Addiction Therapy and Last Hours

One of the things that I discovered is that a lot of patients with HIV have been IV drug users. They have been in what was called "treatment centers". When I ask the doctors how you treat a patient for addiction and if there was counseling it was pretty clear that that did not occur. Almost all of these patients have impressive tattoos that they put on each other to pass the time. It is clear that they could have shared TB, Hep B and C and some other things.

One of the fellows mentions that a patient we might see will just go back to the street. I asked him “Why people take drugs?” He clearly has never thought of it. I asked him if he thought that they like their life, or were they weak or what is their motivation? When I said that many might be depressed and self medicating the idea of addiction as a disease that might need therapy was clearly new. I will talk some about addition therapy tomorrow although this is not on the schedule. This will be interesting for both of us.

One of the most disturbing things today was to see a patient that was probably in his last days. He was alone and very sick not able to move from his bed. His family had hired another patient to be his sitter and he was feeding him. He needed to have a Safe Harbor clean up but I don’t know that he is up to it. It might just be too painful. I decided that we would focus on emotional and spiritual. He told me he was at peace but it did not look like it. He also sadly said that he felt that he was already dead but not dead completely yet. When I tried to ask him what we can do for him at this time he finally asks if we could ask his family to visit every other day instead of once a week. I think we can do this but we spend time talking about building community for those without one. Interesting, they use dry green tea to help with odor and I would say it works better then almost anything we have tried.