The call is for a possible overdose. A tall attractive young woman in leopard skin pants, and a Ginger from Gilligan’s Island hairdo, meets us at the apartment door. She is high. Her balance as she sways in front of us is so bad it is making me dizzy just looking at her. “Thank you for coming so quickly,” she says.
“Is he breathing?” I ask.
“Yes, but he won’t wake up. He had his methadone dose upped today and he took some of my benzos. I did CPR on him.”
The apartment has hardwood floors, high ceilings and big windows that look down on the city from the 4th floor of the recently renovated building. I follow her as she stumbles down the hall. “This way.”
A bare-chested bearded man in his thirties lays on the bed, clearly on the nod, but breathing. He has a strong pulse. Some stimulation and he sits up with a jerk to see me, my partner and four firefighters.
“What did you do?” he says to his girlfriend. She begins to cry. “I saved your life,” she says. “I did CPR on you. 30 and 1. I threw cold water on you. You almost died.” She looks at me and says, “Tell him. Tell him I saved his life.”
“I don’t want to go anywhere. I’m fine,” the man says. “This is my house. Get the fuck out.”
“You should go to the hospital,” I say. “You shouldn’t mix benzos with methadone.”
“We’re both on methadone,” she tells me again. ”I have a note so I can take clonidine. I need it for my anxiety. He doesn’t normally take it. They upped his dose today, and then he took three of my clonodines. That I know of.”
“And he did heroin,” my partner says.
“No, he didn’t.”
“I found three bags in the bathroom,” my partner says. “Sweet Heart.” Sweet Heart is a brand making the rounds.
“Hmm,” she says, “I’m going to have to rethink this.” She says to her boyfriend, “How come you didn’t tell me you scored some heroin?”
“It was just four bags,” he says.
“I have nothing to say. I just want these people out of here.”
We try to convince him to go to the hospital.
“I know my rights,” he says, “I don’t have to go. She shouldn’t have called you.”
We argue the fact that he mixed benzos with the heroin on top of the methadone which makes it necessary for him to be monitored.
“You can’t make me. You’re not going to arrest me, are you?”
“No, we are not the police.”
“Good Samaritan, Good Samaritan,” the girl says, waving her hands in the air. “You can’t arrest us, right?”
“No one is arresting anyone. We just want him to get care.”
“I gave him 30-1,” she says, and “put cold water on him. I’m an x-ray tech. Tell him not to be mad at me. I saved his life.” She turns to him and frowns. “Honey, I love you, even though I’m mad at you. I don’t want you to stop breathing again. You need to go.”
He lets out us his breath and stares straight ahead. “All right,” he says, “I’ll go. Get me my sandals and my phone. Where’s my phone?”
At the hospital, after we leave our patient care report with the nurse, we see the girlfriend has climbed into the bed with the patient. She cuddles him, brushing his hair, while he taps away on his cell phone. “I did 30-1 on you. You should share with me next time. I saved your life.”
Another overdose call. By the time we arrive, the FD is already there. The bald young man with a day’s growth of beard is sitting on the bus stop bench. He wears a sleeveless muscle shirt and knee length basketball shorts. He is awake and breathing, but his pupils are pinpoint. “I wasn’t doing anything,” he says nervously. I recognize him as a guy I saw on Park Street earlier in the day standing with a pretty girl with short blonde hair in a blue jean jacket. The girl caught my eye because when we had driven by the corner where the needle exchange van was parked, I had seen her waiting her turn and remembered feeling sad that such a young pretty girl was a user.
“You’re going to the hospital. You were down on the ground in praying position out cold,” the firefighter says to him.
“Yeah, yeah, I was praying. I had a bad day and needed help.”
“Get out of here. Don’t lie to us. You’re on heroin. Show me your arms.”
“No, no, I’m not.”
“Get on the stretcher.”
The police are here now and they are also yelling at him to get on the stretcher, but he does not want to go.
“You can’t make me go. I know my rights.”
He is alert and oriented enough to known his name, where he is, the date and the president. I am not going to pressure him to the degree the firefighter is.
“You know your girlfriend took your works and the heroin bags out of your pockets and took off at the first sound of our sirens,” the firefighter says. “Somebody saw her. She’s long gone.”
“I wasn’t with anyone,” he says.
“Get on the stretcher. You’re going to the hospital,” the firefighter says again.
“No,” he says.
We tell the officers he knows who he is and where he is. We can’t take him if he doesn’t want to go. They shrug. While one officer talks to a fireman about last’s night’s baseball game, the other officer gets the man’s name and runs it for warrants. It comes up clean. The firefighter has given up, too, and is getting back in his truck with the rest of his company.
I get the young man’s info for the refusal and give him my little talk about where he can get Narcan, and how he should never use alone. He doesn’t know about the Narcan, but says “We shoot up together when we can, but sometimes I do it alone.” He is from the suburbs. They were waiting to get the bus back to where they live and he used. He thanks me. I give him a card with the opioid hotline number on it. He walks quickly down the street looking frantically at the faces in the crowd. Where is the girl?
We follow him in the ambulance at a distance for three blocks, but when he turns the corner, we lose sight of him.
She sits with her pit bull outside the market. There is a small dish of water for the dog and in a plastic bag several empty plastic bottles she will no doubt redeem. She and the dog look very sad.
I met her a year ago when I was walking down by the pond. She asked me what I was looking for and I told her syringes and also the heroin bags. I was interested in the brands. We had a long conversation and she answered many of my questions about the life of a user. She told me she looks for syringes too, so she can exchange them for clean ones. The needle exchange van in on Park Street Monday through Friday, but not on weekends. She likes to have extra syringes.
When I asked her how she got started using opioids, she said she got into pills recreationally. Then one night at a party someone asked her if she wanted some dope. She thought they were asking if she wanted some coke. What she snorted was just like Percocet, except to the tenth degree. It didn’t take her long to graduate to injecting. But now after three years, she announced her heroin days were coming to an end, she said. Her parents were taking her to Virginia to get her back into rehab. She was leaving that Saturday. She was a really, pretty girl, and it was hard to put her together with being a heroin addict. She had lively eyes, and a young girl’s complexion. I wasn’t crazy about her punk rock haircut with the purple streak, but different generations have their own styles.
She doesn’t look quite so good anymore. Her hair is dirty and she looks like she is at least in her thirties, not middle twenties. She says her boyfriend came back into the picture after he had been gone for awhile so she never made it to rehab. They are very careful about when they shoot up. She waits a few minutes after he has injected to see that he is okay before she injects. She needs to know he will be alert enough to notice if she ODs so he can squirt her with the Narcan they always carry. They live under the highway bridge now with a group of other users.
Last week I asked her if she was getting health care and she said no. What about Medicaid? I asked. She lost her ID. She said without an ID you can’t get health care or get into rehab. I asked if her parents can help her, but she said they want nothing more to do with her. Her arms are all scabbed from bug bites that she picks at. That’s why I am here today. I hand her a plastic bag from CVS – cortisone cream for her bites, some protein bars, a bottle of water, a can of food for the dog, and a $5 dollar bill.
I thought long and hard about the $5 bill. The Pope says it is okay to give money to the homeless, it doesn’t matter what they are going to use it for. She seems happy and thanks me, but before I can talk with her more, I get a 911 call. When we turn out of the shopping center parking lot, our lights and sirens on, I look back to see if she is still sitting there, but now, she is up on the move, walking over in the direction where her boyfriend is going car to car, as he often does, holding out an empty soda cup collecting spare change.
We get cancelled before we get to the scene, and when we swing back, I see her scurrying up the street by herself herself (no boyfriend and no dog). She looks like a little girl off to see Santa Claus.