How many times?

How many times in our own life or the lives of our loved ones have we heard that a particular surgical procedure is being scheduled for a date several days or weeks into the future? Most of the time, the future-dated surgical procedure is future-dated because it simply cannot be done sooner than that date. There's a whole bunch of reasons as to why. 

When a person is waiting for a particular surgical procedure they continue to deal with the medical situation as best as they can. A person awaiting a knee replacement, for example, will continue to use their cane. Someone waiting for a bladder procedure might continue to use a catheter. The examples are pretty much endless. In all of these procedures that people engage in while waiting for their surgical procedure, nobody is engaged in a life-threatening or immoral, or illegal activity.

This is not the case for someone who is waiting for a bed in a detox unit so as to begin methadone maintenance or any other form of MAT treatment for their substance use disorder. The person may be 100% committed to the idea of getting off their drugs and starting a methadone or other program. They will be told that the wait for a bed to begin this procedure is in the range of 5 days. During those five days, that individual will be reliant on continuing their illegal drug use and risking overdose. If they live on the streets, they may need to continue their prostitution to raise money for their illegal drugs. They may need to shoplift to raise money for their illegal drug use while waiting for that bed to open.

There is something incredibly wrong with this system of medical care provision. I'm not saying that I have the answers as to how to solve this situation. But it does strike me as horrendous and immoral and illegal and inappropriate that our society requires patients who are seeking care for an officially DSM-5 recognized disease process known as substance use disorder to continue to engage in various aspects of illegal activity while they are waiting for a bed to open up so that they can begin the life-saving procedure 5 days after the fact of being ready for that procedure and getting them away from the drugs they despise.  (My mother would not be at all happy with that run-on sentence. :-))

So my point is this. How can we change this aspect of healthcare provision to the men and women on the streets of Kensington and other places who are 100% ready for detox care and must continue to prostitute themselves or shoplift to raise money for drugs they would rather not take while waiting for a bed to open?

I'm dying over here.

I'm dying over here.

Your male patient on our co-ed floor put me in a chokehold which triggered my trauma from years ago.

I'm dying over here.

I happened to glance into the room across the hall from my own only to see a male patient on this co-ed floor masturbating. That also triggered my trauma from years ago.

I'm dying over here.

I was given Suboxone far too early by your staff person. I was thrown into precipitated withdrawal. You said there was nothing that you could do about it. You told me that I got myself into this situation and now I just need to deal with it. I signed out to find my own relief. You called it signing out ama. I called it trying to relieve my agony since you could not and to survive.

I'm dying over here.

You wouldn't give me anything to eat while I sat in your emergency room waiting 8 hours to be evaluated for admission into your detox. You told me that I could not be cleared for something to eat until the doctor saw me. I was so hungry. I finally left just to find something to eat. I had no money and so I had to do a date. That date exposed me to my first ever sexually transmitted disease that I will have for the remainder of my days on this earth. With no hope of receiving detox care, I immediately went back to the drugs from which I was trying to escape by trusting you for care.

I'm dying over here.

I trusted you to provide a drug-free environment. The patients on my unit all had drugs. Some of those drugs were brought in by one of your staff members. Others were brought in by an incoming patient who buried them under a bush in the smoking area which is easily accessible from your public parking lot. I couldn't resist and so I got high (which, by the way, is the most basic definition of addiction). I knew that wasn't what I wanted and so I signed out. You considered me to be signing out ama. I considered myself to be signing out to run from the drugs that you did nothing to keep out of your building and to try to survive.

I'm dying over here.

I trusted your facility a second time. I went through the admissions process. Another incoming patient saw that I was not feeling well. They offered me one bag of dope imprinted with a label I did not recognize that they had on them. You never discovered this because you didn't search any of us. I went into the bathroom unaccompanied and consumed that one little bag. I left the ladies' room, continued the paperwork to enter your facility, and overdosed. You gave me three Narcans. The medics who arrived informed you that that was far too much for such a situation. You explained to the medics that I would need Narcan once every 25 minutes for the foreseeable future. The medics tried to correct your lack of knowledge. You sent me to the emergency room and, with that, my battle to survive was over for this day because I couldn't see myself returning to your facility. 

I'm dying over here.

Knowing what the reward would be if I could survive your facility, I gave you one more round of trust. I acknowledge that I did a get well about 3 hours before this incident happened. Again, I was going through all the paperwork and answering all your questions. I was dipping out a bit from my get-well. I acknowledge that. But I also tell you, I was very aware that you stuck Narcan up my nose. I tried to stop you from doing it and you squirted that Narcan up my nose twice. You said "You're not alert enough for us." You then told me that now that I've received Narcan, I was a liability to your facility and that I had to go to the emergency room. I've never felt such heartbreak in my life because I knew that this day would be different. I would be putting my drug use behind me once and for all. I was truly heartbroken beyond my ability to explain when I realized that you had Narcaned me when Narcan was not necessary. You violated my trust. How could I return to any place that had done so?

I'm dying over here.

I don't need your derogatory comments about my situation. I don't need your inappropriate nicknames such as 'junkie' or 'whore' often applied to people in my situation. I don't need you to talk about how aspects of my body don't work the way they should. I have heard all these nicknames and I know all my bodily malfunctions. 

I need your encouragement to take the next healthy step. I need you to celebrate that I have volunteered to come into your care. I need you to be a professional caregiver in my world. I need you so very much to fulfill your training. I need you to know something. In the absence of that, you must understand…

I'm dying over here.

In the past 5 months, I've tried 10 times to seek medical care for my substance use issues. I want to heal more than I can possibly explain. I've tried and tried and tried and tried and tried and tried and tried and tried. I'm going to keep trying as much as I possibly can but I want you to know something. In the midst of my battle, I want a healthy life. My strength is waning and I don't know how much I can keep going but I'm going to try. In the absence of continuing to try,

I'm dying over here.

Finally, I want you to know this even though I struggle with this idea myself. I am an inspirational human being. I am made in the image of God. I am worthy of the highest dignity and honor and respect and love. I need you to know this. Through your words and actions and interactions with me, I need you to remind me of this. In so doing, I will be able to break from my current path and one day look at you and my family and all of my loved ones and proudly say… 

I'm living over here!

We have to get away from this misnomer: "All addicts lie all the time."

Substandard and often dangerous healthcare is the norm when the attitude of the healthcare
provider is 

"All addicts lie all the time." 

A bit over 4 years ago “Diane” sat in a jail cell for about 5 months. I would visit her every couple of weeks. During our conversations, she told me how she was completely done with drug use and the entire street lifestyle. 

The court system, under the direction of a very caring judge, was working on finding her placement in a rehab facility. She was placed in a Philadelphia-based Medicaid-level facility.  I learned after the fact that she signed herself out because there were so many drugs on the floor where she was residing that she could not focus on recovery. She was relying on a drug-free environment and this facility did not provide that so she left. 

She was making arrangements to go to a facility she was familiar with but could not get in for a couple of days. Kensington streets were her only option to stay in. She managed to find a room on the avenue. The temptations of the streets and the drugs called her louder than she could resist. She did a small amount of drugs and was dead by morning. 

Her two daughters will be her living legacy.

“Dakota” was an amazing naturally gifted counselor. Her dream was to one day become an attorney. In December 2021, she unintentionally injected an artery. Bleeding was profuse. After several days she was taken by ambulance to Jean's Hospital. 2 hours later one of the ER staff members came into her room and told her that she was being discharged because 

"We need your bed for real patients."  

Her bleeding continued and she died about 5 days later. 

Her two sons will be her living legacy.

Recently a loved one who I met on these streets was seeking care at a detox rehab facility. As is the case with almost everyone going into detox for opioid use detox, she used before going in. There's nothing unusual about that at all.

She had gone through almost all of the admissions process which was about 2 hours. She told me that she was high during the process and dipping but answered all questions and engaged in the entire process of admission.

She tells me that she was sitting in the admissions waiting area for the next step. She remembers being jolted awake when a staff member stuck Narcan up her nose and squirted it. She tried to stop them but they injected Narcan up her nose anyway. (It is medically unnecessary and completely inappropriate to provide Narcan to a conscious patient.)

They told her that she would have to go to the hospital since she was now a liability to the facility for having been narcaned. She was taken by ambulance to Cedar Avenue Hospital, a campus of the University of Pennsylvania. 

She begged and pleaded not to be taken away because she so much wanted the care of the detox. She wanted to be done with her addiction and all that comes with it. After several hours in the emergency room, as I sat with her, she told me how much trust she lost in the facility to which she had entrusted so much hope just a few hours before.

She is now trying to figure out what her next step is going to be. That next step might be returning to the streets and all that street life encompasses for a woman.

Each of these situations has been publicly discussed with professionals in positions of authority who could make a difference and correct some of these wrongs. But no one has and most likely, no one will. And you know why?

"All addicts lie all the time!" 

We have to get away from this misnomer. 

We must consider the statements of these people who have been made in the image of God and who are worthy of the highest dignity and honor and respect and love. They are suffering so tremendously in their own literal hell and their words of complaint and concern in the midst of seeking care must be taken seriously.

To that end, I have been gathering stories of first-hand accounts of mistreatment by professionals in medical facilities. The beginnings of this effort are found at this web link on my blog site. I invite you to read over these first-hand accounts to get a better understanding.

I am searching for accurate accounts of mistreatment. I'm not looking for exaggerated or false accounts of anything. I'm looking for patterns of mistreatment. 

All of this can be anonymously submitted through this survey. 

You can also submit true accounts by email which does not allow for total anonymity since there's an email address involved.  Here’s the email address: PlowDownMedicaidMountain@gmail.com

I invite you to pass along this blog and associated links as you see best for bringing resolve to this sad situation.

Could somebody please explain to me why this is acceptable?

I'm not there now but I was at Horsham Clinic helping a friend to get admitted voluntarily. 

I would love to know why this place allows coed floors. 

I would love to know why the staff did nothing when one of the men pinned my dear lady friend to the floor in a chokehold reminiscent of a rape years ago and therefore triggering her PTSD.

I would love to know why my lady friend was exposed to a male patient masturbating in his room with the door wide open.

I would love to know why the doctor completely negated her expressions of fear about being on that floor and simply told her that if she's that uncomfortable she should go to her room.

Could somebody please explain to me why this is acceptable?

Kirkbride failed and my dear friend is giving up on finding professional care.

I would love to know how, in two out of two times, my loved one was exposed to illicit drugs during her admissions process and once up on the floor. 

In her present condition at those moments, she was not able to resist the obvious temptation and consumed. 

The details that she shared with me were so detailed that I fully believe that other people brought the drugs into the facility and ultimately to her. No one was searched nor kept separated during the admissions process as they should have been.

Let us just assume that those stories were not accurate and she actually brought there's illicit drugs in which I fully believe she did not because I was with her in the hours leading up to both self-determined completely voluntary admissions.

Whether her account of what happened is accurate or not, Kirkbride failed her miserably! Any detox worth its weight or even a quarter of its weight has every moral and legal and ethical obligation to make sure that they are providing a drug-free environment. 

Kirkbride failed and my dear friend is giving up on finding professional care.

Go to your room if you're that uncomfortable.

Should a female patient be expected to stay as an inpatient on a coed floor where one of the men has reawakened her PTSD from a rape years ago by pinning her to the floor in a chokehold while the staff does nothing to stop the situation?

What appears as simply signing out AMA (against medical advice) because they don't want to be there often has deeper roots and needs to be considered as a possible violation of the trust the patient put into the care facility when that care facility did nothing to protect the patient.

The care facility only adds to the trauma when they simply tell this patient who trusted them to simply "Go to your room if you're that uncomfortable."

Imagine

Imagine being so desirous for detox and psychological services that you voluntarily commit yourself to a psychiatric hospital.

Imagine your surprise when after 36 hours, the doctor initiates your subutex when you know darn well that it has to be at least 48 hours. You mentioned that to the doctor but the doctor says… 

No. Trust me. 36 hours is fine. 

Imagine going into precipitated withdrawal almost immediately.

Imagine begging for comfort care as your unexpected precipitated withdrawal wreaks havoc on your mind and body. 

Imagine asking and being told there was nothing that can be done and furthermore being told by professionals on staff in your co-ed unit… 

You put yourself in this situation and now you just have to deal with it.

Imagine being in so much agony that you give 72 hours' notice that you will be leaving since they can't help you with the precipitated withdrawal that they caused by giving you what you would have taken willingly at the appropriate time.

Imagine being stuck in this co-ed unit when a large muscular man, a patient, pins you to the ground in a chokehold reminiscent of a rape you experienced years before and immediately results in PTSD flashbacks.

Imagine walking down the hallway of your co-ed unit heading to your room when you randomly glance into the room across the hall from you and witness a man, a patient, masturbating.

Imagine the conversation with your doctor when you explain that all of this has left you very uncomfortable with being on this unit. 

Imagine your doctor saying… 

If you're that uncomfortable then just go to your room.

Imagine leaving that unit where you came for detox and psychological services further traumatized by these events and lack of caring on that floor and being back at Square One trying to figure out what next to do to remove yourself from your substance use when you know you need professional help to do so.

One person I know does not need to imagine any of this. This happened to one of my loved ones who I met in Kensington and who is desperately desiring to be relieved from their demon of addiction.

What level of administrative and procedural incompetence...?

What level of administrative and procedural incompetence allows multiple incoming detox patients to mingle together in a waiting area while their admissions process is underway!? 

The end result... 

Someone who desperately wants care and wants to stay away from their drugs and has no drugs on them upon entering the building is exposed to someone who does not care quite as much and does have drugs on them. 

The first one ends up accepting the drug because their power of resistance is not where it needs to be and dope sickness has started to set in.

This attempt for detox by the first one ended in near disaster with an overdose in the bathroom because this place does not escort non-searched people into the waiting area bathroom! Fortunately for this first one, someone did walk into the bathroom and realize the situation in time for the person to be saved. This is not how a professional detox facility should be operating. When is this insanity of incompetence in professional Medicaid level facilities going to stop?

Is it any wonder that people are dying at such alarming rates?

Money makes the world go round…

That song title is used for several different seemingly unrelated songs all with the same theme. Money does in fact make the world go round.

There's virtually nothing that is not increased or made better or bigger or bolder in the absence of an increased amount of money. 

You can have all the Faith in the world and ideas for ministry development and yet money will determine how large that ministry can become.

Money drives so much of our society, some might say all of society. There are too many examples to try to begin illustrating my point.

But here's one example that we should really be looking at and the primary purpose of this blog… 

90% of all the women on the streets of Kensington are reliant on prostitution, more commonly known on the street as 'doing a date', so as to raise the needed money to purchase the drugs that they need in the midst of their active drug addiction. Now hold that thought for a minute… 

70% of all the men on the streets of Kensington are 100% reliant on that 90% of women to financially support the purchase of their drugs for their drug addiction.

For the sake of easy math, let's say that the number of men and the number of women are equal on the streets of Kensington. That would mean that 80% of all of the money needed for the purchase of illegal drugs to support drug addiction on the streets of Kensington comes through prostitution.

We are forever hearing about the women being caught up in sting operations and being arrested for prostitution. Their need to raise money in this way is something they're not proud of as they are employed in the only mode of employment they can find to fund their substance use. Their substance use is a requirement of their drug addiction which is a medically recognized disease officially known as substance use disorder.

We arrest the patient in our current system of doing things but we do not arrest the ones hiring the women for the act of prostitution. If law enforcement would start to go after the men who are picking up the women, the flow of money would decrease and we might start to see an end or at least a slowing of the current situation.

So why are the men not arrested for engaging in prostitution with a patient suffering with substance use disorder? From one of the women, I heard of her frequent 'date', an attorney who is an employee of the city of Philadelphia. I've heard of other people in positions of authority in various ways who, with their position of authority, can sway the system in their favor and keep the men from being arrested. 

Let's look at this issue and start focusing on the ones providing the money to the patients who would rather not be patients at all in this deadly game of prostitution for money for drugs.

Money makes the world go round… 

It’s hard to believe that almost 6 and a half years have passed since I first started visiting the people on the streets of Kensington.

February 20 2023

Dear Friends,

It’s hard to believe that almost 6 and a half years have passed since I first started visiting the people on the streets of Kensington.  I’ve been writing about some, but certainly not all, of my experiences in this blog series.

As you would expect, there have been moments of great sorrow and, surprisingly enough, moments of incredible joy and laughter, and privilege.

For me to explain the moments of great sorrow in one letter would fall short of explaining reality as would sharing with you a photograph of a fallen tree to help you understand the destruction of a hurricane.

The moments of great joy, laughter, and privilege are the same and yet for this, I will provide a few examples.

Great joy can be found in realizing that a simple song sheet with encouraging words has saved the life of a reader when they were contemplating suicide.

Great joy is found when the financially poorest of the poor thank me with a gift or a card on a holiday or my birthday.

Great joy and privilege are found when a parent who I have never met reaches out to me in hopes that I know where their son or daughter may be.

Great joy and privilege come when speaking under oath in a Philadelphia courtroom to help the judge and lawyers for the prosecution and defense better understand the true nature of a particular human being, a patient with substance use disorder who, in that particular setting, is labeled as a ‘defendant.’

Great laughter can be found each time we visit.  The best example is ‘The Red Box” story as told by Sara.  You’ll need to visit with us someday to get the full effect of this funny moment as Sara embellishes this true story each time she tells it with more details that may or may not have actually happened.

During these six and a half years, I've learned so much about addiction and homelessness and yet there is so much more to understand. These human beings are not out on these streets by choice. They are out there courtesy of a disease that does not fit in any standard understanding of a disease process. A patient with this disease, formally known as substance use disorder, may have all the determination in the world to reclaim health. Far too often, however, the medical system at the Medicaid level does not provide a smooth, dignity, and respect-filled transition to any extent from illness to health. In the words of one person I know who is currently in this medical twilight zone in their attempts to be healed, 

“It's easier to keep using drugs than it is to find healing.”

During these 6 and 1/2 years, a small team has developed and visits with me on Wednesdays and Sundays. And for this, I am incredibly thankful.  Our efforts as a team meet great needs that I alone can not.  You know who you are…  Thanks for being a part of this! 🙂

There is so much more that we would like to do to serve this population of people who, by the way, are your literal neighbors regardless of where you're sitting and reading this letter. 

Your prayers and your donations of physical items such as clothing and first aid supplies and ‘Stevens Bags’ are very much appreciated as are your financial gifts which make necessary purchases possible.

As this ministry has grown, it has become more personal and private for some of the people I've come to know and love, and for the sake of confidentiality, not shared in any form.

The aspects of the ministry that you hear about on a regular basis revolve around street visits. The water and fruit, typically bananas, are what draw people to us as these items meet a physical need. 

The Christian song sheets and DHRL cards that we hand out are at the center of why we do what we do. Non-judgmental conversation and prayer when requested are very key elements as well.

These public aspects of the ministry and the more private efforts require a lot of prayer and time and energy and funding.

After 6 and 1/2 years, there's only one Church that financially supports these efforts on a monthly basis. I'm very appreciative of that church.

Other consistent financial contributors include a retired pastor, a mother (who I’ve never met) of a former resident of the street, and two other individuals - and that's it. Random donations do come in at times. While all of this is very much appreciated, it's not enough to keep this going. Since the beginning of 2021, I have personally financially gone in the hole by close to $3,000 in easily documentable receipts. This does not include my personal auto expenses which, for a round trip to Kensington is approximately 55 miles two to three times each week. Nor does it include any of my personal expenses such as meals while there.

I am looking for individuals and organizations such as churches to become more consistently financially involved in these efforts.  Would you consider becoming financially involved? Are you a representative of a church or other organization who would consider this?

These efforts currently are not within a 501c3. This seems to be of little concern to donors. If you are in an organization or have personal knowledge of how to become a 501c3, perhaps you could donate your services and help us make that transition.

In the meantime, I humbly and prayerfully ask for your consideration to support our efforts through your prayers and consistent funding. Thank you for considering this possibility.

Sincerely and respectfully submitted,

Chris

Chris Battin

610-368-2038

Funding Options Page

Dead is dead!

A person who engages in a suicide attempt and fails is '302d', involuntary committed to receive psychological services.

A person who signs themselves out of a hospital and who has been told that they will not survive if they do so is not '302d' because they are considered to be of sound mind.

In the case of a substance use disorder, an officially recognized disease in the DSM-5, the mind of such a patient does not think clearly. Therefore, they are incapable of making totally rational decisions and yet they do not receive a 302. Too many end up dead.

Dead is dead regardless of how they got there!

When are changes going to be made?

“We need your bed for real patients.” - One year later

January 7, 2023

One year ago tonight our world lost a Daughter, a Sister, a Mom, and all other manners of family relationships.  Our society lost a future lawyer and counselor. I lost a dear friend.  

I invite you to read her story, some of which we wrote together prior to her final days, by clicking here for the blog:

Absolutely Unacceptable.

In the weeks following her departure from our world, I started gathering stories from other folks who live on the streets of Kensington and have sought health care from local medical facilities. 

Here are their stories in their own words.

In my friend’s memory, I’ve tried to find medical and legal professionals who would like to look into these reports of mistreatment, neglect, and abuse and do something about it.  

No one is interested.

And so, from my humble seat in this nightmare, I keep doing what I do in hopes that someone in a position of authority will take this matter seriously.

In the meantime, my Friend, please know that we love you and miss you and long for that day when we will see you again on the eternal side of Eternity.

Pitchforks and Burning Lava to Drug Free Peer

At approximately the 53-second mark in this clip from the original Rocky, I was standing where the camera would have been sitting as I was talking for the first time ever with a new sense of calmness and decency and oneness with a young lady who, 5 years ago, had pitchforks and burning lava encasing her heart. This young lady was filled with rage and disgust at the world in those years.

And yet not long ago she and I conversed as peers as she shared with me how she found healing and recovery from opioids. She was still there on the street for her own drug-independent reasons and drug-free from that which would otherwise kill her in a minute.

It's moments like this that I thank God for the privilege of serving and getting to know the people on the streets of Kensington.

Contact me now, please.

You moved Home to Heaven 30 weeks ago last night. I'm in the anger stage of grief. That usually means that the survivor is angry with the loved one who has died.

I'll admit, there is some of that. I wish you had stopped doing what you were doing or at least slowed down what you were doing. I even told you that I was getting scared as I watched the pace at which you were advancing your efforts.

But I'm far angrier at the medical professionals who, once you had found your ready moment and submitted to professional care, had the audacity to tell you that they were discharging you from the emergency room in which you had been brought in by ambulance at your request because they needed your bed "for real patients". You died about 5 days later.

That's who I'm most angry at.

For the past 30 weeks, I've been hoping to find an attorney or two or more who would help the overall situation of barbaric treatment by medical professionals upon folks like yourself who were suffering from this horrendous disease of substance use disorder. And so far not a single attorney has been found.

There was one attorney who expressed some interest in coming up with a solution. His idea was to 302 for a minimum of 5 days anyone who overdosed and had been saved by Narcan. Unfortunately, that attorney was also the regular jawn of at least one woman on the street reliant on prostitution to fund her addiction. And so with those kinds of attorneys putting forth some artificial effort to end this nightmare, is it any wonder that we're not making any progress?

I'm looking for attorneys who will look at the legal aspects of this barbaric treatment of the human beings on the streets of Kensington who are being so grossly treated.

Are you one of those attorneys who would step forward? Are you an attorney who does not have the expertise for such a situation but knows of an attorney or attorneys who could help? I'm reaching out to you as well.

Let's end this nightmare just as much as it can possibly be ended.

Contact me now, please.

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