“Dr. Iqbal, are we really going to follow up and keep her in our practice? She's a heroin addict and she's going to be using again this pregnancy. She never went to any rehab or took any suboxone!”
I asked our nurse what she knew about the patient other than what she obtained in triage. She replied that it was all she knew, so I told her the rest of the story.
Fifty years ago, smoking was socially acceptable, and I purchased my first carton of Kools for only three dollars. Liberated and away from home in college, I could inhale freshly lit tobacco whenever I wanted. Ah, heavenly.
My son struggled with addiction for over eight years. He died last March of a heroin overdose at the age of 25. To lose a child is completely devastating. I’ve been working through the many layers of grief and am slowly healing.
I don't blame you for being in pain. It's a nasty wound you have.
When we rolled you back to the OR, bracing against every bump, I was there. When they cleaned out the microbial debris, I was there. When they layered in wet gauze to siphon out any fluid, I was there.
So when I come around the next day to change your dressing, I don't blame you for demanding pain medicine beforehand. I'm relieved that you seem willing to work with me. That the many whispered warnings and notes from your current doctors and nurses seem to be wrong.
In 2008, I had the first of five surgeries on my jaw; I had the last one on December 13, 2017. To deal with the pain from the surgeries and from the prosthetic device implanted in my head, I initially relied upon Tylenol. That medication, however, soon proved useless; it did nothing to alleviate the intense pain I was enduring. But I could not take Alleve or related drugs due to the effect those medications had on my stomach. My primary care physician, who had prescribed Vicodin to my father for his spinal stenosis, gave me a prescription for the same drug. And so began my addiction--albeit a controlled one.
Seven days after we cut out your voice box, you announced that you were leaving. You flung yourself off the bed, ripped at your hospital gown and propelled yourself down eleven flights of stairs with the precise, dramatic flair of a seasoned, stage actor. You were a sight to see.
I followed you down, down, down; my blue scrubs, too big, slipping down over my hips as I ran. There was no stopping you.