Irish doctor with too many thoughts, too little time and a blog that's supposed to check in on reality.

Wednesday, February 22, 2006

Lived in Bars and Danced on Tables

I stopped Cat Power on my iPod at this point, to listen what he was saying to her. The music playing in my ears created a cocoon of silky liquor on the tongue and relaxed slow dancing in a dark bar. The couple across from me on the Luas looked like table dancing was a thus unknown fantasy – they looked exactly like John.
Like Patrick Kavanagh, for whom “every old man I see reminds me of my father”, every stumbling character with that distinctive wild eyed look I see, reminds me of John.
He was the first patient I ever talked to while in my new shiny white coat.
He was the first drug addict I had ever met in my life and I was fascinated by him.
He probably mistook my intense curiosity as a doctor finally taking interest in him, as I was asking all kinds of questions from how much heroin cost to how long did it take him to get expert at finding his own veins. I was particularly fascinated by what exactly he did all day – did he have breakfast in the morning? And then did what – do some light housework, watch some Oprah, read the paper, buy some drugs?
His life’s passing was not marked in hours or days, but in ever increasing desires for another fix and short lived buzzes, and intense personal tragedies. He never knew his father, his mother died in a heroin overdose and his granny, who died the previous year, raised him. She kicked him out of her tiny flat when he started coming home drunk most days at 15. He drifted from hostel to cold footpath to hospital trolley to prison to eventually ending up at the age of 26 (looking like an ill 40 year old) with a 3 year old daughter in care who he hadn’t seen in 1 year, and grieving her mother, who had also died from an overdose. He described how his financial situation worsened when he met his girlfriend – he was now “jumping counters” for 2 (armed robberies).
While I only spoke to him for a half hour nearly 4 years ago, his story pops into my head on a nearly weekly basis.
At the time, I had been on a number of ward rounds and was quickly picking up the medical lingo used to describe patients in a professional but euphemistic way. No one might have cancer – there are, however, a number of queried mitotic lesions. (Which is fair enough, we really can’t go round the hospital talking about “queried cancer” when someone has a cough and a bit of a flu)
Likewise, people like John, probably have a “dual diagnosis” with their “chronic substance abuse” and “poor social supports” (read no home, no family, no job). He also had an “end stage retroviral disease” (HIV).
When I presented his history to the consultant back then, I was told it was excellent. I had used the appropriate catch phrases and probably carried a slightly world-weary “a drug addict – sure you know yourself” look about it all.  I knew the associated medical and psychosocial issues to ask about and include in the plan for ongoing care, which would based on a multidisciplinary approach. I naively considered myself quite the expert on the life of the heroin addict after talking to John. I had conveniently reduced his life to a series of related events, neatly fitting them into the typical pattern of “the drug addict”, I had talked the talk and disregarded the man. A man that had potential, dreams, hopes – and was now just a drug addict.
And numerous drug addicts later, I still don’t have a clue.
I always want to cry when I talk to them. I want to go down to the nearest “flats” and tell the kids hanging around stairwells that stink of urine that they’re worth something. That they’ve a place in the world that doesn’t have to be found in a warmed intravenous amber liquid.
It is too easy to write off their experiences as being too different from ours to be relevant. That the needle and the pain holds their world safely away from ours – a life of fulfilment, achievement, enjoyment, relationships…and maybe some joy in small moments.
This evening I turned off my iPod to observe the couple across from me.
She was leaning over him, her uncombed hair in clumps of varying stages of highlights, her coat dirty and her voice stumbling and coarse. He was stroking her head and mumbling “I love you”. Love was a word with about 4 syllables in his thick inner city accent. His eyes were slightly protruding, his eyelids not quite sure about staying fully open. His pale scarred face remained free from expression. They both had a vaguely disorganised look, like they should be somewhere else but not quite sure where that might be.
She then produced a butt of an eyebrow pencil from her pocket. He held up the reverse of a badge for her to see what she was doing. With an unsteady hand, she attempted to bring the pencil near her eye – and missed. And again she missed. He took the pencil from her, muttering how beautiful she was, and held her forehead like those make up artists in the Max Factor ads. He slowly and meticulously controlled his shaky hand to circle her eyes with the liner pencil. He gently brushed her scraggy hair off her face to reveal a weather beaten face with reddened eyes. She then checked her appearance in the back of the badge and pronounced it unsatisfactory. He decided that instead of redoing her eyebrows, he would proclaim his love for her for all the world to see – with the eyebrow pencil he haltingly wrote “Dec Heart Ros” on the window of the Luas.
She grabbed the pencil, dropped it - I picked it up and handed it back to her and she started telling him who romantic he was.
He started again with the eyebrow pencil – and then asked me if I thought she looked okay. I told her the shade suited her eyes and that she looked very well.
They got off – and walked like so many characters around Dublin - despite the gentle breeze, they were hunched over and waiting for their foot to hit the ground, before knowing where it is.
Bent over, together fighting the wind and the world, fighting the moments of empty pain before the salve of heroin, with fresh eyeliner and love immortalised on a tram window.
And I got off, carrying useless medical terms in my head, some vague ideas about drug addicts and an appreciation for their small moments of joy and romance and a hope that one day, dancing on tables is something they too might do.


Blogger planetpotato said...

that was a very nice post

February 22, 2006 3:03 p.m.  
Blogger Suzy said...

Great post Auds...

February 23, 2006 1:10 a.m.  
Anonymous Sinéad said...

Wonderful post. You have a writer's ear and eye!

February 23, 2006 10:42 a.m.  

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