Yesterday was quite a day.

Having discovered the night before that two of the ladies[1], I've come to know from Emerald City were back in jail at Riverside Correctional Facility (RCF), I decided to visit.  Both of these ladies are people I visited last summer in the same place.  Both told me at that time with total honesty and intellectual belief that they were done with their street lives and were ready to move on in healthy ways.  One of them went back to the streets right away[2] and one maintained a drug-free life for several months of living in a recovery community before being called back by her Entity Named "Addict"[3] who had been lying dormant during those drug-free months.

I sat with each lady yesterday, one at a time and listened as they shared their stories of why they were arrested this time.[4]  Each one shared with me the same outcome.  They will not be leaving RCF until a recovery program has been found for them.  They will not be released into the night to fend for themselves as has been the pathetic and irresponsible way of RCF doing things in the past.  The judge for one of these ladies told her in her recent hearing that he did not want to release her to the night only to hear that she had overdosed after release.  He wants to do everything he can from his legal position to save her life.  This young lady really appreciates that judge's kindness and caring of her as a human being even though it means staying in RCF longer than she may do otherwise.

Both of these ladies have asked me to send them specific books which I can do as long as they are purchased through and sent directly to them by Amazon.  If you would like to sponsor these books for these ladies, please contact me for details.

Before these two visits were over, one other lady from Emerald City came into the visitation room for an appointment with her public defender.  I had a chance to chat with her briefly as well. 

All three of these women, these daughters and for two of them, these moms, are in prison for issues that have all of their roots planted in the fertile soil of Substance Use Disorder.  They know that by being in jail, they are safe from the streets, from "Addicts" decisions for them, warm and have a place to sleep.  All three rely on Medicaid for their health care expenses.

Yesterday was quite a day. 

I arrived at work for my 3-11 shift at Recovery Centers of America (RCA) where I serve as a driver.  There were two admissions scheduled for my shift.  Before I clocked out at 11:30pm, I had brought in four new admissions.  Each one of them had been living with their personal form of Substance Use Disorder for years.  Each one of them was under the influence of their substance of choice when I picked them up in RCA's brand new fully loaded Ford Explorer.  Each one, to varying degrees, shared with me their stories of how they started using these various substances.  As with the ladies from Emerald City, each one had experienced some substance-free time in their lives before their Entity Named "Addict" came calling.

All Seven of these people have families who love them in their role as son or daughter and/or Mom or Dad. 

All four of these people, upon arrival at RCA, realized, if they didn't already, that would be safe from "Addict's" decisions and warm and have a five-star place to sleep.  These four rely on private insurance for their health care expenses.

RCA's mission is to treat 1,000,000 people for their individual Substance Use Disorders.  They do so in an environment and setting that demonstrates dignity and respect.  As I've come to know RCA better over these months, I've come to know a place that is overflowing with compassion for and dedication to the people they serve. 

RCA is providing a level of health care that all people should receive.  They do so in a setting that shows "patients" that they are worthy of dignity and respect.  From the building with its well-decorated halls with inspiring quotes and spacious rooms plus the food that is prepared by the chefs on staff[5], the men and women who come to RCA realize or are reminded that they are worthy of a better life than what they may have been experiencing for years. 

Meanwhile, the men and women of the streets of Kensington, most of whom rely on Medicaid and who are equally worthy of dignity and respect, are rarely, if ever shown this dignity and respect by their health care providers.

RCA is doing nothing wrong by providing excellent care in an inspiring setting to patients with private insurance.  Excellent care, care that inspires the patient dealing with Substance Use Disorder should be "over the top" for lack of a better phrase, for them to realize that they are worthy. 

This level of care does cost more than what Medicaid reimbursement provides.  That does not mean that places that serve more Medicaid patients than private insurance patients should get away with housing their health care in environments that are only a tiny bit better than the street life from which many of their patients reside. 

As a reminder, in "A Tale of Addiction, One Set of Fraternal Twins And Two Sets of Simulated Hardwood Floors" I wrote a story, based on actual experiences, that compares and contrasts these two styles of health care provision for people dealing with Substance Use Disorder.  If you have a moment, I encourage you to read that story so as to fully understand my closing thoughts….

Closing Thoughts

Regardless of one's level or quality of medical insurance, all people are worthy of the highest dignity, honor, respect, and love.  I hope and pray that, from whatever seat you sit as you read this, you will find a way to level the playing field so that all people can receive honorable health care for their Substance Use Disorder in the days and years to come.

PS: For every seven seconds[6] that you spent reading this blog, a set of loved ones across the USA - Moms and Dads and immediate families and close friends - lost their significant other to overdose.  These seven seconds do not take into consideration the women murdered on "dates" nor any of the deaths that occur secondary to Substance Use Disorder.

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[1] both of whom have family in Delaware County and both I have written about previously under their blog names

[2] She maintained a heroin-free life.  She told me this with pride and a smile each time I saw her.

[3] This blog is more parable than scientific or medical fact.

[4] Neither had been picked up by police for what you might expect: "Dating"  Both were brought in for situations far less serious than that.

[5] With the exception of that eggplant dinner a couple weeks ago…  I could have lived without that… J

[6] Based on 2017 statistics (the most recent numbers currently available)

My Heart Hurts Today…

Since December 31, 2016, I've been sharing the true stories of men and women on the streets of Kensington as they deal with addiction, more properly known these days as Substance Use Disorder.  All of these stories have been disguised in one way or another so as to preserve anonymity.

For the past two years and two months, I've visited these people on the streets.  I've sat and stood with them in the heat of summer and the cold of winter.  I've laughed and cried with them.  I've heard stories of inconceivable heartbreak and unspeakable joy. 

I've also royally screwed up a time or two and asked for forgiveness.

During all of these experiences on the streets, I've never felt threatened or in danger in any way. 

I've come to know as human beings, the men and women of the streets of Kensington who, in some cases, at one time called the streets of Aston and Glen Mills Pa.[1] "home." 

I've sought to be a listening ear to these people as they have shared their sufferings of abuse and all sorts of physical and emotional traumas that led them into their current circumstances.

This has been, by far, the most magnificent opportunity to come alongside suffering souls that I could ever hope to find half an hour away from my suburban residence.

Over these past 26 months, I've written 181 blogs (prior to this entry) that have shared my experiences with you. 

Over these past 26 months, I've received donations of clothes, water and various forms of care packages.  I am so very thankful for these donations.

Over these past 26 months, I've received financial donations from people who wanted to financially support this ministry effort.  One of those donations in 26 months has been through a church offering after I spoke there.  One other donation came from a local pastor.  My largest donor has been a man who claims no interest in matters of Christian Faith but supported what I was seeking to do.  And, in full disclosure, one of my donors, a very few dollars at a time, was a drug dealer who hated doing what he was doing and prayed through the depths of his Roman Catholic roots that someday he could stop.  I've not seen him in over a year.  I am very thankful for these donations!

Here's why my heart hurts so much today…

Over these past 26 months, I have invited many people to join me on these visits.  Some of these invitations have been announcements on Facebook.  Others have been specific, one on one.  Not one person from my home area has joined me in a spirit of ministry outreach on these visits…  Not One.

My heart hurts today!

Eight days from today, Emerald City will be no more.  The City of Brotherly Love has evicted this community[2] so as to make room for townhouse/condominium communities already under construction up the street.  These men and women of the streets whose Entity Named "Addict" will not allow them to seek treatment nor housing, will scatter and run the much higher risk of death by isolated overdose. 

These good people, these literal former neighbors of your Delaware County Church will scatter and some already have.  This ministry effort will continue in some new way.  

I hope and pray that you will choose to join me.[3] 

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[1] My home area

[2] They must remove themselves by 10:00am on Thursday, 1/31/19.

[3] For further reading about how my heart hurts today, I invite you to read my recent blog titled: The Urban "Samaritan" - A Message to the Suburban Church

Lady In A Box - Part Two

On March 21, 2018, I wrote this blog of several short stories.  One of those stories was titled, "Lady in a Box"  This story happened as a major winter storm was almost at our doorstep.  Here it is copied into this blog for you…

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Lady in a Box

With this nor'easter bearing down on us bringing 8 to 12 inches of snow in the next couple of days, I wanted to try to visit as many people who I know as I could.  With a bitterly cold light wind blowing through the Frankford Avenue underpass, I was distributing water and no bananas.  At one point, I was talking to a group of five men and women.  I glanced over to a large cardboard box with something of a window in it.  Two eyes looking alive but lifeless were looking out.  I went over to see if they were ok and if they wanted water.  They hardly reacted.  I said it again and the person seemed to become aware of my presence right outside the window.  She said that she was very cold and did not have a blanket or good enough coat for the upcoming storm.  Fortunately, I had a coat with me but not a really good one for the temperatures.  

As I was walking back to this woman's box home that already had a dusty layer of snow on the cardboard roof, I saw a brand new quilt still in its store plastic zipper bag.  I was about to grab it when I decided that might not be such a good idea.  One person suggested that the "owner" of that spot on the sidewalk might get angry.

I sought a second opinion from Casey who happened to be there having walked from the other community where the [other] stories [in this blog entry] transpired.  She agreed that I should not take it from that pile.  "But I can." She said of herself.  She got it from the abandoned pile of other items and handed it to me.  I slipped this quilt through the window to the lady in the box.  Her eyes sparkled for just a brief moment as she saw what was coming her way.  She thanked me and then asked, "Do you have any bananas?" 

My reputation as "Banana Man" follows me everywhere I go in these bridge communities. 

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The lady in the box survived that storm, the remainder of winter, spring, summer and most of the fall until one day in the middle of October 2018, that changed her life forever. 

Jolene, for a long time, has dealt with addiction and homelessness.  If that's not enough to have on anyone's plate of burdens, she also has a large portion of Multiple Sclerosis (MS).[1]  While it did not happen a lot, Jolene could occasionally be seen rolling around in a wheelchair in Emerald City and the Frankford Avenue Bridge Communities and in busy intersections holding a cardboard sign, in search of funds from drivers to support her medicinal needs and life on the streets.

All that changed in an instant on that October day when Jolene was standing in traffic at the corner of Kensington and Lehigh Avenues when a car hit her.[2]  The resulting injuries put her in the hospital and in a coma for the next two months.  Her body detoxed while she lay there unconscious and with loved ones wondering if she would survive.

Jolene came out of her coma and began a healing process that has involved multiple forms of therapy. 

With the help of Prevention Point and  Pathways to Housing, Jolene recently moved into her own apartment, continues her therapies and has an amazing outlook on her newly reclaimed life.  I recently had the privilege of sitting down with Jolene in her living room where we drank coffee that she prepared in her kitchen as she shared with me the events of these past few months and her goals for her bright and beautiful future.

In Jolene's own words, "Who would have ever thought that getting hit by a car and being in a coma would have been the best thing to ever happen to me!?" 

Jolene has her own blog series that you can read by clicking here. 

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[1] 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.

[2] Having no recall of the event, Jolene thinks this is where it happened.

The Urban "Samaritan" - A Message to the Suburban Church

On December 31, 2016, I experienced my first "Homeless Ministry" with Urban Hope Church.  You can read about it in my first blog on this subject by clicking here.  Since that first experience, I have gone from involvement in this ministry to a combination of outreach with Urban Hope and visiting on my own and then to visiting just on my own.  Well, this past Friday, I went back to my roots in this and visited Emerald City with Urban Hope and those people from this Christian community who chose to join us.

For the first part of this specific blog entry, I'm going to share with you a description of the people who joined us from Urban Hope. 

My primary audience for this specific blog entry is suburban Christians.  I'm going to "speak suburban" so that you will understand the point I'm trying to make.  In so doing, my Urban Friends who I've come to know and love are going to think I'm exposing some degree of prejudice that you didn't think I have.  Well, I don't hold these prejudicial ways of speaking.  Please know this.  Sadly, there are too many suburban people who think in these terms that I now present…  Suburban Friends, if I'm upsetting you by this, so be it.

With those thoughts in mind, here I go… 

1. This past Friday, a group of probably 30 Puerto-Rican teenagers and a few African American teenagers who are in the youth ministry of Urban Hope Church along with their accompanying adults of the same heritages along with two other women, one other man and myself[1] prepared hot dinners for the addicted and homeless people of Emerald City.
2. While I've not done an official racial nor gender census, the men of Emerald City are more black than white and more white than Hispanic.  The women are, by far, more white than Hispanic and almost absent of black.  Women outnumber men. 
3. While not a racial aspect of this picture that I'm trying to paint in your mind's eye, here's another point to consider:  Most of the people of Emerald City are from the suburbs around Philadelphia or points far beyond our specific area. 

Please pause and re-read those three statements so as to develop in your mind an image of what's happening here.

Here's a summary of what I witnessed on Friday night:  Based on raw numbers as described above, 

1. I witnessed a bunch of inner city mostly Puerto-Rican teenagers serving dinner to, talking to, and praying with a bunch of mostly suburban white women who, in some cases, were old enough to be their Moms. 
2. I witnessed this total group of teens of Puerto-Rican and African American descents interacting in the Name of Jesus with all of the residents of Emerald City without consideration of that resident's heritage nor their condition of addiction. 
3. I witnessed amazing adult leadership, on this night all of Puerto-Rican descent, from within Urban Hope to guide these young people, these 7th to 12th graders, in this time of ministry.

Here's a tiny glimpse into what these Puerto-Rican and African American teens experienced when they ministered in the Name of Jesus to the residents of Emerald City:

1. When they first got out of Urban Hope's van, the first teens to exit would have heard "Kids on the block." announced by the first Emerald City resident to see these teens.  This announcement is automatically passed down the 150 feet or so that make up the community under this Conrail overpass.  Whenever this announcement is made, all drug activity stops and items related to drug use are quickly tucked away, out of sight of the visiting teens. 
2. Upon receipt of the dinners, conversations, and prayers, these men and women who have the disease of Substance Abuse Disorder, clearly demonstrated their appreciation in the same ways that any other human being would do so. 
3. In one case of appreciation, a big brawny black man with long flowing dreadlocks came up to me and said "Hey Banana Man, your ears are red from the cold.  Here's a hat for you."  He gave me a knit hat and then started giving members of our team hats and scarves from his own supply! 

Suburban Christians, why do I tell you this?

For two weeks prior to me going on this time of ministry with Urban Hope, I announced by way of Facebook and directly to other people - one being a pastor of a suburban Church - that you were welcome and encouraged to join me.  No one so much as truly acknowledged the invitation and yet, at the same time, other Facebook entries were reacted to by you with "likes"  and reasonable comments.

Our Suburban Christian Faith is to be more than high society tea parties in church halls that have been named after dead priests and fundraising events designed for other people and organizations to do the work of the Church.  Our Faith calls us to serve through God's Church with direct involvement with those people who need our Christ-Centered Love most of all.

To drive the point home just a little bit farther... For every seven seconds that you have spent reading this blog, a set of loved ones (parents, extended family and friends) have lost someone precious to overdose.

In the following passage of the Parable of the Good Samaritan, we suburbanites know the dignity and respect shown to members of the clergy (Priests and Levites in this parable.) 

We may be aware that in Biblical times, the Samaritans were thought of as being the lowest of the low.  Us suburbanites also know the often unspoken (so as not to be outwardly rude) belief that Puerto-Ricans and African Americans are somehow 'less' than us whites. 

As is made so clear in this parable and in my experience of this past Friday Night and countless other times, what we, the suburban portion of the body of Christ consider to be 'less than' is, by far, the greatest in its expressions of our Common Christian Faith. 

Luke 10:25-37 New International Version (NIV)

The Parable of the Good Samaritan

²⁵ On one occasion an expert in the law stood up to test Jesus. “Teacher,” he asked, “what must I do to inherit eternal life?”

²⁶ “What is written in the Law?” he replied. “How do you read it?”

²⁷ He answered, “‘Love the Lord your God with all your heart and with all your soul and with all your strength and with all your mind’^[a]; and, ‘Love your neighbor as yourself.’^[b]”

²⁸ “You have answered correctly,” Jesus replied. “Do this and you will live.”

²⁹ But he wanted to justify himself, so he asked Jesus, “And who is my neighbor?”

³⁰ In reply Jesus said: “A man was going down from Jerusalem to Jericho when he was attacked by robbers. They stripped him of his clothes, beat him and went away, leaving him half dead. ³¹ A priest happened to be going down the same road, and when he saw the man, he passed by on the other side. ³² So too, a Levite, when he came to the place and saw him, passed by on the other side. ³³ But a Samaritan, as he traveled, came where the man was; and when he saw him, he took pity on him. ³⁴ He went to him and bandaged his wounds, pouring on oil and wine. Then he put the man on his own donkey, brought him to an inn and took care of him. ³⁵ The next day he took out two denarii^[c] and gave them to the innkeeper. ‘Look after him,’ he said, ‘and when I return, I will reimburse you for any extra expense you may have.’

³⁶ “Which of these three do you think was a neighbor to the man who fell into the hands of robbers?”

³⁷ The expert in the law replied, “The one who had mercy on him.”

Jesus told him, “Go and do likewise.”

Footnotes:

a.     Luke 10:27 Deut. 6:5

b.     Luke 10:27 Lev. 19:18

c.      Luke 10:35 A denarius was the usual daily wage of a day laborer (see Matt. 20:2).

New International Version (NIV)

Holy Bible, New International Version®, NIV® Copyright ©1973, 1978, 1984, 2011 by Biblica, Inc.® Used by permission. All rights reserved worldwide.

                

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[1] By not referencing a heritage, it is understood in suburban talk that "white" is meant.

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.           

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[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.

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.

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[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:

Hippocratic Oath: Modern Version

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.

"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:

Moving these people without having a clear plan for all of them, a plan that includes dignity and respect for who they are as humans, is risky and does not solve the main issue of providing medical care to individuals who have a disorder recognized by the DSM-5.

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. 

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[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.