Hearing Voices


I think I can actually remember the first time I ever felt depressed. I was lying on the cool tile of the bathroom floor at home in the suburbs of Miami, staring up at the popcorn ceiling, escaping the tropical summer heat or some neglected household chore. This was a few years before at age 12, I would spend the most terrifying night of my life on that same bathroom floor, surviving Hurricane Andrew’s Category 5 winds under a mattress with my Mom and Stepdad. Nothing was really wrong on this day, no hurricane, no drama, just me seeking out a space to get lost in my thoughts.

Lying there I imagined myself spinning on this giant ball called Earth amongst billions of people, this giant ball rotating the giant sun, which was part of an entire galaxy in an infinite universe of stars, planets and matter. The realization that I was a miniscule and insignificant speck floating in this vast and endless universe immediately overwhelmed me. I felt panic grip me in my guts, rising up into my throat sucking the moisture out of my mouth. This panic suddenly had a voice, the voice said “it doesn’t matter”. The “it” the voice was talking about was everything; it was me, it was life itself, it was school, my friends, my parents. This voice became louder and louder until it basically turned every compliment that anyone ever gave me into the polar opposite of what they actually said. For example, if someone said, “you’re so beautiful!” the voice said, “You’re not beautiful enough”. If someone said, “wow you’re such a great writer!” the voice told me “you suck at this, quit now”.

Sure, I had both little and big traumas growing up, my parents were divorced, I went through one of the most infamous natural disasters of my generation, but this voice in my head came from a deeper, primal place.

As I got older I found something that made this voice go away: drugs and alcohol. Only problem is that when I wasn’t high or drunk the self-loathing would just return a hundred times worse, so I eventually began a life dedicated to finding the next time I could sneak away and numb out.

That day on the bathroom floor I hadn’t discovered this chemical solution yet. I wasn’t comforted by the idea that the both punishing and loving God from church had a plan for me. I did not trust that my Mother could understand, even though she hadn’t given me a reason not to. My instinct was to withdraw deeper into myself. I had vivid recurring dreams that I was some kind of orphan Tarzan child, covered in mud and living in the jungle trees. I wonder if the dreams were recurring because they were really fantasies, daydreams that helped me cope with the inferior feelings now plaguing me on a regular basis.

By the time any of the Just Say No, scare tactic prevention messaging ever reached my ears it was too late. I had already experienced the warm, healing sensation of red wine hitting my stomach. I had already snuck sips of Champaign at a wedding till’ I danced and passed out and I was already stealing cigarettes from adults, bathing myself in perfume to cover the smell. The messaging that often featured crack pipes, syringes and a fried egg, which was supposed to represent “my brain on drugs”, was completely unrelatable to me. I did not equate the imagery with the solution I’d found of using substances to cope with insecurity and self-doubt. Drugs were painted as a sinister menace that bad people did on a street corner, not a soothing friend that made me feel prettier, smarter and more likeable.

Our new administration has alluded to a plan to develop a “large media campaign” to address the Opioid Epidemic in our Nation. I can assure them that an alarmist, theatrical “Just Say No” style campaign is a waste of time and money. I urge them to take a look at the no-nonsense, fact-based approach the TRUTH campaign used with great efficacy to reach youth regarding the dangers of tobacco products.

One of the first times I ever heard anyone else refer to this malevolent voice I hear was Eckert Tolle. He says “Sooner or later you’ll grow fed up with the voice inside your head with its constant murmurings of discontent its fear-mongering thoughts of the future and its’ questioning of every choice you make. One day, you’ll turn to it and calmly say ‘I refuse to listen!’ That’s pretty much what I do today. When the voice tells me I suck or I’m not good enough, I say “thanks for sharing” and keep it moving!

Code Orange

The Emergency room came to life as a female voice repeated the words “Code orange” over the intercom. Nurses in scrubs communicated in nervous whispers with palpable anticipation. I flipped my ID card over to look up what the hell code orange meant. My heart sank as I scanned down to the orange block: “Code Orange: Mass Casualty Event”. I wondered when my life became a scene out of Gray’s Anatomy.

I was there that day to connect with two individuals who’d overdosed. We call them heroin overdoses but most likely it was fentanyl. Fentanyl is a powdery substance primarily created in Chinese labs, crossing oceans to arrive smack dab in the middle of our Opioid epidemic. It’s mixed with, or sold as heroin, frequently causing overdose due to the astronomically higher potency.

Sometimes people realize it’s fentanyl when they fill their syringes and the liquid inside does not turn a familiar brown. The problem is by then they’re starting to feel their insides churning. Their body has grown frigid and clammy, skin crawling in a papery dread. Their legs have started to kick and jerk on their own, possessed and endlessly restless. Their eyes flood with tears, not from emotion but an unseen force that commands fluids to pour out, needlessly purging nothing. The nose gets a cue from the eyes and commences to stream watery mucus obliging them to sniffle and snort. The pupils dilate mercilessly from an opiate induced speck to eclipsing all color, turning the eyes a demonic black. There is no relief. There’s no remedy like one would turn to if this were a garden variety ill. They could swallow 7 Ibuprofen, wash it down with Nyquil and Xanax and still be tossing and turning in misery. The ONLY thing on earth that can relieve them from this infinite suffer-fest is an opiate. So the excruciating morning is spent stealing a family heirloom from a relative, selling it at a pawn shop for 1/10th of the value and pacing the block in 10 degree weather waiting hours for the dealer. Next comes standing in line at the Pharmacy dripping in sweat as they fork over their last 4 bucks to purchase a bag of hypodermic needles since this is the only instrument that will deliver them from their nightmare.

After these humiliating, guilt dripping gut wrenching activities they must find a public restroom, search for a vein to the ambiance of someone pounding on the door while they drip blood on their only clean hoodie. In the midst of this glamorous experience, they notice the loaded needle is too clear. It’s probably fentanyl. The fear of imminent death is silenced by the need to end suffering.

They awaken on the bathroom floor projectile vomiting; a warm, sticky feeling in their pants that they’re hoping isn’t what they think it is, surrounded by wrinkled judgy faces. A select few agree to hospital transport, aware that the shot of breath enabling Narcan could wear off, sending their body back into respiratory failure. Their lips will again turn blue, foam gathering on the sides of their mouths as breath is replaced with a “death rattle” as they slowly drown. I once asked a guy what it felt like, having been spared the experience myself. His answer was “Ya know when you’re standing on the beach with your feet in the sand right next to the ocean and a wave comes and sucks the sand out from under your feet? It feels like that.” He said. I can pretty much guarantee that no one living this way planned to end up there. The brain, once dependent on opioids is chemically altered, shifting what was once a choice to a necessity.

My title was Peer Specialist; which meant I had found recovery and tried to help others find it too. Without connection to people like me, OD patients are discharged within hours with no follow up or aftercare, likely to relive the event like Groundhog Day.

I asked one of the nurses where I could find the two patients. Her reply made my heart sink and my blood boil “Oh we discharged them to make way for the REAL medical emergencies en route”. The “real” emergencies never came. The Code Orange, which beckoned every available surgeon, nurse, and x-ray tech down to the ER, was the report that there’d been an explosion at a nearby nail polish factory. The problem is that the nail polish factory survivors were fictional. The explosion was real having only seriously injured one individual who was being treated elsewhere. “They wanted to leave she said, so we discharged them”. What she and all the other staff fail to understand is that yes, when told they’re free to go, they will most likely run. At the same time, if they are kindly offered help they are often just as likely to receive it. If every hospital in America were to treat the people recovering from overdose as REAL medical emergencies, offering help instead of judgment, stigma, guilt and shame, this epidemic could end overnight.

The stigma is alive and well in this Emergency room and others like it all over the country, putting a huge brick wall between people who are suffering and the help they so desperately need from the medical community.

A recent study published in The Journal Of Addiction Medicine titled An Exploration of Emergency Physicians’ Attitudes Toward Patients with Substance Use Disorder reported “A significant portion of our study population had low regard for patients with substance use.”

Until we treat the disease of Substance Use Disorder with the same compassion and urgency as diabetes, heart disease, cancer and burn victims, we will continue to bury an entire generation.

Cold Hard Gratitude

Last Sunday I was hunkered down at home, listening to the wind howl and the ice crack outside. We were experiencing a period of polar air, making the Hudson Valley feel more like the Arctic Circle. A look out the back window revealed a frozen creek, the nearly full moon illuminating perfect corkscrew holes from ice-fisherman searching for Yellow Carp.

Extreme weather alerts were issued that night, warning us of the 15 minutes it would take exposed skin to become frostbitten. Trapped inside most of the day by the bitter cold, my eyes glazed over as I binged on Netflix and Hulu, my most urgent concern being loss of power. God forbid I go to bed without finding out who survived the longest on a deserted island without clothes, food or a restraining order for their assigned partner.

I’ve clocked more hours than usual on the couch lately due to an injury caused by my trail running addiction. Trail running is a sport where you pay money to run mostly uphill until your toenails fall off. I was lying there feeling sorry for myself, ice pack under my butt, heating pad around my neck, grateful that the howling wind gave me an excuse other than my injury to be immobilized. I got up to hobble to the small wicker basket containing the various hippty-doo herbal remedies I rely on to dull the pain of crumbling teeth and aging tissue. The previous Friday I went to get one root canal and left with three. Not cool, but way cooler than when I couldn’t afford root canals, went to get one tooth pulled with Medicaid and they pulled four. According to Medicaid teeth are a cosmetic issue, not a necessity. If you happen to be an inmate or in my case at the time, would-be inmate mandated to rehab, the protocol is pull the teeth and give ‘em dentures. More commonly, pull the teeth, promise them dentures and send them packing before this even happens.

I threw some tiny white spheres under my tongue which the girl at the health food store promised would “like totally help with inflammation” and headed back to the sliver of couch not occupied by my two sprawled felines.

I flinched mid-step as the stock ring-tone of my “work-phone” chimed on the counter. I glanced at the clock, 11:30pm, which means this isn’t going to be good. Technically I work a 35 hour Monday through Friday workweek as a Recovery Coach for a non-profit, using my lived experience to connect with people in Hospitals. As a survivor of an opioid epidemic that’s killing upwards of I44 souls a day, I tend to answer my phone when it rings like someone’s life depends on it which it often does, especially on a brutally cold Sunday evening at 11:30pm. I took a deep breath and answered, “Hey this is Meghan how can I help you?” There was loud breathing on the other end accompanied by an echo of the same icy howl I was hearing outside my house only louder. The voice revealed itself to be a man, a man who was asking for help, a man who was literally freezing to death in an abandoned building due to his addiction. I could actually hear his teeth chattering as he begged for help through tears and choking. “I keep trying and trying but I can’t stop, please help me, IM GOING TO DIE!” he said. “Ok, I got you. You’re going to be ok, I’ve been where you’re at I get it and I’m going to help you. Hang up the phone with me and dial 911. They will come pick you up and take you to the Hospital where you can ask for a medical detox” I said. The would-be silence during his long pause was filled with the violent wind barging through shattered windows and decrepit doors. “He finally answers “Ok, I’ll do” it. I pleaded with him to stay in touch and don’t leave the hospital no matter what!

If I bought into the stigma of addiction being a moral failing, I would have shut off my phone and gone back to the jungle with the naked people far removed on my screen. I have a different perspective; I know that people like that man on the phone are one compassionate voice away from a whole new life. A life where teeth are worth saving and life is worth living.

In that moment I was shaken to the core not from the artic wind but from empathy and gratitude. In my previous life when couch surfing didn’t pan out, I took to the subways of NYC in the cruel winter dozing off long enough between stops to get through the long frosty nights. I was understanding with great clarity in that moment how fortunate I was to be pulling him out of that abandoned building instead of dying in there with him.

Sometimes it’s the smallest things that have the biggest impact. Like getting off our couches, turning off our screens and dealing some hope to the hopeless.