Walk Down Misery Street

I interview the patient using a questionnaire: What drugs and what dosages did you use? What education do you have? Have you ever worked? and so on. Then I walk with him to the restroom for the toxicology test. Meanwhile, in the waiting room, a newly arrived patient is already drumming his fingers impatiently on his knees.

The responses to the education question provoked my genuine surprise. The vast majority of patients, regardless of skin color, do not have high school diplomas. How is that possible? In the “capital of the world”? At first, I was surprised when a patient said he had only finished tenth or eleventh grade. After some time, any patient with a high school diploma or GED would surprise me and earn my admiration: “Good job! That’s great you were able to graduate from high school!” And if I met someone who had attended a semester or two of college, he would be considered an Einstein!

Still, education—or rather, its lack—was not the most significant of my discoveries.

It was the endless stream of sorrow. The grief that does not scream, or cry, or go into hysterics. This was a sorrow of a different order. It wore a severe, scarred face, with broken and decaying teeth; it had tattooed arms cut by knives and a body bearing gunshot wounds. It had been torn from all family relations. It had endless arrests for robbery, burglary, and selling drugs. It was devoid of real careers or work experience. It was chronically diseased.

I felt sympathy for these first patients: everything in their lives was broken and mangled, and devoid of even a gleam of hope. I listened to them carefully, promised to call somewhere, find something out. But the stream of sorrow would not cease. From all the state prisons, the courts, the detoxes and psychiatric wards, people would arrive at the clinic with their worn baggage.

The mountain of incomplete paperwork grew ominously on my desk. One patient after another sat before me. Their names and faces started to blur in my memory.

“Which drug did you use?”

“Cocaine.”

“And marijuana?”

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