Cool

So I found this old piece I wrote last year in the middle of an overnight Emergency Room shift when things finally slowed down and it pertained to my last posting so why not continue a theme about addiction ;) Let me know your thoughts.

It's 3:58 in the ED and I'm thinking about how easy it is to spin a human in the wrong direction.

Bed 15 has lower back pain, an almost sure sign of drug addiction or seeking behavior when it presents at 2am. He had surgery 4 years ago- and still dabbles with cocaine. I think of my 9 month old, of how fragile her hair feels on my fingers when I run them through it every morning as I kiss her cheek. I wonder if he was ever held like that. What happened to this man? Who didn't give him what he needed, and how old was he when he didn't get it? Or did he have it all- and just make the mistake, one Thursday in 1989, of snorting a line of cocaine for the first time and liking it enough to try again. Bed 14, his neighbor, is convinced that she's going to die. She has sickle cell disease and comes in every 3-4 weeks with full body pain. Someone told her once, somewhere, that this is the common presentation of sickle cell "crisis" for which the treatment is pain medication and fluids. There is no good way to tell if the patients are actually feeling pain, and no good way to determine whether her misshapen red blood corpuscles are clogging arterioles throughout her body. So we treat her, over and over again, every other week or so. I wonder what she's really here for. When I touch her knee in an effort to examine the joint, she flinches. Was she abused once? Was it a family member?

My daughter's smile saves me from this awful thought, the way she looks at me definitively when she says "dada". The way she won't let me give her bites of dinner anymore because she's decided that now is the time for her to do things herself. What else will she do alone in this lifetime? Will she be safe? Will the consequences of her actions, and what comes her way lead her on a path of darkness? Will I give her enough tools to know herself and to be aware of her choices? Will she seek the highs that life provides without narcotics?

Room 4 is an elderly woman with a fever that has been explored for a month without a diagnosis. She has undergone procedure after procedure, blood draw after blood draw. She's been on multiple medications, the most powerful antibiotics, and her fever persists. Her husband is angry. He stands beside her, holds her hand. He looks at me with discontent and distrust as I enter. Her eyes are the same shade as my daughter's. I picture my little one, at age 63, and I hope that beside her will stand a man as honorable and kind as the man before me. I hope she finds a living guardian- a watchdog to be her advocate and her champion in times of need. These are the family members so often misinterpreted as "getting in the way," and yet these are the ones who save the lives of their loved ones by second guessing and demanding the truth and a plan and some action. Will my daughter be this strong willed? Will I teach her to be? Will I even need to?

I think of how easy it is to hold my baby in one arm; that each of us was as light once. Each had people make choices for us, until they were old enough to start making them for themselves- and so began a journey down the path of choices- choices ranging from utterly miserable and unfortunate and in the dark to self aware, and happy. And patients who travelled both roads are crowding the ED tonight with concerns and hopes. The concerns are different room to room. But both are, perhaps, hoping for the same thing- to return to a place, at 9 months old, where they could be be healthy; where they could be held- and told the right things, and treated the right way, and given the choice again to make a life for themselves, fingers running through their innocent hair, every tear wiped away with laughter and joy- with care- by someone who cared.