When Does the Light Go On?
by Ned Wicker
I’ve seen a lot of overdose patients in the hospital, but this one is a heartbreaker and particularly difficult, because the last guy in the room who realizes he has a problem is the one who has a tracheotomy, receives kidney dialysis and has a loving and supportive family who are sick with worry. Jessie came to us a couple of weeks ago after overdosing on opiates. His live-in girlfriend is an enabler, but at least she had enough sense to call 911.
Officially, the reason for his being in the ICU is that he coded. He coded the first time in the Emergency Department, then coded again when they got him upstairs in the ICU. The overdose caused Jessie’s breathing to slow way down and caused his heart to stop beating. Had he not coded, he would have been placed on the medical/surgical unit for observation. While on that unit he could have received medical detox, but that is not treatment for drug addiction. That’s just getting a person medically stable. As it turned out, Jessie was in the fight for his life, with a team of medical professionals doing everything within their power to keep him alive.
Jessie has been an addict for a long time. He has two kids and shares partial custody with an ex-wife, who is not a user. They have been keeping them from the hospital, mainly because seeing daddy hooked up to life support can be very unnerving for a child. Besides the very first conscious thought Jessie had when he woke up in the Intensive Care Unit was to text his dealer and try to score. The staff decided it was in his best interest to keep him sedated, because of his aggressive and inappropriate behavior. The celebration over his waking up was short-lived because he was in serious shape medically, and it was not at all a certainty that he would live through the night. But he had to text his dealer.
Opiate overdoses are not uncommon at all. It can happen to anybody, any family. These folks are wonderful, church-going, Bible-believing Christians. Mom has been holding vigil in the hospital since day one, the girlfriend is there every night and the brother, who is the medical power of attorney, is a strong, stabilizing force. Dad is a man of faith, who realizes that his son’s condition is not just medical, but spiritual as well. They have rallied together and seem to understand just what has to happen. The enabling girlfriend is being given every opportunity to join the effort, but the addict will always look for the weak link in the chain, to manipulate, divide and take their side.
This has been a learning experience for the family. In the past the idea that Jessie could be a drug addict was unthinkable. After all, good suburban families don’t produce addicts, or at least that’s the image they want to project. It’s always somebody else. That gets hooked and some other family that has to suffer though the torment and uncertainty. Denial is powerful, and addiction uses denial to fool the user into thinking that they are in control, and the user’s family doesn’t want to face the ugly truth that their church-going son is a druggie, so denial comes in handy. Either way, denial is a killer.
Difficult to assess
Progress is sometimes hard to assess. Jessie being alive is progress to be sure, but the dialysis suggests he has a long way to go. He was intubated, but is now on the track, if that is progress. Hopefully his kidney function will return. He’s not out of the woods. The family is gathering resources for the siege ahead. Families have to go through this, because unity is a key ingredient in holding the plan together to get the addict into treatment.
The last thing they want to do now is allow Jessie to make his own decisions, which more than likely will exclude treatment. He will claim he can handle it; he can deal with his drug use without any help from anyone. The addict thinks they know better than anyone else, and will go to the mat to prove it. Jessie is lucky, he has his brother to look out for him. The brother has seen enough and knows that Jessie either gets the treatment he needs of the next time is likely to be fatal.
The next chapter will be a challenge
The next chapter in Jessie’s addiction life has not yet been started. As much as the hospitalization has been an ordeal for his family, Jessie’s real work will begin when he walks out of the hospital. Getting his life back together, getting his career back on track, getting his family life repaired and giving his kids their father back is his biggest challenge.
The addiction could care less about the kids, about mom and dad, about his brother and the girlfriend. Jessie’s biggest choice now is whether or not to use again. Hopefully, he will have that opportunity to chose and will chose wisely.