account had been frozen over a $400 balance that no one would allow her to pay, she could not take her to the doctor. As the chapter opens, Cary has succeeded in explaining the predicament to a call center supervisor:

The supervisor said that she was so sorry.

We were silent for a beat. Then she said that in this one particular case she could see no harm in zeroing out the years-old claim and sending the necessary form to release the hold on Nana’s Medicare account.

No buts.

There were more steps — paperwork and faxing that had to happen between their different offices. We had a long go-round about the $400 check I offered to send, specifically, whether she could accept it from us when their records showed it was owed from the other insurance company. What I remember now are Kafkaesque arguments she ran through aloud about which bureaucratic principles to sacrifice.

In any event, I had to mail signed paperwork to her office, and they’d do something with it for a week, and then she’d have it sent along with a report to their headquarters in another city. Each step would take seven to 10 days. She’d call to leave me a message when the company had officially sent to Medicare the official good-to-go form. Then we’d be . . . good to go! None of this could be done by email, then. One transaction could be faxed, but the other had to be mailed through the U.S. Postal Service. The whole thing should have taken two to three weeks. Like the flu.

Except it didn’t, because something went wrong, someone didn’t get something, and I had to check back with my fave supervisor and then their main headquarters to jump-start the anchor leg of the relay.

A representative at the headquarters talked to me, did not like the sound of it, would not take the baton, and instead started to crawl backwards through the story, repeating my phrases with a snarl in her voice. She was going to undo our arrangement, just for funsies. I reminded her that I was not a complainant trying to get over, but a current customer: Nana wouldn’t sell her house, so we still used their company for home insurance.

Oh! She dropped her professional voice for a moment before recovering her Just-say-no stance, and reminding me that the home and auto insurance segments of the company worked independently.

I needed to talk to a supervisor, I told her.

She needed to put me on hold. Aka time out. Aka punishment.

My patient computer waited in front of me with their company’s website open to the page listing their leadership, in case I needed to name some names — and then this other idea occurred to me. I had mailed the form to that very office and kept a copy. I typed the address into 2007 Google Earth. There it was: the building in which worked the people who stood between Nana and a doctor. I found myself fixated on the front door. Switching the time-out-stupid-earworm-faux-classical-music hold line to speakerphone, I scoured the USAir website, which had flights out of Philadelphia every few minutes. Bingo!

By the time she came on, to tell me that her supervisor was not available, I told her that I was looking at her building, the one with the faux Grecian columns; and that while she was busy not getting the supervisor, I had reserved a seat on a flight that would get me there by 3:30 p.m. She could find a supervisor now or, hey, wait until 3:30 for me to arrive in their lobby. Then she could explain that it was because of her that this black woman had flown in and popped the hell off. Because I was very likely, at that point, to lose my self-control. Her choice. But why, I asked, would you die in this ditch? Why was it worth her job to ensure that a 100-year-old black lady, my grandmother, who had paid premiums from before you were born and would be paying them after she was fired, could not be seen by a doctor?

I told her again what their building looked like. I growled about my surplus of frequent flyer miles, and how I had the ticket ordered, but could cancel within 24 hours. Quoting our young helper, I said that Nana had almost died. And repeated the airline and number of the flight I’d reserved.

Ended up, this latest young woman, though rude and dismissive, was not a total fool. Nana got her clearance.

Excerpted from Ladysitting: My Year with Nana at the End of Her Century. Copyright (c) 2019 by Lorene Cary. Used with permission of the publisher, W. W. Norton & Company, Inc. All rights reserved.

Cary will speak on Saturday, Nov. 13 at the Inquirer’s “Telling Your Health Story” event.