First Responder, Last Responder

by William Skink

I got a call over the weekend from a motel manager about a former client. His alcoholism is taking a firm and final hold on his ravaged body, and his time, she thinks, is short.

I stopped by on Saturday to see how bad the situation was. I have already contacted Adult Protective Services, both by phone (left a detailed message), and by filing an online report. There has been zero follow up.

I knocked on the door, but my former client yelled that he couldn’t open it. I got the manager and she opened the door. The smell hit me instantly.

I cannot describe what the combined aroma of the various fluids that come out of a late-stage alcoholic smells like other than to say it’s overpowering. I had to stand near the entrance of the door to keep from getting sick.

My former client was shaking very badly. He was partially covered with the comforter, but his soiled sheets were obvious. It was hard for him to speak because his body was shaking so hard. I asked and he couldn’t remember how long it had been since his last drink.

He had been to the hospital recently, but couldn’t really explain what happened there. I asked if he COULD be admitted, would he stay at the hospital, or was it more important to continue drinking? I didn’t get a clear answer.

At this point I knew what I needed to do for this old, suffering alcoholic. I asked him what he wanted to drink. He pointed to an empty Colt 45 can, so I walked across the street to the casino and got him a 4-pack.

If you read that and thought WHY THE HELL DO THAT? then you probably don’t understand the physiology of alcohol dependency. An alcoholic at this stage of the disease will die if he/she doesn’t get a drink.

I’m still trying to figure out what else I can do to help this person. I wish there was a nursing home that could just let him safely and peacefully drink himself to death if that is what he chooses to do, but none such option exists.

If my former client was admitted to the hospital, and if he stayed there for 3 days, then Medicare would cover the cost of a skilled nursing facility for up to 90 days, so maybe he could receive end-of-life palliative care.

For that to happen, lots of things need to fall into place, including some degree of willingness from the client.

One of the most absurd anecdotal stories I used to share was the story of a female frequent flier and what it took to get her into a nursing home. If the cost of all the many emergency service responses to her over the years could be calculated, I’m sure it would be in the millions.

When there was finally a medical reason to admit her as an inpatient to the hospital, both myself and her payee closely monitored the situation. She had to be there for those magical 3 days so Medicare would pay, and then the nursing home (who we collectively begged) would place her in a bed.

On the second day she started getting the itch to flee, the itch to find her connections for pills. So what did her payee do to prevent the woman from taking off?

The payee stole the woman’s pants.

And it worked.

What these stories highlight for me is the immense cruelty and inhumanity of the systems we should be relying on to keep us safe and healthy. Instead these systems are making us sick and killing us.

I look forward to conversations about how we can fix some of this. If you’re new here, you should know I am cynical, reactionary, definitely defensive, and have low reserves of patience for bullshit.

I also play with Legos, write poetry, and stockpile ammunition for the end times play the sociopath elite think they can pull off.

About Travis Mateer

I'm an artist and citizen journalist living and writing in Montana. You can contact me here: willskink at yahoo dot com
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