"Cost of Living"

While you reading you can clearly notice the tone of the essay, which has a mixed between pessimistic reality and tragedy. The main topic of this essay seems to be around the huge debt that corresponding both the author and the place where she works, the hospital. Additionally, this essay introduces us to the life of a nurse. The way that she works and manage her life outside her job. First, she tells about her life in the hospital she describes how after the debt of the hospital, they managed to cut their resources and use them as minimal as the can. She also tells us about the things that she has to do in the hospital. Ironically, she works as the person who assigns the billing to the patients. This way, I noticed that the job that she has, not only relates to her life in the present, but has much to do with her life in the past, or in other words when she got her huge debt. 
One of the things that she mainly narrates is the way her huge debt affected her life and how her life is surrounded by this debt. And as I say, the job that she has now relates to her in so many ways. First, she got the debt when she tried to commit a suicide but fails in the way. This way, she went to the hospital, where they helped her with her physical and mental injuries. Finally, because she didn't have a insurance to pay for this emergency, she got to pay it by herself. This way as the work that she has to do in the hospital, which is billing, has a lot to do with her dept. She mentioned in the essay that she feels identified with the people who get a huge debt when they go to the hospital. Therefore, sometimes she tries to help these people and tries to reduce their payment. 

 In the end, something that I didn't understand very well was the conclusion of the essay. 

Was she done with her payment? How so? 

How didn't she realized before?