Nothing to lose.

"The most dangerous creation in any society is the man who has nothing to lose." 

~ James Baldwin (1924 - 1987)

You were shivering and covered with goose flesh. A slick film of sweat enveloped your skin and stayed that way no matter how many times you tried to wipe it away. Food particles floated on top of the murky liquid in your emesis basin, sloshing back and forth on your lap with every tremble of your rebellious body. You looked up at me with eyelids at half mast; you tried to speak but could only moan. With your torso still quaking you finally got a few words out: "I-I-I-I fee-fee-feel like I'm gonna d-d-die." And the look on your face when you said it made me believe you.

Damn. This wasn't what was intended. You were supposed to make it over to your friend who said he had some money. Once you got the money, things would be fine. You'd get what you needed before feeling like this set in. But you stepped off of that bus and walked those four blocks just as you said you would. Problem is, when you knocked on that flimsy screen door, the person who came to greet you wasn't your friend.

"He ain't here," the other person said. You could feel the urgency welling up inside of you. Your head cocked sideways as you studied the person on the other side of that screen. He had you by at least fifty pounds but that didn't stop you from making a quick assessment about whether or not you could take him down.

"He supposed to have some money for me. Did he leave it?"

The other person just laughed out loud when you said that. Then, intuitively he stopped and said, "Don't even think about getting froggy and trying to leap on nobody neither 'cause it won't end pretty for you." That urgency turned to desperation when he slammed the wooden door shut in front of that screen. You started to knock, begging for something, anything he might have in there but the minute you heard that loud click you stepped away. Was it a deadbolt or a glock? You weren't sticking around to find out. 

Light became dusk. And dusk became dark. That urgency and desperation evolved into physical sickness. Innards threatening to hurl and bones feeling like each one was being broken from the inside out. And this? This wasn't what was intended.

Calmly, I took your medical history. I asked you about your story and listened as you told me what happened through your chattering teeth and glistening face. But honestly? The explosion of red confetti dots covering your left hand and forearm explained it all. Well, not all of it. But at least it explained your immediate clinical picture.

"How did this happen?" I asked.

Somehow you got what I meant by that question. You knew that I wanted to know how this happened. All of this. You spending your days roaming around and hoping to get what you need to not feel like you feel now. At what point you even stepped into the threshold of this shitty existence. And I am thinking of that adjective to describe it because this just could not have been what was intended for you life.

"I got in an accident. A bad one. They gave me some pain pills and they gave me a couple of refills. Next thing I knew, I was hooked."

"Dang." You offered me up this lopsided shrug when I said that and something about that gesture made me sad. I squinted my eyes as I tried to sift my brain to get the course of events. Then it clicked and I nodded slowly. "First the pills . . .then. . I guess you turned to heroin because it was easier to get?"

"That and way, way cheaper. It hits you harder, too." You winced between sentences and then went on. "Nobody get on this stuff like they did in the old days. Just about everybody I know that shoot up or snort heroin started off on pills. First they was prescribed by a doctor and then all hell broke loose. Like I don't know nobody that just chose heroin to get blowed right off the rip. No way. It's just the way to keep from getting sick."

I just stared at you when you told me that part. My body filled up with these complex emotions that were hard to get my mind around. Pissed that the medical profession was now a new part of an old problem. Intrigued by this suggestion that shooting up heroin just for the sake of getting high was as played out as Tab soda. Pills had become the Coke Zero, and for many it was on accident. In other words, it wasn't what was intended. By the patients or by their doctors when they acquiesced and gave "just a little" of "something strong."

"So you don't know folks who just decide to give it a shot? I mean, no pun intended."

"Naaah. Not really. Not no more. Maybe some really stupid rich kids. But most folks I know start with pills. For real. The needles don't come until they go broke from buying pills. Then, as for the other drugs, once you all caught up in the life, you just in it. So you'll try whatever, you know? Meth, heroin, speedballs, all that."

Again, I said nothing. I mean, what could I say? Instead I just sat there pondering this quote from James Baldwin because that's what that last sentence made me think about.


"The most dangerous creation of any society is the man who has nothing to lose."

~ James Baldwin

Let me tell you. Some of the deepest truths I've learned about addiction have come from simply listening to the voices of my patients. Patients who have lived it or who are living through it. People like my Uncle Woody or like my patient who explained to me the real truth about how a crack addiction develops. And every time it is nothing like what I'd seen on television or heard through urban lore; the common thread being that this--the wretched monkey now perched upon their backs--was never, ever what was intended.

No it was not.

The sad truth is that there was little we could do for you without resources. I couldn't carefully place you into the open arms of an inpatient rehab facility nor could I hospitalize you until I could. Instead, the ball was placed into your court forcing you in your broken state to dribble down a full court and shoot.

You left before I could wish you luck. That ball before you turned out to be an airball. Your sheets were empty before I could even get back down to you.

I guess in my Pollyanna-ness I imagined this brief encounter as something more pivotal than it was. I pictured us plotting your comeback and me running into you somewhere looking robust and strong someday. And I swear to you, I believed that this could be your story. I did.

But as of today? This wasn't what was intended. The magnetic pull of your own back alley hospitals was greater than me and my scattered words of encouragement. In your mind, you had nothing to lose at this point--and maybe you were right.

I guess I just wish I could have convinced you of all you had to gain.

***
Hump Day, it is.

And now I'm crying because writing this made me think of a Grady angel who left in August of 2009--and now is making me hope this one won't be joining her in August of 2014.

Addiction sucks, man.

The way of the world.

*descriptive details modified to protect anonymity

image from here

Today I was doing a drive-by at the grocery store. I almost never have my dinner act together so instead of being one of those Pioneer Women that either slays her own cattle, grows her own organic super-veggies, or heads out to her deep freezer for all of her pre-shopped-for groceries, you can put your money on me visiting my local Kroger or Publix on at least two weekdays each week.

Yes, it's a bit pathetic and a monumental waste of time. But when it comes to perishable items, I need a combination of the energy to cook them and, well, having them to cook. More often than not, those two things don't line up simultaneously. I'm the queen of wanting a PB and J but realizing I'm out of the J. I often want to make some sauteed spinach or collard greens or snapper. . .  but . . .whoops. . .I don't have any. AND if I try to get all cute and organized but the spirit doesn't move me to cook, I'll purchase all those things and they just might go bad.

Yup.

Oh and did I mention? There's also the part about having to be in the mood to eat whatever that perishable item happens to be. And even worse, Harry does, too. This adds an additional curveball to the meal planning game--especially when the BHE declares that this week (for him) is a LOW CARB or NO CARB week. Right after I've made a perfectly delicious pot of spaghetti. So he sits there looking all forlorn eating a scrambled egg and nothing more.

Mmmm hmmmm.

So yeah. I was in the grocery store because tonight I was feeling like some turkey burgers and that was cool since Isaiah Manning specifically asked for me to make them. The good news is that it isn't a LOW CARB or NO CARB week for the BHE and I just so happened to be in the mood to slave over a thirty minute meal. I had some parts but not all parts of what I needed. The last step was simply getting the ground turkey for the burgers, which is exactly what I did. I even got some of those cute little slider buns because the kids think mini-burgers are somehow tastier than regular-sized burgers. Go Mommy! So, yeah, I was in Publix getting all of these things and pushing my cart and listening to music on my mental iPod and smiling at the thought of how happy these mini-burgers would make my kids.

Go Mommy.

But that's not what I want to talk about. I want to tell you about what happened when I was in Publix this evening. Which has very little to do with my lack of domestic organization.

So, yeah. Where was I?

Oh! I was on the frozen aisle. Trying to decide between the Publix brand brussel sprouts and the Green Giant ones. So I'm leaning inside of the freezer door with cool air blasting me in the face and two bags of frozen baby lettuce-heads (as Zachary used to call them) in my hands. And I was in my own little world because this song called "I Left My Wallet in El Segundo" was playing on a reciprocating loop on my mental iPod so other than that and the sprout comparison, I wasn't paying attention to much else.

"I left my wallet in El Segundo.
I left my wallet in El Segundo.
I left my wallet in El Segundo.
I gotta get it, I got-got to get it.

I left my wallet in El Segundo.
I left my wallet in El Segundo.
I left my wallet in El Segundo.
I gotta get it, I got-got to get it."


I could hear the beat just like it was 1989, and I'm pretty sure I was bopping my head from side to side exactly like it was coming off of a boombox on the porch of my freshman dorm. So, yeah, I'm in the groove and suddenly I feel someone tapping me rather firmly on the shoulder.

Tap, tap, tap.

What the .  ?!

Now, check it--I'm half in/half out of the freezer--and first this strange person has put their hands (or rather finger) on me.  Dude.

Then came this:

"'Scuse me, ma'am. Ummm, I was wondering if I could help you out with your groceries today?"

Wait, huh?

Let me just tell you. Being poked on the arm while you're zoning out on frozen foods and retro hip-hop music lyrics is guaranteed to scare the absolute shizz out of you. Especially if the person asking you instinctively gives you the creeps.

Which this person did.

So I jumped back nearly falling butt first onto the steam-in-bag corn on the cob and family-sized succotash. I reflexively extended my hand for protection. In a way that said, "I don't know you like that--you need to back up OFF me."

He could tell that he scared me.

"Oh. . .ha ha . . .I'm sorry, ma'am. I ain't mean to startle you, you-know-what-I'm-sayin'? I was just, you-know-what-I'm-sayin', tryin' to see if I could help you with your groceries."

Help me with my . . . what?

I scowled at this offer and wondered what the hell he was talking about. What? I realized that my face surely looked mean, so I tried to soften it up a bit. "Um. . . .I'm sorry, what?" I kept my hand out Heisman trophy style because this dude was entering my personal space and talking way too close to me. My fear was pinning me into the freezer and I needed him to back up. He seemed to get the message and took a big step back.

"See, if you was gon' pay with cash, know-what-I'm-sayin', then I could just get your food and then you could just give me the cash."

I stepped in front of the freezer door and let it close behind me. Quickly I fixed myself beside my shopping buggy for safety and did my best to get my mind around the whole scenario.

Huh?

I stood there speechless and staring at this man. He was youngish but obviously was living a hard life. His stringy hair was overgrown and pasted to his head in oily ringlets. I couldn't tell if his complexion was olive or just dusky with filth from not bathing. An enormous tattoo was covering the entire right side of his neck. A giant cobweb with a spider in the center. Two similar inkings were inside of the crooks of both elbows. The drawings were asymmetric and amateur; the fuzzy blue-green ink was crude and wobbly. My eyes trailed down to his legs and that's when I noticed the speckled confetti of scabs and needle sticks along the sides of his ankles.

"Was you planning to pay with cash?" he asked."I mean for your stuff in your cart?"

I kept staring incredulously. "Cash? Uhhh. . no. I wasn't." Which was true because I almost never have cash. "Thanks anyway, sir. Okay. I need to go."

I quickly gripped the handles of the cart and pushed it away from him as quickly as I could. This? This was a drug thing. I know a stonghold when I see one and that's exactly what this was. Instead of trying to make him feel bad or even talking any further, I told myself to get away from him. Before he could say another word, I was down the aisle and out of his sight.

Immediately I felt sad. But then I told myself, This is midtown Atlanta. The heart of the city. There are drugs in the hearts of cities. I stopped for a moment, closed my eyes and said a quick prayer for that man. Then I went back to shopping for my groceries.

The song on my mental iPod changed off of "I Left My Wallet in El Segundo" to some old school Earth, Wind and Fire singing "That's the Way of the World."


"You will find . . . .peace of mind
If you look way down in your heart and soul
Don’t hesitate ‘cause the world seems cold
Stay young at heart ‘cause you’re never (never, nevaaaaah) old at heart. . "


I grabbed some fruit. Picked up the mini-buns and a bottle of sliced pickles. Something about hearing this song after seeing that man felt okay, so I felt myself shaking those ill feelings off. I made my way back to the front and stopped to size up the lengths of the lines. The "EXPRESS LANE 15 ITEMS OR LESS" lane had only one person in it, so I quickly did a estimate of how many things I had to buy. Seventeen. I stepped into that line anyway since in my head what they really mean is "EXPRESS LANE 15 ITEMS OR WHATEVER WON'T GET YOU THE HAIRY EYEBALL."

And so I get back to my music playing in my head as I begin putting my seventeen items on the conveyor belt.

"That’s the way of the world
Plant your flower and you groooooow. . .  a pearl
A child is born with a heart of gold
The way of the world makes his heart grow cold. . . "

"Uuummm, excuse me, Miss. . . uhhh. . .how you doing? I like your hair style and your outfit."

I turned down my mental Earth, Wind and Fire and swung around to see who was speaking to me. This time it was a woman. I could see the dude with the oily ringlet hair pacing around a few feet behind her, picking up a box of Post Raisin Bran and studying it in a way so exaggerated that it seemed like a scene from a bad movie.

How you doing? I like your hair style and your outfit?Say what?

All of it was odd. Flighty and disjointed.

"Even if you spend like, you know, like forty or fifty dollars, if you give me twenty in cash, I could pay for all of it with my food stamp card. All your stuff could go on this and, you know, I'm okay with getting whatever else you want like even to a hundred dollars and you could just give me like sixty dollars or so."

I took a breath and made sure I didn't make this more than it had to be. "No, thank you, ma'am. I'm not paying with cash today. Thanks anyway." There. That was easy enough.

"If you press 'cash back' and get only one thing, you could get a twenty back or, you know, whatever amount and I could get the rest of your stuff. And like I was saying, you know, if you want you could go back and get a hundred dollars worth of stuff." 

Sigh.

"Um, no thank you."

"I had seen your hair and was like, 'That look nice. She seem like she nice.' That's what I told my friend when we seen you. You know, because I got to get my medicine and I have to have some cash to get that, you know, so that's why I was asking you that." She offered me a big, wide smile. Nearly all of her teeth were fractured and decaying; it was an alarming thing to see. I did my best to smile back but I'm sure that it was about as believable as that man reading the label of the raisin bran box.

When I smiled, I guess the dude thought that meant that she had scored because he started walking toward me smiling, too. The sight of them standing side by side, disheveled and anxious hurt my heart. I thought of my mantra that I use often at Grady Hospital--"Everyone was once somebody's baby." Usually that makes me feel better, but instead of giving me some new found empathy, this time it just made me feel frustrated and sad.

All I could hear was Earth, Wind and Fire.

"That’s the way of the world
Plant your flower and you groooooow. . .  a pearl
A child is born with a heart of gold
The way of the world makes his heart soooo cold. . ."

I stared at them while lost in those lyrics. Imagining them born with their hearts of gold and wondering what turn of events caused them to lose their souls like wallets in El Segundo.

"I don't want to be a part of that," I finally said. Then I added, "I hope things work out for you."

Before she could answer me, the Spiderweb dude had pulled her arm to let her know that he'd gotten someone to bite.

"He's cool with it," he told her with his equally decayed smile. Spiderweb dude didn't even bother to hide his elation. And she didn't even bother to let the dust settle on our conversation before turning her jerky, awkwardness over to someone new. Someone who, unlike me, was "cool with it."

The "cool-with-it" man looked to be in his early twenties--a college student perhaps or maybe even a recent grad. His fraternity shirt and cargo shorts gave it all away. It was obvious that the entire scene was hilarious to him. He laughed and said he'd give them two twenty dollar bills for all one hundred on that card. I made brief eye contact with him and he responded with an amused smirk. He glanced down at his buggy full of staples for the week and gave me an animated shrug.

One hundred dollars worth of groceries for less than half that in cash? Why not?

Sure. I could have hissed in that young man's ear about how he was contributing to the demise of two human beings. I could rant about the supermarket I was in and stomp my feet about why, why, why such a thing happened in a place where shopping is supposed to be a pleasure.

But that? That wasn't about Publix. That was about one of the uglier parts of the way of the world. A harsh reality that I wasn't expecting to see or think about while picking up mini-burger buns and brussel sprouts. And as far as that dude who got sixty percent off on his groceries, in this economy I refuse to judge. All I can say is that the whole thing was unfortunate.

Anyways.

I paid for my food and headed outside. At Publix they'll help you put your bags in the car and roll your cart away if you'd like. I almost always decline and today was no different. After I put my last bag in, I closed the hatch, got into my car, and turned the ignition.

Just then, I saw a blur going by from the corner of my eye. Of course. It was that man and that woman, hurriedly running like quirky puppets on invisible strings. . . .darting between parked cars across the lot to whatever empty place awaited them.

And just as I backed out of the space I saw this:

The other guy walking beside the nice employee whose offer he did accept to assist him to his car with his groceries--all one hundred dollar's worth.

Damn.

***
Mental iPod playlist:

Earth, Wind and Fire singing "That's the Way of the World". . . one of my favorites from them. . .


and, of course, A Tribe Called Quest with the hard to shake out of your head "I Left My Wallet in El Segundo."

Substitutions OK.

hug it out.

 Rx:

 Hugs P.R.N.  (as needed)

Refills: unlimited

Generics and substitutions OK.

Today while sitting on the wards writing notes at Grady:

"Excuse me. . . "

I look up and a pale, thin youngish woman is standing on the other side of the nurses' station.  She was wearing two hospital gowns, one forward and one backward, but what stood out most was this big smile on her face. It was almost scary big, actually. Anyways, there were several resident physicians and students scattered around the area doing work. Although this patient's scary big smile was nonspecific and seemed to be aimed at everyone, for some reason, she zeroed in on me.


Aaaahh, of course she did.

"Yes, ma'am?"

"Can I ask you a question?"

Oh Lawd.  This wasn't a "do you know where financial counseling is?" or "can you tell me where the restroom is?" kind of "can I ask you a question."  It was loaded. Kind of like the day that man totally caught me off guard with the race question last year.

"Sure, ma'am,"  I finally answered.

Why not? At worst it would be slightly inappropriate like asking me to discharge her or take out her IV right now or write for some kind of narcotic pain medicine. At ultra-worst it would involve me getting up off my tukas and escorting her somewhere way out of my way or her being psychotic. At best it would be amusing-- and at ultra-best it would be blogworthy.  (I'm always keeping my eyes open for new material.)

Now here's what's funny.  I was thinking blogworthy like . . . . like that day Roy A. called me to tell me that there was a dude standing in the middle of the Grady atrium playing a rusty trumpet.  Okay, so I was already gone that day, so didn't get to see it with my own eyes, (but I still deem it a suitable example of juicy blogworthy material.)

Anywho.  I didn't know what this lady was going to ask me.  I was about to find out.

With her scary-ish smile, she quietly asked. . . .

"Would you be willing to hug a stranger?"

Wait, huh?

"Excuse me?" I asked for clarification. I couldn't help but notice every other person getting exponentially more industrious with whatever they were being industrious on.  Ummm hmmmm. Their looks said. . . .

Hug a stranger? A stranger with a scary smile? Awww hell naw!

I kept staring in her direction and she repeated herself. "Would you be willing to hug a stranger?"


Lawd. She is serious.

But she was looking at me, not them. And she almost looked a little bit tearful.  So I made a quick decision. Why not? Let's hug it out, man.


I walked over and gave this stranger with the scary big smile a hug. Afterward I step back and notice that she is crying. For real, crying.

"You have no idea. . .no idea how much that meant to me. I get to go home today. . .and I'm so happy. I'm going home."

"That's great," I replied.

This lady was not my patient and I had never seen her in my life. I had no idea why she was hospitalized, and still don't. But what I do know was that she seemed to genuinely need that hug.

"And you know what else?" she gushed, "I got a job! I just found out I got a job." She started tearing up again and began wiping her eyes with the heels of her hands. She took a big sigh and regained her composure. "I'm just happy, that's all. That's why I needed a hug. So thanks for that."

And just like that, she turned and walked down the hall.

Wow.

Blogworthy indeed.

little superhero brothers need hugs, too.