Sixteen Bags of Heroin.

Her name was Jillian, and she was as close to death as I've ever seen a 19-year-old girl.

The paramedics from the city brought her in to the large urban Emergency Department where I was employed at the time. (For two and a half years, I scurried around a hospital frequented by some of the most acute trauma and medical cases seen on this side of the state. Despite the pay and hours being pretty crappy, I fortunately gained three years of icky, bloody, heart-wrenching experience during a time when my fellow collegians were just learning where their own asshole was—and how to differentiate it from the red Solo cup full of warm, flat keg beer in their other hand.)

Little did we know that she would be the first of the biggest wave of heroin overdoses seen within the past ten years.

Jillian came in, limp as an old sock, and looked about the same—dirty, smudgy, hairs sticking out at all angles. The medics said it was the third overdose they've picked up since 7am that morning, and their faces said it was only going to get worse. Their breathless report was, of course, given while breathing for her, and they were desperately hoping her heart would decide to go above 40 beats per minute.

"There's some sick junk going around… the narco boys still can't figure out where it's from."

The weak voice came from behind us. The paramedic supervisor, usually all bluster and brass, stood in the doorway while we searched her stickish arms for an unused vein. He was as beat as I've ever seen him; no doubt he'd spent the day and night rushing around helping his overworked medics with more of these limp figurines dotting the city.

What made Jillian unusual was her lack of response to the medications the paramedics gave. I mean, they found her not breathing, with a needle in her arm, and an empty glassine bag on the table next to her. Any self-respecting street provider goes right to Narcan, a trade name for an opiate antagonist that reverses the effects of a narcotic overdose. Well, they gave the drug, usually a one-shot fix—but nothing happened. After a repeated dose failed to rectify the situation, the only remaining move was to ventilate her and get to the hospital.

We ended up getting her stabilized, after giving Jillian five times (unheard of!) the normal amount of Narcan to finally reverse her opium-derived coma. She slept for roughly another four hours, breathing on her own.

Meanwhile, more cases just like her kept coming into our department. We could barely keep up with the stretchers, the medics, the stories, the vomit, the screaming… oh, sorry. I forgot to mention: Narcan, when it wakes you up, rips away your high in a matter of seconds and sends you into a vicious, painful withdrawal state. Patients usually hate you for a while after you give it.

Hey, at least you're alive, you thankless prick. The patients kept coming in waves, two or three at a time, like limp soldiers dragged from some ghetto battlefield.

Over the course of a 16-hour shift in the ED, we lost count of the number of patients who all came in with the same issues. I personally lost track after about twenty; they all just started to blur together. About a week later, the narcotics officers figured out that there was a poorly-cut batch of heroin coming out of a city roughly thirty miles from us. The stuff was apparently way more potent than addicts would expect, so the high you would get from four bags can be accomplished with one. The problem was, nobody knew this at first; people would take "the usual" and then wind up dead. The patients we managed to revive found themselves faced with a choice: tell these nice burly men with badges where you got your stuff, or they will take you to jail. The dealer and his operation were shut down by the police in roughly another week.

Sir, please stop trying to bite me. As much as you may not like us right now, the prison staff is nowhere near as nice as we are.

Jillian, as I said, woke up about four hours after we first saw her. She was scared, shaking, and exhausted; but she was able to talk to us now. It was the one-sided conversation of a person looking for any audience who'd have her, and I happened to be changing her IV bag at the time.

"When did I get here?"

"About eight hours ago." I gave her a brief and shined-up version of where the medics found her, and what we did to help her.

"Oh. Thanks, I guess. This has never happened to me before, even though…"

I know I said I try not to, but this time I couldn't help but prod: "…even though what?"

"I have a big habit. Like, a really big habit. I think yesterday I was up to sixteen bags a day."

Holy shit. Sixteen miniature, pocketable, one-dose-of-melted-butter-happiness bags per day?! I have no idea how she's alive. I didn't even bother to ask how she would take them; I preferred my mental image of them just passing into her body by osmosis to any story she would have about infected arms, bleeding noses, or coughing and hacking through a pipe.

She sighed. So did I.

I had to try.

"You know, I could give you some information that we have. It's not much, just a few phone numbers and the names of some groups around here. I just… I figured if you wanted to talk to someone, about anything, they'd be the people to help you."

Her sunken eyes swung towards me with the look of a soaking wet, miserable kitten. I could see it in her face; she didn't have much else besides doing inordinate amounts of heroin each day. It was where her money went, it was what her friends did; it was who she was. But her eyes registered, probably for the first time in months, the idea of leaving it all behind. She started pouring out her story, each turn more interesting than the last. She had always wanted to go to college after high school; as she was getting her applications together, she started dating a guy from a rough crowd. He was into heroin, and she followed shortly thereafter. From there, she spent a year doing unspeakable things for heroin and heroin money as her habit grew beyond any sense of control. It was, to say the least, painful to hear (and I watch a lot of Law & Order: SVU).

I eventually brought her the pamphlets and phone numbers, even allowing myself a little smile as I handed them over and she thumbed through them like they were hundred-dollar bills. She seemed so excited.

"Oh my God, thank you. I've never woken up in a hospital before… I want to get this shit out of my life. Thank you so much."

She was discharged less than an hour later. As she was walking out, I had rotated to the last four hours of my shift and was at the Triage desk up front. She stood about ten feet away by the pay phones and frantically waved me over.

"Listen… I lied earlier. I've woken up in plenty of hospitals and ambulances before, and I just kept going back to heroin because nobody ever said anything different. They just thought I was some fuck-up kid who would never fix her life. You're the first person in a long time to do anything besides kicking me back out to the street when I was alive again."

"Uh… well. Thanks for telling me—I just hope it helps." (I wasn't totally sure what to say.)

"Listen, I know this is probably against the rules or something, but can I have your phone number? I'm not being creepy or anything, I just wanted to call you in a month or three months or something and tell you I'm clean. Just to let you know. And to thank you."

I gave her a strange little look… but then right there, in full jeopardy of losing my job and breaking all sorts of hospital rules, I gave her my phone number. Call it against the odds, call it a dream, call it whatever you want. I prayed for her to call me in a few months. I wanted to believe that I had made some kind of change, that I had given her a fighting chance.??

This was seven years ago. I never heard from Jillian again.

3 Comments

  • Rob says:

    the job we choose or that chose us is not the best for our hearts and maybe not for our minds. But it is the spark of doing something good or saving a life or making a bad situation better that keeps us coming back and feeling alive.

  • Michael Hughey says:

    You  tried.  Don't beat yourself up about it.  I and many others have been in your shoes.      If we were rich, we would just open up our own detox and rehab clinic, but we're not.  All we can do then is pray.  
    Gadget EMT

  • Grandpa says:

    Thank you so much for your story.  It helps me learn … us learn … what we all are up against.

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Alex Capece

Washington, D.C. Firefighter and Paramedic

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"For anyone who ever wanted to grow up and become a firefighter... from someone who did just that."
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