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Jan 22 17 tweets 7 min read
Why is it important to decriminalize minor drug offenses? Why do I support this #harmreduction discussion that @CityofEdmonton is going to have in only a couple days?

I'm no storyteller like @drdagly and I'm not an expert like @ehyshka.

But let me try to show you why. 🧵👇 1/x
TW: opioid poisoning deaths, residential schools, Sixties Scoop, self harm

Aka: this is heavy. Welcome to my job. This is addiction med front lines. Come see what I see.

It's 2:30pm. I haven't eaten since 8am. I'm tired but we are pushing hard to admit as many as we can. We know the ERs are overloaded w/#COVID. If we can take a few of the patients off their list, maybe it will help just a bit.

He's my last patient to admit. He's tired too

He's a big guy. Wild hair. His chart says he's younger than he looks. The dinky mask we gave him doesn't fit his strong nose but he diligently pulls it up regularly to be polite. He picks at dead skin peeling off the healing frostbite wounds on his fingers. 4/x
We have been talking for 30min. About his alcohol, opioid & crack use. How to manage withdrawal. Treatment options, facilities to go to. The shelters. Those meds he keeps forgetting to pick up.

The conversation lulls. I look down through fogged goggles to check the chart. 5/x
"I saved the money yknow"

I don't look up right away. Where is that lab req...

"My Sixties Scoop money. Got it in September. I put most of it away"

I stop shuffling the papers & look up at him. Put the pen down. Wait. He's not making eye contact, he looking at his fingers. 6/x
"I'm going to use it for a place yknow. Once I can get one. I put the money in the bank & made it hard to get out."

"Thats a good idea"

"Ya. My mom would be proud"

He pauses. I see a tear soak the mask.

"Well not the drugs. That I saved the money. Yknow."

I nod, wait. 7/x
"She was a good mom. I wish I had seen her more as a kid. She went to residential school yknow?" pause. "She was still a good mum."

More tears. That mask sucks them up. I get some tissue & put it within reach. He doesn't take it. But he finally makes eye contact with me.

"I should have spent more time w/my brother too. But I was in jail. For crack."

Pause. I say, "I'm sure they would be proud you're here. It takes a lot of courage to come here."

"Ya. I'm lucky too. Lotta people died this year. Good people." He looks down at a track mark

"Did you lose someone?"

"Who hasn't?"

Good point. I wait.

"Ya. But anyway. I'm going to use that money for the right stuff. The stuff my mom would tell me to get. Not for drugs. I still know some recipes, so I'll start with a big pot. Kitchen stuff. "

We both smile

He asks me again about Poundmakers Lodge. We chat more about treatment options. He rubs his eyes with his sleeve and I notice the long scar on the left wrist. It's old but it explains another facet of his story I'm missing that I want to know.

But he gets up to go.

Me: "Hey X. Just wanted to say. I'm glad you're here. Thank you for telling me about your mom."

He smiles "She was as short as you. Don't know how she made a guy like me"

We both laugh. He takes a shaky step out of my room & that huge body disappears down the hall.

These are the people we are trying to save. With safe injection sites. Safe drug supplies. Decriminalization of drugs. These "controversial" policies aren't left wing radical ideas.

They're evidence based treatments.

To save children. Like this man

Because he's still a child in there. He's still a little boy. Standing on a stool over a big pot. Making dinner w/his mom. Right before he was stolen in the Sixties Scoop. Then traumatized in foster care. Then hooked on drugs. Then hardened in jail. Then homeless in #yeg

And then sitting in front of me. Trying to find a way out from the cycle of addiction, streets, poverty and violence. He's looking at me, asking me to show him an exit that doesn't involve death

He's just a little boy inside, still wanting to make his mom proud.

We need to do better. We can do better.

So please, remember the human behind the news stories. This isn't about political ideology. It's about saving someone's life.

#harmreductionsaveslives #decriminalizepoverty #safesupply #safeinjectionsites #abhealth


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More from @TRexMD780

Dec 29, 2021
@CMOH_Alberta: I didn't think I could reach a point where I would be more angry with you but here we are. By telling everyone to report their positive RATs to their Family Doctor, you have thrown us under the bus medicolegally. I have confirmed with CRA today. Read on

I just had a patient test positive for COVID on a home RAT. She contacted fed EI and she is eligible for the Covid illness benefit but only if she gets a "medical note from her doctor verifying she has COVID"

So, Dr. Hinshaw & @jkenney, how do I legally prove this? 2/10
Anyone could download a picture of a positive RAT. They are practically memes right now. A photo means nothing. And yet, I'm legally responsible to verify this? If I verify they have covid simply by their self report over the phone, & they are lying, that is fraud

Read 10 tweets
Oct 15, 2021
The very public mistake that @CMOH_Alberta made with the 14yr old who passed of cancer, not COVID, earlier this week is not a minor event that she can simply apologize for.

This was a really stupid error, and as someone who works in palliative care, I'll tell you why

🧵👇 1/11
First & foremost: What a horribly public way to disrupt a family's grieving process. I hope they find a way to forgive Dr.Hinshaw & public health, because holding resentment can be toxic to healing, but I wouldn't blame them if they were angry for a long time.

I have filled many death certificates. They are not easy. But in this pandemic, all MDs in this area of work know how important it is to distinguish causes of death from COVID. See @noelgibney 's excellent examples of how in this article:

Read 11 tweets
Oct 14, 2021
Hey Twitter, today was particularly hard with angry, rude & demanding patients with strong anti-vaxx views. I didn't hold it together very well today and snapped at one. I feel very bad but I am giving myself space b/c I know I'm being pushed to my limits everyday.

Please be kind to your doc. We really want the best for you. If we are showing that we are upset, realize you might be pushing us too far. We are human too. Please leave when we say the visit is over, don't keep pushing. It's better to end the convo and come back to it later.
Feel free to post photos of fuzzy animals/pets below. I need a smile after that day. I am going to need to have some serious introspection & self-reflection later about the encounter, but right now, I just need to cool down for the evening so I can think clearly later

Read 5 tweets
Sep 3, 2021
AHS email from Dr.Verna Yiu just laid out how dire things are in #Alberta right now with COVID. See the highlights of the email below.

#abhealth #abpoli #ableg #COVID19AB

"Effective immediately, AHS is postponing non-urgent surgeries and procedures across all zones...AHS will maintain urgent and emergent procedures, as well as prioritized cancer surgeries."

"In the North Zone, surgical postponements up to 60 per cent are expected next week"

Read 11 tweets
Aug 30, 2021
I've heard lots of people, including the UCP Caucus Chair, say we just need to "let #COVID19AB run its course" and "learn to live with it"

What would that look like? Let me try to make some suggestions as an Albertan doc

Thread 👇🧵 1/x
1. We need field hospitals & field ICUs because currently our hospitals do not have capacity for a 4th wave. Also, we are Alberta, not California, so it needs to be field hospitals that can handle winter. This costs $$ but we know @jkenney hasn't used all his fed funds yet. 2/x
2. We need more nurses, doctors, RTs and other HCWs to staff these hospitals. We can no longer just rely on their good will, they are burnt out. So we are going to need to exponentially increase pay for everyone to work in field hospitals, with better benefits & paid leave 3/x
Read 12 tweets
Aug 6, 2021
Hey Twitter of #Alberta. Doctors just finished a town hall with Dr.Hinshaw about the new policy changes. I tried my best to take notes on as much as I could. So here's what I have.

*Pls note: I am NOT endorsing anything, this is what was said from Dr.Hinshaw ONLY*

She recognizes that communication last week was not sufficient or complete and they are going to try to send us more info. They are working on a document with cited evidence to explain their decisions that is coming end of this week or next. 2/x
Her bottom line that was said many times: We need to learn to live with COVID, we can not eradicate it and that is the basis of these decisions/policy changes. 3/x
Read 27 tweets

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