My return to detox was much different than my initial arrival. Unlike before my body was in the process of withdrawing from the drug. My mind had begun to shatter the crystalline shell it had been encased in for nearly a year. I was on the brink of complete and total breakdown.
I didn’t even make it 24 hours before having to go back to the hospital. The infection in my arm had worsened in the night. It now expressed a constant stabbing pain that pulsed harder with even the slightest amount of pressure. I could feel the blood warm as it passed through the effected area and flow back into my core. It all felt just as it had before when I was admitted to Harborview Medical Center six months prior for MRSA. That was also the last time I detoxed from the drug.
Daniel was running around our room frantically trying to get a signal on his phone. Cell phone use was strictly forbidden at ATS (Addiction Treatment Services) and being caught using one without explicit permission would result in a six month ban from the program, or so they threatened. His limbs were all twitching in different directions as he crawled around holding up the contraband device at different angles trying to find that one spot where the mountain refracted the signal perfectly. He soon gave up and went in search of another secluded spot that he may have better luck.
I wanted to write but the recent excursion to the emergency room had taken a toll on my body. It’s surprising how completely exhausting it is to have your humanity stripped of you. Sleep was the logical choice but, since sobriety always brings with it my ability to dream, that potential was even more terrifying than the prospects of having to return to the hospital. So I fought it off as long as I could. But in the end everyone has to sleep.
“Good morning. How did you sleep?”
My arm is getting worse again.
“What would you like to do?”
Before I outlined it, gave a frame of reference in case it gets larger.
“Do you think it’s getting bigger?”
Yes, but, I, I, I don’t know for sure.
“So you want to draw on yourself?”
Yes I think I do.
I drew two circles on the underside of my forearm. One around the darker red area that I was convinced would soon come to head and another around the entire infection site that was throbbing in a dull pink color. The shape of the circles again reminded me of when the med student drew the exact same lines on my opposite arm.
“I want you to pay real close attention to these lines. If the dark red moves outside of this circle at all, I want you to come back here, to the ER.”
What about the outer ring?
“That one isn’t as concerning. If after a few days it’s still not going down though I want you to come back too.”
I want to spend less time in the hospital.
“I know, but you really need to take care of yourself too. This could be very serious.”
It was serious. Two days later I was back in the ER for an IND. It had progressed so quickly there wasn’t even time for anesthetic. They cut straight into the pulse and began to squeeze out the most foul smelling ooze my body had ever created. The pain was unimaginable. My left arm had to be fully restrained and it was still difficult for the three men to keep me from moving so they could get deep enough to remove it all.
I spent the next ten days as a patient of Harbowview Medical Center’s Neuroscience Ward, 3WEST. I wasn’t epileptic but it was the only place in the massive healthcare facility that could offer me a room in isolation. I was diagnosed with MRSA and as such I was told I had to be quarantined.
For ten days I was in that room, isolated but free. My quarantine turned out to be anything but. I was allowed the freedom to move around, not just the unit, but the hospital campus as a whole, without question or harassment. After the first few days my doctor, a younger east european woman who clearly didn’t understand basic protocol, had told me, “Yes, you are in isolation, but this is Harbowview, people leave all the time. Just make sure you’re always here for your antibiotics.”
The nurses were also incredibly lenient with me. They all would tell me about how I’m the easiest patient they’ve had. It’s not an easy title to come across when the competition is incapable of bathing themselves or even using the toilet without coming back covered in feces.
I kept my room very clean. One of the side effects of being a tweaker is that you come to be dependent on cleanliness and order in certain things. During detoxification this priority was only lost for a few days in the beginning, then it becomes even more important than ever. Everything must be in it’s right place at all times.
If it hadn’t been designated a place yet, one must be determined, but only after extensive consideration is given to any potential conflicts. This includes any possible situations that may arise in the future so every decision took an incredible amount of time. Then when something new was added to the arrangement, all previous placements had to be reevaluated given the new information. Often times it called for a complete and total reappraisal of the situation. This process of arranging and rearranging your life constantly is what I’d commonly referr to as “tweaking”.
Perhaps the Neuroscience ward was the right place for me after all.
“How much sleep did you get?”
Sleep? Just now? None.
“How long were you in bed for?”
I don’t know. I, um, I think it was around 6 that I laid down last night.
“And you slept the whole night through?
I was asleep, but I didn’t sleep, I... started dreaming again.
“Oh, I understand.”
The look on her face made it clear that she didn’t really understand what I really meant. She’s thinking what most people look forward to each night. A time to let your mind wander in any which direction it desires; to create beautifully exaggerated images right before you eyes. You can see people who have gone away, visit places you’ve only thought about and adventure in ways we only know of from story books, My experience tends to be very different..
Nightmares would be a much better descriptor than dreams, especially when I’m depressed or anxious. My nights are filled with images of burning buildings, chemical warfare, funeral pyres.There is always fire.
Sometimes it’s something as small as a single tea candle burning in the corner of a room or the dull glow from a torch being used to illuminate the descending passageway I’ve never seen before. More commonly it’s far worse than than. I’ve awoken drenched in cold sweats from the smell of bodies smoldering along the roadside or the burning sensation of cityscapes ablaze in one everlasting urban inferno
The worst are the dreams in which I remember only a single flame. It starts with the flicker of a Bic lighter, which is slowly raised beneath a bubble of glass. Gently rocking back and for a thick white vapor arises and fills the lungs. My pupils dialate into the large ebony discs - “night shift eyes”.
I wish it were that easy again. Those dreams were easier to handle. Now the dreams are chaotic and lack the focus they once had.
The most recent dream I was in a high school gymnasium. I was surrounded by other addicts and high school students. We were setting up for an episode of Antiques Roadshow. We were all given two things to have appraised. If we were lucky enough to be given something of value we got to keep whatever it was.
My first items was a collection of correspondence between the French ambassador to the United States during the presidency of Thomas Jefferson. In this world it wasn't Pichon or Turreau. It was Elizabeth Archer, maiden name of course but likely only because I can't remember what her married name is, despite having attended the reception in Seattle.
It was a joyous event for the most part. We drank whisky in an old community center on Phinney Ridge. I got to mingle with her parents’ friends and people I’d met from the time when I should have been in college but was more interested in walking with fire. Laughter filled the halls as everyone came up to me and said the same thing, “Oh my god! Adam? Is that you? I hardly recognized you. You look great.”
It always made me uncomfortable. I know that they were trying to be nice and compliment me on all the hard work I’d put into losing over 150 pounds. But their words only served as a reminder that in the back of my head five words echoed constantly - I don’t even know you.
I have been struggling with an identity crisis my entire life. As a young child my parents and grandparents had been filing my head with that old cliche, “you can be whatever you want to be.” By the time I was leaving elementary school everyone was telling me that. I wasn’t one of those students who studies hard to get good grades. I didn’t have to study, In terms of math and science there were particular things I never had to learn, they just made sense. .
When my parents were getting divorced I was in the sixth grade. I went to school the same hours as all the other children at Mt View Elementary but my curriculum was a far cry from what the other children learned. I had asked my teacher if it was alright for me to turn in some of my assignments early. She’d never come across such a request before and gladly obliged. I had completely an entire quarter's worth of assignments in a few weeks.
I then entered into a sort of independent study, something unheard of at a school known only for the difficult environment in which the children found themselves and low test scores in every subject. It was a wonderful opportunity to display my mental aptitude, which I did in every way possible. It was also the first time I experienced what would become my social signature the rest of my life, dissociation.
At this time I already knew that I was gay and I didn’t want to be. I was already different enough, I wanted to be more like everyone else and less like the bookworm who’d desk was positioned next to the teachers, not because she needed to keep a closer eye on me, rather it was easier for me to use her computer,
If I could be whatever I wanted then I should also have the power to decide what I was not as well. I decided that I didn’t want to be gay. I didn’t want to religious stigma or social rejection. I didn’t want to speak with a lisp and flare my pinky expressively. I wanted to be just like everyone else.
And so I learned to dissociate my sexuality.
I’m in pain, an incredible amount of pain. My arm is still resonating violently. I was told that a nurse would be in to examine it, however it is nearly 5pm now and there has been no one with a medical background in the building all day. It must not have been deemed a priority.
Addicts are rarely a priority to medical staff. They see them everyday and I assume that at a certain point it just begins to bore them. Another abscess or skin infection, another patient that won’t take their meds, another overdose that was far from accidental. They see the same tired faces who have no interest in giving up the lifestyle and every interest in giving up on life because they feel it’s given up on them. It’s no wonder that those of us who really want help get ignored.
I threw my backpack on the x ray machine, just as I had the day previously. The security officer was a local man, probably in his mid 20s. He had started to smile before seeing my bloodshot eyes and immediately he was all business.
“Visiting or checking in?”
Checking in.
“Empty your pocket here. Is there anything sharp in your bag?”
It’s just my clothes and some electronics, my computer, cords…
“Is there anhything sharp in your bag SIR?”
No, I don’t believe so.
He returned my bag and pointed me to a woman just before the next door. She was younger, likely a student at the university. She took my birthdate, name, the reason for my visit and asked me to sign a consent form for treatment.
 |
| Being administered a single dose of IV antibiotics. |
My signature has been illegible for years. In my youth I would take the time to form each letter with precision. However the more times I signed my name the sloppier it became. By the time I graduated high school it had devolved into a series of three curved lines that barely represented the initials they were intended to. She looked at my scribbles on the page but didn’t think twice of it. I’m sure there is a section in the employee handbook that specifically states “Never question a drug addict unless you have no other options.”
I sat in the exact same chair I was in the day before, directly under the television. It was the closest seat to triage that also had access to an outlet. I had learned to take advantage of access to electricity any change I got. It’s something that you learn being homeless in the 21st century.
Only about ten minutes passed before I was called over to speak with the triage nurse. She recognized me immediately.
“Oh I remember you from yesterday. Couldn’t stay away?”
My arm is getting worse.
“Well let’s take a look here. Do you happen to know your height and…
Six foot four, two hundred and twenty one pounds, though it may be slightly higher today given the amount of fluid you pumped into me yesterday.
“Excellent that makes this go so much quicker. Do you smoke tobacco?”
The answers to all these questions will be the same as yesterday, except I haven’t slammed any meth since then.
“Well that’s an improvement. Let’s have you take a seat back where you were and the intake nurse will call your name shortly.”
It was obvious that they were understaffed again today. I was surprised that it hadn’t taken much longer before the intake nurse came out to meet me. I’d also seen him yesterday. He appeared sympathetic at that time, making sure that I was alright amongst the other people waiting to be seen. I realize now that it was only his way of saying I was being carefully watched.
“What are you doing back here?”
My arm has gotten worse.
“Of course it has, sit in the chair…”
He passed through the curtain which appeared to be made of old gowns that were stitched together. He didn’t even attempt to lower his voice as he went on to efface my existence
.
“These addicts just keep coming in, everyday they show up with some new problem. This is why we’re always so busy. If these junkies would just kick off and let us handle the people who are actually sick we might have enough staff to handle everyone.”
Are you fucking kidding me?
I knew he heard me before he walked away. I sat in the chair for a few minutes enraged. His was not an uncommon response by any means. In fact it was what I had come to expect whenever I needed medical treatment. In spite of Nightingale’s Pledge to serve all in need, there was some unspoken understanding within the nursing profession that only real humans were entitled to decent care. Junkies, tweakers and the like fall into the category of subhuman and therefore were to be treated accordingly.
I’d like to make clear a distinction at this point that this only seemed to be the case with nursing staff, not the doctors themselves. Every doctor that I encountered was calm, rational and took the time to address any concerns about my health that I may have had. They would even go as far as to explain to me exactly what was going on in my body and why it was a result of the drugs and not something else. The nurses would just have that look on their face that said it wasn’t even worth trying to explain why I wasn’t worth their time.
When I awoke next the infection in my arm had worsened and I was on my way back to the ER. The nurse had finally arrived at the facility. It was the woman that I had originally spoken to when I first called about admitting myself. She was an older woman and seemed to be knowledgeable but couldn’t offer me anything more to calm my anxiety about having to be readmitted to the hospital for another two week stint.
I was on my way back to the hospital again.
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