"I don't know why I did it," he said. "This guy came over. He knew I'd been through a hard time, and he pulled out this bag of heroin. 'I have something for you,' he said to me. I didn't do the whole thing, but I snorted a bunch of it. I'm such an idiot." He crossed his arms and rolled his eyes.
"Well, it happens. And now here we are. Let's start again, OK?"
"Yeah, OK. I'm such an idiot."
"You're not an idiot. You made a questionable choice under stress. Don't beat yourself up about it. Really."
We're sitting in an exam room, waiting for the specialist to come in.
"You've done a great job. It's been a hard year, you've been through alot. There's no reason you can't stay clean again for a long time." I hit his knee with the back of my hand playfully.
"I don't know what I'd do without you guys," he says. "You've all been so kind to me."
"Sure, we 're nice to you, but it's you who's doing all the work," I respond. "You make it easy for us to help because you really try. Plus we like you."
The gastroenterologist comes in and we get down to business. My patient praises the doctor for his "bedside manner" and thanks him for his patience with is questions.
"Just tell me, doc," he asks. "Do I have a couple of years to live?. Please be honest."
The doctor sits across from my patient and looks him in the eye. "Look, you're really doing OK. There's no emergency here. I can't make predictions, but just stay clean, eat well, get some exercise, take your meds, go to your appointments, and we'll talk again in six months. You're all right."
"Thanks, doc. I have a hard time believing that, but I'll take you at your word."
We leave the office after scheduling an important procedure and a follow-up appointment. The sun is shining, the air is warm. It's finally Spring. This patient certainly has his issues, and he often walks a knife's edge in terms of his health, sobriety, and ability to remain focused. But for today, we have a reprieve, a new start, another chance at change and growth. And tomorrow? Only time will tell.