It is six in the morning and we get called for an overdose outside.  The address is not a surprise — a side street off Park.  Yet when we arrive, we find no one.  We are about to clear when a police officer who has also responded finds a backpack in the snow and sure enough coming down the street is a man who seems somewhat confused.  One side of him is dripping wet as if he had been laying in the snow.  He has come to claim his backpack.  I ask him why half his clothes are soaking wet.  He hesitates a moment, and then says he was helping a friend shovel.  This answer makes no sense.  It is after all six in the morning and the snowstorm was the day before, ending well before sunset.  

We tell him we were called for an overdose, but he knows nothing about it.   I ask him if he has been using drugs in the last several hours.   “Ohhh, nooo,” he says.  “Well, maybe seven years ago, but not for s long time.”

He knows the date and his name and has no interest in going to the hospital.   I suggest we take him to the hospital anyway.  He can get his clothes dried out and get something to eat, and maybe even get a checkup.  He says no, mumbles a thank you anyway, and says he will just be going on his way.   He picks up his bag and heads up the street toward Park.

The cop and I exchange some small talk, and then as I start toward the ambulance, I see something on the sidewalk.  I reach down and pick it up.  It is a retainer with three false teeth on it.  I start down the street to see if can catch up to the guy.  “Hey,” I call.  “Hey, dude!”

It is still pitch black and I am hurrying down an icy street holding some guy’s teeth.  EMS Moment 1538. I finally catch up to him.  “Oh, yeah,” he goes, “I was missing those, thanks.”  He puts them in his mouth, and thanks me.

“You sure you don’t want to go to the hospital?

“No, I’m good,”he says, and he continues on to Park Street and I head back to the ambulance.

About a half hour later, another crew gets called for a man in the snow on a street several blocks away.  It turns out to be a cardiac arrest.  I listen to the patch.  The man is the same age as my patient.  From the patch, they mention they have given him Narcan to no effect.  

I talk to the crew later and am relieved the man had a brown coat where my guy’s coat was black.  I ask if the medic saw any heroin paraphernalia or bags at the seen.  He says no.  The other medic who responded saw the fresh track marks, but that was it.  He was just dead in a snow bank.  Asystole on their arrival, PEA with some epi.  Called dead at the hospital.

2nd fatality of the morning as a crew from the south end worked and called a man found by his family in the bathroom by his family with the needle still in his arm.  ODs ebb and flow in the city, but the last couple of days have been on the high end.  Another bad batch or just the same old kill you anyway stuff sold on the streets of Hartford.

“So there I was running down the street, going ‘Dude your teeth!'” might have been the end of the story, but then, a month later.

I am taking a man from jail to the hospital for chest pain.  He checks out fine and we end up talking about the heroin trade.  I ask him what the strong brands are and I am a bit upset that the two he names as the most potent I have yet to encounter in my search for empty heroin bags.  He tells me about a month ago he was working in a heroin house.  A heroin house is a place where people can go to buy their heroin ($4-$5 a bag), a clean needle ($2), and they can shoot up under the watchful eyes of drug workers.  (I did not ask if there was a house fee or a fee if one of the house workers with IV expertise gets paid for helping the patron find a vein).  When they are done, they are free to go on their way, safe in the knowledge they have no heroin or heroin paraphernalia in their possession.  And if they OD, the workers have Narcan to revive them.  Not a bad deal.

Except the workers are not the most reliable people.

In other countries, and it is being considered in some states here, there are safe houses overseen by substance abuse professionals who can not only protect the people against overdose, but are there to help guide them to rehab if they are ready.  They are licensed professionals.  In this Hartford heroin house, the staff works for heroin.

The man in my ambulance relates to me how three people overdosed at one time.  The guy who was supposed to be watching was talking to his girl on the phone and went out to the hallway where they had an argument.  My passenger checked in his room, and saw two overdosed dudes, including one who was blue and seizing.  He struggled to give them all Narcan.  The directions on the box he says were not too easy to understand.  “We have to call 911,” he said to the other worker who was higher up the chain.

“No, way.”

I interject to say that you can call 911 for an overdose and have liability from prosecution.

He shakes his head.  “This is a drug house.”

“Point taken,” I say.

He goes on to describe the argument they had and how in the end, the staff took outside in the snow.

The street she mentions is the same street where I had the encounter with the dude who had lost his teeth.

(I need to inject here that when I talk to heroin users and or dealers I tell them I am not interested in any of the specifics that would lead to anyone either being prosecuted or killed or merely harmed.  I am EMS, my job is to help people, and to understand how the culture of heroin as much as I can so I can try to use the information I gain to help people stay alive and maybe find a way out of the heroin trap.)

My partner and I drive back along the street later that day.  I keep my eye out for bags.  There are many, and among them is one of the brands he mentioned that were particularly powerful. (The next day I find the second in the Park).   My collection is back up to snuff, and the mystery  of the dude with the teeth is, perhaps, answered.

My thesis is they gave both patients Narcan.  The guy with the teeth was left in the snow on the same street as he was likely already coming around.  The second guy perhaps was carried or driven farther away as he was still not breathing.  I do not know if that is true or if these patients were related or had anything to do with the supposed heroin house, but the whole story is quite curious.  Always after talking with someone I think of questions I would have liked to have asked.


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