Questions without Answers

I hate heroin. I really have come to hate heroin and everything it does to a human body and soul. Everyday I work tirelessly to counsel, educate and support those afflicted and offer what solace and support to those who love them. I give everything I have (within) into this profession and there are times I feel like I have made a difference and other times when I feel I have done nothing, helped no one. What a profession I chose to do. Long days filled with stressful hours and the realization that you have an enormous responsibility because what you say or do could mean the difference between someone living or dying. I generally do not think too long on the latter because truth be told there is always another thing to do before the end of the day so there is little time to ponder. Today, I felt different. I came into work looking for a chart and could not locate it on the shelf. A thought went through my mind "the person must have left against medical advice". It is not uncommon in this line of work to see people leave treatment because they are not ready to be sober or the craving for the drug is so intense and powerful that to remain in treatment is pure brutal hell. This particular person has been a patient of mine two other times and did just that left against medical advice so I decided to search for the chart in the pile of broken down charts (waiting) for the clinician who had the patient close it out and send it off to medical records. I opened the chart to read what the time and reason the person gave (to leaving against medical advice) in the progress note before closing it out. I read the summary then reread the summary that nursing wrote the evening before just two hours after I left work for the day. "Attempted suicide". Sweet Mother of Jesus, he had a knife and cut self and was stepped up to inpatient (locked down) unit in psyche. As quickly as I picked up the chart to close it I put it down and went over to the inpatient psyche unit this person was admitted. I saw him through the glass sitting on the top of a chair in a room with a television. When he spotted me coming through the door he walked over to me and we sat in a couple of chairs and I asked him what happened. He began to cry then sobbed as he told me "I cannot do this anymore. I cannot get sober. I try and I fail. I do not want to live like that anymore". I asked to see his arm as he told me the details of the night before with the knife and cutting and handing the knife to a staff member as I counted eight individual cuts on his wrist. He told me he had no one. He did not have any family nor any type of support system. I told him he had me. We spoke about long term treatment and I promised to come back tomorrow to see him and when he was stable and ready to come back I would be there waiting in chemical dependency. Walking back to my unit where my office sits in a third floor of an old mansion it felt so surreal. Heroin's monstrous tight hold on the life of a human being that it was better to die than survive. I sat at my desk looking out the window to the gray sky and listening  to the pouring rain and asking myself did I miss something. I spoke to him right before I went home. Why had I not picked up on his sorrow? Was I not attentive enough? What did I miss? Then I have to remember that I am human too. That I get tired. That I am not perfect. That I give so much of myself to this job that I must remind myself the care taker needs to take care. I wonder at times if I can remain in this field much longer because there is never a rest, a break. It consumes my entire waking life. If I am not working with addiction in my professional life I am dealing with it in my personal life. Addiction has been such a long part of my personal life that I wonder if I will ever be free of its pain and torment. And the most ironic part of all this is I am not an addict. I am a mother, a daughter, a sister and I am a counselor. The only part of my life never touched by addiction is my marriage. Often times I wonder why I keep doing all this? How do I keep moving forward? God. I believe that God gives me the strength to keep it all together that there is a purpose, a reason, a plan. I may not know nor understand but I do have faith in God and I believe he watches over me. I believe he watches over my family. I believe he watches over my patients. And I know I will keep moving forward as long as God wishes it. So tomorrow, I will get up and do it all over again. But for now I will absorb myself in a book.