HIPPOCRATIC OATH(??)

 “Hippocratic Oath (Ορκος) is perhaps the most widely known of Greek medical texts. It requires a new physician to swear upon a number of healing gods that he will uphold a number of professional ethical standards.Sep 16, 2002”

“”METHADONE MAINTENANCE IS A LEGITIMATE EVIDENCE BASED FORM OF TREATMENT – UNTIL IT ISN’T””

My identical twin sister’s name is a biblical one, Rachel. It means lamb-like or something to that affect. Which is ironic since there’s absolutely nothing soft and fuzzy about her. Once it “appeared” that I could manage my addiction to methadone my sister began encouraging me to file an official complaint with the Indiana Attorney General’s Office immediately. Despite having cancer and struggling with her own health problems she felt it was truly important to stand up for my rights at that point. My sister’s always been a champion of the underdog. For as long as I can remember my sister had directly confronted any situation dealing with individual rights. Particularly when she identifed discrimination that dealt with the “lower class”. I guess it’s not all that surprising. After all she had one hell of a mentor. Our mother. She felt that the Midtown narcotics treatment program had taken advantage of me. It wasn’t only financially either. She was disturbed by the lack of support that she believed they should have provided me. Especially when child protective services discriminated against me just for being a methadone patient. For many years I had managed to convince my sister to simply let it go or “drop it” in regards to filing a complaint. Truthfully I was terrified about the possible consequences pissing off Midtown might have. I understood all too well that at the end of the day it would be my own ass on the line, not anyone else’s. I certainly wasn’t the ONLY patient from Midtown who realized that we were in a delicate position where filing official complaints was concerned. Over the passing of seventeen years I had overheard clients occasionally mention that it didn’t really matter how unhappy a Midtown client was because we didn’t have any other options treatment wise. And regardless if methadone had been legitimately prescribed or not we were all in the same boat. I’d imagine that the patients who truly had experienced the hell of heroin addiction were even less likely to file complaints or raise concerns. They certainly never wanted to be left to fend for themselves ever again. Obviously not every person who had been admitted would have a legitimate need to complain. I’m assuming the majority of patients had a positive experience with the program. Or at least considered services satisfactory. Of course even if patients were “over the moon” with treatment. They understood why their problems could never officially be addressed. Partly because Medicaid reimbursement hadn’t yet kicked in. Also because Midtown’s “clients” didn’t always recognize they were afforded certain rights as a patient. “Objectivity, fairness and respect”- wasn’t likely to be a priority if they did actually file. In fact I had been warned by several “clients” that no matter what was happening it simply wasn’t worth the risk. Since it was the ONLY outpatient clinic in Marion county Indiana. This meant that unless a person could afford to walk away it was best not voice concerns. Which meant even when Midtown’s methadone patients did have a good reason to file a complaint, it wasn’t a realistic option for them. At the end of the day opioid withdrawal “trumps” civil liberties – Every time guarantee. Hard to give a damn about the amendment right to petition when staring methadone withdraw straight in the face. I’m honestly puzzled at how this aspect of our patient care was overlooked by the many trusted healthcare professionals that most of us were struggling to pay each week (?) Surely one of these educated professionals might have remembered that you never bite the hand that’s been feeding your powerful opiate addiction. Especially where methadone, a schedule class two narcotic was concerned (??) And for those of you who didn’t already know. Before the year 2018 in Indiana, methadone didn’t grow on trees. I believe it was on day nine of methadone withdrawal that my sister’s fierce will finally got the best of me. She pulled me aside one evening after dinner and insisted that I file a complaint with the Indiana Attorney General’s Office via their website. I nervously paced back and forth behind my sister seated in front of my Dad’s computer. She was determined to get the last word in. Especially after watching the living hell I was enduring back then. She reminded me that I had never been unable to eat or sleep without a Vicodin. We even placed a phone call to the attorney general’s office asking if my identity would be kept confidential after filing. We were told that unless an investigation takes place, my name wouldn’t be revealed. Even after hearing this part I was still uneasy. I also felt guilty about voluntarily attending treatment with methadone in the first place. After I mentioned this to her she spun around in my father’s chair and asked me who’s to blame when a person is raped? Would it be the victim’s own fault if she was dressed provocatively? I decided to go ahead and finish filing the complaint online with her. A short while later we were finished. It had been done. Soon afterwards I forgot about it. Around that same time period my sister had given me a pill. One that I’d never heard of before. It was called Subutex. It was an opiate based narcotic and it stopped my agony right in it’s tracks. But it was merely a temporary reprieve. My system would resume the hellish track it had previously been on approximately twelve hours later. However accepting my sister’s medication offered me an opportunity to clear my head and rest up before the next regularly scheduled fight. It would have been too much to hope for that it would last a whole day or even two. Still twelve hours was definitely nothing to complain about! I immediately realized that if I was going to ask someone from Midtown for their help. I’d have to move quickly before my withdraw symptoms returned. Almost impossible to concentrate on anything once they reappeared. It was absolutely wonderful being free from opioid withdraw once again. Eating, sleeping even laughing! But the entire time I knew that it was bound to happen again. I couldn’t bear the thought of leaving again just to suffer endlessly. She had only that one pill to give me. As the clock began to count down towards withdrawal I became more desperate to remain with my family. I grabbed the phone and hastily started leaving messages for Midtown. My clinician wasn’t overly thrilled about speaking to the staff concerning my situation. I could tell from her voice she didn’t honestly believe that the doctor might help me. I reminded her that everyone from Midtown was entitled to a medically supervised detox. I assumed I could bargain for another week at no expense. It was probably the most I could hope to receive at that time. Truthfully I didn’t have any desire to return. What I needed was a break from the symptoms in order to make other arrangements, if it was even reasonably possible to make other arrangements without opioid medication. I convinced myself that surely my seventeen years spent at Midtown as a paying “client” would have to count for something! They’d not refuse a small dose of methadone for the purposes of a detox. And at that time I’d have even agreed to the fruitless three day taper method. Possibly even just one day. I didn’t care about the long term implications here. I couldn’t think that far in advance with opioid withdrawal hanging over my head once again. It wasn’t as if I could have easily accomplished this anyway since I was living back home with my parents. I’m not sure how I expected to manage any of this without anyone finding out. But I wasn’t thinking straight. I was in pure panic mode. Like being trapped inside of a burning building and searching for any possible escape route. I knew the end was coming closer and closer. Buying time is the name of the game in survival. After leaving numerous voicemails finally the phone rang. I answered immediately expecting it to be my former clinician. Surprisingly it wasn’t her voice on the other end of the line. Instead it was the doctor’s voice, Midtown’s specialist. I became nervous since I knew that the doctor wouldn’t have called me directly unless it was important. Without being prompted I began to explain my situation and asking him to please consider helping me just temporarily. I provided a full description of my symptoms and reminded him that I’d happily accept any arrangement he’d be able to swing. After I finally stopped talking the doctor had only one question for me. “Did you actually file a complaint with the Attorney General’s Office?” I was taken completely by surprise with this question about filing a complaint. I was under the impression that the doctor wouldn’t know which patient had filed. I also thought it likely that the doctor wouldn’t even be aware a complaint had been filed at all. Here’s the thing about filing complaints with the Attorney General’s Office. It’s not made explicit but the respondant (in this case the doctor) always receives the complainant’s copy (in this case the patient). When I was told that only investigated complaints required them to reveal names I had assumed that prior to any investigation I would first be made aware or informed that they were getting ready to proceed with one. I wasn’t in the habit of running around filing official complaints of this kind. I had no idea what to expect as a result of filing one. Thought at best it would be the equivalent to a write up and it would sit in his personale file for a brief period of time. It was a bit naive of me but without being accoustomed to these complicated matters I didn’t understand the process. I did however strongly suspect that the doctor had the authority to deny me care based on virtually any reason. This put me in a very vunerable position at that time. Medicaid reimbursement in the state of Indiana did not happen until the year 2018. And I didn’t have the cash to pay a private doctor’s office for medicated assisted treatment. I always knew deep down that one day I’d be forced to rely on Midtown for their services again if I didn’t want to suffer. I wasn’t sure how to respond to his question. Obviously I was left scrambling for any available excuse I could find. I considered denying it altogether but clearly he was already aware that I had in fact filed my complaint. I began to cry and plead my case. I was absolutely terrified about what might become of me once I was left without medicine. I wasn’t sure what to do or where to turn for help. I knew that methadone withdraw lasted far longer than any other opioid out there. I also knew even a thirty day inpatient rehab would be incredibly difficult and likely wouldn’t solve my problem. I’ve never been more scared or more desperate in my life as I was at that very moment. And despite having already suffered from methadone maintenance, particularly the admitting standards. I was hoping to merely take it all back! Thought if I apologized to him he’d find a way to forgive me. Surely he’d not simply allow me languish alone. I had sacrificed so much just to continue with this treatment already. Didn’t anyone remember that part?? Evidently not. When I stopped to catch my breath I heard his reply crystal clear. “NO” He got off the line before I even had the chance to hang up. I fell down to the floor sobbing. Soon enough I’d be sick all over again. What was going to happen to me now? How was I ever going to get the rest of my life back?

I lost all of my physical photos. However I had taken pictures with my phone’s camera as a back up in case something bad ever happened! Guess which ones me?? Lol

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