“Why won’t he give me some?” he asked earnestly.
I explained to my drug-seeking, manipulative, and overtly sexist patient named Craig* who took a bus across state lines to visit me in the ER yet again why his doctor – my colleague and friend – would not indulge his one simple request: “just” 1mg of hydromorphone.
Drug-seeking tip #1: if you know the generic name of dilaudid, a potent narcotic pain medication, you know too much, and I know you’re drug seeking.
“But that lady doctor in Huntersville gave me some,” Craig pleaded. “All I had to do was tell the nurse, “I need 1mg of hydromorphone,” and she got it for me.”
Like that’s going to happen, I thought. “I can’t speak for what another facility does, but I know we are very judicious giving pain medication here. Narcotic addiction is a serious problem. Until your labs come back and we can find a physiologic reason for your pain, he’s not going to prescribe anything,” I stated firmly.
“Well, f***. Usually I say that if it’s a lady doctor. They’re stingy, those b*****s. When it’s a male doctor, 9 times out of 10 they’ll give you something, unless they’re homosexual like good old Dr. Nygard*.”
Drug-seeking tip #2: If you can give me your statistics of who does and does not give you narcotics, you know too much, and I know you’re drug seeking.
I had to turn around to stop from laughing. Dr. Nygard is not only my colleague and friend, but my female friend’s boyfriend. He was going to love this. (And he did. And was teased on it relentlessly for the rest of the shift by multiple people.)
I composed myself and answered, “I’ll let him know you disagree with his medical decision-making, but like I said, until your labs come back, you’re not going to get anything for pain.”
“When does the shift change? I want a real doctor,” he demanded.
Drug-seeking tip #3: If you know you’ll get a new doctor in the ER at shift change, you know too much, and I know you’re drug seeking.
“Not for a long time, sir. I’ll tell Dr. Nygard you’re unhappy.”
And so went my afternoon with drug-seeking Craig who tried everything within his power to get “just” 1 mg of hydromorphone for his acute epigastric chest pain.
Drug-seeking tip #4: If you specifically want hydromorphone, come up with a different chief complaint. Morphine and fentanyl are more efficient in acute coronary syndrome (aka heart attack) than hydromorphone. Yet, you know of a chief complaint that’s going to get to be seen quickly, so despite your error, I know you know too much, and I know you’re drug seeking.
His labs came back unremarkable as we suspected. His ridiculousness and rude behavior earned him a ticket from the sheriff. He had to be escorted out by multiple security officers. And, he was later arrested for trespassing for attempting to re-enter a psychiatric facility from which he was banned. Oh, Craig.
Little about Craig made me envy him. Despite his relatively young age, he looked to be at least 20 years older from his drug abuse. He was homeless, and he decided to come to Wisconsin in the dead of winter. (Dude. It’s cold here.) He desperately needed help, but he had burned too many people in seeking help that no one who knew of him wanted to help him. Little about his was admirable, but one thing: his effort.
Craig knew he needed something that he couldn’t get himself, and he was willing to do everything within his power to get what he wanted. Granted, it was a narcotic pain medication. Drug addiction is generally something we don’t admire and with good reason! But it’s been years since I’ve had the same level of perseverance and zeal let alone sheer effort over a goal. (Mine was an ex-boyfriend. I definitely crossed into all kinds of zones of crazy on that one. Trying too hard to get back with an ex is generally something we don’t admire and with good reason!)
Yeah, yeah, yeah, I’m a goal-driven person and try all the time. Yeah, yeah, yeah. But I really haven’t had fervor in my efforts for a while. For some unknown reason people tell me they’re impressed with me. But let me let you in on a little secret: I don’t work that hard, and if it looks like I do, I’m probably enjoying it to some degree. And if I don’t like what I’m doing and still working hard, it’s because I love Jesus. Seriously, my entire faith journey can be summed up with the words: “OK, fine.” This is how I respond to my Lord and Savior. Hardly saint material there!
Despite being a crazy Catholic for years (and a cradle Catholic for life) that I’ve ever had that level of fervor for Christ, even though I profess I love Him above all things. I envy that level of zeal. The closest I ever come to it is during Advent.
I love Advent. It’s a season that acknowledges the inherent human need for something outside of ourselves to fulfill our needs. It’s a time where we can admit we don’t have it all together. It’s a time to be reborn just as everything outside is dying. It’s a time to admit we need a savior.
All the readings, daily and Sunday, just hit my heart in the right places. Here’s some favorites:
- “You know the time; it is the hour now for you to awake from sleep.” – Romans 13:11
- “Lord, I am not worthy to have you enter under my roof.” – Matthew 8:8
- “Wait for the Lord with courage; be stouthearted, wait for the Lord.” – Psalm 27:14
- “Strengthen the hands that are feeble, make firm the knees that are weak, say to those whose hearts are frightened: Be strong, fear not!” – Isaiah 35:5
- “Come to me, all you who labor and are burdened, and I will give you rest.” – Matthew 11:28
- “Do not be afraid, Zechariah, because your prayer has been heard.” – Luke 1:13
Advent reminds us every day of our universal need for a savior.We all get stuck in routines, we all have our baggage, we all have our moments of weakness, we all are afraid at times, but most of all, we all need a something or someone to help us.
I don’t know about you, but I find asking for help really difficult. I find admitting I don’t have everything all together very difficult. I find permitting myself to be imperfect very difficult. I find needing a savior very difficult because most of the time, I don’t want to admit I need to be saved. I’d rather just grumble, suck it up, and continue to live my life as I’m living it.
Yet, the truth of Advent is simple: We all need a savior, but few of us are willing to really admit our need for him.
That’s why Christian philosophers write (and even tweet) things such as this:
I know I wimp out all the time. I’m too afraid to ask for help, and I miss out on a lot of opportunities to humble myself and allow Jesus to be my savior. (But then He still helps me out and offers me the giant slice of humble pie that is a stomach bug that wipes me out for 3 days. Ah, the benefits of being sick in bed. Thanks for that one, Divine Physician of mine! You’re too good to me all of the time.)
As irritating and frustrating as Craig was, there’s something admirable about a drug addict’s willingness to admit he or she needs something outside of themselves.
I had another young drug addict who was obtunded from an accidental overdose of heroin. I administered a dose of the reversal agent called Narcan (naloxone), and moments later he woke up. “Where am I?” he asked, obviously startled.
“You’re in the emergency room,” I told him. “You overdosed on heroin, and I’m here to help you.”
He grabbed my hand, bowed his head, and said,
“God, grant me the serenity to accept the things I cannot change,
Courage to change the things I can,
and wisdom to know the difference.”
This was not his first time seeking help, and based on the statistics, it would certainly not be his last. But this man’s willingness to not only seek medical attention but to also admit his weakness to Our Divine Physician in that simple Serenity Prayer struck me and has stuck with me.
We seek medical attention so easily. We consult Google, watch medical dramas thinking they’re real (nope), tune into medical daytime talk shows like Dr. Oz even though some of his claims are blatantly false. Why are we so scared to do the same for Our Divine Physician?
“We trust ourselves to a doctor because we suppose he knows his business. He orders an operation which involves cutting away part of our body and we accept it. We are grateful to him and pay him a large fee because we judge she would not act as he does unless the remedy were necessary, and we must rely on his skill. Yet we are unwilling to treat God in the same way! It looks as if we do not trust His wisdom and are afraid He cannot do His job properly. We allow ourselves to be operated on by a man who may easily make a mistake – a mistake which may cost us our life – and protest when God sets to work on us.”
– St. Claude de la Colombière, Trustful Surrender to Divine Providence
Jesus doesn’t want to scam us. He doesn’t want to hurt us. He only wants our good. Advent is all about Him preparing to come to earth to live in our wretchedness with us. What kind of person let alone deity does that!?
Ours does. We have an insanely loving God who just wants to be with us. He doesn’t want to be our savior to hold it over our heads. He wants to be a savior to lead us to a better, more fulfilling, more peaceful life. And He knows how to save us from ourselves because He Himself took on our broken, humiliating human nature just to offer Himself up for us.
As He is known especially during this Advent season, our God is Immanuel or “God with us.” He is with us in our need, our doubt, our joy, our everything. He knows our pains, our aches, our every physical, emotional, mental, and spiritual need. He is with us.
I can never say anything better than my favorite, Henri Nouwen, so I’ll just quote him:
“By calling him Immanuel, we recognize that he has committed himself to live in solidarity with us, to share our joys and pains, to defend and protect us, and to suffer all of life with us. The God-with-us is a close God, a God whom we call our refuge, our stronghold, our wisdom, and even, more intimately, our helper, our shepherd, our love. We never really know God as a compassionate God if we do not understand with her heart and mind that he “lived among us.” (John 1:14)
– Henri Nouwen, Donald McNeill, and Douglas Morrison, Compassion: A Reflection on the Christian Life
He lived among us and knew every physical, emotional, mental, and spiritual anguish. There’s nothing on this earth that He doesn’t know intimately, and that includes us and our unique need for Him and Him alone.
One would expect if God were to be born on earth at all that He would be born into a place of power with His own people receiving Him. But Jesus was born in a stable with no room for Him in the inn. As Fulton Sheen writes in Life of Christ, the inn is a gathering place of of the successful whereas the stable is a place of “the outcasts, the ignored, the forgotten.” He was born into rejection and died rejected.
Jesus was not just a kind, peaceful man who preached to treat others better. He flipped tables in the temple. He called out the ruling class on their hypocrisies. He met with outcasts and even healed them on a day of rest. Jesus was not exactly what people expected, but as Fulton Sheen writes, “divinity is always where on least expects to find it.”
So, too, I saw a glimpse of the zeal of God where I least expected to find it: in a drug-seeking, manipulative, and overtly sexist patient named Craig who would stop at nothing to get “just” 1mg of hydromorphone.
I only hope I can find some of that fervor in my own spiritual life in these last few days of Advent. I’ve been slacking on things I just to find such joy in, and I wish I had more desire to put effort into my spiritual life. My heart just feels like it’s hibernating, much like the earth outside right now, which covered in inches upon inches of gorgeous white snow.
I am praying for a some spark of life in my heart this upcoming Christmas season, however that turns out. I recognize my need for Jesus mentally, but it’s not translating into my efforts. I’ve been lazy, and I need a spiritual kick in the butt. I suppose when everything is hibernating we notice those little signs of life all the more. Maybe being in spiritual hibernation, the smallest signs of life can kickstart my heart into a new springtime. Christmas is mere days away. We shall see…
*Please remember details (such as and ESPECIALLY names) have been altered or omitted to protect patient privacy. See about page for more information.