Thread by @StefanKertesz

1/On this #OverdoseAwarenessDay - I'm sharing the story of one man our clinic mourned, a man we code-named "Jonah"

The severity of his addictions was matched his overwhelming candor in teaching us about them. Alcohol, opioids, loperamide, stimulants, on and on.

2/Although Jonah first presented to me as a patient with pain, potentially in need of opioids, early on he confessed to me that wasn't quite true.

Yes he did have pain, but more crucially he explained, he had many drug & alcohol problems.

3/Jonah was the 1st person rescued with naloxone I prescribed.
He lived many years that followed.
While we got illicit opioid use close to 0 with bupe/naloxone, he struggled with other substances & an underlying emotional/spiritual distress.

All of this he told us

4/There was no one on our team who didn't embrace him. He sought inpatient & outpatient treatment. And we knew in a painful way-
.. the situation was so far beyond us, and him

And so we were present for him.
Because that's what you do.
Just *show up*

5/As our patient kept returning, alive, it brought the Bible's Jonah to my mind.
Jonah, you remember, fled a Divinely assigned task.
He demanded to be thrown into the sea. And despite defying God and demanding to die..
he was brought back alive, for a Divine reason

6/"The waters compassed me about, even to the soul; the deep was round about me; the weeds were wrapped about my head.

I went down to the bottoms of the mountains; the earth with her bars closed upon me for ever;

yet has Thou brought up my life from the pit, O LORD my God."

7/I told our team that the codename "Jonah" was his.
I'm not speaking of science, but my faith

As overwhelming as his problems were to us (think of us as sailors rowing to keep afloat amidst a storm) there Jonah was, alive for so long.

"God must have a purpose here" I thought

8/It was hard to find a clinician who didn't appreciate Jonah, even as we were frustrated by the cataclysm of his addiction
When opioid use was down, other substances went up. Over years, he taught us so much

Were we his Nineveh, hearing words we needed to hear, for our sake?

9/Finally in the last 12 months, too much hit at once. Whether it was toxic OD or suicide or in-between is hard to say.
The whale took Jonah away, as I see it.

But Jonah, were he alive, might say

"oh not really, doc,
that's My Bad, not the whale's"

/fin

10/ @maiasz @ASAMorg @LeahLeisch @DrEllenEaton @AllysonVarley @AJ_Gordon @AjayManhapra @robertrexrecord @slsatel @DrSarahWakeman @honoraenglander @papergirlmacy @noMOdeaths @MInczeMD @DrAudreyJones @AMERSA_tweets @nabarund @PainPtFightBack

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