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I'm almost there.
I also live in the Bay Area. My rent is locally cheap but nationally very high. My wife has a chronic illness and an unrelated acute issue that recently required surgery. She can barely work. Until this most recent surgery I was keeping ahead, but expenses are up and income is down and that's not true anymore.
I have good health insurance but there's a lot more to medical costs than just doctors, and to partially manage her daily quality of life it's not weird to cook her three different dinners and she can only stomach one. This explodes our meal budget.
We're childfree but one of our dogs recently also got diagnosed with chronic illness. They are our kids, full stop.
Shit happens. Don't be a dick about it.
You sound like the exception not the rule.
I think you'd be surprised how many people live in cities and have medical expenses. This dude doesn't even have kids.
Word