Over my shoulder, as I was heading back to my car, I heard a soft-spoken
whimper...
"Banana Man?"
Turning around, I wondered who had just called out in this quiet tear
toned soft voice of despair. I saw a human-shaped form under a black quilt,
walked over to it and saw some long hair and enough of an eye to realize this
was one of the ladies of the community. She spread the opening of the
quilt just enough for me to see her eyes and her eyes only.
"'Rose'
is that you?"
She spread the opening of that old black quilt a bit more and there she
was. With tears running down her cheeks just as they had upon our first conversation,
she shared with me her agony of despising her current life situation, wanting
life to be better and asking me to take her to detox NOW.
As she began to cry harder than perhaps I’ve ever seen her do so, she
leaned into me for a hug. It had been about 6 weeks since we’d seen each
other. During that time, we had one brief Facebook chat.
As she began to sink into my chest, I showed her that I was still
wearing the bracelet that she had slipped onto my wrist when she asked me to
love her as a daughter. She cried harder. We held each other, there on
that sidewalk as would any father and daughter[1]
upon rediscovering each other in a daughter's agony. Tears
flowed from both of us.
After a few phone calls to develop a plan, we went to Gaudenzia for
Detox. It was determined that there might be something medical going on
in addition to the obvious SUD[2]
related issues. We went to the hospital that they recommended for
evaluation in the ER. It was midnight
before Rose was being taken to her room for admission to receive antibiotics
for an infection, the specifics of which were still to be determined.
From our arrival at Gaudenzia to the moment of being lifted to her
admission bed, Rose endured with grace and determination to see it through, her
personal version of increasing dope sickness as the hours ticked by.
Shivers and nausea were followed by sweats and vomiting. Determination to see her mission through to health
and healing grew within her as did the pile of soiled linen in the corner
hamper.
For the next 36 hours, four of which I sat with her on Monday, she
twitched and turned in the increasing discomfort of being treated for her
infection and barely at all for her detox.
36 hours after being admitted, 40 hours after determining to be done with
addiction, Rose signed out AMA[3]
in obvious physical and spiritual agony, yelling at heroin - telling it to stay
away from her and craving it at the same time.
Rose is back on the street fully absorbed in addiction and free of her
infection.
Rose is a patient of SUD. Her
SUD was all but ignored and her infection, a condition brought on by her SUD
and its associated state of homelessness was treated. By treating the
infection and not the SUD, the doctors and nurses of the hospital who are representatives of the Hippocratic Oath did one thing. They helped Rose regain
the strength that was being absorbed by infection and in so doing made her
stronger for her to continue her life in addiction and homelessness.
SUD and the infection are both disease processes that should have been
treated in totality and simultaneously. By treating a secondary symptom
of SUD - the infection - the Doctors within this hospital did not promptly
address the main cause of the infection - SUD itself.
Damaged Determination
[1]
Reminder: This is an honorary relationship.
[2] Substance
Use Disorder
[3]
Against Medical Advice
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