“So, I am going to ask you something I haven’t asked any other American.”

A side-glance to where Richard was sitting in the driver’s seat revealed that he was concentrating on the road. There was no hint of smile or amusement on his face. Wherever he was going with this line of questioning ought to be interesting.

“Why is health care so controversial?”

I laughed out loud.

This was in 2011, during the height of warring rhetoric surrounding the Affordable Care Act.

Richard and I had both moved to Houston for our careers. Before moving to Texas, I had been a lifelong Californian. Richard was a British citizen, who had grown up in England and Trinidad. From our first meeting, there had been a certain kinship between us, a sense that we both felt like outsiders trying to navigate living somewhere with few personal connections.

“The first time I went to a doctor’s appointment, the receptionist asked for the co-pay. I had no idea what she was talking about. She had to explain it several times and was clearly getting annoyed with me.”

He went on to share how he had tried to talk to some of his coworkers about the National Health Service (NHS) in Britain and how it worked for each British citizen. His tone suggested that his input hadn’t been appreciated by his colleagues.

I felt for him.

Most people struggle to navigate these political minefields, but it must have felt even more isolating to do so as an immigrant. I could have offered him a direct answer to his question, a pro-con list of the various sides of this seemingly endless debate. But I sensed that this conversation offered a deeper opportunity.

“I have a preexisting condition,” I said.

Then, I launched into a long story of being born with several heart defects, of a childhood with multiple open-heart surgeries. I have a lifetime supply of stories that began, “This one time in the hospital . . .” As one might imagine, my medical history often makes me feel vulnerable. More than anything, I am immensely grateful for having had consistent access to insurance and quality health care.

As an adult, I “pass” as healthy. I walk, I hike, and I occasionally do yoga and Pilates. Yet, I still catch people glancing at my surgical scar, the one that slightly peeks out above most of my tops. There is always that split-second calculation in my mind. If this person asks, do I trust enough to give an honest response?

That moment in the car with Richard was so freeing. I told him all of it, including my own feelings about the ACA debate. Richard reached over to hold my hand, and I knew.

Not long after we were married, I went to my cardiologist to ask how my heart and body would fare with pregnancy. The doctor basically said he’d get back to me on that. The reality is that children with my condition wouldn’t have survived to adulthood in previous generations; cardiologists don’t have a big pool of data from which to make recommendations to someone like me.

After a lot of tests, the recommendation was to have another surgery to fix a leaky pulmonary valve. Less than a year after we got married, we had to draw up wills, advanced directives, powers of attorney, and all the other sensible documents that one must have in these situations.

My mom later told me a story from the early morning of my surgery. We had just arrived at the hospital, and I was focused on my conversation with a nurse. Meanwhile, the intake clerk was requesting all the health-care documents from Richard. My mom essentially had to pry them out of his hands—it was all too real for him in that moment. Hours after the surgery, I was waking up from the anesthesia but my eyelids were still too heavy to lift. I heard a vague whisper; it sounded almost like a prayer.

“I love you, and I am here. I love you, and I am here.”

Health care is not a sexy topic. I would prefer not having to discuss it as often as we do. But when all of this surfaced on our sixth date, I learned so much about my future husband. Essentially, I realized that I could be authentic and vulnerable with him. I intuited that he was the kind of person who would show up during the hardest moments, and it has proven to be a wonderful foundation for our lives together.

And these days, not all of our hospital memories are painful. Since that last surgery, I have given birth to two healthy boys.

Editor’s Note: A version of this piece previously appeared on the author’s personal blog.