Saturday, July 29, 2006

Hoping for a Miracle

"I relapsed," he said over the phone. "I was shooting cocaine diluted in vinegar. Plus I was drinkin' a whole lot. I almost died in detox."

His liver is almost gone, and he just keeps pouring gasoline on the fire. We'll meet on Wednesday with my psychologist colleague and try to come up with a plan.

Another patient who I've been trying to find for six months also finally surfaced. His liver is also mostly shot, and he hasn't had a drink or used drugs in three months, or so he reports.

"Can't I have just a few beers a day?"

"Well, that's asking for trouble, really. We need to keep you clean. Plus, your diabetes is way out of control."

He regards me dubiously, then talks about liver functions, bilirubin, hepatitis viral load. Very impressive grasp of the issues, but still not sold on the sobriety part. Denial, I guess.

Some of our success stories are walking the streets today, while those who were not so successful (in our terms, anyway) are in the next world, hopefully learning some of the lessons they missed down here.

We all carry our pains and losses and traumas, and we all have deep-seated reasons for why we are who and what we are. It's hard to not judge another for how they choose to cope, but we might find their moccasins pretty damn uncomfortable if we tried them on for a day.

For every patient who manipulates us and pulls the wool over our eyes (or tries really hard to do so), there's another who's forthright, honest, authentic, and easy to read. The very sweet gentleman who I mentioned at the beginning of this missive is a troubled soul with a trauma history to which I am not yet privy. If I actually heard his story, his recidivism vis-a-vis drug use would make even more sense, but I can hear the plaintive note in his voice which calls desperately out for help, and we'll keep extending a compassionate hand. Whether he takes that hand remains to be seen, but for now we hope that our presence in his life can cause some small shift, some minor changes that could lead to major decisions about improved life and health.

We've seen some miracles, and I have no doubt that there are more to come. If he shows up to our appointment on Wednesday, that will be the first. If he comes to the next one, even better. If he goes on the wagon, gets with the program, stays clean, turns himself around and begins to help others do the same, then that's a miracle of the highest order (and we know several who have done just that), and I'll be the first to congratulate him on his recovery. Until then, that hand is extended, and the rest is up for grabs.

5 comments:

Intelinurse said...

Keith-
How do you do it? How do you perform your job day after day, and still maintain the positive outlook that people will change and will turn from their addictions? I can only surmise that it requires a willful balance of caring and ambivalence...I am so impressed with your attitude-very balanced. I love the moccasin quote.

Keith "Nurse Keith" Carlson, RN, BSN, NC-BC said...

Dear Intelinurse 2B,

One has to choose to understand that some people will never take the bait and clean up their act, perhaps due to trauma which they just cannot recover from for various reasons. Other people simply seem to have chosen a life path that does not allow them the room to seek sobriety and healing. The task seems to be not seeing this as a character flaw. Rather, it's an illness, not just a way of life/lifestyle that someone chooses and can let go like an old t-shirt.

What do people abuse their bodies? Why do they do things that they know are killing them, or at least hastening their demise? What was their childhood like? Are their parents addicts? Were they abused? Abandoned? Raped? Bought and sold? Neglected? The stories I could tell you.....

In the end, some people make the healthy choices---somewhere within them there is a well of strength and desire for change that overwhelms the part of them that is sick, injured, or damaged. Everyone has the potential to be healthy and whole. Sadly, some people don't get there, and while we may sometimes feel angry and frustrated and just want to slap them silly, we remember the truth and keep moving on.

Kuan Gung said...

What a wonderful post and I enjoy your realist approach. You indeed I'm sure have reaced out to many and they have responded, that's the beauty of this all. I've always been amazed at some of the massive denial out there, simply amazed. Someone once said to me that the story is written on everyone's face, and you can see the affliction of "the fade", a total disconnect from the soul and the reflection of grim imprinted on theri faces. Thank you for what you do, so very much.

Anonymous said...

My mother died of alcoholism. She was a refined, upperclass woman with a loving husband. While my father was alive, he was in complete denial that she had a problem. She didn't start drinking until her mid forties and hid it very well until the end. When I dragged her into detox, the doctor thought she suffered from depression not alcoholism - then I told him her alcohol consumption was $700/month.

She never reached the stage where she admitted she was an alcoholic. I coped by repeating the Serenity Prayer over and over.

Denial is an incredibly powerful factor in alcholism and drug abuse.

Stephen said...

Of late, i've been trying to give up caffeine. It gives me arthritis. I think of myself as way too young for arthritis. And yet, it is very hard to give it up. Now, i'm not saying that caffeine is as addictive as cocaine, or nicotine, or alcohol, or anything. Quite the opposite. I expect these other things are worse.

Am i trying to abuse my body? Do i enjoy pain? If so, why do i spend so much time on exercise of mind and body? Addictions suck. They drain at your ability to choose.

It's not a new idea. St. Paul writes to the church in Rome, chapter 7:19, "For the good that I would I do not: but the evil which I would not, that I do."