Slip sliding away.

Slip sliding away

slip sliding away

you know the nearer your destination

the more you're slip sliding away.

~ Simon and Garfunkel

_________

You'd been sleeping for what seemed like three days. Your admission diagnosis was for a common reason--"altered mental status"--but what would happen next wasn't clear.

The first day they brought you in with soiled pants and underwear. Your body was limp like a rag doll, or better yet, like some sort of carnivorous animal shot with a tranquilizer dart and chemically restrained. Strong in body, muscular like the king of the jungle. . .but still and quiet.

Someone pushed their pointed knuckle deep into your sternum hoping it would arouse you but  . . . nothing. Another doctor came and mashed hard on your finger nail with an ink pen while a medical student watched. "Noxious stimuli," the doctor said. "This helps me see if he responds to painful stimuli." The student nodded in acknowledgment.

That first day, you didn't respond to much of anything. Your loss of continence combined with the gash on the back of your head made someone think that maybe you'd had a seizure. That was enough to get the Neurology team in to see you. It was also enough to prompt several tests to be run on you including a spinal tap and an MRI. 

By the time I got there, you had moved from somnolent to "groggy."  Heavy eyelids, slurred speech, words that came out as nonsense--but this was better than how you reached the ER. I glanced at your arms and found them sprinkled with red dots like confetti. Next I saw the middle-aged woman whose pained expression from the bedside chair clenched the diagnosis for me:

Drugs.

You were too out of it to participate in that conversation, so on my first visit I just spoke with your mom. Watching how her lower lip quivered when she told me of your long battle with substance abuse and depression hurt me deep in my heart. Sips of alcohol in middle school. Then some marijuana. A few wild friends nudged you into harder things like powder cocaine and prescription pills. Before you knew it, this became too difficult to manage. You needed something quick and predictable to see you through the complexities of your mood disorder and your physiologic dependence.

"Heroin will help you not be sick." This was the word on the street so you clenched your teeth and got over that fear of needles that you'd had since your boyhood.

And from there things went crazy.

This was the story your mother gave me with her quivering lip and tired eyes. This wasn't the first time she'd been here.

When you finally woke all the way up, I happened to be there rounding. You were astounded at the fact that you were in an adult diaper and you asked about your mother right away.

"Oh my God. My mom--was she here?"

I nodded. "Her and, I think, your sister."

"Did my mom. . . .agghhh. .  . .was she crying?" you asked while smacking your palm to your forehead. I noticed your fingernails then. Painted black.

"Not really crying. She was just kind of. . . ."

"Trying to talk with her lips trembling? She only does that when she's trying not to cry."

I didn't want to answer that so I just stood there staring at you. That was enough, though. You dropped your face into your hands. "Fuck!"  You balled up your fist and pounded it onto the bed.

I reached out and gripped the hand rail. I wasn't sure what to do.

"She's done this with me so many times. I'm so tired of dragging her through this." You punched the bed again, this time startling me.

"She didn't seem mad. I mean, she just seemed concerned," I finally said. I wanted you to feel better and this was all I could think to say.

"That's the freakin' problem. She's not mad. She freakin' forgives me and prays over me and lets me back into her house. And it's fine at first and then I fuck it right up."

I bit the inside of my cheek awkwardly. I didn't really know what to do, so I just sort of stood there like I'd been frozen with some kind of remote control.

Your situation was different for me. I mean, yes, I have seen people addicted to intravenous drugs but in Atlanta at this hospital, it's definitely not the method of choice. I was used to hearing about relapses of crack cocaine and tales of bodies being sold to get hands on it. Bodies neglected from the full time job of smoking tiny white rocks in little glass pipes. And empty promises to get out of hospital beds.

You were this college educated person with blue blood lineage. The one whose behavior screamed black sheep but whose mother loved him like a precious lamb.

"Is it the craving. . .like. . feeling sick that makes you keep coming back to it?"  I asked this really dumb question, yes. But only because I was curious.

"It's the hating myself, really." You looked down at your arm band and twirled it on your wrist. "That's what makes it so hard when somebody is trying to love you through it. It's really, really hard to have someone loving you like that when you don't love yourself."

"Why do you think that is? I mean, that you don't love yourself?"

You pause for a moment and laugh. Your eyebrows raise and with a tiny shake of your head you replied, "Now that's the million dollar question, isn't it?"

I guess that was when I realized how dumb that question was, too.

"I'll get myself all clean and then it goes full circle. Feeling like I don't deserve to be happy."

"Hmmm." I tapped my fingers on my lower lip as I listened. Maybe it was out of nervousness or maybe it was to keep myself from saying the wrong thing. "Have you been talking to the psychiatrists still?"

"I do. I mean, I always do. It's so messed up. . . you know? I realize that this isn't normal, you know? I know the drill. . . talk it out. . .get to the root of the pathology. What happened to you? What fucked you up as a kid that now has you extra-fucked up as a grown up? See? That's what's so messed up. I can't put my finger on that thing. . . that one awful thing that allegedly started all of this."

"Pathology." "Allegedly." You were obviously highly intelligent and your insight was unreal. And you were right. I had no idea what the answer was to all of it.  So I just sat there listening because honestly, I'm not a psychiatrist and I don't exactly know what to do with all of this information or even the first place to start psychoanalyzing any of it.

"Wow, that's deep," I said instead.

"Yeah, that's one way to look at it," you replied. Just then you looked down at the adhesive from the IV taped to your arm. Next to that was a scar from the IV drug use poorly disguised by a tattoo. You caught me looking at it and shook your head. "I bet you're thinking, What a waste."

I looked at you and thought about my words before speaking them. "That's not what I'm thinking at all."

You chuckled and covered the scar with your hand. 

"I'm thinking I wish that you didn't have to be in this situation. You or your loved ones. I'm wishing I knew the key to making this go away." 

"I know the key," you responded. That kind of surprised me. You put up your thumb like you were going to hitch-hike and then turned it in on your chest. Next came a  big sigh and you added, "That's the problem." 

I narrowed my eyes and nodded. "Do you pray?"

"Naah. Not my thing. That always seems to come up, but I don't know. It never has soothed me or made me feel anything." 

I chose not to respond to that, recognizing that my first question on the subject was enough. 

"So. . . .it looks like you're recovering from the overdose. I spoke with your mother and she says she's willing to bring you back to North Carolina with her."

"Of course, she did." 

"How do you feel about that?"

"Undeserving." 

I reached for your hand and squeezed it.  You let me.

"You're a pray-er aren't you? I can just tell you are. You probably have Jesus on the mainline, don't you?" 

I smiled and released a little laugh. "Hmm. I guess that's fair to say. I think he even has a text package these days."

"Wow, man. L-O-L and O-M-G, literally," you retorted. That idea amused us both.

We sat there with our eyes locked and our hands locked, too.

You spoke first. "Well do me a favor, okay? Pray for me, will you?"

"I will." 

"You promise?"

"I promise."

"And my mom, too, alright?"

"Got her covered." 

After I finished up my exam and the necessary elements of the visit, I gave you a hug. Tight like the way a mother hugs a son. Something tells me that you felt that part of it. I sure hope you did.  

That night I prayed for you. And never saw you again.


***


Now playing on my mental iPod. . . 



Someone special reminded me of this story the other day. Today, I am praying for you, too.