I came to paint you a picture of an individual whom I hold closely to my heart. He is 5’9, medium-build with blonde hair, blue eyes and a happy-go-lucky persona. It might be my biased opinion but I would say he has kindest smile this side of Lake Ontario. This may resemble the beginning of a personal ad although in reality it is my best friend. Moreover, the picture I just painted for you is that of an addict.
I was completely unaware that his situation became as harmful as it had until we got together at my apartment for our annual Christmas coffee-date. Unfortunately, I did not have the chance to speak with him since I began medical school in August. Yet, I could immediately tell his mood was off. I knew he struggled with opiate-abuse in the past, but he had been clean for two years and just finally started working to get his life back on track. Regardless of my school routine, I always told him that I would be there to chat, lend a hand and be a positive force in his life; little did I know that I had already let him down in my role as a friend, as I pursued my goal of becoming a physician.
A voice resounds in my head: “Tehmina, I didn’t want to bother you because I know how important school is… but I started injecting and it’s gotten bad” he said, rolling-up his sleeves to reveal purple tracks, lining the entire length of both arms.
“Mike, I don’t really understand what happened or what is happening, but I’m listening.” I attempted to make the disappointment in my voice subtle. I was absolutely not disappointed in him, but rather from an overwhelming feeling of failure within myself. I work extremely hard to get work-life-balance down pat and I felt like I had neglected my friend. I began to inquire further: “What is it that you’re getting out of this? How did you move from snorting to being clean to shooting up?”
Scanning the television screen in front of us, he turned to me with a somber smile and said, “Well, it’s cheaper than oxy and not as bad as heroine. Hydromorph is practically everywhere…it makes me forget how much I have screwed up.” I knew he was trying to make light of his situation. “I know that this drug is bad, but it’s re-wired my brain; I can’t stop chasing the imaginary dragon.”
“What imaginary dragon? I’m listening,” I interrupted for a second and let him continue.
“The imaginary dragon you chase is that very first high, the one that gets you hooked, the one that makes you feel like you’re superman and not the loser junkie that you really are. But, I know I will never get that high again, I just can’t stop. I started stealing from my parents, even when I used the bathroom just a minute ago, I can tell you exactly what’s in your jewelry jar and I thought about how much I could get for it.”
I was stunned; I had never felt like my belongings were unsafe around Mike. I could not believe that this was the same guy who walked me home from school every day and always walked me home at night. “Well, I’m glad you’re verbalizing how you’re feeling and more glad that you didn’t take anything; not because any of that jewelry matters but just on the principle that we’ve known each other for 20 years! I’m glad that you’re working through those thoughts and I’m listening...” before I could say anymore he interjected with:
“Do you know how many ways I thought of securing drugs from your house?!” With the knowledge that I live in the heart of downtown, it was not something I originally thought of but responded with “No, but from what you have been saying, I feel like it’s been really overwhelming to try and stay clean, but I’m listening.”
“It has been really overwhelming!” He exclaimed, “It’s everything. My parents don’t trust me, my friends are all users except for you, and this city is full of scripts and pills. I need to get out of this environment. When I don’t get high, it’s all I can think about; it’s consumed my life. I want it to stop, but these drugs control every aspect of my life. Tell me how am I supposed to be helped?” His tone sounded so defeated. “I have to be clean for at least a month to enroll in my rehabilitation program. If I could stay clean for a month, I wouldn’t be going to rehab! I feel like I am set up to fail and when I feel like I have failed, I shoot-up. I do it knowing that for a couple of hours I won’t feel like this loser I’ve become.” At this point he was almost in tears. This is his illness experience. Day after day, the cycle continues.
I comforted him the best I could, re-directing away from his negative thoughts. I assured him he was not a loser and there was still plenty of time to make changes. It takes a lot of courage and vulnerability to admit what he was saying to me. And sometimes courage is that tiny little voice that says “I will try again tomorrow” and if he needed that reminder from me to stay clean, I would make time to do it! Whatever it was, I wanted him to know that I’m listening.
To sit and watch him go through this, as his best friend on the outside looking in, I realized that this was in turn my illness experience. My frustrations arise from witnessing my best friend go through his illness experience and feeling as though I am powerless to help him. I feel sick at the sight of my friend suffering and making mistake after mistake. I try to empathize with the judgment that he faces every day; yet it still does not feel as though I can do enough to remedy his situation. I feel sick for not being able to support his rehabilitation 110%. It is incredibly disheartening that this happens more often than it should. Ultimately, I am sick of the statistic my best friend is becoming.
Addictions are incredibly powerful and consuming illness experiences. Addicts are often stigmatized and many times physicians become desensitized to these same scenarios playing out over and over again. But, by telling you about this today, I feel like he is no longer alone in his struggles. We all know someone like Mike out there. Even if this illness experience just reaches you, at least together we can say, “We’re listening.”