(This Thursday Meditation takes on a different look as I’ve reprinted an article from the Pittsburgh Post Gazette. Thanks to my brother J.F. for sending it.)
Life in the ER: Alive but ungrateful
Monday, February 28, 2011
By Dr. Thomas A. Doyle
She was 19 and she was dead. Skin like a gutted trout’s belly, lips the shade of rotting grapes, not moving or breathing. Her pupils were tiny lead pencil tips, murky and dull. She had been unceremoniously dumped on our doorstep, literally tossed out of a car which peeled away the moment the door was closed. A fresh needle track peeked out of a thatch of old ones in the crook of her left elbow.
Yes, she was dead. But as Billy Crystal said in “The Princess Bride,” she was only mostly dead. She was just taking death out for a test drive, putting a down payment on the farm, sightseeing on the Stygian ferry, tapping the bucket with her toe. Luckily for her, mostly dead is a little alive.
Our team descended upon her and in moments she had a working IV line and oxygen was being forced into her lungs via a bag/mask device. I ordered Narcan, an antidote to overdoses of opiates such as heroin or Oxycontin.
The change was nearly instantaneous; she squirmed on the stretcher and gulped a huge gasp of air. Her eyes snapped open, pupils returning to normal size. She began thrashing about on the bed, tearing off monitor leads, yanking out her IV.
“Relax, sweetie,” soothed our charge nurse, who could pose as the Norman Rockwell archetype of a kindly grandmother, “You’re going to be OK.”
“Don’t you ‘sweetie’ me, bitch!” our modern Lazarus squawked, slapping away the nurse’s hand. She tugged at her gown. “What the hell is this? Where’s my shirt?” Her fingers found the shreds of the grimy sweatshirt we had cut off during the resuscitation. She eyed us accusingly and whipped a piece at the wall. “You cut my [expletive] shirt! You [more expletives] cut my shirt! Y’all are going to pay for this.” Wagging her finger in my face, she listed her demands. “I want a shirt. I want a taxi. I want my wallet, my cell phone … and give me something to drink, my mouth tastes like crap!”
I picked up the shred of sweatshirt and dumped it in the trash. I pulled up a stool next to the stretcher and stared silently at her. After a few seconds of trying to ignore me, she snapped her head around, shoved her nose a couple of inches from mine and bellowed, “What’s your problem!?”
“You’re welcome,” I said softly.
She replied with an additional string of expletives, including some rather creative ones questioning my parentage and sexual orientation. I continued to stare back. Finally I interrupted and said, “You know you just about died.”
All that earned me was a sullen glare.
“Next time might be too late.”
Stony silence.
“If you’re interested, we could try to set you up in rehab …”
“Screw rehab!” she exploded. “Just let me out of here!”
“Fine,” I replied, tossing my hands up and heading for the door.
As I approached the threshold, I heard her muttering. “Rehab! Yeah, like you care about me.”
I halted, mulling it over for a moment. I pivoted on my heel, crossed back to the bed and answered, “You know what? You’re right. I don’t care about you. Who are you to me? Some nobody I’ve never seen before and, at the rate you’re going, I’ll never see alive again.
“I do care that another human being, one just a few years older than my daughter, is completely ruining her life as well as the lives of anyone who ever loved her. But I’m not one of those people. I don’t love you. After seeing how you treat people who help you, I don’t even like you.”
Her mouth popped open to respond, but she seemed momentarily taken aback.
I lowered my voice and continued, “I can only hope you have somebody who still loves you. A mom, a dad, maybe a baby brother or sister. I mean, for God’s sake, you’re 19! It tears my heart out to think that only a few years ago you were probably playing hide and seek and bringing home fingerprint art and dressing up as a puppy in the school play. But in the end it doesn’t matter if I care. It only matters if you care. If you don’t, then why should anybody else?”
“Just get out of my face! You don’t know shit about me!” she spat.
As I tromped out of the room, I bumped into the charge nurse.
“That Narcan sure works fast, doesn’t it?” she commented.
“Yep,” I agreed. “She went from dead to asshole in 60 seconds.”
That garnered a melancholy chuckle and a sagacious glance over her glasses. We walked a few steps then I pulled her aside.
“Hey, listen, make sure social services sees her before she leaves. It probably won’t do any good, but at least give the kid another chance.”
Stepping back, I clapped once and rubbed my hands together. “OK, then. What’s next?”
“A family of three kids who ate cat food in room 7 and an old lady who’s convinced she has worms in her ear in room 12.”
“Of course,” I sighed. “Just another day at the office …”
Three hours later, at the end of my shift, the social worker stopped me and said, “I sent that girl to Gateway.’
“Really?” I replied. “She agreed to go to rehab?”
“Yeah, she’s on her way. By the way, I’m not sure what this means, but she wanted me to tell you it wasn’t a puppy. It was a giraffe.”
Dr. Thomas A. Doyle is a specialist in emergency medicine who practices in Sewickley (tomdoy@aol.com).
I have spoken of my 17 year old daughter before a Textbook case – Heroin addict I could have wrote a book! – legal issues placed her in a Rehab. A 60 day stay, as opposed to the previous 2 that were 14 and 21. He consequences are now not mine to dictate,, if she doesn’t follow the aftercare program, then she will land right back into 60 day rehab, and then another 5 months at a less intense facility. She has been gone for now 50 days, and shortly, she will come home. I have been to Al Anon meetings, and my husband – her step father, have been couples counceling. Libby, in my heart of hearts,,, even with all the preparation I have been doing,, I am very scared. She has minipulated me- I am her target,, because I have a soft spot for my daughter,,, my only daughter,,, please just tell me one thing that will get thru to me,,, I have come such a long way in my education and attitude towards her addiction,, maybe, I am just having a few weak days. I speak as if there will be magic words,,I know there are not. I supose I admire you and your story so very much, that I turned to you for a “word of wisdon.”
I can relate to this post. I have my own set of ER stories. My son also was alive but ungrateful in an ER several times. We never really know when it is….that one time they they will finally want to surrender and get help. They can be led to water but they cannot be forced to drink.
Chrissy, I found it helpful to not let my son force me into a decision on the spot. I used the slogan “think ” a lot and therefore took more time to think through what was best for the whole family, not just him. When he came back to live with us I had a written contract that he signed and I don’t let him off too easy now. I remind him of the terms when he breaks a rule. So far so good. He is still sober and moving foward slowly.
There is no one right way as I have found but I certainly know how I have allowed his addiction to continue in the past when he lived at home. I always think through what I do with him and ask myself “whose responsibility is this? Mine or his” Sometimes questioning myself helps me.I have a drug test visible on the kitchen table and will use it if I suspect usage. Keep going to Al ANon. I have also found therapy to be very helpful in my growth with this problem.Good luck to you and take good care of yourself in all those small ways that you can and whenever you can as this is a draining disease.
My heart is heavy today. It is the anniversary of my son’s death from addiction. It’s hard to believe it’s been 3 years. It seems as though it was yesterday. As I reflect on all the years of psychiatrists, psychologists, parent-child relations classes, sober homes, prison, etc., it’s a testimony of just how difficult living with and dealing with addiction really is…
Chrissy, try not to be scared when your daughter comes home. I know it’s going to be difficult, but she will see that you’re scared and you’ll be vunerable to her manipulations. I pray for your family and your daughter. I hope this will be the last time in rehab, for her.
Jane, therapy really helped me, too. I will pray for you and your son. I know things are moving forward slowly, but slowly is a good thing.
Libby, thank you so much for publishing this ER story. Or, should I say, thank your brother. There are so many stories like hers…
Thanks to all of you mothers for your support. It means so much to me.
Love to all of you,
Barbara
Our dearest Barbara,
Please know that we are ALL with you today, sending our love and prayers and strength. I’m sure your heart breaks every day and especially today. I am with you; we are with you. Imagine a chain of mountains surrounding you with love and protection. There we are.
With love and respect,
Libby
My dearest Chrissy,
Sure you’re afraid. Sure you have moments of intense weakness, doubt and deep lonliness. This is normal and we all feel it. The problem is that we think we are alone and that something must be wrong with us.
I agree with Jane that there is no one answer – how I wish there were. I have no words of wisdom, but I have found wisdom in things that Jeff and Dr. MacAfee have told me.
Jeff repeatedly said, “Never deny an addict his pain.” I didn’t understand this for the longest time. I figured that I was his mom and my ‘job’ was to keep him safe. In the end, when I finally got out of the way and allowed him to feel the consequences of his addiction, HE chose. I had to SURRENDER to the addiction and face the fact that he could die. He didn’t and for this I am on my knees in gratitude. I know we are lucky.
Dr. MacAfee says, “Relapse, when handled with care, is a learning experience.” He once told Jeff, “If you want to use, use.” Jeff said, “Don’t tell me that, Doc.” MacAfee’s response was, “Only you can stop, Jeff. I can’t stop you.” MacAfee says to use a ‘candle’ instead of a ‘sledge hammer.’
Stay Close to me means, “I love you, Jeff, but I can’t fix you. I can’t fight your fight. You have to do it, but when you do, home is here for you. We didn’t move away from you and we never will. The choice is yours.”
My love to you,
Libby
Barbara,
Youare in my thoughts tonight as I pray for serenity for you. As Libby said, we are all surronding you like mountains with our thoughts of love and peace as a salve for your pain at having suffered such a great loss. This is a horrible disease that only those of us who live it every day could understand.God bless
Jane