Back to work:
We are working in a large inner city hospital. Specifically, our unit focuses on orthopedics, surgical cases, and trauma. We work 12 hour shifts at night, and we will be working a substantial amount of overtime. Im taking a small break, and I have been very busy, but nothing really cool has happened tonight. I'll type out a story from the past.
Jennifer is my patient in room 3. She is blonde, 5'10", a former high school standout in volleyball, and she is 28. Her room smells like roadkill, so I have to wear a mask. Her lower leg and foot is all bandaged and oozing through a yellow and brown drainage. Here is her story as she told me.
She was involved in a car accident at age 21. This resulted in a back injury that was not surgical but caused her tremendous pain. She became addicted to Hydrocodone. She missed an appointment at her pain clinic when she was 23, and the pain clinic dismissed her (this truly does happen with the pain clinic/narcotic health care system; I hear horror stories often). She started going through withdrawals and became desperate. One of her friends introduced her to a street dealer who provided her free Hydrocodone. The dealer didn't give them to her for long and required favors of her. She obliged out of her desperation. She then tried some heroin he provided, and at that point she was hooked. Her habit became larger, and she became more desperate. She started selling her body to support her habit.
She ended up moving to Las Vegas with her dealer/boyfriend/pimp. Her habit continued to escalate. She had a baby that was born addicted and taken from her. She became depressed but still hooked.
In October of 2014 in year 5 of her habit, she came home to find her stash missing. She knew it was probably the neighbor who had a key but was not trustworthy. The neighbor wouldn't open the door, so in her anger and drug-lust, she decided to kick through the window. When she brought her foot back, her Achilles Tendon was shredded by the broken glass.
Her hospitalization required surgery, a 2 day stay in the hospital where her need for drugs was quenched and probably worsened by the prescribed Dilaudid, and instructions to return to the surgeon in one week for a dressing change and wound evaluation. She never went for her follow-up, and now she is in room 3 with me. She said to me, "I didn't want to come in, but my leg smelled so bad I couldn't get any customers." So very sad...
I tried to reassure her, I made a social work consult, I offered her programs, a safe living space, and drug rehab. I did everything I knew to do, but essentially in my job role, I'm pretty helpless when it comes to these matters. The surgeon came in and offered her extensive long term care with a good prognosis if she did her part and followed thru with care. The second option was amputation. She thought for a few minutes and said, "cut the fucker off! I have to make my money".
Her leg below the knee was amputated the next day. She left 2 days later with her same pimp/boyfriend/dealer. I couldn't help her.
2 months later, I had another prostitute. I spoke with her at length too, and she lived in the same area as Jennifer. In our discussion Jennifer came up, and my new patient told me she was turning tricks out of her wheelchair. I'll never forget this, and there are many similar sad stories. I often feel helpless even though I try my hardest to make a difference.