“We are taking him to rehab,” she said. I could hear a faint sigh of relief and happiness permeating her voice, which had been distinctly absent for the last few months. I could also hear wind whooshing in the background and a distant trail of her voice, which meant they were already on the road.
This year, I had the privilege of rotating through an addiction clinic, Addiction Allies. During the rotation, I heard many stories similar to this one. It surprised me just how many of the accounts contained a medical professional joking about opioid use or presenting a drug as the solution to pain.
On the first day of my summer fellowship, I almost stepped on a used needle. The road was littered with needles and syringes, a byproduct of widespread intravenous drug usage and a physical embodiment of a much larger problem. The United States is in the midst of an epidemic that takes over 115 lives per day.
There are patients who leave lasting impressions on us in one way or another throughout our training. I had never expected an angry, alcoholic patient who left against medical advice to be one of those patients for me.
On the first day of my neonatology elective I met Aaron, a one-day-old infant born to a mother with a history of intravenous drug abuse. The mother was reportedly attending a methadone clinic during her pregnancy to address her opioid addiction, but her urine drug screen was positive for fentanyl.
“Great, six weeks of crazy people!” This is the sort of attitude with which I went into my psychiatry rotation. Couple this with the fact that while most schools only have four required weeks of psychiatry, my school has six weeks. Of course, I would have more free time compared to other rotations — it is called “psychation” for a reason — but at what cost? Mental illness was something that made me uncomfortable.
In the past few weeks, there has been considerable press surrounding needle exchanges and the recently declared HIV epidemic in Indiana.
The first time I talked with my friends about needle exchanges, I had a visceral reaction. “Why would you give people new needles?” I asked, completely outraged. “Isn’t that enabling and therefore doing a disservice to the very people you’re trying to help?”
As soon as we walk through the recovery program doors, we are greeted with enthusiastic welcomes and familiar smiles. For the past two years, three of my friends and I have been leading exercise workshops at a rehabilitation program for patients overcoming addiction. At first I was nervous about how our program would be received. Would the clients be annoyed by our presence? Would they want to participate in our exercise routines?
“He is beyond the help of human aid” / He quoted from the big book / He stared directly at me as he spoke / And that one line was all it took
A common complaint among emergency room physicians surrounds the solicitation of pain medications. Nearly half a million ER visits in 2009 were due to the misuse or abuse of prescription painkillers. Several years ago I worked closely with a family physician in Binghamton who warned a [bout patients who feigned illness to acquire narcotics (…)
A mere five weeks into my third year of medical school, I met a patient who would leave an indelible mark. Jose was a Hispanic man that teetered between overweight and obese; I am a tall, medium-build Chinese-American who was thin in high school. He struggled with depression during 40 odd years of life; my biggest worry growing up was excelling on the competitive piano circuit. He spoke of a family rife with discord and unhappiness; my family is intact and supportive. He dropped out of college; I want to stay in school forever. He ate rice and tortillas; I ate rice and tofu. We were different but for a moment, our lives intersected.
Monday mornings of my first semester of med school I’d reach into the smaller pocket of my backpack, grabbing around until I heard that pill-rattle sound. Over time, it’d come to rival my coffee machine in its Pavlovian salivation production.