I bought an airline ticket to Mexico a few days after the November presidential election, feeling, as many Americans did, that I’d lost my country. But that seat – the day before Inauguration Day – went unfilled: I decided to stay home and fight. Even though, with the impending repeal of Obamacare, staying may be to commit slow suicide.

If Donald Trump’s dreams come true, I may well not be able to afford health insurance, and become one of the 45,000 Americans expected to die annually (as public health professionals recently wrote in the Washington Post) because they lack insurance and thus proper medical care.

I don’t know how I contracted follicular lymphoma, but fortunately, it’s a “good” cancer. Fatal 40 years ago – as late as 2008 a medical study determined “...the median survival of patients with follicular lymphomas is approximately eight to ten years” – the cancer is now highly treatable. For a price.

And that price – $60,000 worth of modified genes delivered through a plastic tube into my arm – was beyond my pocketbook until President Obama signed the Affordable Care Act, which eliminated limits on health insurance pay-outs; I’d already met the lifetime cap set by my then-insurance company, with my first genetic infusion. Instead of joking around when my kids asked: “Daddy, are you going to die?” (“Of course I am, and so are you!”), I could schedule a second Rituxan drip. And a third, and a fourth, until the ever-growing lumps in my groin disappeared.

So you can’t imagine what a load was lifted from my shoulders when Obamacare took effect in 2010. I was 54, working (badly) on a book on happiness, and watching my chosen career, journalism, and my retirement plan, and my old, drastically-sunk-in-value house all fall apart, as well as my marriage, which foundered badly following my then-wife being diagnosed with multiple sclerosis. Amid a perfect storm of bad news, I clung with both hands to the “hope” Obama talked about – and then delivered.

Now the hope is gone, along, maybe, with the ACA.

I understand the Trump voters’ anger toward “elites,” and I’m definitely one of them – two Ivy League degrees, writing for liberal publications, talking philosophy over glasses of wine, preferring Bill Maher podcasts to television, writing books that nobody reads.

Even worse, perhaps, I’m an international do-gooder: instead of making money to pay for my treatments, or working through a church on domestic social issues, I’ve spent much of the last dozen years putting together volunteer teams that build houses for the destitute in foreign countries. In many eyes (including those of an immigration agent I encountered a few trips back), that makes me “unAmerican”. As if coming to the aid of the ultra-poor in India or El Salvador or South Africa is morally inferior to working with the mainstream poor in the US.

But here’s the thing: once you’re diagnosed with cancer, and understand you may never see your children graduate from college, let alone find a good partner and have children of their own, you don’t look at the world the same way.

Getting cheques in the mail, and the occasional public accolade, was nice, but it didn’t make me happy: what did was the face-cracking grin on the little girl’s face when she walked into her own brand-new room, even if she would share it with two brothers and two sisters. My own kids – like most American kids – took their bedrooms for granted, which meant I only seemed to “make a difference” on the planet when I left the US.

My now-abandoned plan was to spend a couple months in Mexico, actually learn Spanish (on my fourth attempt), and determine whether I could get reasonably priced cancer treatments down there, or perhaps in Nicaragua. I’d be closer to my kids in Tulum than in California, too, so they could easily visit from New York, and perhaps get past the scarring from their parents’ divorce (largely due to poor health-induced economic issues).

And if I still couldn’t afford treatments? That’d be okay; I’d already dealt with my death fears after reading, many times, that “ten years left” article, and had made sure that decade was a good one.

Who wants to live past 70, anyway?

As it happens, my mother, for one. She’s 96, and I moved back to the West Coast in large measure to share her last years. But there’s no end in sight (though she doesn’t qualify for Obamacare): she’s still sharp, companionable, and pain-free, and my fears that she was hanging on mainly to see the first female President proved unfounded. Which made me think: If she’s sticking around to see what the new administration brings, maybe I should, too…even if it kills me.

And not merely to bear witness. As an “elite”, as a well-educated writer and idealist and international volunteer – as well as a cancer patient – maybe it’s time I pulled a page from the Trump playbook and took some shots of my own:

“Hey, guys, my life has value even though I’m terrible with money, sport the proverbial “egghead”, think corporate capitalism is destroying the American ideal. When I travel with Habitat for Humanity, or my own non-profit in the Dominican Republic, I’m showing the world that the US does care about other people and cultures, that we’re not a bunch of yahoos drunk on fake news; I’m exporting democracy at the grassroots level, not from 20,000 feet. When I listen to your spoiled-child complaints, tolerate your contrary-to-fact opinions, I’m not showing weakness: I’m trying to understand why you prefer make-believe to science, name-calling to honest debate, destruction to building. “Go ahead, take away my health insurance, leave me by the side of the road like an old, unwanted dog. But no, you can’t shut me up, and I’m not going to let your policies kill me. This is my country too, and I’m going to fight to keep it.”

Chris Goodrich is the author, among other books, of Anarchy and Elegance: Confessions of a Journalist at Yale Law School.