The Stocks of Face-Saving

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Clipboard under my arm I approach the door.  “Knock, Knock” I say aloud, pulling back the curtain and moving into the room toward the patient, I rub slimy germ busting formula into my already chapped hands.  There in the bed, blanket, standard white pulled tight under unshaven chin, blond and balding, he waits his turn. 

Eyes turn shyly toward me, embarrassed.  “Are you the social worker?” he mumbles.  “Ya, that’s me” I say.  He adjusts his long legs into a sitting position on the gurney, wraps the blanket around his knees as we proceed.  At first glance I decide this guy is from the world of the arts; sensitive and starving.  Working through the preliminaries, the myriad of questions, I learn he’s a musician, he’s hardly making it financially, and the silent flow of tears tells more.

He’d been a good kid from a good family, grew up in the Midwest, complete with loving mom and dad, brothers, grandparents, Uncles, Aunties, Cousins.  “I’m the only one, really” he says in answer to my asking him questions regarding the family history of chemical dependency.  Says he got “into some trouble” 10 years ago, but after treatment and a half way house, went about setting straight his life.  He found a girl to love and marry, they had a baby a couple years ago.  He says the marriage is over now.  “We grew apart, I guess.”

He tells me last night he overdosed on drugs he’s never touched in his life, others he’d been terribly addicted to 10 years prior, plus a handful of a friend’s old prescriptions for sleeping, some for anxiety, and added with that a handful of pain pills that were the cause of all his problems in the first place.  He can’t say for sure that he was trying to kill himself or not “I don’t really know what I was thinking” he says mopping up the stream of silent tears.  All he can tell me is that after being “clean” a long time, he’s an addicted mess again.

He says that four years ago he hurt his back. His doctor gave him prescriptions for Percocet and oxycontin.  Two years into the medicines his back didn’t hurt anymore, instead everything else hurt – vicious and demanding hurt – every time he tried to ditch the meds.  He told me at my request the step by step process he had gone through trying stopping “the pills”.  Now he’s up to “30…. no 60 dollars worth every morning to even stand upright…I can hardly get to work and make it through the day.”  

His hands shake as they fist the blanket in his lap.  “I can’t miss a day without my body shutting down.  I can hardly walk, I can’t live without it.  Everything’s wrong.  I have diarrhea, I sweat, I chill, Haven’t eaten for three days.  I can’t sleepI can’t fucking go on like this.  OK, I AM suicidal.  Ya,I was last night too”. 

Unstoppable tears shame him as he works through the details of his situation.  Of all the hurt he moves through in this sterol over-lit room with this total stranger asking him to recount hard things to admit even to himself, the rawest of all relates to his adored 2 year old daughter.  Little is spoken.  What he does say is that since the divorce, he gets to see her a couple hours a week.  “It’s my fault.  I can’t have her anymore then that, not her Moms… I’m barely getting to work.  I drop the ball for the pills.”

You might think me a bit sadistic, but in my spirit I’m having a party for this young mans despair.  Down the hall in Exam 3 in spit hood, four pointed to the gurney, thrashing and growling is a guy I’ve seen before.  The last time I saw him, a couple years before, he’d been in much the same situation as the man sitting before me, but without the vulnerable truth telling of the dozens of ways his life was an utter disaster.  Everyone else was the reason he was in the ER that night.  He hadn’t cried in shame that he couldn’t be a dad to his kids, keep a job, function as a husband.  So instead of the humiliating process of admitting he was a mess, surrendering to the process of detox and treatment – allowing others to help – instead of that humiliation, his small and terrified six year old son got to be the one tonight to call 911 telling the operator he thought his daddy was dying.  Now the boys daddy is trapped like a wild animal after assaulting two of our staff in a drug craze, trapped until the Haldol kicks in.  I wish sometimes that all my patients could be an invisible mouse on my clip board, following me around from room to room. 

As my thoughts return to the young man before me, he and I work the details and challenges through, one tangle at a time.  It becomes clear that regardless of why, after a great childhood, he took a wrong turn, that what matters now is he’s ready to do all the painful parts of taking a right turn. He still has a great family.  Yes, they are sad and shocked to received a call from us 3 a.m. with news he had overdosed in a suicidal attempt , that he has been hiding this addiction for 4 years.  He is the one to make the phone call and openly tell them the whole mess he’s been hiding.  Yet they are there, more than willing, from 8 states away, to buy the ticket he needs home, to willing to set limits in ways that will help him heal, to join him, not in an enabling way, but from a place of strength, as he surrenders to the process of a new beginning.

I stop by his room just before he is discharged.  “Just came in to tell you I’m happy for your new beginning. Take Care” are the words I say,… but inside what I’m REALLY saying is “God, like the rest of ’em, right turn or no, great family or not, please stick with this guy.  He won’t make it without you.”

“The Truth Will Set You Free” John 8:32

Amelia

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