Before the Demon Came Calling… A Redue of the Original Story

 **********

Over the past eight years of writing, certain blog posts have etched themselves into my memory. They are the ones that resonated most deeply, the ones that gripped me with raw emotion and offered profound insights. I'm revisiting these impactful stories, using the capabilities of AI to ensure their essence shines even brighter. In this journey of rediscovery, I've stumbled upon something truly remarkable – a way to amplify the heart of each message.

What follows is an invitation to experience this blog in a unique way. Before you delve into the blog post itself, please listen to a brief yet powerful conversation. Imagine two computer-generated voices, imbued with unexpected wisdom and perspective, discussing the very story you are about to read. Take just twelve minutes to absorb their insights. Then, open your heart to the blog that unfolds below. Let the emotions it evokes guide you and consider the profound ways you might extend a hand to the extraordinary individuals living on the streets of Kensington.

Here is the "Deep Dive" discussion about this blog.

**********

Please know that while I am not Melanie’s actual father, I felt compelled to write this from a father’s heart.

Word had reached me that my daughter was living under the harsh glare of the overpasses in Kensington. Addiction, a relentless tide, had pulled her away years ago. Yet, in my heart, she remains the apple of my eye, the undiminished love of my life. I had already visited those bridges a few times, each trip a desperate prayer whispered into the urban grit, hoping to find her. Tonight, my prayer was answered.

I found her set apart, struggling to keep her balance. She was within sight of the makeshift community huddled under the bridge, yet isolated enough that a passing car could easily stop, and a predator could snatch her away into the night. My heart clenched. I walked towards her.

“Hi, Melanie.”

She turned, a slow, almost liquid movement, and leaned into me with a weary sigh. Her smile was soft, bewildered, tinged with embarrassment. “Hi, Dad,” she mumbled. “Why are you here?”

My answer was simple, raw: “You’re my daughter, and I love you.”

For the next hour, I stayed rooted beside Melanie as she cycled through moments of fragile uprightness to slow descents, until her head rested on the urine-stained sidewalk. The air hung heavy with the scent of despair, a stark contrast to the community of tents and broken souls across the road. A rhythm played out in her struggle: moments of hazy alertness where she’d look at me, smile through a runny nose and the trail of drool escaping her lips. “You’re still here?” she’d ask, each time a gentle surprise.

And each time, my reply was the same unwavering truth: “Of course I am. You’re my daughter, and I love you.”

In one of those fleeting moments of clarity, a memory surfaced. I told Melanie how I wished we could go to McDonald’s, like we did when she was small. A flicker of childlike longing sparked in her eyes, even through the haze. “Can I get a chocolate milkshake?” she asked, the words slurred by the drugs, yet the desire clear.

“Of course, you can,” I promised, the familiar comfort of her childhood favorite a small offering against the vastness of her pain.

For another hour, my precious girl existed in a fragile balance, a human ‘weeble wobble’ threatening to fall but somehow staying upright.

Then, without warning, the cycle broke. Melanie stood, straightened her shoulders, looked directly at me, and repeated, clearer this time, “Dad? You’re still here?”

“Of course, I am, Melanie. You’re my daughter, and I love you.”

A simple question, a lifetime of love echoing in the answer.

“Can we go to McDonald’s?”

“Yes,” I said, my heart lifting with a fragile hope. “Let’s go.”

“I have to change my shirt first.”

“That’s fine, Princess. I’ll wait.” The endearment slipped out, a whisper of the past.

Twenty minutes drifted by, then my princess reappeared. She had washed her face, and changed into a long, flowing summer dress, bright pastels against the grimy backdrop. Her makeup, surprisingly, was perfect. As she walked towards me, a wave of memories crashed over me – birthday parties, school plays, laughter echoing in sunlit rooms. How could such a beautiful woman, my beautiful woman, call this desolate underpass ‘home’?

Dinner, via the McDonald's drive-through, was exquisite. We parked along Lehigh Avenue, seeking a semblance of privacy for our broken reunion. We ordered the same things: breakfast food and chocolate shakes, a bittersweet echo of happier days, before the demon had darkened our door.

As we drove, Melanie asked me to pull over onto a quiet side street. She opened the door, a tremor of fear in her eyes as she begged, “Don’t leave,” then quickly explained she needed to “date” to get money for her “medicine.” My heart fractured. It was in that moment, amidst the shattering reality, that something shifted. It felt like God, or some higher power, stepped into the car, filling the suffocating space with a quiet, undeniable command.

“BE CALM. I GOT THIS. ALL WILL BE WELL. I WANT YOU TO SEE WHAT MY LADY CHILDREN ON THE STREET ENCOUNTER EVERY DAY AND EVERY NIGHT. ALL WILL BE WELL. JUST OBSERVE. YOU WILL KNOW WHAT TO DO NEXT.”

For the next half hour, my daughter, my love, paced the intersection a hundred feet behind my parked car. In the rearview mirror, I watched as she watched for cars slowing, assessing. Her pastel dress, a beacon of lost innocence, stood out starkly against the encroaching night.

Three times, cars pulled over across the street. Each time, my precious daughter walked cautiously to the passenger window, engaging in a silent transaction of desperation. The third car parked directly opposite mine. I watched her face as she approached, then the subtle slump of her shoulders as she realized this offer, too, was not for her. With each rejection, the fragile joy of our McDonald’s dinner seemed to leach from her, replaced by a hollow despair.

I couldn't bear it any longer. The thought of witnessing my own child, my Melanie, debasing herself for survival, broke something within me. As the third car sped away, my angel looked utterly broken. I couldn't just watch. I motioned for her to come back. She slipped back into the car.

“How much money do you need for your medicine to get you through the night?” I asked, my voice thick with unshed tears.

She paused, a flicker of thought crossing her weary face, and answered without a trace of pride, “Forty dollars would keep me reasonably comfortable for the next eight hours.”

Perhaps I'm wrong, but in that moment, I knew what a Dad would do.

I gave her the money and drove to a place she directed. She disappeared around a corner, her pastel dress swallowed by the shadows, and returned within minutes, her “medicine” in hand. Then, in the dim light of the car, she prepared her first dose. Five times she plunged the used needle into the arm I had once held as a baby, before finally finding a vein that would accept the injection.

As the drug took hold, Melanie visibly softened, her body relaxing, her spirit quieting. She settled, as she had countless times in childhood, her head finding its familiar place on my lap, the weight of her trust a heavy ache in my chest. The demon’s shadow receded, for a moment.

My heart yearned for the uncomplicated peace of those bygone days. But for tonight, it was enough to know that this daughter of mine, this exquisite, broken soul, was here with me, content in this fragile closeness.

In those childhood mornings, I would often brush her hair as cartoons flickered across the television screen. Now, looking down at my beautiful, wounded gift from God, I saw the tangled knots in her curls, a physical manifestation of the chaos in her life. Reaching into a travel kit, I found a hairbrush. For the next hour, Melanie lay in a semi-conscious state, yet fully aware of the gentle strokes of the brush through her hair. Addiction, homelessness, streetwalking, the very demon itself – they all seemed to loosen their grip, to grant us a temporary truce in the darkness.

But even the best of nights must eventually end.

I drove God’s gift back to the harsh reality of the overpass, back to where our fragile evening had begun. Respecting the woman she was, despite the child I still saw, we said goodnight. A hug, a kiss… and then, almost instinctively, that silly little nose rub we had shared in happier times, before the demon came calling.

---

To the reader: This is just one story, one night under the bridge. But it is a reality faced by countless fathers, mothers, and daughters in communities everywhere. If you feel moved by Melanie's story, please consider getting involved. Reach out to local organizations that support individuals struggling with addiction and homelessness. Your time, your resources, your compassion – any of these can make a difference in rewriting stories like Melanie's, offering hope where despair has taken root.

**********

Blog Analysis Addendum: Before the Demon Came Calling

Original Blog Title: Before the Demon Came Calling… A Redue of the Original Story

I. The Human Narrative: The Father’s Choice

This narrative moves from a tender "chocolate milkshake" reunion to a "fractured heart" reality. You witnessed Melanie—in a pastel summer dress that whispered of her lost innocence—preparing to "date" just to fund her next eight hours of biological stability. The "Humble Witness" moment here is the father’s desperation: he provides the forty dollars himself, choosing to fund the addiction rather than watch his "Princess" be violated by strangers in the shadows. He then performs the ultimate act of parental care—brushing the "tangled knots" of her hair while she is in a semi-conscious state, a temporary truce with the demon.

"Five times she plunged the used needle into the arm I had once held as a baby, before finally finding a vein that would accept the injection."

II. The "Lynne’s Laws" Article and Section Review

This story identifies the profound need for Article 4, focusing on the preservation of the family bond during a medical crisis.

Article 1, Section 1: The Medical Necessity and Parity Mandate. Melanie’s "liquid movement" and "slurred words" are clinical markers of a severe neurological hijacking. This mandate ensures that when a father finds his daughter in this state, he has a legal right to demand an emergency medical intervention, not just a McDonald's dinner.

Article 2, Section 3: The Predatory Environment Emergency Provision. The "cautious walk to the passenger window" of three different cars is the definition of an exploitative environment. Under this section, Melanie would be granted Emergency Priority Status the moment her "Safety" was identified as being at risk.

Article 4, Section 1: The Family Intervention and Support Act (New).

• The Law: Recognizes that "Addiction is a Family Disease." It mandates that the state provide immediate "Crisis Navigation" for parents who find their children on the street. It forbids the system from "locking out" parents from their child’s medical information or treatment path when that child is in a state of diminished capacity.

• The Application: This would have given the "Dad" in this story a direct line to a 24/7 medical transport and stabilization unit, rather than leaving him to brush her hair under a bridge.

III. The Professional Tension and Consensus

• The Supportive View: Family therapists and emergency physicians argue that the current system "orphans" the addicted person, cutting them off from the very people who love them most. They support Article 4 because a father’s love is a powerful clinical asset that the current HIPAA and Medicaid "privacy walls" often destroy.

• The Skeptical View: Civil libertarians worry about "Involuntary Commitment." They argue that even a "Princess" in a pastel dress has the right to refuse care, and that giving parents too much power could lead to abuse.

• The Lynne’s Law Resolution: This is a Capacity Issue. If a patient is "semi-conscious" and "mumbling," they lack the clinical capacity to make life-saving decisions. Lynne’s Laws empower the family to act as "Temporary Medical Guardians" until the "Cellular Protest" is stabilized.

IV. Legislative "Teeth": The "Duty to Respond to Kin" Standard

• The Objective Standard: If a family member locates a loved one in a high-risk environment (under a bridge/streetwalking) and requests a "Lynne’s Law Intervention," the state must respond within two hours.

• Strict Liability: If a parent calls for help and the system fails to arrive, and that child subsequently "comes up missing" or overdoses, the state is held Strictly Liable for the failure to honor the family’s plea for intervention.

V. The Prevention Savings

By empowering the father through the Family Intervention Act, the state saves on:

• Long-term Foster Care/Social Services: Keeping the family bond intact reduces the total breakdown of the community.

• Emergency Search and Rescue: Stopping the "Missing Persons" cycle before the daughter disappears into a predator’s car.

VI. The Corrected Path

Under Lynne’s Laws, when Melanie asked, "Can we go to McDonald’s?", the father would have been able to say, "Yes, and then we are going to a place that will help you keep that smile forever." He wouldn't have had to hand her forty dollars for "medicine" or watch her walk toward a minivan; he would have been the one to sign her into a stabilization unit where her pastel dress and her dignity would be protected by the Power of the Law.

#LynnesLaws

Medical Representatives within the Medicaid system of health care providers are not treating their patients as they should.

This article from WHYY is about the exact area of most of my visits.  I would encourage you to read or listen to it and check out the pictures.  

I'm thrilled that the transportation organization SEPTA is providing social services to these amazing men and women who have this medical condition known as Substance Use Disorder.

I'm happy that police whose role is street-level law enforcement have the Police Assisted Diversion Program that assists these amazing men and women who have this medical condition known as Substance Use Disorder.

I'm just wondering when the local medical community whose professional members have dedicated their careers to the ideals of Hippocrates for the purpose of medical provision to medical patients will actually step forward and start to treat their medical patients who have Substance Use Disorder with prompt dignity and respect-filled care.

If you're reading this blog and not familiar with Substance Use Disorder, it is recognized as a medical disease. The Philadelphia Police Department and SEPTA should not have to be involved in a leadership role in treating medical patients who have a medical disease.

Medical Representatives within the Medicaid system of health care providers are not treating their patients as they should.

Let's personalize this personal situation:

In this picture from the article, you see Kenneth Harris interacting with a woman who needs services related to her Substance Use Disorder. 

• As I see this woman's red hair, the way she's leaning forward toward him, the way she's reaching out with her left arm, I'm wondering if this is Melanie, who I introduced to you on July 27, 2018. 

• In this picture, to the left, you see part of a doorway.  That doorway leads up steps to the elevated train line that runs above Kensington Avenue.  It is on those steps where I administered Narcan to Allison, a Delaware County resident.  She revived, was taken by ambulance to Episcopal Hospital and was told by the Registered Nurse on duty in that emergency room which is dedicated to health care provision to patients who are experiencing life threatening situations and who at the beginning of her career had dedicated that career to the ideals of Hippocrates to:

"Get out of My Emergency Room!"

It is high time that the Medicaid-based medical community - in the spirit and name of Hippocrates - steps forward and invites their patients into a prompt dignity and respect filled healing experience so that these people - these inspirational human beings who are made in the image of God and worthy of dignity, honor, respect, and love - can get on with their lives and back to their families and realize the joy of living.

There's a world of difference between the styles of health care provision to Substance Use Disorder patients depending on their Private vs. Medicaid insurance status.  Here's a blog that looks at those differences.  The private insurance realm of this tragedy can and should lead the way in finding solutions so as to save the millions of lives that lie in wait of much wanted and needed prompt dignity and respect filled health care services.

**********

Blog Analysis Addendum: The Abdication of the Healer

Original Blog Title: Medical Representatives within the Medicaid system of health care providers are not treating their patients as they should.

I. The Human Narrative: The "Reversed Role" of Kensington

In this account, we see a neighborhood where the traditional boundaries of profession have been flipped. SEPTA outreach workers like Kenneth Harris and the Police Assisted Diversion (PAD) program are the ones leaning in, reaching out, and offering "dignity and respect." Meanwhile, the medical community—those who have literally sworn an oath to "do no harm"—are the ones pushing patients away. You recount the chilling experience of Allison, who, after being saved by Narcan and taken to the hospital, was met not with healing, but with the command: "Get out of My Emergency Room!" This narrative exposes the "Hippocratic Gap" where the poor are treated as a nuisance rather than a priority.

"The Philadelphia Police Department and SEPTA should not have to be involved in a leadership role in treating medical patients who have a medical disease."

II. The "Lynne’s Laws" Article and Section Review

This blog identifies the need for Article 5, focusing on the professional accountability of healthcare providers.

Article 1, Section 1: The Medical Necessity and Parity Mandate. This story highlights the lack of parity. If Allison had been a cardiac patient revived by EMS, no nurse would have told her to "get out." This mandate legally forbids such a dismissal by classifying her post-Narcan state as a high-risk medical emergency requiring 24-hour observation.

Article 1, Section 3: The Hippocratic Accountability Act (New).

• The Law: Mandates that any medical professional (doctor, nurse, or administrator) who explicitly refuses care or verbally dehumanizes a patient in a substance-use crisis (e.g., "Get out of my ER") is subject to an immediate ethics review and potential loss of state medical licensing.

• The Application: This would hold the specific Registered Nurse in Allison’s story personally and professionally accountable for her failure to treat.

Article 5, Section 1: The Medicaid Equity and Quality Mandate (New).

• The Law: Requires that Medicaid-funded facilities prove they are providing the same "Dignity and Respect" standards as private-insurance facilities. It mandates "Blind Intake" protocols where a patient's insurance status cannot be seen by the clinical staff until after the stabilization plan is enacted.

III. The Professional Tension and Consensus

• The Supportive View: Ethical medical boards and human rights advocates argue that "therapeutic nihilism" (the belief that treating addicts is useless) is a violation of the Hippocratic Oath. They support Article 1, Section 3 because it restores the integrity of the medical profession by weeding out those who refuse to treat "the infirm."

• The Skeptical View: Nursing unions and hospital administrators worry about "Burnout" and "ER Safety." They argue that staff who are overwhelmed by the volume of Kensington cases may snap under pressure, and that "Accountability Acts" will make it even harder to staff these critical hospitals.

• The Lynne’s Law Resolution: This is an Infrastructure issue. Lynne’s Laws don't just "punish" the nurse; they mandate that the state provide the Resource Support (extra staffing and stabilization beds) so that the nurse is never in a position of "despair-driven rejection."

IV. Legislative "Teeth": The "License to Heal" Standard

• The Objective Standard: A "Refusal of Care" is documented as a Sentinel Event.

• Civil Liability: If a patient is told to "Get out" and subsequently suffers harm (a second overdose or injury), the facility is held Strictly Liable. Additionally, the Hippocratic Accountability Act allows for a "Private Right of Action" against the specific professional who verbalized the rejection.

V. The Prevention Savings

By forcing the medical community to take the leadership role away from SEPTA and the Police, the state saves on:

• The Cost of "Non-Medical" Policing: Police officers are more expensive and less effective at "treating a disease" than doctors.

• The "Revolving Door" Cost: Treating Allison with "dignity" the first time reduces the likelihood that she will be back on those SEPTA steps with a needle an hour later.

VI. The Corrected Path

Under Lynne’s Laws, when Allison arrived at Episcopal Hospital, the nurse would have seen her as an "inspirational human being made in the image of God." The Medicaid Equity Mandate would have ensured that her care was indistinguishable from that of a private-pay patient. Instead of being told to "get out," she would have been invited into a "healing experience" where her life was valued, her family was contacted, and her "joy of living" was the only goal.

#LynnesLaws

 

The people on the streets of Kensington are not nor have they ever been nor will they ever be 'zombies.' The people on the streets of Kensington are inspirational human beings made in the image of God and are worthy of dignity, honor, respect and love.

Our dear friends on the streets of Kensington endure many inappropriate and derogatory titles from people who know no better and take no time to better understand what's going on in that person's world.  I won't repeat any of these titles here with the exception of the one I'd like to address in this blog:

 Zombie

According to Wikipedia, A zombie is a mythical dead person who has returned to life as a walking corpse. Mythical things that have been "re-animated" are called undead, and a group of them can be called the living dead. The Zombie myth came from the Caribbean.

To the stigma focused eye of a person traveling down Kensington Avenue, the men and women of the streets might seem to be zombie-like with their mannerisms and behaviors.  "Dipping" is not the behavior of a zombie.  It is the evidence of being high in an addiction, (more properly known as Substance Use Disorder), that has no easy way of escape.

Incoherence to the world around them, wobbling rather than walking, laying on the sidewalk in all kinds of obviously uncomfortable positions, uncontrollable drooling,…  These are some of the outward behaviors that lead the stigma focused onlooker to refer to these men and women as "zombies." Without getting out of the car to actually meet one of these people, the idea of them being "zombies" will only continue. 

By taking the time to step out of your car and comfort zone and talk to one of these people, you will discover that the person of your displeasure is actually a real person who had a real childhood and who lives in their adulthood with hopes, feelings, and dreams for the future.

Rather than explain this point further, allow me to reintroduce you to "Melanie."  In this blog written on July 27, 2018, you will see misconstrued behaviors of a 'zombie.'  Look closer.  Read about her embarrassment in front of 'Dad,' her desire to dress beautifully, her love of McDonald's and chocolate milkshakes, and having her hair brushed while watching Saturday morning cartoons. 

"Melanie" represents hundreds of other people on the streets of Kensington who are not nor have ever been nor will ever be 'zombies.'

"Melanie" represents hundreds of other people on the streets of Kensington who are inspirational human beings made in the image of God and who are worthy of dignity, honor, respect, and love.

P.S.:  With the judicial system and the Medicaid level medical system having failed her miserably, Melanie remains on the streets 2.5 years after I wrote the blog titled:  "Before The demon Came Calling….

**********

Blog Analysis Addendum: Beyond the "Zombie" Myth

Original Blog Title: The people on the streets of Kensington are not 'zombies.'

I. The Human Narrative: The Image of God vs. The Stigma of the Eye

This narrative addresses the "inappropriate and derogatory" titles used by those who view Kensington from the safety of a car window. You challenge the "stigma-focused eye" that sees only "dipping," incoherence, and drooling, and rebrands them as the behavior of the "undead." By reintroducing Melanie, you remind the reader that these "zombie-like" mannerisms are actually clinical symptoms of a Substance Use Disorder that has no easy way of escape. You replace the mythical "walking corpse" with a real person who has a childhood, a favorite McDonald's order, and a "desire to dress beautifully."

"Melanie represents hundreds of other people on the streets... who are inspirational human beings made in the image of God and who are worthy of dignity, honor, respect, and love."

II. The "Lynne’s Laws" Article and Section Review

This blog solidifies the need for our final Article 6, focusing on public and professional education to dismantle stigma.

Article 1, Section 1: The Medical Necessity and Parity Mandate. This story illustrates the "Nuance of Observation." What the public calls "Zombification," the law must define as Severe Neurological Impairment. This mandate ensures that "dipping" is treated as a sign of medical distress, not a reason for social shunning.

Article 6, Section 1: The Anti-Stigma Medical Training Mandate (New).

• The Law: Mandates that all Medicaid-funded healthcare providers and first responders undergo "Humanization Training." This training must include the history of patients like Melanie to ensure that clinical staff see the "Image of God" rather than the "Stigma of the Street."

• The Application: This would prevent the "Episcopal Hospital" scenario where a nurse’s bias led to a hostile discharge.

Article 6, Section 2: The Judicial and Public Safety Re-Classification Act (New).

• The Law: Legally strikes the use of dehumanizing language (like "zombie" or "junkie") from all official police and court records. It requires that these individuals be referred to as "Patients in Crisis" or "Vulnerable Persons."

III. The Professional Tension and Consensus

• The Supportive View: Sociologists and medical ethicists argue that language shapes treatment. They support Article 6 because they know that when a doctor views a patient as "undead," the quality of care plummets. Humanizing the patient is a prerequisite for healing them.

• The Skeptical View: Critics might argue that "language laws" are just "political correctness" and don't change the reality of the streets. They worry that focusing on "titles" distracts from the "hard work" of clearing the streets.

• The Lynne’s Law Resolution: This is a Diagnostic Integrity issue. You cannot treat a disease you do not respect. By legally mandating a shift in language and training, the law ensures that the "eye of the provider" is focused on the Patient, not the Stigma.

IV. Legislative "Teeth": The "Dignity Audit" Standard

• The Objective Standard: Facilities are subject to a Dignity Audit. If a pattern of dehumanizing language or behavior is documented (as with Allison’s "Get out of my ER" case), the facility’s state funding is placed on probation.

• Strict Liability: Under Lynne’s Laws, if a patient is denied care based on a "Stigma-Driven Assessment" (treating them as a "zombie" rather than a patient), the facility is held Strictly Liable for any subsequent harm.

V. The Prevention Savings

By dismantling the "Zombie" myth, the state saves on:

• The Cost of Avoidable Deaths: Humanized patients stay in treatment longer, reducing the fatal overdose rate.

• Public Trust: Building a system that treats people with "dignity, honor, respect, and love" encourages more people to "trip in their sprint" and reach out for help.

VI. The Corrected Path

Under Lynne’s Laws, the "stigma-focused onlooker" would be irrelevant because the Medical System would be a fortress of dignity. When Melanie or any "neighbor" in Kensington sought help, they would be met with a provider who has been trained to see past the "wobble" and the "drool" to the person within. They would find a system that honors their "image of God" and provides the "prompt, dignity, and respect-filled care" they have deserved all along.

#LynnesLaws

Thank You for Praying for Us.

I had prayed and asked my friends on Facebook to pray that I would find specific people who live on the streets of Kensington and with whom I try to keep in close communication.  I drove to a common corner, an intersection of two main streets, to find one who is from Delaware County. 

Not there… I drove up one street, looped around, drove down that same street several blocks past the original point, looped around again and came back one block short of the common corner where I felt certain I'd find her. 

Even though she was fully dressed for the winter cold and had her back to me, a tiny tuft of her curly hair with its uncommon shade announced her identify as would any "Hello, my name is…" sticker worn at so many social gatherings.

"Hi, Melanie,"  I called out as she stood on what I presume is her favorite corner when looking for a date.  I'm permitted a bit to presume this.  After all, it was on this corner where she took me on Friday, July 27, 2018 and I told you about in a blog titled  Before The demon Came Calling... (The section of that blog that speaks specifically of this street starts out with: After dinner, as we drove, Melanie asked me to pull over on a side street…)

Today, as I parked my car on that same side street, I noticed that she was in no rush to greet me further.  When I gingerly approached her, she looked sad and sick.  Sniffles and her general appearance told me and she confirmed that she was fully dope sick and standing there trying to find a 'date' so as to fund her next injection of 'heroin' which is hardly heroin at all these days.

We chatted only for a bit.  Before we parted, she was the first of this day to receive a care package that had been donated to me very recently by one of my former high school classmates years ago.  This care package, and about 50 others, have been or will be distributed one by one in the very near future. 

Melanie also told me that she needed a new pair of boots because the ones she had on were just about worn out.  I still had a pair of boots in my car that had been given to me by a now-retired administrator at my former college - Eastern University.  They fit her almost perfectly.

As we parted, Melanie reached out for a hug and did not let go for a while… And so, there I was… To the unknowing eye and stigma thinking brain of an out of town observer, I was hugging an addict, a prostitute, and I won't even utter the additionally derogatory terms often associated with women in her situation.

But no!

To anyone who has taken the time to get to know Melanie, you will know that I was hugging an orphaned former Delaware County resident who knows of Aston, Chichester and Glen Mills, Concord Road, Saint John's Episcopal Church, Elam United Methodist Church and all point in between and around.

Melanie is not any of the derogatory titles often applied to a person in such a situation.  Melanie is not even part of "them" or "they."  Melanie and the hundreds she represents on the streets of Kensington are no less than an extension of "us" and "we" and have every right to receive all of the dignities associated with such a classification.

Thank you for praying for Us. 

Melanie Walking Alone and Looking Lonely

In the past few weeks, as I was driving down a particular street in Kensington in my luxury vehicle provided by Recovery Centers of America where I am employed as a driver, I was about to pick up a person who has private insurance and wanted to be done with his Substance Use Disorder issues. 

As I was driving, I saw Melanie walking alone and looking lonely.  I so much wanted to stop and spend a bit of time with her to let her know she's loved and cared for.  The only thing that stopped me was the lack of parking and the long line of cars already stacked up behind me. 

And so, I drove on to meet this person who had called 1-800-RECOVERY a few hours earlier, had his[1] insurance cleared and scheduled a time to be picked up at an address of his choosing.  As I did so, I thought about Melanie:

• the times we had chatted on these same streets and under bridges and in my car as we dined at McDonald's
• as we sat side by side in the visitor's area at the woman's jail while she, as a patient of Substance Use Disorder, sat next to me in her one-piece orange jumpsuit as a prisoner of the city and developed a plan for her future.
• the time I spoke under oath on her behalf at one of her court sessions
• and more.

When I arrived at the address that this new (potential) RCA patient had requested for pickup, we saw each other.  He looked at me and stated that since it was "Banana Man" picking him up, he would go even though he was hesitant to do so.[2]  And so, off we went toward RCA and the high-quality care that comes with private insurance detox and rehab.

As I write this blog, this private insurance patient of Substance Use Disorder has gone through the process of rediscovering life on a healthy path.  Melanie, also a patient of Substance Use Disorder but reliant on Medicaid for her detox and rehab is trying to be found on the streets of Kensington by her caseworker who has some exciting news...

---

[1] As a way of further adding anonymity and privacy in my blogs, pronouns (his/her, etc.) are very often switched up.  This story, while very real, may or may not be about a man who I brought to RCA.

[2] Our paths had crossed only a bit at some point in the past.  This person was not one of my "regulars" but I did recognize him as having seen him before.

A Time of Mental Rot

 

I have, just this morning, learned of the overdose death of a young man with whom I've had some interaction on the streets of Kensington.  He and I have several Facebook friends in common.  I'm deeply saddened as I learn of his passing.  

As I write this, I'm trying to find that balance of sharing with you my thoughts, honoring him and being sensitive to his family's agony.  This young man spent the last several months in local jails, was discharged, and overdosed within hours.  

Why Die? 

In the words of a woman of whom I've written here and as she unwittingly followed the same path: 

“This (time in jail)  is a time of mental rot.” 

“This process only builds up more resentment in people who are already dealing with resentment from the emotional traumas that got them here in the first place.” 

This woman went on to describe this time of mental rot… 

As a time of sitting in an oversized toilet stall  with no privacy around the toilet and sharing that toilet stall with some other woman she doesn't know, having two cots in that toilet stall with something that's supposed to resemble a mattress and one sheet to cover herself at night.  It is a time of little to no therapies and living inside one's own head and reliving the emotional traumas that escorted her into addiction and convincing herself more and more that she's just not worth it.  It is indeed a time of "mental rot."

Jail is no place for a patient of Substance Use Disorder to receive treatment for their condition.  

Detox and Rehab Facilities are designed for patients of Substance Use Disorder. 

Jails are designed for people guilty of a crime. 

Having Substance Use Disorder and behaving accordingly with active drug consumption should not be viewed as a crime worthy of jail but rather a condition worthy of appropriate treatment. 

If you, governmental leaders, insist on having medical patients of Substance Use Disorder residing in your jails, then you must provide the therapies that are needed so that your patient/inmate will be healed enough and have the resources so as not to be called back to their substance(s) and be dead within hours.

Much of this blog series looks at this topic.  A next blog to read that you may find helpful is this one:

This Week with Tabitha and Melanie

 

 

 

 

A Cast Now or Surgery Later

A couple of years ago, "Cecile" came up to me in Emerald City and shared with me how he had pulled someone out of the path of an out of control motorcycle.  The person was fine but he now had a broken arm. 

People on the streets do everything possible to avoid going to the E.R.[1]  Cecile had put a splint of his own making on his arm.  His arm was completely useless for a couple weeks as he tried to bring healing to it without professional care.  In time, his arm "healed" but had a noticeable bend in it.  He was told by a doctor who visited Emerald City that the day would come when surgery would be needed to correct the improperly healed break that could have been dealt with early on if proper care had just been provided when it was needed.

Melanie and Natalie are sitting in jail cells at RCF[2] as I write this blog.  Both ladies have been there for three to four months.  They have both detoxed from their "medicine" and have been in a holding pattern, living in a cell that can better be described as an oversized toilet stall with cots.  They have received no counseling nor therapy for their Substance Use Disorder issues. 

Their "broken arm" has been the addiction/homeless phase of their Substance Use Disorder.  Their time in a homemade splint has been these past months as they have sat waiting for the legal system to find them a medical bed in a facility to provide the care - the cast - that they should have had months ago.

As they sit and wait, they think.  They climb inside their own heads, talk to others who are in this similar holding pattern and develop their own -  largely unguided - understanding of what happened to get them where they are today and how they might correct their path.  In the absence of the placement of a proper cast at the time of injury, their soul may heal but with a bend that will require "surgery" since healing was not provided at the time of the injury.

Would it not be better for these ladies, - who represent thousands of other men and women in this same situation - if we as a society had the mechanisms firmly in place to provide the cast when it's needed and not wait to provide the surgery long after the injury? 

---

[1] Mostly because they have come to know that most E.R.s treat them as something less than human.

[2] Riverside Correctional Facility

Comparative Studies in Addiction

Reliant on Medicaid to fund her healing, Melanie sits in a jail cell for 3, 4, or 5 months with all of the constraints of an imprisoned person while awaiting handcuffed transfer to a medical facility that is charged with the privilege of serving her in her healing from Substance Use Disorder.

Reliant on Private Insurance to fund his healing, Ralph sits in a plush luxury vehicle for his transfer to a medical facility that is charged with the privilege of serving him in his healing from Substance Use Disorder.

*****

An Imperfect Analogy:

If the use of insulin was considered wrong would medical patients who have been diagnosed with diabetes be living in tents under bridges or out in the open on city sidewalks?

Would they be unemployed, 'panhandle' and 'date' to raise funds to go to their street corner insulin dealer to buy their insulin to avoid 'insulin sickness?'

Would they be derogatorily described as "Diabetics?"

If the use of heroin was considered acceptable would medical patients who have been diagnosed with Substance Use Disorder be immediately treated upon request in emergency rooms, clinics or hospitals?

Would they survive and be employed to raise funds for their family instead of going to their street corner heroin dealer to buy their heroin to avoid 'dope sickness?'

Would they be derogatorily described as "Addicts?"

Patients who have been diagnosed with Diabetes and patients who have been diagnosed with Substance Use Disorder are all medical patients who have been diagnosed with a medical condition that results in its respective sickness if a 'medicine' is not provided to avoid that sickness.

One diagnosis is socially accepted.  The other is not.

Sitting in a Cell with SUD

Once again in my time of blogging, I find myself eating lunch at the Applebee’s on Aramingo Avenue following a wonderful visit at RCF with “Melanie,” my Delaware County neighbor.  As a patient of SUD, she sits in her jail cell minute after hour after day after week after month awaiting word that the legal system has found a bed for her within the medical system for her to go to that will meet her rehab needs.

She’s been sitting there waiting in a jail cell designed for criminals longer than your standard 30 days of typical private insurance rehab.  It’s a time for her to contemplate her navel or come to the conclusion that the system just does not care.  Rather than receive the emotional and spiritual healing that could be had within rehab,  this extended stay in jail only adds to the emotional trauma that she has experienced thus far in life. To the system, she’s just one more ‘case.’ 

To those of us who know and love “Melanie” for who she is with her fun, lighthearted and playful spirit, we mourn her prolonged and unnecessary suffering in a cell – an oversized toilet stall shared by previous strangers who now sleep in neighboring cots and share an exposed toilet.

Let us remember now and never forget, “Melanie” and the hundreds/thousands of other sons and daughters who are sitting in cells with SUD when they should be in rehab getting therapy. 

12 to 14 Weeks!

As you read this, “Natalie” and “Melanie,” two very intelligent women who are reliant on Medicaid, are sitting in their respective jail cells waiting for evaluations and court-ordered inpatient treatment to which they will be transferred by guards in a prison van with barred windows while wearing handcuffs.  Their combined wait time is 12 to 14 weeks. 

Their cells are nothing more than oversized toilet stalls with no privacy walls around the toilet.  There are two cots with very thin mattresses and one sheet for her and one for her previously unknown cellmate.  There is little to no therapy nor inpatient treatment happening for these women who suffer from Substance Use Disorder.  They sit in their cells minute after hour after day after week after month until the court has identified a placement for them.

Two quotes from people going through this process:

“This is a time of mental rot.”

“This process only builds up more resentment in people who are already dealing with resentment from the emotional traumas that got them here in the first place.”

Is this any way to treat human beings who are suffering from a disease that is officially recognized as such by the medical community?

This Week with Tabitha and Melanie

I started working as a driver at RCA[1] in October of last year.  Shortly after my start date, as I was visiting Emerald City, I mentioned my new employment to a few people.  "Tabitha" told me that she had been there as a patient maybe 6 months earlier and had recently relapsed.  She wanted to go back.  We talked about it each time that I visited this under-the-Conrail-overpass community.  I started to realize that I was more annoying to her with my urgings than I was helpful.  I dropped the subject and waited for her to mention it.

From time to time, she would say that she'd like to go.  There was one day, maybe two months ago, when she marched up to me very determined…  "I'm ready to go to RCA."  " Let's make that phone call."  I said with a smile.  Her response:  "Well, not now…"

This past Wednesday, as I was sitting at my computer composing a letter to a judge for Melanie who is in this jail and had a court hearing the next day, Tabitha texted me:  

"I want to go to detox now.  Please come get me before I change my mind!"  

Following some brief texting discussion and determining a place to meet, I drove to Kensington and Somerset.  I found Tabitha right where she said she would be.  She got right into my car and said "Let's go!"

Within three hours of that initial text, Tabitha was entering the RCA facility of her choosing and beginning her experience of five-star level services for her Substance Use Disorder.

Tabitha has private insurance.

The following morning, I put the final touches on my letter to Melanie's judge, drove to the Juanita Kidd Stout Center for Criminal Justice building and found my way to courtroom 906.  After sitting for almost two hours, Melanie, who has been in jail for about nine days at this point, was escorted to her chair next to her public defender who she had never met until this moment by a deputy who had her in handcuffs.  She remained in those cuffs for the duration of her hearing.  Prior to Melanie entering the room, this judge casually mentioned that she had been handling "Miss (Family Name's)" case (many years).

With no evidence of compassion for Melanie as a person, the judge proceeded with "the case."  She mildly lectured Melanie for failing to do this and that.  In the end, the judge decided to keep Melanie in custody while an evaluation of needs is done and a report provided to the court.  This process takes six to eight weeks and sometimes longer.

Six to Eight Weeks!

That's 42 to 56 days of sitting in[2] an oversized toilet stall[3] with no privacy around the toilet and sharing that toilet stall with some other woman she doesn't know, having two cots in that toilet stall with something that's supposed to resemble a mattress and one sheet to cover herself at night.  That's 42 to 56 days of no therapy.  That's 42 to 56 days of living inside one's own head and reliving the emotional traumas that escorted her into addiction and convincing herself more and more that she's just not worth it.  That's 42 to 56 days of "mental rot" as described to me by another person in a similar situation not long ago.

Melanie has Medicaid.[4]

Tabitha and Melanie both have Substance Use Disorder, a medical situation officially recognized in the DSM-5.  With private insurance, as you read this, Tabitha is receiving 5-star services so that she can reclaim her life of health.  With Medicaid, as you read this, Melanie is mentally rotting in an oversized shared toilet stall.

It's time to Plow Down Medicaid Mountain.

Please pray for both of these ladies who do know each other but are not aware of these events in the other's life!

---

[1] Recovery Centers of America

[2] (in the cleaned up words of another person I visited earlier this year)

[3] The jail cell

[4] As a patient reliant on Medicaid, Melanie does not have the option of "making that phone call" and going to a detox/rehab that offers the dignity and respect that is deserved by all human beings.  There is, obviously, much more to this issue than is presented in this blog.  For additional understanding, please click here.

Pray for Melanie...

For over a year now, I've been sharing stories about "Melanie" in this blog series.  Here they are in reverse date order (for some reason I can't control).

Last summer, as I visited Melanie in jail, she promised me that she would never go back to using heroin.  She has maintained that promise and has told me so each time I've seen her since then.  She has continued to live on the streets for her own reasons that go beyond the point of this blog. 

Melaine has done fairly well until about 10 days ago when, again, for reasons of her own, heroin reentered her pattern of life and her bloodstream.  She has overdosed twice in these ten days and been saved by Narcan twice, once by a resident of the streets and once by a Philadelphia police officer who knows and cares very much for her.

On Wednesday, I found Melanie shortly after this second near death moment.  She asked if she could rest in my car.  She slept for the next couple of hours while I made my rounds visiting people with bananas, water, and song sheets.  I informed each outreach worker who I saw on the streets of Melanie's situation and each one had a different solution based on their experiences and the group they represented.

In the end, Melanie, with the help of the good people of Prevention Point, got out of my car and was considering going in there for help. 

As we hugged each other, I held her extra tight as I was keenly aware that I might never see Melanie alive again.  Her walking path of life is far too thin these days AND it is on the side of a cliff on what I'm calling "Medicaid Mountain."

Pray for Melanie...

A Tale of Fraternal Twins And Simulated Hardwood Floors

Nearly 100% of the people whose stories I anonymously share here 

are reliant on Medicaid to cover their health care costs.  

In recent months, I have become increasingly aware of the lack of care, compassion, and competence on the part of Medicaid level providers as compared to their private insurance counterparts.  

Medicaid patients are losing their lives as a result of these differences.  

It is time for those of us who care to 

"Plow Down Medicaid Mountain!"

George and John, in the following story, are fictitious characters.  What they experience, however, is factually based on what I have witnessed in the worlds of Substance Use Disorder Health care provision in the two insurance realms.

Please consider joining us in making changes to this system.  A private Facebook Group is forming for us to share stories, compare notes and support each other as we seek solutions.  

**********

On the Day that George and John were born, their parents, in a fog of addiction, gave them up at local safe drop off stations, George on one day at one such station and John on another day at another station.  As fraternal twins, they looked nothing alike.  They bore no identical traits other than the propensity for addiction that lingered quietly within them. 

George and John were placed in loving homes through adoption. 

George's home was one of considerable financial wellbeing, mostly through his parent's many real estate holdings.  George went to the finest schools as a child.  In 2008, finances dried up for George's family and times got tough.  His Dad and Mom moved their family of three into the basement of a family friend who had a dark side.  This friend introduced George to aspects of life that no child should ever know.  The resulting pain and confusion within the soul of George awakened the inner demon of addiction.  Heroin became his only and best friend.

                                                       

John was adopted into a hard-working family.  Mom and Dad were both tradespeople.  Dad was a plumber and Mom an electrician.  Mom and Dad loved athletics and as John grew, they encouraged him to find a sport that he enjoyed.  John was awesome at high school baseball.  On one fateful day, he slid into third base and shattered his leg.  Surgeries lasted for months.  During this time, to manage his pain, John was put on opioid-based pain relievers which handled his pain and awakened his inner demon of addiction.  In time, heroin became his only and best friend.          

Twins separated at or near birth and who know nothing of each other have been shown to often do the same things throughout their separated lives.  George and John are examples of this phenomenon. 

On the same exact day toward the end of 2018, George and John made the same decision...

George woke up in his tent in a "homeless people's encampment."  He glanced over at his tent mate, a young lady in her twenties.  She lay there blue and lifeless with a noticeable facial injury, the result of a date gone bad just hours before.  This, combined with other recent street deaths of friends by overdose, pneumonia and one out of control car and his own multiple overdoses saved by Narcan in recent months watered a seed of rational thinking that had laid dormant for years within George. 

John lived with his addiction and his family and kept distant from them but not from it in his basement apartment.  He began to realize that life was not going in the direction it needed to go.  One night, upstairs, around his parent's kitchen table, John confessed his sadness and self-loathing to his Mom and Dad.  The three of them through a lot of tears and a tiny bit of yelling decided on a course of action to address John's addiction.  With private insurance cards in hand, phone calls and arrangements were made for John to enter detox and rehab.  Later that same day, John injected one last dose of his needed medicine, was picked up by a driver from his rehab home of the next 28 to 30 days, arrived and was met by men and women who treated him with the dignity and respect deserving of any human being. 

From the moment John entered the building and on his walk to the admissions office and then to his detox room, John walked through tastefully decorated halls lined with portraits of famous strugglers of addiction and inspiring quotes from people throughout the decades.  He could not help but notice the brightly lit lounge areas with their electronic fireplaces and large screen TVs.  Under his shoed feet, every step of the way, he walked on well maintained simulated hardwood floors.

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."  Once filled out, he handed the papers back along with his Medicaid insurance card.

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 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. 

John's road to recovery is well underway. 

George is living in a tent.

The one thing both facilities have in common:  Simulated Hardwood Floors

For further reading on this topic, I invite you to read these blogs.

It's Time to Plow Down Medicaid Mountain!

This Week with Tabitha and Melanie

Calling ALL Bulldozers! It's time to Plow Down Medicaid Mountain!