A Simple Business Transaction

We give away 2 “house packs” of cigarettes per week for any client who needs one. Roxy didn’t need one. She came in with four cartons of her own. But that didn’t stop her from asking every day.

I explained that the house packs are for clients with no cigarettes of their own and no money.

“My insurance pays you assholes a fortune! Everyone gets two packs a week, now gimme mine!”

I’ve learned to choose my battles. And this wasn’t worth going to war over. They’re dirt cheap cigarettes and she can have her two measly packs a week.

There were much bigger fish to fry with Roxy. She was a fat, nasty piece of work and a horrible drug addict. She’d been to countless rehabs and was just using them as lodging because she had nowhere else to live. She had good insurance through her husband who she hadn’t seen in over two years. She was smart enough to realize with this type of insurance she could pick up the phone at anytime, anywhere in the country, call an 800 number and within hours be flown to the rehab of her choice. And that’s exactly what she did over forty times before landing in our place.

She knew what to say to the doctor to get the meds she wanted. She knew what to say to her counselor to get him off her back. She knew what she could get away with and what she couldn’t. She had no intention of getting and remaining sober.

For Roxy, and for us, it was a simple business transaction. And it’s happening with a thousand patients in a hundred rehabs across the country. We’d put up with all her nastiness, minor rule breaking, complaints, demands, screaming and outbursts and we’d remain polite, smile, feed her, take care of her, and in 30 days she’d be gone. We’d all get paid and she’d be rested up for another drug run followed by another stay in another nice rehab somewhere else. It was fair trade and nothing would change.

Roxy wouldn’t get better. The rehab wouldn’t get better. And no one would learn anything.

It’s the way the treatment world goes round and I’ve come to accept it.

What I’ve never been able to accept is the rudeness. There’s drug addiction and there’s just being an asshole. Roxy had a bad case of both. So I spent most of her first week avoiding her unless I was forced to deal with some conflict.

One night about 8pm a female staff approached me and said she couldn’t wake Roxy up for meds. Roxy never missed meds.

Is she okay, I asked.

She’s asleep, snoring loudly, but won’t wake up.

“Won’t wake up” worried me and I rushed to her room.

She was in bed making an awful half snoring, half gasping sound. I turned on the lights. She was on her back, extremely pale, and her lips were blue. I immediately dialed 911 and told a tough female staff member to do whatever she had to do to wake her up. As the staff member started shaking, yanking and whacking Roxy to no avail, the operator asked, “What’s your emergency?”

I explained to the operator what was going on and the first thing he told me to do was get her to the floor. I did this with help of three co-workers. The operator then asked, “Do you have an AED device?”

I turned my head, looked out across the living room at the glass case mounted on the wall that read AED in big red letters.

“No”, I said.

Now, I’m not one for gadgets. I don’t really know how to work anything. I can’t fix anything around the house. I break stuff. I’m constantly fumbling with my fire stick controller, fucking up my TV, I can barely work the office computer, and I’ve never sent an emoji in my life. I was worried that this kind of technical skill and a high pressure situation would not mix well and could potentially end with Roxy dead.

But half a second later I came to my senses and said,

“I mean, yes, I do have an AED device”

“Get it!”, he demanded.

Turns out, it is very easy to use. I opened the glass case and a voice started telling me what to do in clear simple directions.

I got her shirt off. I had trouble removing her bra and in a fit of panic found the strength to rip it open like I was the Incredible Hulk. I placed the two patches with wires where the device told me and waited 3 seconds… The machine said, “Do not shock”.
Phew!
The 911 operator then commanded, “Start CPR!”
Shit!

I worked away on Roxy and just as I was starting to tire, EMT’s burst through the front door and took over. They had machines, equipment and some sort of breathing device hooked up to her within seconds and were shouting things like, “Don’t leave us!” and “Come back”!

In that moment I wanted nothing more than Roxy to live. I finally heard an EMT say, “There she is!”.

The relief I felt was immense.

As they put her in the ambulance, the head EMT said to me, “If you had called 10 minutes later, she’d be dead.”

Her roommate had snuck fentanyl pills into the rehab and had given Roxy one. This, mixed with her detox medication had led to an overdose. The roommate was kicked out of the treatment center and Roxy was back from the hospital 2 days later.

Shortly after I got into work I was told she wanted to see me.

As I made my way to her room I thought, ugh, she’s going to hug me and I’m going to have to hug her back. She’s going to cry, thank me, ask me how she can ever repay me for saving her life. I’ll give her some generic reply like, “I’m just glad you’re okay.” She may even tell me she loves me…

I got to her room and said, “Hi, Roxy.” She whipped around, looked at me, and said, “I’m out of cigarettes. Get me a house pack.”

We locked eyes. I stared at her for a second. And she stared back.

I wondered if anything would ever change.
With Roxy.
With drug addiction.
With insurance companies.
With rehabs.
With me.
With my life.
With the world.

Finally, I said the only thing that could be said…

“One house pack, coming up.”