The practice that I had previously been with had closed down. I felt that the island of Galveston did need an urgent care clinic. In September of 2001, I decided to open an urgent care clinic on my own. As I was under-financed, I cashed in my retirement account to do so. I was the only employee – doctor, nurse, receptionist, marketing, billing, file clerk, and maintenance man. I was working 16 hours a day, mostly seven days a week.
The first lesson I learned was medical income takes three to six months to arrive after the patient is seen and that that payment was always less than was billed, while expenses do not wait to make themselves known. This created a strong tension between my wife and I. I was never home and yet had really nothing to show for it. I felt that I was working hard for my families future and yet I felt that my wife did not recognize this or that she thought I just did not care. This frustrated and depressed me. I was trying to provide the stability I had promised myself as a child. I was trying to make for myself the home I had always desired, and yet it seemed that my attempts were becoming more and more impotent.
I would work sixteen hours and then drive the hour home. My wife and children would already be asleep. I would get up and leave for work after only seeing them for twenty minutes or so as we were dressing. I would make the hour drive back to work to start it all over again.
This went on for a year. My stress level rose and my depression worsened even though I did not recognize it as such. My wife also became more stressed and depressed. I felt that I was letting my family down. When I tried to sleep, my mind would race with all the things left undone from the day before or yet to do in the day to come.
I needed rest. The clinic building I had bought had a shower and my fatigued mind thought that if I slept there a couple nights a week, that I might be able to be more productive. I had a patient that suffered from migraine headaches that would occasionally need a Demerol injection to get relief from pain. I had had it a couple of times after my surgery and it made me feel completely relaxed. I would lie sleeplessly on an air mattress in my office. It was only a few steps to the cabinet in which I kept the Demerol. In a moment of weakness, fatigue, and not thinking clearly, I tried it. I injected my thigh muscle with 50mg of Demerol. It was just like the first time I had taken Fioricet, incredibly sweet relief.
Just as the Fioricet held my headache at bay, the Demerol held my self-reflection at bay, but only temporarily so. In the past, as squeezing doses together had kept my headaches from returning, taking Demerol more often kept my self-reflective monster away. I took it all the time. Day, night, weekday, weekend, work or time off. I took it before seeing patients. And it is only by the grace of God that I did not hurt anyone. I took it when driving. I took so much of it that I started having seizures because the metabolites didn’t have enough time to wash out. I wrecked my truck because I had had a seizure while driving home traveling 70 mph on the freeway and I didn’t have a scratch. I don’t know why I didn’t die that day and I kept telling myself that God had something more he wanted to do with me. I don’t know what it is, but I hope I don’t miss it. That being said, there were times when I wish I had died that day, but that was just my cowardice.
It became less and less distant to the narcotic cabinet. My wife was concerned and wanted to get me help so I went to rehab, twice. I think that she thought that if she only could love me more, that she could help me to recover. But addiction does not seem to work that way. I kept going back to the narcotic cabinet, not because it make me feel good, but because it made me not feel. In my mind, when I took it, I didn’t have to see my impotence to give my family the life I had always wanted.
