Please Know...

As I come to know the men and women of Kensington, specifically the homeless and addicted, their stories become increasingly sensitive and personal. Their collective story is what I am trying to share with you as my way of breaking the stereotypical beliefs that exist in regard to these fine people. Names are rarely their actual names and wherever I can do so, I might use the opposite pronoun (his/her, etc.) just to help increase their privacy.

Sunday, January 13, 2019

The Final Days of Emerald City

As I begin to type this, I’m sitting in the Applebee's on Aramingo. To my right, a few blocks away, men (mostly) are preparing to call it a night and claim a hollow tube of cement for their bed. These tubes will fairly soon be part of the drainage system for the new section of I-95 that is under reconstruction in this area.  These tubes will eventually carry all sorts of yuck from our nation’s highway to some other place out of sight and out of mind.  In the meantime, these tubes serve as sleeping space for men who much of society wishes would be out of sight and out of mind.  Ironic… Isn’t it?

A few blocks in the other direction is Emerald City, a well-documented community of tremendous suffering and a few good laughs.  I’ve been reminiscing about Emerald City with each of my recent visits.  Emerald City at 10:00am on Thursday, January 31, will no longer be a community of suffering and grassroots safety.  It will become just one more anonymous Conrail overpass welcoming new residents to the area.

In one very real way, that’s fine. People should not be living under bridges and homeowners/renters should not be dodging dirty needles.

But here and now, I am reminiscing about the five overdoses I witnessed under or near that overpass.[1]  All were saved by another addicted resident who carried Narcan.  I think ahead, wondering if this soon to be dispersed community of daughters and sons will have the same protection once so many have moved alone to abandoned houses.  I catch myself wishing that every legitimate detox/rehab in the five-county area would each adopt a few of these men and women so they can reclaim their lives.

As I reminisce, I think of

the men and women who called Emerald City and the Frankford Avenue Bridge Communities 'home.'  Many who opened their lives to me have moved on.  I have no idea where most of them are or if I'll ever see them again.  

the Christian woman who always had a Bible opened on a prayer table next to her mattress.  She died of pneumonia two weeks after she told me she needed to find a home for her kitten so that she could focus on putting her life back together.  The kitten is now full grown and has lived with me since that day.

the tears shed by women and men as they tell me of burnt bridges with family members who they still love.  I think of the messages I've passed back and forth between Emerald City residents and family members when direct communication has been far too painful and yet very much wanted and cried for to return.

the sharing of stories of how so many of these fine people wound up there…  Almost all of the stories involve some form of trauma. 

the two patriarchs of the community when I first arrived.  One was a skilled tradesman and the other a pastor.  I had the privilege of sitting with them for hours on end over these past two years until both have moved on to parts unknown.  I miss them.

the two ladies who were murdered on dates[2] and wonder how their lives would have been saved if the medical and legal communities could have removed all of the barriers to health care before these fateful days for each daughter.

that one drug dealer who discretely and routinely tucked money - anything from a couple dollars to 10 or 15 - into my cooler or banana bag as a way of showing appreciation for visiting and contributing to the community.  I recall his tears one day as he told me how much he hates knowing that he is potentially harming people and can't figure out how to stop doing what he does.  He's not been there for a long time.

the men who have confided in me their self-loathing, fears and frustrations as they try to reclaim a better life.

the two women in one day who at separate times and unknown one to the other gazed into the side mirror of my Chevy Uplander.  One was using it to put on her makeup for her afternoon of dates.  The other was using this mirror to pop a couple of pimples.  As each one gazed at themselves, I held my cell phone near enough to them so they could hear this song.  Each had the same exact reaction.  They continued to gaze into the mirror and completely stopped moving as they listened.  Months later, both ladies still live in Emerald City.

the man and woman who have managed to stay together as a couple for these two years.  I met them when I first arrived and have come to know them for the fine people who they are.  They now are in an apartment.  I'll be visiting them soon.

the ways I could have done and said various things differently and better as I have related to these good people.  I reflect on these words and actions and ask our LORD to show me what led to this word or that action and where and how I need to change.

The list goes on and on of all that I think of as the days of Emerald City come to a close. 

The mission will shift from this bridge to other sidewalks and settings.  The mission will continue for me and the many people and organizations who reach out to these residents of the streets of Kensington.           




[1] Two of those overdoses were within a ten minute period and both were saved by the same person!  Two others required CPR.
[2] I met the one only 24 hours before her death.  To the other, I provided water, soap, and towels so she could wash her blackened flip-flopped feet following a night of 'dates.'  As she washed her own feet, with her permission, I read to her the scripture of Jesus washing the feet of his disciples.

Tuesday, January 8, 2019

In the Absence of Dignity and Respect for People on Medicaid and Dealing with Substance Use Disorder, the "Cure" for Dope Sickness is $5.00 and a few blocks away.

For the past couple of years, I have been serving men and women who live on the streets of Kensington and who are dealing with Substance Use Disorder.  I've been in situations where, as I look back on them, I know it has not been me doing these things nor engaging in these conversations.  Our LORD has allowed me the - well, I'm not sure what to call it - to sit on the sidewalk, in jail and in hospitals with people who are looked down on by society out of a total misunderstanding of the disorder they endure.

This past October, I started serving people who deal with this same disorder in a very different format, that as a driver for Recovery Centers of America.  RCA's goal is to serve 1,000,000 people who deal with Substance Use Disorders[1].  They do so in multiple settings that convey dignity and respect.  I would add to that hope, honor, and love.  As a driver, we convey that to the patient by picking them up in a black Lincoln Continental or similar vehicle.  A few who get in may be accustomed to such luxury and not actually notice it.  For others, having the back passenger side door with its tinted windows opened for them, being greeted by comfortable seats and an awaiting snack filled cooler is more decency than they have experienced in a very long time - if ever.

It's this latter group of people I'm focusing on here and now.

From time to time, and more times than one might think, I hop in one of these luxury vehicles and drive to Kensington to bring a person to Devon who, only a few hours earlier, called 1-800-RECOVERY, chatted with a caring person at that number, had their insurance verified and shared the basics of their overall situation.  The ride is scheduled and off I go.  So far, these have not been people I already know.

Since October 1st, I've been in Kensington several times.  On one of those trips, I was stopped at the red light at Lehigh Avenue and Emerald Street.  As I sat in this Lincoln, the seat of which was giving me a back rub(!) I looked toward Emerald City and saw so many people who I've come to know and love.  Two of the men were standing there conversing back and forth as they often do.  The movement of humanity to the right of the street itself mimics that of a busy mall filled with shoppers.  One of the ladies who I've known for two years turned the corner and proceeded into Emerald City.  She was dressed in such a way that I knew she was returning from a 'date' or multiple 'dates’ or an afternoon of not finding anyone to rent her body so as to support her unwanted desperate need for her medicine.

My heart broke for the disparity of it all. 

RCA is doing it right!  From the patient's first contact with RCA, they are experiencing what EVERY human being dealing with Substance Use Disorder should experience, dignity and respect.  Funding from insurance makes this level of physical demonstrations of dignity and respect possible. 

Not long ago, I drove a woman from the Philadelphia suburbs to Bracebridge, RCA's Maryland Facility.  As I drove, she told me about her trips into Kensington to buy her "medicine."  She buys from the same dealers that many who I've written about in these blogs buy from.  She named the same streets that I've come to know.  She knows the harsh reality of the streets and does have private insurance.  She had not seen any pictures of where I was taking her. 

Try to imagine the stunned silence that overcame this person as I pulled up to this estate and opened
her car door so she could enter this front door as a person made in the image of God and no longer bearing the labels put on her by people who know no better.

Click here to Visit the website for Bracebridge.

Many - No, most but not all - of the good people of the streets of Kensington are on their home county's version of Medicaid.  Medicaid funding for Substance Use Disorder is not at a level that makes Lincolns possible.  That does not mean that health care for people with Medicaid and dealing with Substance Use Disorder should be absent of demonstrations of dignity and respect. 

When a person contacts RCA, upon insurance approval, they can be taken to one of several RCA facilities before dope sickness has a chance to firmly set in.  Here's how I described in a recent blog the far too common plight of the person with Medicaid and dealing with Substance Use Disorder.

George knew what he needed to do to enter detox.  For the next few days, as he continued his normal routine of living in a tent and 'flying a sign' at street corners that read "Hungry," George connived to survive and hustled to pull together an extra $60.00 so as to buy extra dope to hide on him during his expected one day wait in the Crisis Center several blocks away.

With enough money in hand, he bought the extra dope, and then walked to the Crisis Center, pushed the button on the brick wall next to the secured ill painted metal door with the wire laced security window located in the middle of its upper half.  After a couple pushes of the button, a security guard opened the door and asked why he was there.  After explanations, the guard told George to come in and strip down in public to one layer of outer clothing, to empty all of his pockets, remove his shoes, allow himself to be frisked and to walk through a metal detector.  With growing fear and trepidation and a fading determination in his heart, George complied.  With socked feet, he walked across the worn and tattered simulated hardwood floors that ran throughout the facility to the awaiting receptionist, was handed a clipboard with papers to be filled out and told to "Sit over there and fill these out."

As George sat down, he glanced around the room of grey chairs each attached to the one next to it.  Three other people were in some stage of being processed.  All were asleep.  One was a woman whose 'one layer of outer clothing' had obviously been her only clothing for quite some time.  A man, asleep and draped across two chairs and covered with a blanket, lay motionless representing the hours of waiting he had endured thus far.  The other waiting room resident and only Caucasian of the three looked suspiciously familiar to George.  As George looked at him, asleep in his chair, he wondered if this was the same man he's seen in a recent "Has anyone seen my son?" flyer posted up and down the main avenue.

One urine sample, one medical exam, one interview and six hours of room observation later, George was starting to experience dope sickness and needed to use the bathroom.  From observing, he knew that anyone who asked to be allowed into the locked bathroom would be checked on after a very short period of time.  George knew that he could not, during that short interval of privacy, prepare and inject the dope that he had smuggled in and stored on him where nothing to be consumed should ever be stored.

With an onset of diarrhea from dope sickness nearly guaranteed any minute, George requested to use the only bathroom.  He entered it and saw one toilet and two urinals against one wall none of which had any hint of current privacy provided except for the small holes in the wall that suggested that privacy enclosures once existed.  All pipes typical of bathroom fixtures were boxed in so as not to be used in combination with one's belt for the purposes of hanging and ending the misery.  But what did that matter?  By requirement, George had surrendered his belt hours ago.

It was more than George could take.  He walked out of the bathroom without feeling better, politely told the nurse that he was leaving, was reintroduced to his belongings, left and found a back alley nearby to use as his bathroom. 

The lack of dignity and respect demonstrated by the current health care system for those people with Medicaid and dealing with Substance Use Disorder is one of the barriers to them getting the care and cure that they need and deserve as equal members of our human race. 

As our sons and daughters with Medicaid sit and wait in the absence of dignity and respect and as their dope sickness settles in, they know that the 'cure,' for as temporary as it may be, is only $5.00 and a few blocks away. 

If the medical administrators within our current system would like to take more seriously their vow to uphold their Hippocratic Oath[2], then surely they can review the process of medical care to those members of our society who are on Medicaid and who suffer from Substance Use Disorder.



[1] Of all kinds…  This blog emphasizes the drug portion of the issue.
[2] Physicians and nurses of the E.R. and Urgent Care, each one of you has, upon your graduation pledged your career to some version of the Hippocratic Oath.  While your version may have been slightly different, the following is, I'm sure, a reasonable representation thereof.  I have made bold and red, the points therein that most apply:


I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.
I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

—Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, and used in many medical schools today.

Friday, January 4, 2019

"Emerald City" as we know it, will be no more effective 10:00 a.m. on January 31, 2019.

"Emerald City" as we know it, will be no more effective 10:00am on January 31, 2019.[1]  Some of its residents will go into shelters provided by Prevention Point and other organizations.  Thanks to Pathways to Housing, some will actually get their own apartment. The residents whose "Entity Named Addict" chooses to remain on the streets will go to similar tent communities.  New tent communities will be and already are starting to pop up elsewhere.  Some of these men and women will take up residence on an open piece of sidewalk without a tent.

Some of these fine people, and here's a big concern, will find an 'abando', that is, an abandoned building, move into it by themselves, continue to take their medicine, overdose and die.  No one will be around to see that this son or daughter, [2], is in danger.  This human being who has been made in the image of God will be gone forever.

Emerald City and its previously populated three other local Conrail overpasses are the creation of a similar eviction from "The Tracks" a couple of years ago.  See this Channel 6, Action News report.  Be sure to watch all of the videos.[3]

Emerald City is a 'grassroots safe injection site.'  It will no longer be a place where one addicted person administers Narcan to another community member when overdose seeks to claim their life.  Unnoticed death by overdose is incredibly rare in this community.  Of the five overdoses that needed Narcan that I've witnessed in Emerald City, all were saved by a resident who provided it (as well as CPR in two of those situations.)

Residents of the area will be pleased that they can safely walk down both sides of the sidewalk.  Incoming developers will be pleased that they can start building their expensive and expansive apartment complexes.  Daughters and sons will scatter to new areas and some will die.  Parents and loved ones will be broken hearted and live the remainder of their days like this:



I'm happy that many of the people who I've come to know and love have already moved on to actual housing or detox and rehab.  Many more remain. 

Hold those thoughts for a moment…

Yesterday, January 1, 2019, as I was standing at the back of my car I heard "Hi Banana Man. How are you?"

Looking across the street, I saw a young lady standing next to her tent at this location under the bridge.  She came over to my car and looked through a few winter coats and other clothes that I had, thanks to Beth, a friend in the Delaware County suburbs.

As Jen was sorting through these items, she was sharing her thoughts about addiction, life in Emerald City and this forthcoming eviction.  This obviously intelligent and well-spoken woman put into words so clearly the situation at hand for the hundred or so people who are currently calling this railroad overpass 'home.'

The more I listened to her convey her very clear message, the more I quietly wondered if she would be willing to publicly share it with you, my blog reader.  I asked her if I could interview her without showing her face and with using a blog name of her choosing.  "The camera could be looking at me as I ask you questions and as you share your thoughts off camera."  Her response surprised me when she said that she would like to be interviewed on camera and using her real name.

Jen excused herself and went to her tent to get dressed up for the occasion.  We walked outside of Emerald City itself to this location on Lehigh Ave.  Our thought was to do one practice interview and then do the real one for sharing.  The practice interview was so honest and natural that it became what we, Jen and I, now present to you.


Jen could easily be your daughter, sister, cousin or aunt.  She's one among a few thousand people within Philadelphia who are addicted and homeless.  Let's do all that we can to address the real issues and stop evicting these good people from their grassroots safe injection (and living) sites. 

Note: I checked in with Jen two days after this interview to be sure she still wanted to be publicly recognized.  I was told that she did.  Thank you, Jen, for sharing your thoughts!  I never post pictures of anyone without their permission which is why there are almost no pictures in my blogs. 





[1] The City of Philadelphia has chosen to evict this community of people.  Attempts are being made to find housing for everyone.
[2] this resident of Philadelphia or any of its surrounding counties
[3] Every person who is interviewed is a person I've come to know and still see on a regular basis.

Saturday, December 29, 2018

What if Emergency Rooms Treated Opioid-Addicted Patients?

Imagine this:

Your adult son/daughter lives in your home and you know they inject heroin on a regular basis.  You're fully aware that each injection could kill them even before they pull the needle out of their arm, leg, neck, face or on rare occasion, butt.[1]  Or perhaps she/he is on the street, homeless and yet, from time to time, reaches out to you by phone when a phone is available.  Something happens within him/her one day and they turn to you for guidance on how to separate themselves from this entity named "Addict.". 

This is your big opportunity to guide your child, your flesh of your flesh, your bone of your bone, your extension of you into a better and healthier life.  He/She has stepped away ever so briefly from the torment of "Addict" and wants a complete separation and divorce from it.

You know from past experience that your local emergency room will not provide any substantial treatment so you turn to Facebook and an online support group.  You pose the following question and receive a dizzying array of answers:[2]

*********************

Mom: My son wants to go away, as soon as possible to a 30-day program. Is there any help for him? Where can I take him?

Comments:
I think 30 days is not enough time but god bless him

Mom: You are right, I just meant not a 5 day, 60-90 day program.

Try and get him to Eagleville.

Call Eagleville or Malvern

The Phoenix Recovery Project

Take him to the Net at 5th and Spring Garden.  They will treat him while they find a bed for him.

Horsham Clinic 

You should try to take him out of your area.

Florida is the best thing I did for myself.

No please don't send him to Florida!!!!! There was just a post about Florida please stop saying Florida its not for everybody and a lot of body brokers out there keeping them high.....

Try Eagleville, keep him close!

I am not sure what body brokers are I just know for me it was the best thing.

Teen Challenge

Teen Challenge is for adults and teens.

Mom: He is an adult.

That is fine it is for adults also. Great program

Mom:  (He has city) and state insurance

Call Teen Challenge (in your city)

Try Eagleville they're a walk in.

So is Horsham Clinic.

See if your ins will pay for the Retreat at Lancaster County

Look at Horsham or Malvern, or Eagleville and while he’s there look for extended care PHPs or IOPs going down in levels of care each step, it’s really up to your son to take advantage wherever he goes, but the more TREATMENT he gets the more of a chance he has.

Teen Challenge seems like they have all those things including detox.

 They don’t I’ve been there.

Pennsylvania Adult & Teen Challenge is a leading drug and alcohol addiction rehabilitation treatment center that provides highly specialized treatment by offering medically-monitored inpatient detoxification, 30-day inpatient clinic…

Kirkbride

Recovery Centers of America in Devon is an incredible place. 1 800 recovery is the phone number.

He can't get medical clearance for treatment so he goes ROUND & ROUND UGH

Mom: Thank you all.  It does go around and around.

Pyramid, white deer run, Eagleville, valley forge, colonial house, fire tree, Malvern, treatment trends

Valley Forge and White Deer Run knew me by my first name

Net 5th n Spring Garden usually places within 48 hrs food, warm n comfort meds

Get him somewhere asap no time to Waste.

Malvern. There’s one in willow grove and one in Malvern

Self Help 215-677-7778

****************

As the clock ticks and you are trying to sort this out so as to try to save your child's life, you're aware that at a minimum, she/he will inject 1 to 4 (or more) bags of heroin approximately every four hours so as not to become dope sick.  From their perspective, even though they truly want to get away from this entity named Addict, they must continue to consume their "medicine" so as to avoid the horrendous symptoms that come with dope sickness.

Depending on where he/she buys these bags, the price per bag will be $5.00 to $10.00 each.  Do the math.  That's $5.00 to $40.00 per injection every four hours around the clock until treatment can begin. 

For your son, that's a lot of panhandling at a local intersection or hauling of scrap metal to the local junkyard or theft or, in rare cases, some aspect of drug distribution itself.   

For your daughter, at $10.00 to $30.00 per "date,"[3] that's a lot of sexual activity the awareness of which breaks your heart and that often brings her to heavy tears as she's trying to apply her makeup while gazing into a random piece of broken mirror or at her reflection in the side window of a parked van.
                        

Wouldn't it be better for everyone involved if your daughter or son could enter any emergency room or urgent care facility and say "I need detox and rehab."  The professionals in these facilities would then have the opportunity to fully live up to their Hippocratic Oath:


I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

—Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, and used in many medical schools today.

What if Emergency Rooms Treated Opioid-Addicted Patients?




[1] Typical when all veins have been used to the point that they don't accept needles without collapsing.
[2] This is an actual discussion with all identifying references removed.
[3] Sometimes more and often less when the 'man' doesn't pay her anything

Thursday, December 27, 2018

The Two Worlds of Addiction Recovery

I'm living in two worlds these days. 

My employment for the past couple of months has been as a driver for Recovery Centers of America (RCA) in Devon Pa.  It is a privilege to be involved in the transportation of people coming to RCA.[1]  These individuals have varying stories as to how addiction entered their lives.   The one thing they all have in common is that they have decided to face their addiction and get on the path toward a healthy life.

People coming to RCA have called 1-800-RECOVERY, had a discussion with a caring person at that number, had their insurance verified and been medically cleared.   Not everyone who does so needs transportation from us.  Some come to RCA thanks to a family member or friend.  For those who do need a ride, we pick them up in one of four vehicles.  It might be one of our two Lincoln Continentals, a Lincoln Navigator or a Ford Explorer.  All are black unmarked vehicles that demonstrate dignity and respect toward the man or woman who is being transported to their five-star experience in detox and rehab.[2] 

These people begin their treatment almost as soon as they arrive at RCA.  This minimizes the discomfort of the withdraw symptoms common to ending their relationship with alcohol or drug usage.

That's one of the worlds in which I live…

Here's my second world as I have described in several recent blogs:

I have described in "I Need My Medicine" the reason people don't just stop using their drugs.

In An Entity Named "Addict", I've provided a description of what addiction does to an addicted person and their family.

In Let's imagine… and Dear Emergency Room and Urgent Care Staff, I've urged professionals on the front line of medicine to take the initiative in not simply encouraging addicted people to seek help but to actively initiate that help for those who want it.

In A Tale of Addiction, One Set of Fraternal Twins And Two Sets of Simulated Hardwood Floors I present a look at two very different paths to treatment for this horrendous disease.  One path is for those with private insurance and one path is for those people who do not have private insurance.

And that is the point of this blog! 

People who have private insurance and people who do not have private insurance are all human beings made in the image of God and worthy of dignity, honor, respect, and love.  All deserve our societal best to walk alongside them as they do the work of putting their addictions behind them. 

People who do what they can for addicted and underinsured folks have told me that "This is just the way it is.  If they want help, they just need to tough it out."  To this, I say that far too many of our nation's sons and daughters and their families are being destroyed and the system must change.  A sense of urgency blanketed in an environment of dignity and respect must be provided to the underinsured.

Trauma-Informed Care

Please take the next couple of minutes to watch this video for a professional's description of one small but essential part of what needs to change within the care system of our nation's underinsured daughters and sons.

Finally, I don't pretend to have all the answers for how to smoothen the path toward addiction recovery for the underinsured.  I just know in my heart that change is needed.  Let's work together and learn from the model presented by RCA to present dignity, honor, respect, and love for all persons suffering from addiction.




[1] We also transport people back to their home and to outside appointments while they are a patient at RCA.
[2] I have transported people from their homes right down the street from RCA, southern New England(!) and within walking distance of Emerald City.

Wednesday, December 26, 2018

The Power of Addiction: Does Anybody Hear?

Please Pray for "Teresa."

************************
Does Anybody Hear Her

She is running
A hundred miles an hour
In the wrong direction
She is trying
But the canyon is ever widening
In the depths of her cold heart
So she sets out on another misadventure just to find
She's another two years older and she's three more steps behind

Does anybody hear her?
Can anybody see?
Or does anybody even know she's going down today?
Under the shadow of our steeple
With all the lost and lonely people
Searching for the hope that's tucked away in you and me
Does anybody hear her?
Can anybody see?

She is yearning
For shelter and affection
That she never found at home
She is searching
For a hero to ride in,
To ride in and save the day
And then walks in her prince charming
And he knows just what to say
A momentary lapse of reason
And she gives herself away

Does anybody hear her?
Can anybody see?
Or does anybody even know she's going down today?
Under the shadow of our steeple
With all the lost and lonely people
Searching for the hope that's tucked away in you and me
Does anybody hear her?
Can anybody see?

If judgment looms under every steeple
If lofty glances from lofty people
Who can't see past her scarlet letter
And we never even met her

If judgment looms under every steeple
If lofty glances from lofty people
Who can't see past her scarlet letter
And we never even met her
Never even met her

Does anybody hear her?
Can anybody see?
Or does anybody even know she's going down today?
Under the shadow of our steeple
With all the lost and lonely people
Searching for the hope that's tucked away in you and me
Does anybody hear her?
Can anybody see?

Does anybody hear her?
Can anybody see?
Or does anybody even know she's going down today?
Under the shadow of our steeple
With all the lost and lonely people
Searching for the hope that's tucked away in you and me
Does anybody hear her?
Can anybody see?

He is running a hundred miles an hour in the wrong direction

Songwriters: Mark Hall
Does Anybody Hear Her lyrics © Sony/ATV Music Publishing LLC, Essential Music Publishing, Capitol Christian Music Group



Thursday, December 6, 2018

Suicide by Deliberate Overdose Averted and Two Tiramisus To Go

One of the privileges of relational ministry is to walk alongside another human being in their darkest times.  I've had such privileges several times since visiting the good people of the streets of Kensington over this past couple of years.  This only happens in depth when trust has been realized and that only comes with time.

One of these experiences happened recently when I was contacted by a resident of the streets who has been doing everything they can possibly think of to find detox and healing.[1] 

I won’t even go into the details of all that this person has tried to do to find healing.  Those details are actually already mentioned in general terms throughout this blog series.

Imagine if you will, being required by your body to inject a drug that you are well aware may kill you before you can even remove the needle from your being.  If you are a lady on the street, imagine knowing that your only source of income to buy that drug that may kill you is to rent out your body to a guy who may be kind to you or who may kill you.  Imagine being called every conceivable harsh term often used to describe a woman who walks the street in this way. 

Are you getting the idea?

I’m not done…

Imagine knowing that your children have been taken away from you permanently, your family has turned their back on you, you have several STDs, blisters, abscesses, and, most recently, a doctor has told you that your organs are failing due to your drug use that you’d like to stop but can’t because you can’t get into a detox unit without jumping through so many hoops that your mind blows just thinking about it.

Multiply all of that by a factor of 10 or more and add on top of that the torment that you feel in your soul because, in reality, you are a very committed Christian who knows that all of this is wrong and you’d like to stop but can’t.

Are you starting to understand?

Now hold those thoughts for a moment…


What is a heroin overdose?

An overdose occurs when a person consumes more heroin in one injection than their body can handle.  That’s really all an overdose is…

Just as you might ‘overdose’ on pizza and end up with indigestion, any drug addicted person could end up with death by injecting to much drug in one dose.  It’s just that simple…

Now let’s combine these two topics…

If my life is a living hell from which I can not find my way out and no one around me seems to know or care what to do then all I need to do is inject more heroin than my body can handle in one injection.  My obvious solution to this misery is literally at my fingertips with far more ease than using a gun or rope or stepping into traffic.  I’ll simply fade away and never know I’ve died.

This is the place in which one of my street friends found themselves a few weeks ago.  Well, actually, my description is a faded shadow of their reality over those days.

I was deeply concerned and sought prayers and professional guidance on what to do.  With the seemingly guaranteed day of earthly departure come and gone, when I received a text the following morning indicating he was still with us, I sighed and cried in relief.  

Permission to photograph
was obtained from
Mr. Croquette Potato Head.
The tiramisus did not
want to be photographed.
Out of respect,
I've used this very similar
photo from the web.
We met for lunch.  Both of us ordered French Onion Soup.  He had a chocolate milkshake and I had the happiest chicken croquettes with mashed potatoes and gravy that I’ve ever seen!

On the way out, there was one more temptation to overcome and fall victim too:

Those gorgeous desserts in the display case right at the cash register!!!

It didn’t take long to identify what we were getting…

“Two tiramisus[2] to go, please.”




[1] To say that the medical system is so outrageously incapable of providing care for those who need it at the volume it is needed these days in this current crisis is one of the understatements of the century. 
[2] an Italian dessert made with layers of sponge cake soaked in espresso coffee, Marsala, mascarpone cheese, and chocolate

Tuesday, December 4, 2018

Dear Emergency Room and Urgent Care Staff,

Dear Emergency Room and Urgent Care Staff,

More than once, I have sat with a man or woman as they have been treated in your facility. On occasion, these good people have been admitted to your hospital for the primary cause of their visit.  Almost always, that cause has as its underlying issue, the addiction for which they suffer and the lifestyle that this addiction brings.  Pneumonia[1], acute diarrhea[2], bruises and breaks, slashes to the face, black eyes and torn ligaments from being hit by cars, motorcycles and abusive 'dates' are a few examples.   Pre-existing conditions made worse by life on the streets include diabetes[3], epilepsy[4], multiple sclerosis[5], arthritis[6] and more. 

For the many who come to you for service and don't need to be admitted for their presenting medical issues, far too often, I've seen you say "Have a good day."   Occasionally, and far less than most of the time, I've seen you hand them a sheet of paper with names and phone numbers "of places that might be able to help you (tomorrow or on Monday when they reopen) with your addiction."

As they leave patched up but still emotionally/spiritually bleeding to death from their addiction of which you were fully aware and did not apply your medical training, you are setting them up for additional crisis of which you may not be aware.

When you say "Have a good day." to that man you've treated, he leaves to continue his day, not feeling well from whatever brought him to you but on the mend thanks to whatever treatment you've provided.  He will go to his local street corner to 'fly a sign' that says "Hungry".  His increasingly emaciated appearance will actually help prove his case to folks who get stuck at his red light and are forced to consider this man for a minute.  Some may actually give him some change or random food item that they happen to have.  Others may yell or spit at him.  Some who know they won't get stuck at that light will throw things at him as they pass by.

When you say "Have a good day." to that woman you've treated, she leaves to continue her day, not feeling well from whatever brought her to you but on the mend thanks to whatever treatment you've provided. 

She will go to her local street corner to stand there well dressed seemingly waiting for a specific person to pick her up for a meeting when in fact she's standing there well dressed waiting for that random male to pick her up to use her for his own purposes.

Her increasingly emaciated appearance will actually hinder her ability to find a "safe date."  Through her own experiences and those of other ladies on the street, she will begin to realize that her natural physical beauty has faded to the point where "the only dates I can get are with guys who want to hurt ugly girls like me."

Some guy will stop to scan her and decide "She'll do."[7]  With fear, she gets into his broken down car or classy high end vehicle and they drive away. 

Half a day after being in your health care facility and four hours after hearing in a phone conversation the above bold red highlighted quote, the author thereof was assaulted by such a guy and would have been raped if she had not "kicked the shit out of him to get away from that car parked in a back alley many blocks away."  She continued:  "I walked those many blocks back to the bridge and he followed me in his car most of the way shouting horrible things at me the entire time."

Realizing that finding safe dates due to her declined physical beauty, women of the street may be tempted to turn to a pimp[8] who will arrange for dates to come to her.  Such is the case with one woman who has shared these thoughts with me.  Again, to drive home my point with you, this woman was in your health care facility not long before starting to consider this option.

Physicians and nurses of the E.R. and Urgent Care, each one of you have, upon your graduation pledged your career to some version of the Hippocratic Oath.  While your version may have been slightly different, the following is, I'm sure, a reasonable representation thereof.  I have made bold and red, the points therein that most apply to this open letter to you:


I swear to fulfill, to the best of my ability and judgment, this covenant:
I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.
I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.
I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.
I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to cure.
I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.
—Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, and used in many medical schools today.

Finally E.R. and Urgent Care Staff:  The next time any man or woman comes to your facility, please inquire into what your organization can do in the here and now for them to combat their addiction.

Sincerely,
Chris 






[1] an inflammation of one or both lungs, usually caused by infection from a bacterium or virus or, less commonly, by a chemical or physical irritant
[2] frequent and excessive discharging of the bowels producing thin watery feces, usually as a symptom of gastrointestinal upset or infection
[3] a disease in which the body’s ability to produce or respond to the hormone insulin is impaired, resulting in abnormal metabolism of carbohydrates and elevated levels of glucose in the blood and urine.
[4] a medical disorder involving episodes of irregular electrical discharge in the brain and characterized by the periodic sudden loss or impairment of consciousness, often accompanied by convulsions
[5] a serious progressive disease of the central nervous system, occurring mainly in young adults and thought to be caused by a malfunction of the immune system. It leads to the loss of myelin in the brain or spinal cord and causes muscle weakness, poor eyesight, slow speech, and some inability to move.
[6] a medical condition affecting a joint or joints, causing pain, swelling, and stiffness
[7] This is, of course, after multiple guys have stopped to scan her and then tell her to her face that she's far too ugly for "this line of service." 
[8] somebody, usually a man, who finds customers for a prostitute in return for a portion of the prostitute's earnings