I will never tell them I am full of shit

Know what I would like to be when I grow up?

A doctor who works in a substance abuses treatment center.  I would wake up every morning and begin drinking coffee and getting dressed and hopping into my car with excitement, anticipation and glee.  I would rush over to the treatment center, always arriving at least 30 minutes before the rest of the day shift staff.

They would all slowly shake their heads as they arrived right on time or even a little late and saw I was, as always, already there; their beacon of hope.  They would greet me with their sleepy faces and say things like,

Doc!  You’re the most devoted person I’ve ever met!  I’m so lucky to work with you!

I would over hear them talking about how there’s just somethingabout me.  Something that is more than just having a job and getting a paycheck.  Something like a saint or a great volunteer.  Something wonderful that makes me show up early, stay late, and want to talk with the fucked up druggie clients more than anyone on staff.  They would compare me to other doctors they had worked with who seemed more interested closing their office doors and reading up on a bunch of scientific gobbledegook.  They would go on and on about how much time I spend with the fucked up druggie clients in the cafeteria as they keep their faces low toward their plates; full of shame over the whys and what-fors of the past how-ever-many years.

The craziest thing?  I would encourage that shit so I could continue to believe it.  I would manage my hair style to look just bedraggled enough to make my coworkers think I was there, at work, early and late and tired, but so devoted that it was only they who noticed my exhaustion.  Only they who pointed it out just to see me wave it off and say things along the lines of,

Oh noooo, it’s nothing.  We’re here for a higher purpose, my friend.  No amount of sleep is worth more than that!

I might even give them a hug or meaningful squeeze on the shoulder as I stare deep into their eyes, as if to say,

You’ll make it kid!  You’ll some day find the ability to love this place and these poor, fucked up people just as much as I do.

More than anything, my coworkers would feel glad for each and every client they saw walking down the hall and into my office for their weekly meeting with me.  Me!  The wonderful, insightful, helpful, saintly me!  They would say things to each client such as,

Now you’re headed for real help, my friend!

and

Watch out buddy!  Now you’re going to find out what true recovery is all about!

and

The buck stops right there, pal!  Your misery is soon to come to an end!

Do you know how much compassion, understanding and hope I would offer those fucked up druggies?  A shit ton.  A milliton.  Infinity times google plex multiplied by a bazillion times forever!

Well, only if their drug of choice included opiates.  Codeine, Demerol, Heroin, Oxycontin, Morphine, whatever.  As long as it’s opiates they’ve been using, they will have my rapt attention as long as they want it. 

If they’re a pot head, alcoholic, speed freak?  I will cut their appointment short by telling them they’re doing so well that they obviously don’t need to be talking to me so much.  I will send them on their way with a meeting schedule of the local 12-step fellowship and maybe a book or two to help them feel they are well on their way to leaving their days of Driving While Intoxicated, sitting on the couch in a cloud of THC, or dismantling their neighbor’s mailbox at 2am due to being so jacked up on speed that they believe it contains an alien that is just waiting to come out and speak of the secrets of the universe.

But those opiate addicts?  Those motherfuckers will be near and dear to my heart and, more importantly, my wallet.  Mostly because they like it when they’ve come out of their stupor enough to look at study after study and brain scan after brain scan that ‘proves’ they are never, ever going to be normal again.

Oh sure, they need lots of support when I first tell them this.  They need support, as it is not easy to be told by a trusted, well educated, highly involved doctor that your opiate addiction has permanently ruined your neuro pathways and, for the rest of your life, you will never be able to feel another emotion again.  Having a baby will not inspire awe, loosing a family member will not bring grief, landing your dream job will not inspire excitement or joy.  Nothing.  Zero.  Zip.  Nada.

They need a grief counselor at this point, and I am more than happy to be just that; a shoulder to cry on as they grapple with the reality (the reality I’ve given them anyway) that a life of feeling anything is over.

Just when it looks like they will crumble, I will offer hope on a silver platter called methadone.  Methadone, the wonder drug of all wonder drugs for those who are in their position.  The wonder drug of being able to operate, feel, love.  The wonder drug of all wonder drugs that just so happens to be offered by a clinic just down the street for a small weekly fee that I’m sure they will want to come up with because, you know, emotions are a good thing!

I will never tell them I’m full of shit.  I will never tell them the truth about methadone:

• Dizziness, sweating, weight gain, sedation, loss of libido
• Increased tolerance requiring a larger and larger dose over time
• The fact that it can rot their teeth and settle in their bones

I will also never tell them that they can probably make a nice little profit off of their methadone if they so choose; that it’s a fine drug to sell on the street if they can manage to hold back from using their entire dose. 

I will never tell them no one ever manages that for long.

I will never tell them my spouse owns the methadone clinic; that we are building a new house this summer because there is nothing, I mean nothing, more profitable than being a regulated, rule following, legalized, admired, helpful, saint like drug dealer with the ability to hand pick my own clients.

_____________________

Yes, I actually do know a local doctor who does this and whose spouse owns the only local methadone clinic.

Yes, I could actually stab both of them in the face.