LOWHANGERZ

It was in October 1986, while I was just hanging out at home & relaxing (no crack –believe it or not) and I coughed.  During the cough I felt a “popping” sensation in my right groin and a small, egg-like (goose-egg) protrusion emerged in my inguinal area.  This was a textbook case of an inguinal hernia.   My dad’s longtime friend & classmate, a general surgeon, repaired my hernia – I had the surgery on a Friday and was back to work on Monday morning.  I used a cane to get around the first few days, but within a week I was jogging again.  The only reason I even bring this up is because I was given a blister pack of 25 Percocet when I got discharged from the hospital.  The Percocet was for the pain and I was instructed to take one every 4 – 6 hours as needed.  I took one, and it was great.  It got rid of the pain and gave me a great high.  I did not wait 4 – 6 hours before eating three of them at once.  This was my indoctrination into the world of prescription pain killers (narcotics, opiates, oxycodone… Oxycontin had not yet been invented) and I just loved them.  Unlike crack, I could eat these pills all day and function normally, so I thought.  It would be a while before they became the center of my world, but the seed was planted.  This incident carries as much relevance in my story as does that night in April when Jackie turned me on to crack cocaine.

In December I was on a one month ER rotation that consisted of 24 hours on and 24 hours off. Every week it would alternate between coming in at 8 am and coming in at 8 pm.  It really didn’t matter because by this point I was working 24 hours, going home and smoking crack for 24 hours, going back to the ER for 24 hours, and finally coming home to sleep for 24 hours.  That is how the entire month went.  I had my rituals for cooking the crack, buying the paraphernalia at a local bodega, and cutting the rocks – they always had to be cut into perfect square-shaped pieces.  I would line them up into rows of 5 or 10 and carefully choose the next rock and then re-align the rows to fill the empty spot.  This was done in complete silence – no radio, no TV – just watching the clock jump from 10 pm to 1 am to 3 am to 5 am & I Love Lucy.  It’s amazing how no one confronted me – maybe it’s because I was Dr. T’s boy and I was beyond reproach.

Well, in January 1987 I was back on a general surgery rotation being on call every 3^rd night.  Even though my days ended at 6, 7, 8 pm, the night I was on call I had to be available for emergency surgeries and admissions.  One night I got off at 6 pm and I was on call.  I was allowed to take call from home since I lived in the hospital housing, the apartment building across the street from the hospital.  I got home and started smoking crack to calm down.  After my 2^nd hit, the pager went off.  I ignored it.  #0 minutes later it went off again and I ignored it.  It went off once again around 7:30 and I ignored it.  I sat on my couch and told myself “just one more hit and I will go across the street to see what’s going on”.  Around 11 pm my phone rang – it was the head nurse and she said that there was a post-op patient who needed to be seen immediately.  Still, I smoked a few more hits of crack and then took a look at myself in the mirror.  I was greasy and bug-eyed.  My pupils were so dilated, so I did something that I had never done before.  I had an ampule of morphine in my doctor’s bag, and I took it out and shot it up (using a vein in my foot so the track mark would not be seen) hoping that it would counteract the crack and constrict my pupils.  All it did was really space me out.  I washed my face and went across the street – the cold winter air helped refresh me.  I entered the ward (all bug-eyed) and the head nurse directed me to a female patient who just underwent a mastectomy.  Her wound was bleeding badly – I didn’t know what to do.  I emptied the three Jackson-Pratt drains (Google them if you want to learn what they are) and I checked her blood work.  She was low on platelets, so I ordered platelets and a transfusion and told the nurse to call me if she kept bleeding.  How disgraceful – the family was outside her room waiting to return to her bedside and all I wanted to do was get the hell out of there so I could return to my apartment and continue with the crack.  I couldn’t look anyone in the eye, and I can only imagine what they saw, what they thought, and what they felt as I was trying to help this patient.  This is what happens when you are a crack-addicted doctor going through a general surgery training program. 

February 1987 is where things started to come to a head – I was on an Open-Heart surgery rotation.  (The chairman of the surgery department was a heart surgeon and this rotation was his pride & joy.  He was a very good-looking, well-built 6’4” man from Texas (held in high esteem world-wide).  Daily rounds started at 4:30 am and the days went on till 8, 9, 10 pm every night.  I resented working that hard.  I came across as an aloof, arrogant, whining spoiled-brat.  There was one other intern (Anksar) on the team, an Indian doctor who was married with 2 young children.  I felt bad for Anksar because he always had to pick up the slack – the brain damage – that I was responsible for.  I was always tired and one day on rounds I sat down on the easy chair next to a patient’s bed and while getting some history from him and taking notes I fell asleep.  A deep sleep – I was passed out from fatigue and lack of sleep from sleepless crack-filled nights.  Anksar saw me passed out on the chair and he left me there and got the rest of the team and an administrator to show them all that I fell asleep on rounds.  This increased the tension, but nothing happened to me as a result of that particular incident. 

Shortly after the sleeping in the chair incident, I was scrubbed in for a CABG (coronary artery bypass graft operation) and after the senior resident (a dead ringer for Major Winchester on MASH) harvested the veins from the patient’s leg, the veins that would act as the bypass grafts and carry the blood past the clogged section of the cardiac arteries, he told me to close up the leg.  Again I was exhausted (from smoking crack the night before) and I was unable to successfully sew up that leg.  I tried for 45 minutes to stop the bleeding and close the wound, and all my hacking around did was make it worse.  Someone finally looked down my way noticing that I was making a big mess of that patient’s leg and a senior resident took over and closed the leg.  Shortly after the surgery the leg got infected (no doubt as a result of my butchering it) and it had to be amputated.  It only got worse from there… the patient got septic, went into multi-organ failure, and after a week in the ICU he passed away.  While his death was never officially connected to me and the mess I made of his leg, I knew that this was another death that I was responsible for and would have to live with for the rest of my life. 

Well, somewhere in the middle of the month, after smoking crack the night before, I was once again scrubbed in on a CABG – this time it was a private patient of the Dr. G (the Chairman of the Surgery Department).  In the locker room before the operation, he was chatting with me about how the Mets won the World Series.  He may not have know a lot about me up to that point, but all that was about to change.  My job for that operation was to hold the patient’s heart in place so that Dr. G could sew in the bypass grafts.  All that simple – just hold the heart.  Well, while standing there with this patient’s heart in my hands, I fell asleep.  I remember waking up the next day in my own bed and I knew that I had some serious “ ‘splaining “ to do.  There was a message on my answering machine telling me to report to Dr. G’s office at 11 am.