Heroin

Twice this week I have been working in the front hallway of our ED running the Express Care.  I hear an overhead page from triage for help to the waiting room for an unresponsive patient. We run out to the waiting room to find a triage nurse, a tech, and a security officer struggling to load an unresponsive, twenty-something, white male into a wheelchair.  His eyes are rolled back in his head, mouth gaping open, with occasional grunting respirations.  This kid is moments from death.

We know how to save this kid.  In fact, the nurse calls for narcan from the waiting room.  Get him to the back, give him narcan, save his life.  I can't speak for my coworkers, but a second thought is always in my mind as we save his life.  "You stupid kid!!  Maybe we shouldn't give him narcan and just let this whole problem end a little more quickly."

Usually within an hour the kid is completely lucid and often becomes a pain in the ass.  This particular kid started demanding food and then complained about what we gave him.  He became disruptive and verbally abusive to the nursing staff.  He ended up leaving AMA within an hour of being carried through the door, half dead.

After one episode I quickly went back to my other patients and responsibilities.  I turned around to make a plan for moving some patients with my triage nurse.  I see him leaning over the computer desk, head in his hands.  "Greg, what's going on?" I ask.  "Oh, didn't you know?  My kid overdosed last year.  I was the one who found him and started CPR.  I've seen dozens of kids like this since - this one just got to me.  I need a minute."  Everything just stopped.  We talked.  Then I left him alone to catch his breath.  I hate heroin.

My emotions are equal parts anger, frustration, sadness, and fear.  I hate this drug!  I hate what it does to people.  I feel hatred towards those who use it.  I feel hopeless and afraid.  I feel afraid of myself and how easily I become jaded. 

This is an epidemic in our country.  How did we get here?  How do we get out?  I know next to nothing of public health, AODA management, or law enforcement.  I only know emergency medicine.  I know how weird it is to save somebody's life and then immediately want to punch them in the face.  I know the grief in a parent's face that tells the story of a tragedy relived.

Where do we go from here?  I have no idea.  As clinicians we definitely need to reign in our narcotic prescribing.  We need to show young people what heroin overdose looks like.  It's really scary!  I want to tell my story and how this epidemic effects us almost daily in the ER.  I want to explain the complicated and conflicting emotions that come with caring for these people.  I want the problem to go away.  I hate heroin. 

The only way I know to search for answers is from a Christian worldview.  I hope that even if the Bible is not your language of spirituality, you will at least find some truth in the following story.

What would Jesus do?  What did he do? The story that comes to mind is the wild, demon possessed man, "a man from the tombs with an unclean spirit...and no one was able to bind him anymore, even with a chain"  Mark 5:1-17 NASB.  Scary! This guy was running around naked, living in a graveyard.  People had tried to chain him up because he was so wild.  He just broke the chains!  Jesus said, "Come out of him, you unclean spirit!".  And then Jesus asks, "What is your name?" I paused here as I read the story.  The demon answers and says "Legion, for we are many".  But I wonder if that's who Jesus was talking to.  Maybe he was actually talking to the man, not the demon. Maybe Jesus looked this pitiful, wild man in the eye and asked, "What is your name?"  This makes sense to me.  He called out to the human heart in this tormented man. 

What do we name these people?  I name them addict, idiot, stupid kid, loser.  But that's not their name.  Maybe we need to look through the crazy, manic, frightening behavior and ask people "what is your name?"

Maybe this is a way through this epidemic.  Maybe we need to look these people in the eye and ask, who are you?  Who is the real you?  What is your name? What is your real identity? Maybe they've been struggling for so long that they forgot.  Maybe we, as healthcare providers, forgot that this pain in the ass who can be frightening and disruptive, is a human being who is deeply wounded.  What is your name?  No, really, what is your name? It's not stupid kid or pain in the ass.  It's Kyle, or Demontre, or Andrea.  Real people with moms and dads, friends, kids, jobs,  and broken hearts.

I'm not saying this is easy.  Jesus was brave and bold and so tender and compassionate.  I don't feel that way in the frantic moment in the waiting room.  I want to learn this way.  Maybe, when the dust settles, getting to know this person's name will give them hope.  Maybe it will give us all hope.

 

 

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