“CHRISTENSEN!” HUCK BARKED, FROM halfway down the hall. Darby cringed, but didn’t look up from her iPad, which she was using to chart notes on her last patient.
Her boss was the only person who insisted upon calling her by her surname, which given its inevitable connection to her father she preferred to avoid. She typically went by Dr. Darby, a moniker that every other colleague of hers respected. The fact that Huck didn’t irritated her, but she was used to these sorts of micro-aggressions (and much worse) from him.
She had figured out long before that he had a chip on his shoulder about her pedigree, and what he viewed as her privilege. Whereas she came from a wealthy family and had enjoyed the best things money could buy, Huck was a self-made man. He had put himself through state schools, clawed his way up the ladder and made a name for himself after he helped a drug company develop a breakthrough rescue med for opioid overdoses. He was considered to be one of the world’s foremost experts on opioid addiction, and she had once felt lucky to have landed a position on his staff.
She didn’t feel lucky now. Darby wasn’t the only one he targeted, but he gave it to her the worst. He missed no opportunity to remind her that while she had eaten from silver spoons, he had pulled himself up from his bootstraps. He made clear his belief that every accolade she had ever received had been because of who her parents were. She might have stood up to him more if she hadn’t known that he would use that against her. He had insinuated more than once in front of their superiors that her standing in the community caused her to take too much for granted.
“It seems you’ve done it again.” He was next to her now. Unable to ignore him any longer without seeming blatantly rude, she looked up from her tablet.
“What’s that?” She wondered what he would press into her about this time.
“The hospital will continue to fund your research.” He looked as if he had just sucked a lemon.
“How much?” She was usually careful to be as emotionless as possible in front of him but couldn’t train the hope from her voice.
“Three hundred thousand.”
It was exactly what she’d asked for.
“I agreed to what they offered,” he continued. The funding board’s decision wasn’t anything Huck even remotely had the power to approve or deny, and both of them knew it. But that wouldn’t stop him from puffing up his own self-importance at Darby’s expense.
“You can’t let your clinical work slip, got it?” His threat made her want to knee him in the balls.
“It never has before,” she nearly sang with put-on levity, though her words were absolute truth.
Darby began walking away before she gave into temptation and actually did knee him in the balls and made her way down to Emergency, where she’d been called in for a consult. A fourteen-year-old girl who had nearly died from whatever cocktail of drugs she’d ingested at a party the night before was finally coming to after having her stomach pumped.
She didn’t have to check her iPad a second time to know which room her patient lay in. She could tell from the distraught-looking parents, a white couple in their early fifties with red-rimmed, haunted-looking eyes who stood uneasily outside.
“Mr. and Mrs. Agid?” she asked, hoping she was pronouncing the name correctly. She extended a hand. “I’m Dr. Darby. Can you please tell me what you know about what’s going on with your daughter?”
The story they launched into was one she had heard before. Hannah had been a good kid, thriving in school until she’d fallen in with the wrong crowd. For the past six months, she had become unrecognizable—disinterested in her studies, skipping sports practices to go out with her friends. She’d never missed curfew, so, in their minds, there had been no reason to ground her. But they knew there was something going on.
“Did you ever suspect drugs?”
“Honestly, no.” Mrs. Agid looked guilty. “We thought she was just moody…going through regular teenage stuff.”
“The toxicology report still hasn’t come back.” She was careful to keep her voice calm but not reassuring. Chances were, things were worse than the parents thought. Kids who just dabbled rarely overdosed. “We don’t know anything conclusively, but from what I’m reading in her chart, she’s most likely on an over the counter drug that’s sometimes called ‘Lean’ or ‘Syrup’.”
The parents exchanged a confused look.
“It’s an opioid made from a cough syrup that contains codeine. Kids mix it with Sprite and a few other things for flavor. It tastes like a sugary cocktail, but it is highly addictive. Given Hannah’s state, she may have mixed it with alcohol or other drugs.
“I don’t understand how this could’ve happened.” Mrs. Agid said shakily. Darby kept her face neutral, though she had heard similar sentiments. She had no platitudes to offer, and figured she’d better get to the examination.
“Let me see what I can find out.” Darby nodded a silent goodbye as she slipped into the girl’s room.
“My parents are going to kill me,” Hannah offered in a raspy voice, skipping introductions altogether. Before she had spoken, Darby had wondered whether the girl was even awake. This particular drug had a mellowing effect, and it took a long time to fully break out of it. A sheen of sweat coated her skin, confirmation that the withdrawal was underway.
“You don’t need them for that.” She said without an iota of humor. “You nearly did that yourself.”
Hannah said nothing in response.
“We could waste time waiting for the toxicology report, which will tell me everything I need to know, or we could save time and have you tell me exactly what you remember.”
Twenty minutes later, Darby emerged from the room having heard yet another familiar story. Peer pressure. Some guy Hannah liked. And the next thing the teen knew, she had a forty-dollar a day habit that she’d been quietly nursing for months. Like other young girls her age, Hannah didn’t seem to appreciate the seriousness of her problem. She figured that she’d be grounded until she was old enough to vote, which was probably true, and that all the fun would stop. She viewed herself only as a teenager in trouble with her parents. She had no idea how wrong she was.
Steering the Agids to one of the small consultation rooms just outside of the ER, Darby sat them down for a talk. “I know it might be a stretch to think of your daughter this way, but, physiologically speaking, she is an addict. She will go through withdrawal. She will crave the drug she was on. And, because she can’t have it, she will be attracted to other addictive behaviors. I know that, right now, the drug seems like the problem, but drugs are always a symptom of other problems. Her addiction, and the problems that fed her addiction, won’t simply end once the chemical is out of her system. Her life will need other changes as well.”
When he finally chimed in, Mr. Agid’s voice was angry and louder than it needed to be. That was usually how the dads reacted in situations like this. “What kind of other problems could she have? Three months ago, she was thriving. She’s a good kid.”
Darby kept her composure.
“Even in homes in which parenting is strong, teenagers can struggle. It’s common for girls Hannah’s age to have body-image issues, feel pressure to perform socially as well as sexually, and prioritize peer relationships above everything else. Establishing social status is a natural part of child development, but kids today often lack certain social skills that were common in your generation. At the same time, they’re thrown into adult situations from a very young age.”
Mr. Agid still looked angry. Mrs. Agid simply looked tired. Darby suggested they join a parent support group and recommended a few other resources before she bade them goodbye.
By the time she walked off her shift, Darby felt as if she had been on duty for much longer than twelve hours. Hannah had taken a turn for the worse and was in critical condition. Her body wasn’t processing the drugs and alcohol out of her system as quickly as it needed to in order for her to recover.
Darby had been stoic when delivering news to the Agids, but the parallel emotions of anger and sadness, not to mention the worry, always ate her up inside. It was hard to explain to people how the emotional drain of her job took a physical toll. She put on a brave face—to be strong for her patient’s loved ones, and to be seen as the consummate professional. But spending so much of her day tamping down her emotions came at a price.
At home, she took a long, hot shower, and slipped into flannel pajamas that engulfed her in pleasant warmth. She fed herself and her beloved hermit crab, Consuela, and settled into bed with her Kindle. She wasn’t even two pages into her book before a Facebook alert slid across her iPad’s screen. Michael Blaine is online, it read. She found it hard to ignore, no matter how good her book was.
Burning the midnight oil?
Immediately, she saw that he was writing back.
Something like that…I’m still in the office. You?
Just left. Need to sleep, but I’m too keyed up.
I know the feeling, he commiserated.
My patient might die, she admitted.
My building might fall down. Literally.
For some reason, this made her laugh.
So what are you going to do to fix it?
I don’t know. What about you? How are you going to fix your patient?
I don’t know.
We suck.
You’re right. Let’s self-medicate.
…says the doctor who works with addicts. ::head shake::
She smiled.
Right now? He texted back immediately.
Too tired. Tomorrow night?
Good timing. I’m out on the red eye at midnight.
I’m not off until 7:00. How about 8:00 at my place?
Perfect.