Termination

When I came back from Bonnaroo in mid-June I was expecting some resistance. My boss had gone from being really cool to being petty very quickly. Though I had asked for the days off my first day on the job and told that it wasn’t a problem, she still had trouble adapting the schedule. She had told me earlier that I would have to find people to cover my shifts. That was impossible. Interaction between staff at the clinic was minimal, largely asking favors and some small-talk at the end of the day when the patients went to sleep. I didn’t know anyone, or their schedules, well enough to ask for assistance. I couldn’t understand why she simply wouldn’t work with the information *she* had to make a good schedule.

I simply left notes on the schedule saying “out of town” and reaffirming the dates. She had already signed off on the days after losing the sheet the first time. Right before I left I notice she had me on the schedule for Monday the next week. I left a little note and drove off. She had buffeted and given me a day off before I needed. I think she was trying to make me leave and come home a day early. Bonnaroo is on a fixed schedule and no $9/hour job was going to keep me from missing out.

I came back. There were no random drug-tests I had been partially expecting. I did my shift and only had a small foul-up at PHP where I was trying to find a patient who had just been reassigned over there. Things change very quickly day-to-day and I was rightfully somewhat disoriented after nearly a week absence.

The next day I came in. I was about fifteen minutes late for my shift. I had driven from Green Cove Springs to Lakeland that morning to earn some extra cash. I left when it was dark out and made it back to my bed for a twenty-minute nap before an eight-hour shift lasting until 11:30pm. I was always a little late, I had a good excuse, and no one had ever brought up my chronic tardiness even in passing. There was a thirty-minute shift transition, so the clinic was always over-staffed in that time period. The time clock was also about ten minutes faster than anyone else’s clock or any other clock in the clinic.

I had been in building for about two minutes before my boss walked up and told me she needed to see me. I knew what was up. She walked me to the Res-5 lounge and Jim was inside. Jim was our human resources officer. I knew I was being fired. I put on a smirk and listened to them as they began, “unfortunately, it’s not working out. We’ll need your name tag and any keys you have.”

As I pulled off my name tag, I asked, “What’s not working out?”

“It’s just not working out.”

I tossed her my name tag and walked off.

I don’t know why they fired me. I broke a lot of rules there, granted, but nothing that wouldn’t have been immediately adjusted upon mention. My training was incomplete to say the least so I had a good excuse for acting on common sense and compassion.

It’s my belief then that my termination wasn’t based on any one event, but several small things. I believe first and foremost was the time I took off, so early in my “career”, to go to Bonnaroo. Bonnaroo is an open-air drug market and some patients knew this. Despite my addendum that I only go for the music, the gossip-circles amongst the patients and staff probably led to that piece of information making its way up the ladder. The FSU quarterback was also on the front-page when I got back after being taken down in the middle of a crowded street proclaiming his divinity.

I believe the circumstances surrounding Seth. He had also given me his phone number before being discharged so that I could check up on him when he got out. He told other patients. A more naïve and younger heroin junkie had asked me, very loud, during lunch whether I had called. I simply put my fingers on my lips and told him that I wasn’t allowed to do that and I would be fired if anyone else found out. Perhaps this was an example of me miscalculating patients understanding of my often too-compromising take on clinic rules and professional distance from the patients. I don’t doubt that others heard this and it perhaps spread.

I was also fully responsible for Clark’s AMA. I researched and found his daughters graduation date with only a request for his silence in return. I don’t know if word got out, but he left to see his daughter graduate.

I also won $100 from corporate for winning an essay contest. I contributed one of these entries – heavily edited, of course – and was contacted back. I attempted to work out something to where I could perhaps edit their newsletter as an alternate job… my way of trying to move up out of a dead-end job. I informed them in my last email that I wasn’t sure how long my employment would last, being that I was being paid “only slightly higher than your average Taco Bell employee.” Perhaps my hint that I had other talents than executing flawed rehabilitation programming was too strong. I never got a response back.

This attempt at upper-mobility also manifested itself in staff meetings where I would talk about problems techs were having and proposing simple fixes. This generated warm responses from fellow techs yet harsh rebuttals from the administration. My training in Student Government to automatically take on leadership was woefully misplaced in that context. Subsequently, I learned my place and kept mum. I hadn’t really spoken more than a few words to my boss since my first suggestions were shot down with, “we’re not going to change things for you.” Perhaps it was my reply that got me into trouble, that this wasn’t for me. “We have a high turnover rate… [these problems are] easy to work around once you get used to things, but are easily correctable for all the new staff that are always coming in.”

I think these things, and perhaps others I’m not even thinking of, were the cause of my untimely termination. It is also interesting to note that the only other recent college grad there was also terminated. Those who unquestionably executed orders from the top kept the jobs; those who saw that there was something wrong with an 80% relapse rate were fired. At least that’s how it looks to me. It’s hard to respect a system whose odds of success are lower than flipping a coin.

It took me a month to find another job. I had two interviews in three weeks for office jobs. Temp agencies weren’t calling me back. I gave up and took a job as a server at a hotel buffet attached to a comedy club. I really don’t know what happens next with employment. It’s a weird, weird time in my life.

I’ve also changed my pen name to Tunico. “To Nick.” This is so that everything I write is dedicated to Nick, my roommate of two years and longest friendship on record… who died July 6, 2005 of self-inflicted asphyxiation. “To Nick,” phonetically.

Clark goes AMA

Today was a mess. I was written up in the first ten minutes of work for having accidentally brought home two pair of keys. Apparently they blamed everyone else but me until I rolled in and offered them without knowing they were being missed.

New patients were everywhere. There's something about Friday... their family tries to get them in before the weekend binge comes. It was also storming outside, so all 40 in-house patients plus 40 PHP patients over for lunch were crammed inside.

In the middle of the ruckus, my boss asked me to take Clark over to the apartments so he can get his stuff. He was completely calm and no one was fighting him, so I never suspected he was going AMA. AMA means Against Medical Advice, meaning the clinic hasn't approved the patience discharge. The patients are in on their own accord and can walk out whenever they want being that it's not a lock down facility. Going AMA, however, does put oneself at risk of having their insurance companies asking for reimbursement.

Clark was going AMA because of what I had done. I had given him the date of his daughter’s graduation (I found it online) and he was determined not to miss it. He had already been in a month, which is the average time for patients, and he was ready to go. The quiet broken man was steadfast in resolve not to do any more damage than he had already done.

His therapist approved his discharge, but it didn't make it's way up the chain of command. They disagreed. Their official stance was that his recovery was not yet complete - that if he were released at that time, he was likely to rebound. He needed to be held longer for his own good.

... another hole in the wall of secrecy at my clinic where I've seen the brilliant luster of profit outshine the dull ambience of common sense. The mere suggestion of forcing a patient to slip further away from his family, missing his daughter’s high school graduation, to spend another week at rehab awakens a deeply recessed fire inside of me. This isn't textbook political theory anymore, this is the real thing.

This is profit over people. This is the direct manipulation of insurance providers by a trusted source to milk as much money as possible at the cost of further ruining a weakened mans life. I know from my own family the anger that comes when a father misses a daughter’s graduation, even when he thinks he's unwanted. I can think of no clearer agitator to bring Clark back to the depths of addiction than having the one daughter who still talks to him turn her back.

Adding to me anger is that a week ago I watched them discharge The Kid. Every tech and patient who knew him was confident he'd be returning to addiction within an hour of getting home. He sat around and told "war stories" of past drug use all day, every day, giving other patients lessons on how the well off get high. Not everyone can afford to shoot coke, ya know. He had already been to fifteen rehab clinics. The first time I talked to him he wanted me to know that he'd be partying in Bourbon Street the night he got out. There's no way his obsession got past his therapists...

Yet The Kid was medically approved by the clinic to leave after 30 days. Clark was told to stay for five weeks. Clark talked about nothing but the loss that his drinking addiction had wrought him... his wife, his oldest daughter, his job... and how much he wanted to start over, while The Kid's eyes would glow when he talked about the taste of cocaine under the tongue during the blood rush after injection. But The Kid was ready to enter the real world, according to the professional staff, but Clark wasn't... Clark needed seven more days. Besides, his insurance would cover it.

Clark was pissed too. He knew it was about insurance. In his quiet way, he raged against the staff. He had recommended Dennis for the "scholarship" that the clinical staff brings up whenever patients cite insurance as a reason why some people stay a week and others a month and a half.

"If we feel that a patient is not ready for discharge and his insurance hasn't approved additional coverage, we'll keep the patient at no cost to him and attempt to recover insurance cost later," is what my main boss - who's never introduced herself to me - often tells patients during group sessions.

Dennis was about forty, coming in from DC with a crack habit. He was about the friendliest man I've met at the clinic. I thanked him at least once for always being positive, always saying "hey!" and patting me on the back as I walked by. He was a reliable smile in a sea of depression. His spirituality kept him afloat.

But his insurance ran out after eleven days. I didn't even get to say goodbye.

Apparently, under the strictest professional guidelines, a poor black crack addict from the hood can be cured from his addiction in a quarter the time as a middle-class white salesman from a nice suburb on Lake Michigan.

Funny how things work out like that.

Aaron R.

The first day I met Aaron was his last day before PHP. Being new to the job and still acquainting myself with all our clients, I approached him and struck up a conversation. Quickly I learned that we were mutually fresh out of college with identical majors. Though belonging to two different political parties, we had a quick non-obtrusive sparring that political science majors do when they meet each other than runs itself more like an inventory check than a real debate.

Our next encounter was at his room right before lights out at PHP the next day. I was making the last hourly checkup of the night and he and his roommate were last. They were sitting across from each other reading with the thick smell of fresh baked cake in the air. His roommate immediately offered a slice.

I sat and spoke with them for a couple minutes. They were the youngest men at PHP. Aaron was in on a preventative step. Like me, he drank a bit in college. The difference was that he couldn’t stop when he got out. He realized it early and brought himself to treatment so he couldn’t hurt anyone else.

We talked about the nature of addiction, about the off-switch that most people are equipped with and the genetically lower thresholds that most addicts have to override that switch. Anyone can become an addict – but for most people here it’s genetically easier to get there. We talked about how we both have addiction running in the family, and how lucky we both were to be able to walk away from our demons while still young.

Aaron is my daily reminder of the all-too-human core inside everyone at Lakeview. There are no monsters here. Take the drink or drug away from the abuser and you have an injured yet completely recoverable human. Keep the drug or drink away and you have God’s greatest miracle: Rebirth.

Mike S. [late night posting, to be edited later]

"I just don't think I beleive in this 12-step stuff... I mean, I believe in some of it," Mike said outside of the Narcotics Anonymous meeting. I had just delivered he and 12 other patients to a small church a couple miles from the clinic.

"I was pretty damn skeptical too until I came here. Which steps do you believe in," I asked.

"Well, the first," he said. "I believe I am an addict and am powerless over drugs. I just don't believe in the God stuff. I'm not religious."

We talked about our own religious background, both near-pentacostal, and how that had soured our taste for religion permanently.

"Do you believe there is a power greater than yourself," I asked him.

"No, I don't believe in a spiritual higher power."

"That's not what I asked. Some people in here talk about God as meaning "Group of Drunks," which I think is pretty clever. A group is bigger than yourself. Is an army bigger than a single person?"

He agreed. He countered that that was merely power...

I told him that was the basis of the second step... that there was a power greater than oneself - the same self that was admitidly powerless over addiction. Using a power greater than oneself as a tool was the only salvation for an addict. Just as an army is more powerful than the single soldier who alone cannot win a war, a group of recovering addicts is more powerful than the single addict trying every morning to be clean.

Unconvinced, I walked him to the front door of the church. Afterwards, I walked back to the van. I like giving the patients some time alone without the staff watching. It's not my place to be in their anyway...

What's odd about that conversation was the sheer lunacy of me defending a program I feel robbed me a year ago this week. On my birthday, my girlfriend of nearly two years cheated on my at an Al Anon convention in Orlando that she was a speaker for. That I didn't "speak the language" of The Program was the primary reason sourced before she asked me if I could find her recovering addict of a new boyfriend a job. Like everything in this world, perhaps it's just that The Program needs to be taken in moderation such that the power greater than yourself doesn't dominate everything in your life...

Nate S. [new late night post, more editing]

“My name is Nate, and I’m addicted to anything that gets me high.” There’s usually a small bout of clapping after that, slightly disorienting to any newbie in the AA or NA program. Nate is a man with a lot of addictions, one of the walking testimonies that addiction is a singular disease with a hundred paths.

He’s from the outskirts of town, one of several formally isolated communities getting swallowed up in urban sprawl. He has a wife and a beautiful little girl, both of whom I’ve met twice now. The first time was running in to look at the schedule and the second was today when I helped him load his groceries into my work van.

He was being transferred over to the PHP apartments after spending nearly three weeks in detox getting the heroin, crack, and meth out of his system. His attitude had changed a lot sense I first met him. We joked on the ride over to PHP about him calling me the “fun police” after catching him trying to cheat phone policy.

“I just hope my wife sees it.”

We joked the day before about how he needed to get his wife the biggest diamond in town for their next big anniversary. She waited three years for him to get out of prison for selling an ounce and a half of cocaine to a narc.

“That was the first time I sold to anyone outside my circle of friends… first time. Always happens like that, ya know?”

He was sober for a year and a half after that. He completely threw himself to the church. Then he slipped. He fell harder than he ever had before.

The catalyst to him coming here was his wife sending their daughter into the garage him get high. He’d snap at her and tell her to get back into the house.

She finally left him. She could handle being without him for three years in prison but couldn’t take him getting high inside the house with their daughter there.

He spent a week getting more messed up than he ever had before he finally getting into rehab.

Nate is one of the scarier patients in how much he reminds myself of all the possible me’s. Maybe had I stayed with the wrong friends a little longer, had people not come into my life at certain points… I could see myself in his shoes, especially when we talk Pink Floyd albums and our favorite live shows.

Sue D.

Sue is about 40 years old and from bayous of Louisiana. She had been nearly catatonic for the past three days before I spoke with her, sleeping nearly all day every day after her arrival. She was outside smoking with Liz, a worn woman of similar age but with the stress of life deeply engrained in her face who I believe to be the Mystery Scatter. The Mystery Scatter has been leaving foul droppings wrapped in linens in the ladies restroom trashcan and shower.

Liz had taken Sue under her wing the way a sick animal nurses a smaller sick animal to health in the same den. It was a horrible and potentially explosive conglomeration of neurosis’s… a Mystery Scatter and accused thief taking on the position as friendly elder and egging a woman on to continue sleeping eighteen hours a day. Nothing good could come from that.

I sat down next to Sue after the incident with Seth. After dinner I had regained my composure and went back to dealing with patients - she happened to be the first. I started asking her questions about where she was from. The dam burst open.

She accused late-night staff of being apathetic to her late night crying, accusing one of them of telling her to stop wallowing in her self pity. Her whole story was on the verge of coming out.

Her story really involved two people, her angelic and innocent seventeen year old daughter who had been raised in a very protective environment. The second actor was the kid next door whose parents had nearly abandoned him for being a “bad seed.” As so many sick people do, she took him in and acted as a surrogate mother.

The neighbor kid joined the services and had come home after boot camp for final a final goodbye. He stayed with Sue that night.

Sue heard crying that night. She walked down the hall to and heard it coming from her daughter’s bedroom. She was being raped. She had been a virgin.

Once back at school, her daughter was teased for it by the other students. An accomplished member of the school’s marching band, she refused to participate in her final recital out of embarrassment. In the eyes of the school, she was merely that girl who had slept with the neighbor boy.

Sue fell back on the pain killers she had for a prior surgery. It’s pretty easy for addicts to get extra pills from their family doctors… pain is something that can only be measured by the individual feeling it. Most doctors won’t fight a patient who says they merely want to feel better.

It got bad, such that her daughter was taking care of her.

“You can stay here, Mom. I’ll take care of you,” was one of the last things her daughter told her before she left.

“You don’t need to take care of me anymore. That’s my role. It’s time for me to be a mother again.”

I had the talk with her that I have with most patients that have family issues. You have to leave it all back at home for a little while. The only way they’ll get better is if they spend this time focusing on themselves enough to fix themselves. Focusing on fixing a marriage or the pains that brought them to addiction while they’re supposed to be focusing on the addiction itself is a shortcut to relapse.

It’s a hard, if not impossible, yet entirely necessary task.

“You’re here to fix yourself now so you can deal with that stuff when you get out.”

It’s a hard argument to make. Forget about your failing marriage, except during the ten minute phone call every night. Forget about your hurting daughter, except when the group therapist asks about it. Forget about how much you hate being in some clinic in the boiling Florida heat away from your friends and family.

I told her it’s like trying to get to an emergency in an ambulance. You’ve got to open the door, get in, turn the ignition, and drive there. It’s an ordered process, with a necessary first step. Her first step was getting “clear.” She didn’t like the words sober or clean. Once “clear,” then she could be the mother she needed to be to a wounded daughter.

Seth L.

Seth is eighteen years old. I don’t remember where he’s from. When I first started working at the clinic, he was community leader running the community meetings and the 12-Step Meeting (an Intro to AA/NA type environment). By all accounts, he was the model patient.

The first time I talked to him I was in his apartment over at PHP, which stands for Partial Hospitalization and is the final step before entering a halfway house or the real world. His roommate was Charles, a patient about my age from Chicago with my same major – only on the opposite end of the political spectrum, but respectfully so. I had promised to bring him a Russell Kirk book, but I was later told not to by staff.

I had just gotten done making my final rounds at the main men’s apartment building. All the men were lounging around in their apartments watching a Michelle Pfeiffer movie before lights out. Then I got to Seth and Charles’s apartment, which was in another building that was halfway renovated. Theirs was a little different from the rest.

Seth and Charles were sitting across from each other silently reading with the TV off. The smell of something cooking in the oven was strong.

“Would you like some cake?”

It took me a moment to respond back, “sure…”

In my short time at the clinic, it was always me running around doing favors for the patients – warming up meals, finding silverware, finding out what nurses want, when can they get their extra cash, more cigarette’s etc..

Seth fixed me a slice and I sat down and talked to both of them. Charles and I had a mini-debate-type thing a couple days before that poli-sci major’s do that isn’t so much confrontational as exploratory. Never negative feelings attached… it’s more or less a checklist. We walked away mutually impressed – that’s when I offered to loan him the Russell Kirk book. Kirk is a fine conservative writer that most conservatives have never heard of. I hadn’t had a chance to speak with Seth.

I joked with them that I felt that I had just stepped into my grandparent’s house, which turned into a nickname that stayed. I found out that Seth was in for Oxy’s, common for the younger people at the clinic.

I didn’t see him again till two days later. I was assigned to take him back to his apartment after dinner so he could get his things and come back to the main facility. He was on “watch.”

I helped him get his things at his apartment. He had a new roommate who was asking him what was up. “The changed my meds and want me over at the main facility,” he lied.

On the drive over he told me he was on suicide watch. We talked for a little bit about depression and suicidal thoughts. I told him my take on it, how I’ve coped with strong depression in earlier years. He told me how be bottled everything inside. He asked me what the cost of living was in Jacksonville. He wanted out of his hometown so he could start over. It was his own sister that got him hooked on Oxy’s.

Back at the facility he slept. I didn’t see him again until the next day. I was outside by the lake with a bunch of the smokers and was walking to peek around on the side of building where some other smokers congregate to make sure a tech was there. There was. But there was also Seth. I hadn’t seen him since him awake since he’d been transferred.

He looked horrible. He was sitting by himself in the parking lot staring at the ground. I started walking his way.

Just as I sat down next to him another tech walked up to us and said, “time to go." They’re free time was coming to an end and they had to choose between doing homework – largely writing their autobiographies and reading 12-Step books – and doing meditation

“I’ll get him inside, can you give me a couple minutes?”

“No,” the other tech said. I gave her a look to let her know I was serious. Seth looked like he needed to talk to someone, not go sit in a room while a therapist read calming words. He needed to get some things out and no someone gave a damn, not spend more time in silence.

The other tech went for my boss. They immediately dispatched with Seth. They laid in on me for what seemed fifteen minutes. They told me I was being manipulated by Seth. “All addicts are the same, they lie and manipulate.” That offended me on two levels, the first being the lumping together of everyone with a drug problem as treacherous sociopaths and the second being them ignoring that I had made an informed decision without his immediate input. I saw him from across the parking lot and made the decision to talk to him.

I did tell them right away that I would do as they say. I’m on their payroll hired to institute their program. They were in positions of authority and I do as I’m told when on the clock.

That wasn’t good enough. I had to believe them that taking three minutes to talk to him was deleterious to his progress. I couldn’t though. Not right then at least. I knew the success rate of any rehab clinic is something between five and thirty percent. Two thirds of the patients will wind up abusing again. Who the hell were they to override common sense to stay within the guidelines of a failed program?

Something caught my boss’s attention and she had to leave the conversation. I walked off. I cried. I can’t even say exactly why. I can't remember the last I cried... but there I was on the dock out by the lake trying to stop the tears.

I went to her office today and told her it was because I empathize. Seth is a kid I could easily see hanging around my friends and I. He’s not just a random abuser, he’s a smart kid caught up in some bad stuff and wanting to get better. He’s scared as hell. My protective instincts and natural response to someone in that situation were completely overridden without even a moment’s consideration to confirm to a pretty ridiculous standard of timeliness and order that no staff member exercises in their own life.

It hurt though. That was very unexpected. I didn’t realize I was being as emotionally drawn into the patients as I had become.

Phil D.

“At some point, you look in ya boxers and ya see grey, man,” Phil said outside on the picknick tables that the smokers congregated at. He, Eric and I were all sitting out there before lights out. They were joking with me about the “looking busy” remark I made when they asked me what I was doing.

Phil’s humor had been a source of contention for us in past days. A tall, very heavyset older black man with a budding fro from the casino country of New Jersey, I first met him I was to drive him to the hospital using a company van for the first time. I looked all sorts of nervous behind the wheel of a two ton van - eye level eight feet off the ground behind a an enormous V8.

“I drive a little Japanese car, Phil. It’s like… 4 inches off the ground. Stick shift. This thing is huge.”

My confusion and fear of driving the machine was a source of limitless humor to Phil. As I sat in the car about to pull out, adjusting myself to the new driving console, another employee came to me and told me she needed the van and would drop him off.

Phil got out, ran to another patient he knew, and immediately began his story about how I almost killed him by running the van into a ditch. The obvious lie of the story, coupled with the fact that only he and I knew the truth, bothered the hell out of me. snapped on him once or twice catching him telling the faux story hours and days later.

I had made an effort over the past few days to get cool with him. I don’t want any lasting negative tension between any client and myself, even if his humor was on a different level from my own… even if that meant just dealing with him talking about how much he missed “wet dreams” or fretted the graying of his pubic hair.

We were talking about addiction right before the joke, about me needing to make sure his window was closed so he couldn’t sneak out. It was just house rules. People have done it before. He told me what I’m used to hearing by now – a junkie gets what they need no matter what we do. I told him it was our job, at least for the time being, to make getting drugs and alcohol difficult and such that if you do try, you get caught and kicked out of the program.

He went on though, ignoring my reasoning. He had something else to say, and like a good politician he retorted to the argument he wished I had made.

“I don’t drive a car back home. You know… we find what we need. Find a bike that’s unlocked. A dope-head knows another dope-head when he sees one. He jus’ axks till he finds a someone to tell him where a seller his, then you gotta find a needle. But you find what you need, boy.”

“I’m too old for this shit,” he told me. He had been to several programs. He showed me the thick scars reaching towards his wrest from his the underside of his elbow. “I work wit’ kids. They see that kinda shit… the axks about that kinda stuff.”