10:00 Sunday morning.
On a happy walk to Alaskan Commercial to buy groceries; I can see it
just a quarter mile ahead.
“Hey!”
I walk
a few more steps in hopes the voice isn’t directed at me but there is no one
else outside within 500 yards and I realize I will have to engage.
“Hey!”
I stop
walking and turn toward the voice, an older woman in a red shirt, who waves at
me from the doorway of a ramshackle house across the street.
“I need
your help!”
“You
need help?” I repeat. Maybe she’ll think
I’m an idiot and ask someone else.
“Yes!”
she says and retreats inside. I wait for traffic to clear, trudge across the
muddy street, through a muddy yard, have a choice of walking up a wheelchair
ramp (a clue to what I’ll find inside?) or snow-covered stairs. I take the stairs. The snow will clean my boots a little.
The door
is ajar but I knock anyway. There is no answer. I push open the door and enter a short mudroom and an
overwhelming miasma of rotten food, feces, seal oil, and vomit. The small living room is strewn with flotsam
over old linoleum that has likely never been swept since it was laid. Sunlight streams through the windows,
highlighting a bucket next to the sagging couch, half full of the likely source
of the smell. The red-shirted woman is
gone, but a young Yupik girl in her mid-20s stands silently centered in the doorway
to the living room. She stares at me
with dark brown eyes half hidden by puffy cheeks tinged scarlet with acne.
“How
can I help?” I ask her. I remember to go
silent. It’s called the “3.5 second rule”:
wait at least 3.5 seconds after speaking to a Yupik because their conversation pattern
is slower than white people are used to. I wait. She says nothing, just stares, unmoving.
“Someone
said they needed help?” Nothing. Stare. She reminds me of an animal caught in
a trap.
“I’ll
help if I can.” Stare. 30 seconds pass. I stay still on dirty cardboard in the
mudroom, conscious of my filthy boots. I
stand openly, non-aggressively, my gaze directed at the space between her
eyebrows so as to project eye contact without actually looking into her soul. She seems torn between bolting and accepting
my offer.
“I
think she’s having alcohol withdrawal” she says timidly “she’s seeing things
and acting crazy.”
“Hellooo!”
cries a voice from another room, “who’s here?
Are they here to help?”
I step
to the end of the cardboard, peek around the corner and see the woman in red
reclined on a bed in a back bedroom. I turn to the girl, who hasn’t moved.
“How
long has she been seeing things?” I
think through my OPQRST pneumonic, O stands for “Onset”. She says nothing, stares at me as if gauging
my usefulness, or gullibility.
“Can
you describe how she’s been acting crazy? Does anything set her off?” I ask.
P stands for “palliative or provocative”. I pause to give her the requisite time to
reply.
“It’s
alcohol withdrawal” she says again, more confidently. “I’m having alcohol
withdrawal.” She has decided what to do with me, how I can be useful.
“Oh, you’re having alcohol withdrawal!” Pause.
“I
drink a lot.” She starts to tremble, but
it looks forced. I’ve seen plenty of
alcohol withdrawal, including my own.
Tremors are different than trembles.
“When
was the last time you had something to drink?” Back to O.
“Two
hours ago.”
“What did
you drink?” Pause.
“I… it
was vodka, I think.” She has not stopped
staring. Her eyes are lovely - and
inscrutable.
“Well,
if you drank two hours ago you’re not going through withdrawals” I say
matter-of-factly. I smile to soften the
truth; no one likes to hear the truth.
She stares at me then snorts a puff of laughter –or disgust - and puts a
hand to her chest.
“I’m
having chest pain from the withdrawals.
I’ve had withdrawals before, I know what they’re like. My chest hurts. I need you to call an
ambulance.” Ah, they need me for my phone.
“You
want me to call 911?” She nods
silently. I sling my backpack off, set
it down on the chest freezer that sits in every mudroom in Alaska and pull
out my phone. I dial 911 and hand it to
her.
“I don’t
know your name or address so you’ll have to talk to them.” She takes the phone, looks at it briefly, and
makes a tiny, impatient grunt. I see her thumb twitch over the hang-up button.
“Are
you here to help?” the lady on the bed yells.
I look around the corner and give her my biggest smile.
“Yes, I’ll
help if I can!” I yell back.
“Who
are you?” she shouts. “Oh, you’re the
person I waved at across the street! Are
you here to help?” I look back at the
girl. She is holding my phone out to me.
It has been disconnected from 911.
I don’t take it.
“If you
want an ambulance, you’re going to have to talk to them” I say patiently. She
says nothing, just holds the phone out to me. We stare at each other for 20
long seconds. I take the phone.
“Do you
want an ambulance?” She starts trembling
again.
“My
chest hurts.”
“On a
scale of 1 to 10, how much does your chest hurt?” Pause.
“Seven.”
“Then
let’s call the ambulance.” I dial again and hold it out to her. “I don’t know your address, you need to tell
them.” She takes it and this time she
lets it connect.
“I’m
having chest pain” she says simply. She
gives her age and location then hangs up. The 911 dispatch doesn’t ask many questions,
they get these calls all the time.
“Do you
have something to drink?” the lady in red asks, weaving into the living room.
“No, I
don’t. I stopped drinking a while back.”
“Oh,
who are you?”
“I’m
John.”
“Come
in and talk with me!” She plops onto the
couch, the definition of bedraggled.
I
remove my boots and enter the bright living room. I have to squeeze past the
girl who has not moved. Her head swivels
to track me as I pass.
“I’m a
nurse, if it makes you feel any better” I tell the girl.
“You’re
a nurse?”
“Yes.” She mulls this over. I choose a child’s plastic school chair to
sit in; it’s clean, it’s lower than the couch which makes it non-threatening, and
it leaves the other chair open for the girl if she wants to join the
conversation. I hope she will. I hope she’ll trust me, call off this charade,
and we can have a good conversation. My
foot nudges the bucket, which sloshes. A
sickening wave of fresh stench erupts.
“I’m
Mary*. Tell me about yourself!” chirps the red lady expansively, draped over
the couch.
“I’m
John. Ummm… I grew up on a farm.” Pause.
Gasp. Breathe through mouth.
“Oooohhh,
I LOVE farms! In fact, I have always wish
I was on a farms!”
“Are
you from here?”
“Yes, I’m
from here. My mother, she left me – oh,
I don’t know how many plots. I have…”
she waves a hand in a general direction “sooo many plots. Sometimes I have to… you know about the
homeless people?”
“No, I
don’t know about the homeless people.”
“You’re
a nurse?” the girl asks just as the paramedic knocks on the door. She is still standing in the same spot she
was in when I arrived. The paramedic
cracks the door and pokes his head in.
“You
having chest pain?” he asks, eyes flicking between the three of us.
“Yes”
the girl says.
“Can
you walk to the ambulance?”
“Yes.” He withdraws his head and she follows him out
without a backward glance.
“I have
had so, so much things happen in my life” says Mary thoughtfully.
“I’m
sure you have.”
“I’m
57. And how about you?”
“I’m
47.”
“Oh, I’m
older - then I can boss you around!”
“Sure.”
“I’d
boss you around until you got tired of bossing… oh! Excuse me.
I just farted!”
“That’s
OK. Well, I’d better get goi…”
“No! Stay – please stay! I get so lonely!”
“OK. I’ll stay a few minutes.”
“Do you
have anything to drink?”
“No. I used to drink but I don’t anymore.”
“I feel
sooo sad!”
“What
makes you so sad?”
“I don’t
have anything to drink!!!”
“You
said you liked farms. Have you been to a
farm?”
“One
time we went to Canada, to a farms.”
“What
did they grow there?”
“Oh,
fruit trees, and, well, just everything that grows!”
“Mary,
how old were you when you went to Canada?”
“How do
you know my name?”
“You
told me, just a few minutes ago.”
“How
long have you been here?”
“About
ten minutes. You called me over, remember?
You stood in the doorway and told me you needed help.”
“Ha!
That’s right! What were you doing?”
“I… was
just out for a walk on a glorious Sunday morning.” I almost let slip that I was
headed to the grocery store. She didn’t need to know that I had money and
access to alcohol. There are no rules
for the desperate drunk.
“Do you
have anything to drink?”
“No, I
quit drinking.” I add that every time as the gentlest of
suggestions that not drinking was an
option. She seemed to hear nothing beyond “No”. I stood up. “I’d better go. It was nice to meet you, Mary.” She pouted, but shook my outstretched hand. I grabbed my backpack, stomped into my boots,
opened the door, and looked back. Mary
lounged in the sun on the beaten couch, a frown on her face, staring into the bucket
of vomit.
The
fresh air was life itself. As I walked I
wondered what game the girl was playing. Sometimes when someone is truly in
alcohol withdrawal – which can be deadly – the doctor will order them a
beer. It comes wrapped in tin foil so
the other drunks in the emergency department can’t see that it’s a beer but
since soda cans don’t come wrapped in tinfoil really the only mystery is which brand
the hospital stocks. Maybe she faked
chest pain to get a Sunday morning beer – the most expensive beer ever, if
you’re a taxpayer. She may also have
gone in search of pain medicine. I
wondered if she went for herself or for her mother, if Mary was her mother –
family ties are less nuclear here. Maybe she would get the beer or pain
medicine and tuck it into her sock to bring home because it was too painful to
see her loved one so desperate. I do
know this isn’t the first time she’s done this; she knew all the triggers.
From talking with nurses in the E.D. I know
this same story happens all day, every day in Bethel. Being here is like stepping through Alice’s
looking glass and can quickly turn a mundane walk to get groceries into an extraordinary
rabbit-hole.
*Obviously, not her real name.
