 The toll taken by medical debt and by the fear of it are clear every day in the ER. My patients worry aloud that if they follow my advice to stay overnight for testing to see if their chest pain is a heart attack or if their dizziness is a stroke, they will face even more debts they cannot pay. Some fear debt so much that they show up too late. I will never forget the woman who came to the ER one evening with a fungating cancerous mass.