Sun streaming in the window, dancing across my wall. Suddenly jolted awake. What time is it? Where am I? Who am? My arms and shoulders ache with any movement. Crap. You slept in. Its Monday morning. You're in in bed. You're you, and you shouldn't still be in bed.
Burning coffee slopped down my shirt, inhaled cereal choking me. Bike chain clanks off in the middle of an intersection. Sweaty, soggy with coffee, hands covered in bike grease I roll into the clinic. Busy waiting room. Late late late. Rushing to change in the washroom cubicle. My hands are itching like crazy due to the THREE separate knuckles that some kind of sick evil mosquito feasted on over the weekend. Shirt, pants... no scivies... typical. One sandal off, second sandal--splash. Sandal in toilet. I'm late, I have no underwear, I'm hot and bothered and my sandal is IN THE TOILET!
This is the worst day ever.
Enter patient number one. A tall, well-built, Persian man in a stylish black leather jacket. Swollen black eye, staples across the shaved side of his scalp, arm in a sling, limps in. I saw him two weeks ago, he has been clean for seven months and moved out to Burnaby from the DTES this past weekend. He was excited about the move, and the sobriety. But on Saturday when he stopped at the pharmacy downtown he was assaulted and left on the sidewalk, where he lay unconscious for 12 hours before anyone called an ambulance. Just another passed out junkie. Quickly wiping tears away he shared how it felt... being left worthless on the street. Pain. Loneliness.
Memo to me: GET OVER YOURSELF.
Monday, May 26, 2008
Wednesday, May 7, 2008
The Poverty Industry
His tall, imposing figure in a thick down camouflage jacket nearly blocked the door as he stepped into the examining room. The unshaven face made a thin veil over his pock-marked, scarred cheeks. As I sat down by the desk he stood with a massive slurpie in one hand and a blue licorice strand in the other, occasionally using the licorice hand to run over the top of his head and flip his pony tail behind him, hesitant to sit down. This picture of a hardened criminal juxtaposed with a nervous child seemed strangely incongruous.
$10 per week of methadone prescription, that's $20 for a two week script.
$10 per week of other prescription drugs if they are daily dispensed by the pharmacy.
Methadone and poverty are big business. Several pharmacists in the downtown East side have built empires around this. They receive ten dollars as a dispensing fee on any medication. So for methadone which needs to be witnessed daily, that's ten bucks a pop. If the patient is on six different medications and the prescription is written to be given out daily by the pharmacy, they just made sixty bucks in a few swallows. So big deal, the pharmacist is getting rich off of tax payers' dollars. Just a little entrepreneurship, right? I'm sure doctors do the same thing with 'efficient' billing and sneaky tax cuts. Right up until you start paying a person with an addiction to bring you their prescriptions. Giving them money that goes straight back to crack, heroin, booze, or crystal meth.
Then there's the recovery house business (some run jointly with a pharmacy no less!) There are a few run by the health region, but many are privately run with no restrictions to what they provide. They survive by getting most of your welfare/disability check deposited directly to them and providing you food and lodging. The worst stories are of six people crammed in small rooms, harassment, abuse, open drug use, and horrendously unhealthy cheap meals.
One of my favourite Jesus stories (other than saving the party by turning water into booze) is when he looses it in the temple courtyard where people are selling stuff. He knocks over tables in righteous anger against those who prosper from inequality and take advantage of the poor. Poverty and injustice break my heart, more than that they piss me off. Something deep down in my gut bubbles with anger. But exponentially worse in my mind at least, is those who prosper from the brokenness of others.
Here's where it all comes full circle. As a medical professional my living ultimately comes from suffering humanity. If I am not actively involved in trying to change the system, in preventing suffering and not just benefiting from it, by definition I become the oppressor. Stick that in you pipe and smoke it doc! Who are you judging anyway?
I got out of jail yesterday and I need my methadone script.Okay. No. No. Are the answers.
Why don't you have a seat? I venture.
All I need is my juice. Can I have all my meds daily dispensed? Its just easier for me that way. And can I get my meth script for two weeks?
Have you used since coming out?Its like learning a new language. The language of drugs and poverty. His body quivered in frustration and his words were angry in response to the answers he was given. He stormed out with a two day methadone prescription in hand. Why so angry? In his eyes, this crazy doctor had just cost him $40.
Not much.
How much is not much?
Just a couple flaps of seven and a rock or two.
$10 per week of methadone prescription, that's $20 for a two week script.
$10 per week of other prescription drugs if they are daily dispensed by the pharmacy.
Methadone and poverty are big business. Several pharmacists in the downtown East side have built empires around this. They receive ten dollars as a dispensing fee on any medication. So for methadone which needs to be witnessed daily, that's ten bucks a pop. If the patient is on six different medications and the prescription is written to be given out daily by the pharmacy, they just made sixty bucks in a few swallows. So big deal, the pharmacist is getting rich off of tax payers' dollars. Just a little entrepreneurship, right? I'm sure doctors do the same thing with 'efficient' billing and sneaky tax cuts. Right up until you start paying a person with an addiction to bring you their prescriptions. Giving them money that goes straight back to crack, heroin, booze, or crystal meth.
Then there's the recovery house business (some run jointly with a pharmacy no less!) There are a few run by the health region, but many are privately run with no restrictions to what they provide. They survive by getting most of your welfare/disability check deposited directly to them and providing you food and lodging. The worst stories are of six people crammed in small rooms, harassment, abuse, open drug use, and horrendously unhealthy cheap meals.
One of my favourite Jesus stories (other than saving the party by turning water into booze) is when he looses it in the temple courtyard where people are selling stuff. He knocks over tables in righteous anger against those who prosper from inequality and take advantage of the poor. Poverty and injustice break my heart, more than that they piss me off. Something deep down in my gut bubbles with anger. But exponentially worse in my mind at least, is those who prosper from the brokenness of others.
Here's where it all comes full circle. As a medical professional my living ultimately comes from suffering humanity. If I am not actively involved in trying to change the system, in preventing suffering and not just benefiting from it, by definition I become the oppressor. Stick that in you pipe and smoke it doc! Who are you judging anyway?
Thursday, May 1, 2008
Overwhelmed by Hope
"I don't like dirty people. And I don't like people who love their drugs more than their kids."
These were the words of one of my colleagues, a good friend in fact, who I have great respect for. We do the same job yet we see the world from opposite ends of the kaleidoscope. Apparently I quite like dirty people. I've been doing an elective in addiction medicine in the Downtown Eastside and I love it. I love it so much that the question as to whether I really needed to deliver babies the rest of my life flittered across mind. Don't worry, it was only transient, I will definitely be returning to the happiness ward. However, I have worked with some passionate, maybe nearly crazy, but undoubtedly inspiring individuals who have dedicated their lives to working with a deeply vulnerable population.
Poverty, addictions, homelessness, prostitution. Words you think of when you imagine what is apparently the poorest postal code in Canada. Strange. Because its where I feel most welcomed. People talk to you on the street... granted, not always soberly or eloquently. They yell greetings at each other. They sell nick-knacks on the sidewalk: a speaker system, a pound of Starbucks coffee, 4 litres of fruit juice, an instant pawn-shop appears and disappears in minutes. They know each other by name.
I don't want to idealize things, they have more than their fair share of heart-wrenching experiences, abuse, and crippling addictions but I wonder where there's more love. In the Eastside or in lovely, sterile, rich Point Grey, closer to my residence (ouch).
They have a photo contest each year run by the Pivot Legal Society and have a book just recently published with photos called Hope in the Shadows. My heart breaks to hear my patient's stories, but somehow they reflect to me the essence of what it means to be human. In their pictures you find love and community.
These were the words of one of my colleagues, a good friend in fact, who I have great respect for. We do the same job yet we see the world from opposite ends of the kaleidoscope. Apparently I quite like dirty people. I've been doing an elective in addiction medicine in the Downtown Eastside and I love it. I love it so much that the question as to whether I really needed to deliver babies the rest of my life flittered across mind. Don't worry, it was only transient, I will definitely be returning to the happiness ward. However, I have worked with some passionate, maybe nearly crazy, but undoubtedly inspiring individuals who have dedicated their lives to working with a deeply vulnerable population.
Poverty, addictions, homelessness, prostitution. Words you think of when you imagine what is apparently the poorest postal code in Canada. Strange. Because its where I feel most welcomed. People talk to you on the street... granted, not always soberly or eloquently. They yell greetings at each other. They sell nick-knacks on the sidewalk: a speaker system, a pound of Starbucks coffee, 4 litres of fruit juice, an instant pawn-shop appears and disappears in minutes. They know each other by name.
I don't want to idealize things, they have more than their fair share of heart-wrenching experiences, abuse, and crippling addictions but I wonder where there's more love. In the Eastside or in lovely, sterile, rich Point Grey, closer to my residence (ouch).
They have a photo contest each year run by the Pivot Legal Society and have a book just recently published with photos called Hope in the Shadows. My heart breaks to hear my patient's stories, but somehow they reflect to me the essence of what it means to be human. In their pictures you find love and community.
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