“Overdose! Atkinson Street! “
We grabbed the AED, oxygen tank and an emergency kit. We helped our patients get out of the clinic, and then ran to the street past the metal detectors. We ran towards the group of police officers and outreach workers that had been drawn to the emergency.
I work in a shelter-based hospital in Boston near the intersection Massachusetts Avenue and Melnea Cassis Boulevard. There is a large homeless population. Overdoses are common in this area . Outreach workers and shelter staff are available to help people in need.
The man in front of us that day was pale and almost blue. He was also stiff and barely breathing. His pupils were sharp and his oxygen saturation meter read 68%. This was consistent with an overdose which had suppressed his desire to breathe.
A woman supported his upper body to keep it from the wet asphalt while I and the outreach nurse did our initial assessment. People often use drugs with their friends and romantic partners. They also have valuable information about the patient.
As I administered oxygen and unwrapped Narcan (Naloxone), the nurse asked me if I knew him. She replied, “No, not personally, but we are all family here. “
As we continued to administer oxygen, took another round of vitals (oxygen up to 98%), and waited for the Narcan to kick in and the ambulance to arrive, the woman gathered up his valuables and zipped them up into his jacket pockets.
He began to breathe more deeply, and his color started to return. He sat up soon and was able tell us his name as well as answer some of our questions. I asked him about it and he said that he was a veteran suffering from PTSD and that he would sometimes use drugs to get depressed. Before I could decide which question I wanted to ask, the woman said exactly what I needed to say: “Thanks for your service.” “
He refused to go to the Emergency Room with the EMTs but did accept a Narcan Kit from us. The woman said to him, “I’ll watch out for him.” After a moment, he said, “I should’ve finished my nursing degree.” “
” It’s never too late! The outreach nurse and me spoke in unison. We need compassionate people who understand the needs of their communities and are able to help us cope with healthcare provider burnout.
Her comment brought back memories of when I was first working as a doctor and helping at a fair. I was only able to administer Narcan half-a-dozen of times before being assigned to the Narcan training booth. A woman approached me and asked for Narcan training. I asked her if Narcan had been used before. She replied, “Yes, I think a hundred times on friends who overdosed. But it’s always good for a refresher.” “
Too many times in medicine, there is the feeling that doctors and other healthcare professionals have all the answers. We have to convince our patients to follow our instructions. This approach has not worked with drug users — there have been overdoses that reached an all-time high despite the fact that life-saving drugs are available, but patients don’t get them .. We are failing to recognize the expertise and knowledge of those who understand this community.
In my experience as a provider of healthcare to peo