We are sent to a detox center for a diabetic. We find a sixty-year old Puerto Rican with a blood sugar over 600, although he has no complaint. He has come to the center to kick his heroin habit. But first now he will have to go to the ER to get his sugar under control. “I did three bags of heroin this morning,” he admits, “then I flushed the rest of the bundle down the toilet, and came here.” He is a man with deep eyes. He speaks quietly. “I spent eighteen years in prison,” he says. “When I came out, I saw there was so much suffering in the world. People on the outside are used to it, and they don’t see it, but I saw it. That’s how I got started. I’ve been on and off of it for most of my life.” He tells us how he lost two brothers to heroin and a sister and two cousins to crack cocaine. “My father died at ninety last week. He was all I had left. I was lost without him. It was a setback for me, but I looked at myself this morning and knew I wouldn’t see seventy if I didn’t get a hold of myself. I knew it was time for me to come in.”
At the scene of a motor vehicle accident, a wife yells at her husband who has driven his new Toyota into a parked car. He called her and gave her the address so she could bring his insurance card. The address isn’t in the best part of town. After she leaves, he waits with the cop for the tow truck to come. The cop thinks something isn’t quite right with him, and asks if he is a diabetic. He is, he says, so the officer calls us to check him. He looks to be in late thirties. He wears blue jeans and a college athletic sweat shirt. His sugar is 43 a little on the low side. His answers to questions are slow. He can’t remember if he ate or how the accident happened. When I go to roll up his sleeve to look for a vein, he at first refuses. “I have issues,” he says. “We don’t care about that,” I say. He has track marks on his arms. I put in an IV and give him some sugar that clears his mind up. He looks at the front bumper of his car which is all mashed in. Driving along and he veers off the road. I wonder what he’s thinking now. Maybe I should have stayed home. Maybe I should have had a sandwich before I shot up. I wonder up the road what lays ahead for him. I don’t think he has thought about that yet.
A wife comes home from work and finds her fifty-year old husband on the kitchen floor, semi-responsive with vomit on his face, chest and the linonleum. His skin is cool. She calls 911. He recently had shoulder surgery and is on blood thinners for clots in his legs. She has no idea what has happened or how long he has been there. When we arrive, we find he can answer questions. He is not hurt, his grips are equal, there is no facial droop, but his speech is slow. He looks at his wife and says “Sorry.” I ask what meds he is on. I’m thinking maybe he has taken too many and maybe drank, although I can smell no liquor on his breath. He seems familiar to me; not his face, but his whole manner as we pick him up. We are in this new freshly built home, a large sparse home with hardly any furniture, but he seems just like a homeless man in his demeanor. Here is this guy with a well dressed wife, and he seems in his faded jeans and grey tee-shirt and flushed face to be just a street man. He looks up at her and again says, sorry. We get him up on the stretcher and as we start out the door suddenly I hear the wife say, “Hold on a minute.” She has found something in the bathroom. Heroin.
She is beside herself, she is so angry. The officer asks her if this is something he regularly does.
“No, He’s been clean for almost sixteen years — since before I met him. He’s been very upfront about his past with me, but I’ve never seen it. He doesn’t even drink. I can’t believe he did this. I could kill him.”
“It’s the most addictive drug in the world,” the officer says. “No one ever completely beats it.
“I just can’t believe this. I’m in shock.”
She comes to the hospital with us, riding in the front. “Is he okay?” she asks.
“He’s stable,” I say. “He’ll be all right.”
She cries. “He’s been so depressed,” she says. “He lost his grown son two weeks ago. He’s been out of work with his injury. He’s had no money. We have a new home and with him not working, we can’t afford to put anything in it.”
“He’s beaten this before,” I say, “He can do it again. Don’t be too hard on him. It sounds like he’s had a rough go.”
“I could just kill him,” she says, but not as harsh this time.
After we leave them in an ER room, I come back later and glance in. She sits next to his bed, leaning against him, her head against his shoulder, his big arm around her. He brushes her hair. Niether of them speak.