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She sat across from me in one of the two Queen Ann’s. Her eyes were fixed to the floor and her shoulders slumped downward, as if burdened with the weight of unspoken tragedy or just lowered in silent resignation.
I had read her admission notes and was already writing the psychosocial in my head before I asked her any questions.
22 year old white female, complaint of cocaine dependence. Patient admits to ETOH and poly-substance abuse since age 11. Began using intranasal powder cocaine 3 years ago and has been using I.V. intermittently for the past six months in amounts averaging from 1-2 grams daily while binging.
I didn’t need the chart to tell me she had likely been supporting her habit with dancing or hooking or both. It came with the territory. So did some other things, but that would wait for the moment.
She was a pretty girl. Even with the raven bags under her eyes that strangely accented her wan skin, and the track marks in the soft tissue at the bend of each arm, she had a beauty that almost overshadowed the ravages of her addiction.
Almost.
She was shivering, but didn’t say a word. I went to a linen closet and got her a blanket. She wrapped herself in it without speaking.
I would get past the preliminaries with her as quickly as possible. Like all addicts, she had a story that went past her drug use. That story was my job. The rest, the drugs she used, how much and when and for how long was just the requirements for documentation; an insurance matter. But it was a matter that had to be attended to.
I wish I could tell you that these matters are great and mystical puzzles; that it requires real intelligence and finely honed skills to figure it out. I can’t though. One look at her and I had a pretty good idea what the story was. Something, somewhere in her life had caused her enough pain, enough trauma, that she would stick needles in her arm to keep from thinking about it.
Something had robbed enough self worth that she could crawl naked on a dirty floor scraping up the money for her habit from a crowd of drunken lechers. The only trick was getting her to talk about it.
I would do that. I had my ways. But I still had no assurances it would help. Addictions have a way of forgetting the things that cause them and moving forward on their own volition. When repressing the trauma is killing you, though, the only answer that makes sense is to get it out; to face the demons as it were, and talk.
And talk she eventually did. About her father.
He started touching her at age six. That progressed to other things as he continued grooming her; using her.
And along the way he taught her, in his own way, what all fathers are supposed to teach. Her worth as a human being.
For him, her hand was worth five dollars. Her mouth twice that much, even more if she “finished.” Other parts of her body had their value, too. And he paid for, owned, all of them.
For ten years.
He trained her well enough. Eventually, when she wanted money or other things, even booze, she came to him. She would tell me later that it made her feel special, even powerful.
But that illusion of power eventually played it’s way out, and you could see the results all over her life and all over her body. Every degradation she ever suffered had ultimately traveled through a spike and up her arms. Every violation a prescription for more. Humiliation and abuse became a deviated septum and hepatitis C; Every needle mark a thousand unshed tears.
That power? It had lead her to my office, unable to look me in the eye or even to tell someone, anyone, that she was cold.
Two months after she left treatment, a month after her father began serving time, I got the call that she was dead. It was an overdose, of course. They found her splayed out next to a dumpster. Whoever she was using with just dumped her onto the pavement to avoid problems with the law.
I’m sure the coroners report gave drug overdose as the cause of death. I think it was a homicide. Her father murdered her when she was six years old.
It just took her 16 years to figure it out.
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Originally Posted by Lester Burnham
