76: Vigilante Nursing – Renegade Wound Care When the Medical System Fails (Sort Of)

When the medical system is set up to see as many people as possible, and attempts to combat the opioid epidemic by shaming anyone who uses substances, what options do we have to help those in the community? How about taking vigilante nursing to them? We talk with Jason B. to find out what exactly he does in his work. Jason fills us in on why he got into helping the substance use community, how he goes to their houses and provides education on how to take care of wounds, and advises people on if they need to visit the hospital or not. Jason uses care and compassion to help those in the area who have found care and compassion to be highly lacking in the medical community. Jason also informs us about best practices for preventing the need for wound care, how he has changed his mind about harm reduction, and how he believes the medical field needs to be built again from the ground up to actual meet it’s original goals of helping people. Listen in and learn all about vigilante nursing and renegade wound care in our modern society. Join the conversation by leaving a message, emailing us at RecoverySortOf@gmail.com,  or find us on TwitterFacebook or Instagram, or find us on our website at www.recoverysortof.com.

Here is the Drug Policy Alliance episode

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Transcript:

recovery sort of is a podcast where we discuss recovery topics from the perspective of people living in long-term recovery this podcast does not intend to represent the views of any particular group organization or fellowship the attitudes expressed are solely the opinion of its contributors be advised there may be strong language or topics of an adult nature

hi welcome to recovery sort of i’m billy i’m a person in long-term recovery and i’m jason a guy in long-term recovery so this week we’re here with jason benard and we are going to talk about harm reduction and reaching out to do uh trauma care in the community um so getting into that jason c and i decided we would try to come up with an interesting back story so what we understand jason is not an addict himself but got into this line of work and we weren’t exactly sure why and it’s always amazing that people would help addicts when they’re not addicts so you know that i always assumed anybody that works in the treatment field is an addict and if the not that then they’re doing it for money so that was my only two reasons for their family yeah they have like a family member yeah that really mattered a lot so uh so we decided we would try to come up with a re like a backstory reason why he got into this so i’ll let you go first yeah you could go first all right so jason this is your backstory of what happened to you that got you into helping substance abuse people so when you were three years old your parents went to a movie and as they were leaving this movie they walked through a shortcut in a dark alley and during a botched robbery attempt for your mother’s pearl necklace they were sadly killed from there you became an orphan you got a little lost in the system somehow you were left behind they just completely forgot about you and you were adopted by a rat with a black belt from there you were trained in martial arts by this rat in the sewer and unfortunately one day your your rat dad was injured in a serious battle trying to save the world and he ended up on pain medicine and eventually you lost him to addiction and then you ended up in a swamp forest area and there was a small green fellow who trained you in the ways of nursing and and now you’ve dedicated your life to fighting the dark side of infections

that’s my that’s my version oh that’s a that’s a take on several superheroes all rolled into one gosh now mine sounds insulting so i don’t know if i want to even say it it’s way less noble

yours is like a noble path of heroism oh it’s yours so mine was after seeing all these reality shows dr pimple popper and these other medical shows that you’re on a quest to start a new reality show that exploits the trauma of addicts

i actually did think something along those lines i was like does he just really like weird wounds that’s kind of into that you’re actually closer with that yeah you’re closer jason with that one so how how did you end up wanting to really like i mean because this is not like i don’t say it’s not your job like you you have a job and then this is something you just really felt compelled to do outside of that absolutely just to clarify for everybody listen and jason uh works with voices he has his his full-time gig already and then you know he said you know what voices of hope i really want to help people in the community who are struggling with substance abuse and will not go seek medical attention for whatever reason i want to take it to them and so that’s like you got to have a drive to do that right you’re not this isn’t just like oh my god i can get a job here and work extra time so tell us your story we’d love to hear that so i’ve been a nurse now for almost 15 years little short of that and in the very beginning i wanted to do wound care no clue why just wanted to do it um started working in down in hopkins and the burn unit i didn’t really like it it was a people and everybody was i thought nurses were kind of mean um then once i got my license as a nurse i was a tech then i started working in the icu and someone kind of tapped me and said you’re really good with wound care um from that point on she kind of pushed me to get my certification in it which is weird because it’s i guess when you find someone that likes it you kind of know it and you then she i don’t know she was the whole reason i got into it fast forward six years i found myself in an outpatient wound clinic and an infectious disease doctor who herself had never been in any kind of recovery or anything like that i don’t think she even had been around drugs before or any kind of like even alternative lifestyles she asked me to come with her on a volunteer project she did she didn’t really tell me what it was she said wear jeans show up here and it was for the baltimore city needle exchange program she needed a wound nurse and in the past year of her watching me she was bringing people in and not really saying she was bringing them in and picking me to take care of them to see if like she kind of i guess i was she was vetting me i guess for last better term um and she was one of the head doctors for the nep down in baltimore city her specialty was infectious disease with hiv like viral stuff and hepatitis that’s how she got involved um the year i got involved with them she left and went to asheville to kind of continue the same thing there um my i wasn’t i wasn’t going to follow so she basically had set me up there to take over her position doing wound care and um then i don’t know i didn’t want to work for the city i started working at another hospital and their wound center i managed it and they were sent the needle exchange program was sending people to me

and that’s it then i got

i started i now work in a cardiac cath lab which is complete opposite of that um i wanted to follow a different director things kind of sucked with my old director and to get into the cath lab it’s great money i mean it’s phenomenal money and stuff but it’s a conveyor belt of humans that’s all it is and through like different health department people i met you guys and you guys had a need and oddly enough i’m i don’t think i’m good at a lot but i’m good at that like wound care and talking to people and it’s basically it’s like dog training you just train the person to take care of themselves and you just kind of guide them a little bit i mean it’s it’s not that complicated when you actually boil it down but um there’s a bit of compassion involved which is way different than i think i can do anywhere else when you’re kneeling down taking care of someone in in their house or their tent or wherever it’s a completely different vibe than sitting in a hospital like the hospital people want to be there you’re being invited in someone’s home who really doesn’t want you there you know it’s a it’s different i don’t know it fills the nursing cup if i could get rid of all organized medicine i would and step into this kind of wow like that’s where i’m at my life like i’m 45 and i don’t know i didn’t come out i didn’t have anybody in my life until i got older that had any kind of addiction issues um that was my wife’s family like my family had the closeted stuff no one had really died from it they’re all functional folks you really didn’t you only see pictures of your grandfather holding a big beer stein every picture and you ask that’s in every picture like oh he was a functional alcoholic but i didn’t know what that meant like okay but he drank every day but he was he worked in the steel mill so that was acceptable right he actually super glued that to his hand when he was four it was like it was like a gallon stein i’ve never seen stein’s this big he had a he had a cigar and a stein every photo kids there’s an infant land on his lap and he had a stein and a cigar so dated it reminds me of those 80s pictures of like kids birthdays where the person smoking the cigarette like leaning over them lighting the candles right right in front of their faces right we’re looking at it now be like oh my gosh birthday and the cigarettes

nobody cared back then it’s crazy so that’s i mean you made some incredible statements in that just the the conveyor belt statement of medicine the fact that you are someone who works in the medical profession and would wipe out the medical profession to do something completely different or start start it afresh uh that says a lot about the condition of modern medicine to me yeah i mean just a more personal question then we’ll delve into some of that because i want to get into that a little more do you find that’s a like a personality thing that you can deal with what i’ll call deal with like some of the trauma and wound care like i see that stuff and i almost like i can’t even look at some of the injuries let alone try to like think rationally about okay how do we treat this and what do we do so it’s funny you say that the woman i asked the woman that got me into this the nurse why she chose me like why and she said that there was a patient that we saw um who had a huge amount of gangrene on their leg and their back and she had her hands inside the body and she’s like do you want to feel the spine and i said sure she’s like put gloves on and she’s like but you need the smell first and that was my test the smell which is an awful odor if you walk into a room with gangrene you know immediately it’ll make most people puke and she’s like do you smell that she’s like lean in and the fact that leaned in she’s like you’re a wound care person huh so yeah she wanted to see what it is disgusting it was the worst smell i’ve ever smelled in my life instant gag but the fact i did that and the fact that i was anxious and i wanted to take care of this this patient she’s like that’s it you’re you don’t get people like that often right that’s amazing no it’s not it’s disgusting it’s really gross but you see that in other people um i met a nurse recently that we were talking wounds about what i what i do with you guys and we’re just talking about stuff she’s like well what would you do for that so what did what does that smell like and like right there the smell thing the minute someone asks about the smell either they’re fascinated by it or right they’re weird enough to want to do it but um yeah it’s it it is very bizarre it’s very visceral yeah so in this work like why aren’t people seeking medical treatment why are people willing to go to hospitals or some of these you know pop-up so um that’s i think it’s multi-fold at least i can speak for the people in like in where voices he reaches out and some for towards the city it’s fear of it towards the city it’s more fear of medicine lying to them um up in this end of town it seems to be more fear of being treated poorly there’s a lot of there’s a lot of scars and battle wounds for emergency room and critical care people and i think it’s um i don’t i we call it caregiver role strain i don’t know what it’s called elsewhere but it’s a you just get battle bruised and when you see something coming at you you automatically put up your defenses and you fight instead of care i mean because ultimately we just get paid to take care of people but when someone comes in and they’re like oh you know i really hurt myself or i had this infection and the first words out of the nurse’s mouth or we’re not giving you pain medicine that’s battle words yeah and i recently had that with a coworker who’s a middle-aged you know guy’s my age he’s 47 and he went in for some issues with his back and and never did the words you know pain medicine come out of his mouth but as soon as he went in he said that was one of the very first things they said to him as well we’re not giving you any kind of pain medication he’s like i want someone to do something about my back i don’t give a [ _ ] about it and i think medicine recognizes there’s an issue with like drug seeking behavior but they’re they’re attacking it completely inappropriately right that is not the way you do the opposite way like you can’t say i’m not giving you pain medicine because it’s that’s that’s a tool in the toolbox to take care of people if pain is limiting your ability to do things you should treat it right but to say you’re not going to do it when the person walks in or discusses problems that’s and that’s where we are and i i think we dug ourselves in in the 80s and 90s and um in the early 2000s and then all of a sudden we realized like we’re like in a giant hole like of addiction and people selling prescription pills and the pharmaceutical companies are involved in it and then all of a sudden like how do we dig ourselves out we we make the patients that need it suffer which is the only way out is by everyone hurts instead of the people taking responsibility for it and trying to find a better way to do it see if we gave out free drugs to everyone who wanted them we wouldn’t have to worry about it anymore the more i’ve someone told me that about two years ago i said you’re absolutely out of your mind then recently i started thinking about it if if you legalize things in that sense and you streamlined it to where it’s safe you wouldn’t need me for 90 of the stuff that i’m saying because it’d be no adulterants you’d totally disband the underground drug trade and all the unnecessary people locked up all the necessary people locked up all that stuff would dissipate and you could actually socially work towards taking care of people yes yeah and we talked with some some ladies a couple weeks ago about the war on drugs the failed war on drugs people from the drug policy alliance and they had explained how the like the ripple effect of the drug war you know kind of ripples out into all these other areas and then recently i was going through a ted talk about addiction and they were explaining how some of the the questioning and things that they ask when people go into the emergency room you know well how often are you using where are you getting your drugs you know those kind of things are very like stigmatizing and can put people in a really bad place when they go in there to seek treatment for you know say it’s from iv drug use and they have some infection um they’re put in a place where they have to start thinking like are they going to try to take my kids is a cop going to come start asking me a bunch of questions like all those sorts of things and so you know it’s like indirectly that the medical field has become like this extension of this war on drugs it’s it’s it completely has it wasn’t until once they legalized uh marijuana in maryland from medicinal it took almost six months for that to actually come through on our computers as a medicine you can check up until that point though for like six seven months they were drug addiction it was it was into the drug use category which i mean anything we and all medicine is a drug so all of it technically is drug use but that category includes amphetamines uh benzos like for for recreational stuff where addiction stuff but it had cannabis wasn’t put into a regular medicine it took six months for it to catch on so there’s six months of people that have a drug problem and they actually had a legitimate prescription so i run into this uh doing therapy in the intake form it’s like can you list your prescriptions you’re on do you know how often do you use alcohol and how often if at all do you use illicit drugs and people don’t know where to put their medical marijuana prescription they’re like most people put it under illicit drug use and i’m like that’s a prescription put it under prescription like don’t yeah that’s a legitimate prescription that’s right so that’s interest do you know if the like does the medical field treat let’s say uh what i’m gonna call prescription addiction because to me like addictions addiction but if you put someone on valium even though it’s prescribed by a doctor and they’re on it for several years they’re addicted value you know it’s like that’s a that’s to me it’s the same thing as any other addiction but does the medical field look at it like that or is that different it’s different if you’re on prescription versus as long as there’s a piece of paper from a doctor it gets questionable when when people doctor hop for that paper that’s a different kind of thing and usually i don’t i don’t know how the doctors look at it i know that i know that a patient that i had recently seen at my hospital for heart stuff was deemed addicted to methamphetamines because his utah said he had methamphetamine his he had been on vivants for adhd for like four years and that’s what was coming up positive and then i think i added you know i had her see the guy we went to go pick him up and he he’s a seller dweller guy like he lived in his basement he played video games all the time like this guy he’s pasty white heavy set i’m like he’s not an amphetamine addict but every doctor had deemed him is that i was like did anybody look at his drug list like he’s on adhd medicine like and the guy the guy upstairs hadn’t had his medicine since he had been here he had been there for about a week and he complete attention issues like he’s fidgeting in bed i’m like if you’re withdrawing from like like amphetamines you don’t do that like he’d be sleeping everything off like his adhd was running rampant i mean it baffles my mind that as educated as we believe and i believe doctors in the medical profession is that we would look at addiction differently whether it’s prescribed by a doctor or whether it’s blinders we have blinders on yeah it goes back to medicine being a conveyor belt i mean i’m an idiot and i can see that yeah no no it’s common sense they’re great they’re brilliant but they’re they some of them lack common sense and there’s there’s so many blinders on they see like the heart doctors see the heart part but don’t see the rest of it the um and that that’s actually interesting about wound care because it’s all of it like it’s every system in the body like the nerve pain the wounds all this other stuff it’s the whole person combined um like the heart doctors see the heart stuff the kidney only sees the kidney that and how they interact slightly they don’t look at the big picture anymore yeah there’s no time for it i think we’re coming to that understanding with you know drug addiction as well like it’s not just a oh this happens so you’re an addict so if we just treat this thing you’ll just take away the opiates they’re not going to be a dictator you have to treat the human right like there’s a soul yeah there’s a soul inside that person that’s broken a little bit yeah you need some duct tape and love and it’s almost like you got two entities fighting on the same like the war on drugs has teamed up with the the desire of insurance companies to make money and like those two forces in tandem are what’s fighting it because you get the war on drugs saying these people are cruddy that they should have made better choices and then you got the healthcare insurance agency saying you need to get this [ _ ] done fast to make money like this is we’re only paying you for 15 minutes to see in them not half an hour so you better you know limit your time and not take all the effort you need to really do something for it it’s almost open to pandora’s box so if they actually go after the drug issue you’re opening up pandora’s box then you’re going to deal with psychological stuff past trauma um issues that that nate that need like long-term therapy and then you’re still treating the addiction portion and it’s just it’s a throughput it’s per head it’s speed versus per person well and that’s where i believe like some of the work you get into kind of i’ll say crosses over it’s like people that are willing to neglect their own health to the point of you know serious gangrene or or serious infection that you know is not right right or healthy like there is a i don’t want to say it’s a mental disorder but there’s definitely some sort of mental trauma or or something going on there that would lead a person to just ignore that sort of thing so i it’s interesting because i’ve been kind of exploring that recently i’ve seen things i’ve never seen before in the wild like going into someone’s house and their arm is dead like just dead like dead from above the elbow down wow and they don’t want to go to the hospital and they’re scared to have me even come by that’s why like when i go out i make sure i’m with someone especially new people like new visits someone that’s actually like a peer recovery specialist so because i get tested and this house tested me i walked into the house and guy had a dead arm didn’t want to go to the hospital he’s he’s a veteran um young too and the whole house was was a house it was you everybody was using in the house and the girls like you’ve never done heroin uh you’re right i haven’t i haven’t i haven’t the person leaned in they were they were watching the door he leaned in he’s like i’ve been arrested gun charges drugs you name it heroin it’s no big deal i’ve done it all i’m in recovery though you can too i’m like that’s why i bring people with me because it’s not like i can’t relate i’m not trying to relate right i’m like you are right and you i’m not trying to show you someone that says not lying the one thing i’ve learned is everybody knows a liar right immediately you asked don’t accuse me just ask me but what i get to know with the people in the in the house like asking him what why did they why why did you let this go and he said i’m scared of the truth like i’m scared i know what’s going to happen and i think that’s kind of what brings people to drugs too is being scared of what’s happening like a lot of his escapism they just check out for a minute and then the minute becomes a week week becomes a life it’s like when you meet people i always ask when they started what they were doing leading up to that the initial like where they would they feel they they slipped and it became like a habit instead of being like a thing to do for fun and you can usually piece their life back together to them everything’s been on pause there’s been no advancement in their social life there’s been no advancement except for the tiny community of people keeping each other alive and i think that’s where you guys come in like you guys are stepped out of that now everybody’s in recovery and you guys are like we can still keep you alive but hey guess what there’s a whole other world with no no drugs like you you can do it like there’s a whole recovery side of this like it takes a lot of work it takes a lot of effort but look we’re in it and we’re still taking care of the people that we took care they were taking care of us before yeah and interestingly we’ve been exploring some of this we went through like the traditions of our 12-step fellowship we were talking about you know a desire to stay clean and it challenged me to think about the way that i look at people that are using and i’ve sort of been coming around to this idea that i can have the same love and compassion and empathy for people that are actively using as i have for people that are in recovery like those those two things aren’t mutually exclusive and for a long time as a person in recovery for years it was easy to say oh these people that are out using you know they just they get what they deserve and that’s the life they choose

that’s very uh it’s not a comfortable realization to be like man i need to have or i can choose to have compassion and empathy and love for these people whether they find recovery or not is completely up to them but i can still love and care about them and hope that something turns out that’s actually why i tell people when i meet them i’m like look i don’t i don’t care where you are if you think about recovery if you want to go into a program whatever you want to do i don’t care it doesn’t bother me like what bothers me is that you have this wound that no one’s taken care of right you’re suffering and you you mean something to me i tell everybody like i get permission to touch them i get permission to take pictures i’m like look i’m going to treat you like your family and i don’t care your story is yours to share with me if i if you want to share it go ahead if you don’t i don’t care like i’m going to take care of you right now and i’ll be back next week that’s it so you treat everybody like a friend so i and and i want to bookmark that pictures comment because i do want to come back around to that near the end uh i think it’s interesting um so what are you finding is it all stuff from iv drug use or are you finding like i mean are there are there weed wounds like do people can i ask one question leading into that it might lead right into that so like what typically do you guys do i mean like there’s a big rv outside with a thing on it and you get like what’s a normal visit or what’s that so um it’s a lot of it’s word of mouth now before it was the street team saying we got a wound nurse we got someone that does this um we’re gut out so now i got a list of people i try to schedule i oddly enough i can’t schedule a lot of the folks that are actively using a week before can’t do it like regular medicine right um we chased one woman around for weeks every house no she doesn’t live here anymore she was here two days ago yeah she lived here then not now like okay so we like nailing people down has to be the day of but we go out uh two to three people if we go out in a car it’s just two people um and you basically knock on the door and reduce yourself i mean this is like grassroots this is this is i when people say what is harm reduction i was like let me just tell you about a visit because this is a hundred percent harm reduction and up in up in this county the person i take with me also can provide harm reduction services like safe use supplies um we will trade out sharps containers we’ll take stuff from their house or their like hotel or um tent or wherever and and make sure they’re safe where they’re at um but it’s basically you walk in reduce i give a quick rundown about me most people don’t care they know you guys well they know voices really well and the voices is bringing someone and they trust them we haven’t hit that in harford county yet the other county but up here is like hey this is what’s going on and i read the person immediately i try to joke with them if they laugh i know that it’s a different kind of interaction i can have but they’re real serious i know i need to be real serious um if they’re shy and withdrawn like i gotta get there’s a whole nother body language thing i gotta get into with them um but i mean i’ve taken people to the hospital up here already my first rule of thumb in the city is no one ever in my car i go out on one call one call that was like kind of an emergency call i’m taking a kid to the hospital which it and it’s i knew it was the right thing to do so the rules kind of there are no real roles hard and fast safety and

it’s everything’s different each person is different right and then when we go on the truck it’s a three-person gig um a driver someone in the back with me and me because i get so transfixed on the person that i could be rob blind like i mean i like i don’t take anything with me but i could be rob blind i mean people would take my shoes off and i wouldn’t even know like oh [ __ ] where my shoes go um because i’m i’m usually kneeling down in front of them like i always lower myself down so there’s no like like pressure kind of stuff on them and just talk to them looking up at them and just talk to them about what’s going on so at that moment i’m numb to the rest of the world so that person in the back watches out for me but that’s like we’ve been in parking lots we’ve been in abandoned food shops we’re still getting the the truck the the camper running to efficiency and it’s we’ve got to find the right drivers and so that’s a complicated beast yeah and there’s a lot of low wires up in this county there are a lot of the wires where we’re gonna we’re we’re going to take out someone’s power at some point i know i just know we are i don’t want to that’s why i won’t drive but we’re going to take out the power somehow that’s way more optimistic i just assumed we were going to hit cars and run over someone honestly so the people driving have been great everybody driving it have been phenomenal um and they’re much more conscious of the height than i am i’m like oh no you can make it but that’s it i mean that’s a normal visit you go out and then we have some supplies i’m kind of limited because not being a doctor we can’t prescribe um the stuff i get i’m sure you can buy over the counter like target can order it for people so as long as target can order it without a prescription i can in my with my certification i suggest expert use meaning that it my license covers me um because it’s something that you could buy over the counter and my experience with it has garnered that uh protection to suggest it for a wound um but for i don’t even know what the legality is uh with the rest of it i just tell people look this is a suggestion don’t use it i’m gonna give it to you don’t use it i don’t care like if if you think it’s hurting you stop like common sense plays into this um because i i haven’t met i haven’t seen of the other wound people that do this across the country no one that i’ve ever spoken to has ever been sued no one’s ever come back and said hey you cost me my arm everybody knows what’s happening and all we’re doing is try to stop them from going to the emergency room when we can and urging people to go when they need to it’s trust built stuff i never in my life thought i’d see vigilante nursing yeah that’s exactly yeah that’s wow everybody at work when i tell them they’re like why do you do this i i what do you do this for why would you go into someone’s house it’s so unsafe that’s so this like that’s what nursing is like we were trained to do something for people like it doesn’t say where the care and compassion has to happen don’t have the doctor’s office right like

and we’re only here for a little bit of the amount of time whether you’re clean whether you’re not whether you got whatever your life story is we’re not here long you’ve got 100 years to make or break a difference and like 40 good ones to do something that’s it i i still strongly identify with the people you’re talking about and not only so much in the fact that they they’ve used drugs and struggle with that problem but like in the sense that i too avoid the doctor when i know something is wrong that i don’t want to hear the truth about because it sounds awful my back hurts frequently and it’s like i don’t really want to go find out i need a back surgery i’ll just keep working on it right uh we were just talking before you got here this morning of like trying to escape and avoid the reality or the consequences and i’m like that’s my life story and right now i’m currently like i’m not going to get the vaccine because everybody i see that gets it gets a really sore arm for like a week and i’m like i’ll just take my chances later like i don’t want that sore arm for a week right twice so i i mean i just i get it these these seem like very human conditions or reasons why people don’t go and then if you add on uh well i’m kind of preoccupied feeding a 24-hour monster in my body that says i need more drugs and you add in the fact that i’m going to be treated like absolute dog [ _ ] when i go there well yeah that doesn’t make it very likely that i’m going to want to go to the medical professionals yeah and and even when i go to the doctor now i mean in the beginning of you know my recovery i was very adamant about letting all the doctors know like i’m in recovery i can’t take any so i don’t do that as much anymore because i’m a little bit worried of what treatment they’re going to provide i mean like you’re going to treat me different because i say i had a drug problem 20 years ago you’re putting yourself you’re putting yourself on that track when you first meet people yeah i don’t recommend that medicine and people ask questions share or if they ask a specific that has something to do with it but you get put on a track immediately yeah and and there’s a there’s still a stigma and you know i’m like i just want them to tell me what the best level of care is not start making decisions about what i did 20 years ago you know and it’s it’s tricky too because like i’ve had surgeries in recovery where they’re like look here’s pain medicine and i’m like ah is there any way we cannot right like i i got a history with that i’d rather avoid it and they’re like look this is part of healing honestly like your muscle needs to relax and be pain-free enough to not be swelled up so that it can heal itself and i took that and trusted it and and i don’t know if it’s true or not honestly but now i look at it like well if i tell the doctor my history and he tries to avoid pain medicine what if it was the better medicine for me in that moment and i’m like not getting it because he knows i i used some time ago in my life like that’s scary too so now i’m like i don’t know what the [ _ ] to do it’s it would you you hit the nail on the head um pain medicine is important like muscle relaxing is important when you have surgeries really is like hip transplant all this stuff a lot of medicine now is switching over like the hospital i work out now they do iv um i it’s basically iv tylenol it’s high dose acetaminophen iv works amazing amazing for that super expensive um but it’s amazing and that’s standard of care and it decreases the amount of opiates need like 10-fold right so they don’t they don’t discharge you with a ton of pain medicine anymore because we’ve learned um like they’re they’re doing rapid recovery now you get a new hip or knee you’re standing that day you’re home that day cove had pushed people to do that partly insurance is saying this might be good and that scares me whenever insurance is like hey go get it insurance is making the decision so but the speed of recovery is i know that my the hospital i worked at before and with my mother-in-law um she she drinks heavily daily and being honest about that got her out quicker so she didn’t go into absolute withdrawal wow and so that was being honest um and they were like thanks for being honest like this is how what we’re going to do then we have a whole protocol for people with alcohol abuse issues um and she wasn’t gonna tell them so by like day two being in a hospital she would get the shakes and hallucinating holding hearts like she’s she’s a pretty heavy drinker um so that honesty actually helped her uh we see a lot of people put down on their their uh med list that they’re allergic to all opiates no one’s allergic to right you know exactly what that means when you see it it’s usually a flag that pops up handcuffs and track marks yeah exactly like you’re looking for iv sites you’re like hey do you can you help me get an iv in you yeah right here um but it’s i don’t know what the answer is that’s a whole different i mean that’s a whole different talk like stigma associated with substance issues because i mean honestly today’s time it hits everybody i honestly don’t know of a single soul in my workplace that doesn’t have someone in their family has died from some drug or alcohol because this is this conversation’s come up multiple times and everybody’s like that’s disgusting that’s the dregs of society you should just let them die really you fought for your nephew just because you have a like a nice rich family and you can bottle them up in your basement he was different yeah well he wasn’t like other people right he’s not like the people that don’t have a place to live yeah he’s got this nice house no he doesn’t like it’s the same people everybody deserves a chance this episode has been brought to you by voices of hope inc a non-profit grassroots recovery community organization located in maryland voices of hope is made up of people in recovery family members and allies together members strive to protect the dignity and respect of those that use drugs and those in recovery by advocating for treatment support resources and mentoring please visit us at www.voicesofhopecilmd.org and consider donating to our calls so what are you running into out there like what’s the the kind of stuff you run into i don’t know much about wounds or anything but i’m curious a little so right now like i classify him like it’s you got your 1970s like just abscess just a little like you know dirty needle abs as you find out someone’s been licking their needle to clean it and it’s a little wound you like they are most folks know how to treat it um and those are like your run-of-the-mill like track marks with an infected site that kind of stuff i’m picturing when you used to blow up the basketball with the the little hand pump and you lick the needle first before you pass it in like i can’t believe i see i’m naive to a lot of this and that’s why when i’m that’s why i also like to have people with some seasoning under their belt when i go out because i’ll get in the car and be like do people use their forehead as an injection site oh yeah i did it before wow i’m like wow yeah like where do you tie off right how do you do that that’s why we’re losing so many people yeah yeah it’s not overdosed it’s asphyxiation right off of the tourniquet um but so there’s a whole new type of wound out there and it’s i started seeing it i guess like five years ago you saw it a little bit we actually had a presentation at hopkins about it and it’s it’s one of the adulterants in it is levi masol which is an old cattle dewormer and it makes its way into the supposed heroin quote unquote by way of cutting it with coke because it’s in like 80 percent of cocaine that people buy because it passes a street test in bleach it looks acts just like coke so like one in a thousand people will have a reaction it could be anywhere in the body it’s not an injection site but it’s a severe reaction that affects the outer layers of skin but doesn’t go into the muscle it’s a very distinct very distinct wound so we saw that like someone’s ear fell off their nose fell off like all this and that’s yeah it’s just from drug use and that created like a big like what the hell’s going on so they tested the tissue and luckily hopkins and dermatology is they they had enough wherewithal to dig deep into it and see what it was it’s leaven the salt to vasculitis so i stopped seeing it we never saw it again and then a kid came to me like four or five years ago and he had wounds on the opposite arm of his injection and it was very similar to that but this was during this is all pre coven this is um there was according to him there’s a dry run in the city and he would he’s like all the heroin i’m buying now has little pink and blue dots in it and stuff i’m like those are crushed up pills that’s just the skin to a pill that hasn’t been ground up right so that’s what he was using at the time and he was having the same allergic reaction and you treat it by not by by changing your source telling the goodbye from somebody else without pink and blue dots in your drugs um and not injecting around the site anywhere near there and his arms cleared up it’s a long slow process but it’s immune reaction so it’s clean like your immune system’s fighting your own body so you don’t the risk for infections lower um and then then i worked for you guys and this is like ground zero for chaos up here there is pan the pandemic created a whole new um shortage of injection drugs and i see a couple abscesses here and there but i don’t like i’m seeing these crazy wounds that all start the same way it’s like a purple blister usually around the injection site then then this purple blister looks like it flattens out and creates like a lake effect look to it and all of a sudden the whole tissue dies and it can be big wow it could be the whole hand it’s it’s insane and one of the health somebody again had to wear with all the habit tested and it’s um oh it’s an animal tranquilizer they haven’t uh i can’t think of the name of xylazine they don’t use that anymore either it’s one of the just old drugs i’m assuming someone’s buying in bulk um somewhere from like a chinese drug manufacturing place or something where’s the old drug warehouse

it’s all these old things that nobody uses anymore and i guess they’re they’re looking through the like the list to see so it’s an old track that they use on animals so oddly enough that’s one of the things that i’ve found the internet has opened up is this uh treasure trove for drug illegal drug manufacturers they can go through all this old medical literature and go oh bingo here’s something that shows these characteristics and these properties so now we can cut that into this drug so these a lot of especially coming out of china a lot of these illegal drug manufacturers are specifically just going through all these different old medications and some of them aren’t illegal yeah some of them are 100 legal to import yeah you can get like a 10 pound bag of white powder that someone’s telling you you order from china xylazine and you’re just dumping it into like a big mixing bowl it’s one of the ways they were getting around a lot of the the when we heard about like the bath salts and all that that’s sort of where that whole thing came from it’s just going through old medical literature and figuring out oh this drug has this effect and it’s not really illegal people just don’t use it anymore so we can introduce it in this way and throw it out and say that it’s bath salts or whatever and you know as they keep digging up all this old as as everything’s put online and these treasure troves of information are out there people are using some of that information to make illegal drugs and unfortunately with this not everybody reacts to it like um i had the privilege of taking care of a couple here the girl had nothing she came in because her boyfriend had wounds they’re using the same drug they’re using the same needle which is not warranted but they’re still doing wow even after the even after they have clean stuff available to them um and she he’s getting wounds she’s not and it’s just it’s your immune reaction to that drug so these aren’t drugs that are like well accepted body wise like this immune reaction thinks probably why they’re not allowed but they stopped using those because people react to them because level muscle they stop using and they used to use it to deworm children um and kids were having these weird wounds pop up they’re like oh it’s the drug so we stopped using it but now it’s hit the secondary drug trade wow those wounds are a complete beast i have a hunch that’s the with the dead arm i have a hunch that started with that and just kind of snowballed so do you find you’re having like any kind of success like are there people you’re able to help that never have to go seek medical help that recover well and wouldn’t have without the the expert knowledge so the i have one one client that she uses in both hands um then i made a deal with her to stop using m1 just as a show her proof that we can heal it and b to prove to me it’s what i think it is and her her one hand is almost completely healed wow she looked like i mean i hate to say it but like a halloween decoration i mean i everything i’m saying today i’ve told them so like i’m pretty honest and i tried to be joking but serious about the gravity like you got halloween decorations on the end of your arms like it’s horrible so the one but she i think i’m like this is all learning experience for me she i think she’s addicted to injecting into her hand too i i didn’t know that was a thing like injection site addiction where like she can see it um she’s not hitting veins and it’s she just gets blood in the syringe and that’s what what acknowledges to her that everything’s about to get better but it’s not i mean she’s just like dumping a bunch of trash into the tissue killing it but she still i guess she still gets the drug into her system and we can’t get her to use elsewhere like i’ve tried all that like i’ve tried different teaching about different injection sites how to make other veins appear that kind of stuff like the secret the secret box of nursing stuff you’re never supposed to share like i’ve dug deep for her you didn’t try the forehead no i i won’t even bring that up with her yeah that yeah that’s still i still think about that it looked like the abscess burst and it looked like a unicorn whose horn got popped out it was a socket on their forehead so and and we had made this assumption and then thought well i don’t even know if that’s true are most of these wounds or injuries from uh iv drug use is it predominantly the causes iv drug use so i’ve i have personally treated one traumatic wound which was i shouldn’t have been there this is a it’s a learning experience for our group um there it was a it was a split it was two people i was seeing one actually had injection drug issues like um wounds the other one had a weird wound that was um a stab wound fresh like three inch wide like i had no business like that that would have been that’s our catchphrase we need to get out now like like like oh so i had to go dig back into the traumatic wounds like can you breathe shortness of breath like take a deep breath hold it do you feel any pain that kind of stuff um so all of them have been injection drug except for that one yeah but i’ll treat anything like i mean it doesn’t bother me like anything if you show me a wound i can help you with it you haven’t run into any infections from like people who ate too many edibles or anything i’m still waiting i haven’t seen anybody like fall asleep and get like the zipper from the pillow they’re laying on embedded in their face none of that stuff i’ve seen all of that well i thought that people who own edibles that jump off the roof because they think they can fly yeah is that good so we thought what you know if a lot of this is coming from iv drug use obviously what are some things that people that are using can do to be safer well um honestly safer use supplies making sure um ironically like voices does uh all your kits and stuff uh just to make sure everything’s fresh new and clean um don’t reuse sharps uh ever like ever ever never ever like one time you should be one and done holy [ _ ] one and done don’t use it again the first time you use that needle the tip actually bends um the third time you use the needle you can rip the hole into your vein and that’s where the problems occur so like you you get like a one that’s why hospitals have a three stick rule but you can only try to stick a person three six then you need to get someone else to do it it’s because you’ve already ruined the needle um and you’re not skilled enough to get it if you can’t get in the third time and most people keep poking and jamming with that needle and you’re just fish hooking the inside of the vein um that’s where the scars come up i’m just thinking back like i the idea of throwing away a needle that it was so hard for me to acquire in 1999 [ _ ] you right i’m using that [ _ ] like 70 times right and people like nah i clean them i lick them i run bleach through it i lick it again like it’s it’s horrible these stories so i think harm reductions actually nip that in the bud the fact that you can ask for syringes nobody judges you that you know how many you’re asking for we just need to keep track of them for safety and make sure we’re getting back what we’re giving out dude we got syringe delivery it’s like uber yeah it’s like uber eats for for tools it’s amazing to me i’m like who the hell thought we’d live in this world you can call up and order like hey i’m going out what are you going out for i’ve got shops box and some long i’m like awesome it’s wild but i i do agree like if that’s what’s gonna save people’s lives and body parts then that’s worth it i think this community we’re dealing with up here and i think in the county where i’m at it’s the distance between your service and in the city they just drove up to neighborhoods i mean we had multiple spots throughout the city there’s a nondescript white winnebago would roll up people line up outside come in dump your sharps get new ones um but even then people were taking them and selling them for a dollar a piece and to combat that because we’d only give out 10 this is when they were actually counting them and being pretty um strict about it we just started giving out as many people wanted to stop people from selling them for a buck um because people are like oh yeah they you know i just sell them that’s not the point so i i don’t know if you know this but like you guys take them to the really rougher areas where more of them are needed but then white people come over and we still got to buy them you’re not bringing them to my neighborhood yeah so that in the county i would live in it’s every neighborhood is not in my neighborhood every single one so um that’s that’s a hard nut to crack nobody thinks they have a drug problem in their neighborhood right the last house i was in i was looking out the back window of the four car garage apartment that was standing in and there was an in-ground pole there was a half court basketball with painted lines um look regulation that like this is that’s the community where it’s at we’re never going to take winnebago in that community right everybody’s going to complain i’m surprising and complaining they saw two people in a car that didn’t recognize in there so it’s yeah so new tool every time new tool every time they give out alcohol wipes and [ _ ] too like i’ve never had like that just that’s what you get when you go into the doctor i don’t know alcohol wipes that was filthy i hear horror stories of people like i just used whatever’s in the mountain dew bottle it might have been pissed it might have been mountain dew i just used that yeah well i want to circle back a little bit on the the needle exchange and that a common what i’ll call misconception with needle exchange or giving out unlimited needles is that oh you’re just enabling drug use um obviously i would say to that you know giving someone a needle is never gonna encourage them to use heroin like i don’t no one is going to go oh i got this free needle i guess i’ll go shoot some dope now making people wear helmets on a motorcycle doesn’t make them drive like right like it doesn’t make you have a motorcycle it’s just harm reduction is just that right but it sounds like what you’re saying is there’s definitely a lot of health benefits to having clean needles in the using community besides just that community themselves and the individuals themselves obviously transmission of different diseases from people sharing needles or so i i can’t i can’t speak for the health department numbers up here i know in the city in the time i was involved with it there was i think a 17 decrease in hepatitis and that was the year i was involved that wasn’t from needle exchange on um and hiv through iv drug use had dropped exponentially it the hiv stuff in the city was actually sexually transmitted more than it was um needle wise where it was the inverse before right and these are things that affect the whole community the medical system they’re not just individual people with individuals it decreases a huge strength and that’s partly what my job is too it’s decreased the strain on the emergency room even though they’re the biggest pain in the asses with treating people not putting a load into that emergency room might change it a little bit if i can stop people from going there and not have to sit there start sweating and getting sick and wondering if they’re going to be seen in like six to eight hours if i can do that at home and they’re comfortable and they’re safe and do the same thing they’re gonna do with the emergency room i can stop them from going there and creating a hassle for everybody i’m picturing the seventh grader who comes home from school like man on the way home from school i accidentally got in the needle exchange line and they gave me free needles guess i’ll do hair work

yeah that’s that’s not gonna happen and so obviously the the clean needles clean supplies um are there any sites clean um there’s antiseptic wipes that we have um they give out small wound care kits that kind of stuff treat it on your own it’s education and it’s also um also i think it’s getting the word out it sounds silly but it i’m sort of preventive care too so if i can teach someone when i’m there and the people that are there with them to take care of themselves and hey this is probably why you got this happening you know this is you know you reuse your needle a couple times you gotta abscess from it like don’t do that like just call us call the hotline we’ll get it out to your house yeah call uber we have to come up with a name for it we have to come up with a name right user user no i don’t know i’ll work on it i’ll have it next week uh so what could the medical field do differently i know that’s a large question so um what could they do to make people want to come there if people don’t want to go there i mean they’ve got enough reasons beyond the fact that the medical field is treating them like butt but how could the medical field act different i think you’ve already mentioned a couple things the fact that if we can decrease some of the the load on them helps right uh and and you’ve mentioned you know just the fact that you’re compassionate but what could the system do is it really breaking the whole system and doing it from the bottom up of treating people different in general um i i my gut i’ve been through a bunch of different things i think it is that it’s 100 that i i think we’re not set up to actually we’re more about like i keep saying it per head and the speed care you know like they started monitoring hospitals based on like like you do a hotel you know like were you comfortable did you get a good meal like that’s [ _ ] like you should be did someone care about you right and that’s all it takes a little bit of compassion but you’re not really awarded for that you’re awarded for throughput you know like the hospital like oh you know you were spent too much time in that room you could have got that patient up to the floor and put another patient in that room and we had to go and divert now we’re in trouble with the state like it’s all about throughput um you don’t get awarded for kind compassionate care i don’t know how to fix that um one of my dreams is that i could if if the opportunity arose is just go and talk to the people at the hospital like the hospital up here is horrible i mean it’s horrible i’ve and i’ve not been there so i can’t speak from that experience i can only speak from the experience of other people that have been there and had issues um i’ve been there jason had his own horrible experiences and it wasn’t even around drug use it was around mental health with my daughter and our own experience in the emergency room and i will yes the [ _ ] hospital is somebody it’s horrible yes and like i i was joking yesterday but if if we can’t fix it i’ll just get inside of it and get a job and just [ _ ] it up from the inside like i was like just break the machine you know just get a job in the emergency room and work part-time and just fix it from the inside like it was one of those things it’s because it’s it bothers me so much no one gets into medicine to make to get rich nobody does everybody started at some point because they want to do right for other people and at some point that flips then they start judging who they want to do right for i’ll do right for you and you know the 60 year old diabetic has no limbs because he hasn’t been doing what he’s supposed to do right he still eats cake every day yeah that’s fine but the kid who turned to drugs because his parents beat him and he had been molested when he was a kid i don’t want to take care of you like how do you judge that right it drives me insane i’m convinced that hospital is behind the scenes filming a what not to do documentary and at some point they’re going to reach out to me and like oh we need your signature so you can be in this film right how to not treat a mental illness crisis i dropped the kid literally dropped the kid off there that had a wound they had said well you can leave just leave you know it’s probably better if you sign out and the kid just walked home with uh with his whole foot was split in between his second toe and his third toe that you could stick your fingers in oh my god and he walked two and a half miles ripped every stitch out and was sitting at home and didn’t want to go back he didn’t leave with any antibiotics because he signed out against medical advice he didn’t give any scripts and he just went home and like i was like this can’t be true i’m like did you get paperwork and he just he said they had me sign this paper i’m like that’s your ama paper anything else they give you antibiotics no so i drove him back to the hospital because his foot was red infected and up to his ankle um and you have to go through a metal detector before you go into the hospital you basically pat it down at the emergency room wow i’ve never seen that before this isn’t the wild west up here right like i don’t understand why are people bringing like hand grenades in like i don’t understand why they got like a metal detector like a wanding people yeah yeah we don’t have a really huge violent crime issue up here i mean there’s lots of you know minor petty crimes around drug use but someone still blows up right it’s not shootings in violent crime at all no it’s a tiny little community hospital i don’t understand unless there’s other stuff that’s happened that it hasn’t been made public i’ve never seen a hospital like that i mean historically living here for a long time i wasn’t born here but i’ve lived here for 30 plus years now the hospital’s always had a terrible reputation even before you know it was like oh i’m not going to union i’d rather go you know drive myself an hour away than to go to that hospital and when we had kids we wouldn’t take our kids there we would drive them up to ai dupont in wilmington because that’s a much better hospital than made for little guys here yeah yeah as a children’s hospital as well but yeah when we had issues with our kids we took them to ai dupont we didn’t take them you know and that was an hour drive one way when there’s a hospital that’s literally 10 minutes away well here’s a little known factoid the crap at that hospital has been there since i was born um i was born here and my mother had a miscarriage there and she laid on the bed and heard the nurses talking [ _ ] about her wow i don’t understand why she’s so sad i don’t understand why she’s uh she has stillbirth but she gave birth to something that they thought was alive and had died at some point between the beginning of labor and birth and they talked my mom and my mother said i’m not close to her she’s like don’t ever be a nurse like those nurses and that’s something that scarred her forever because i mean she’s in her like late 70s and still holds that chip that these are the it’s a horrible hospital the worst people in the world and um where’s the oversight i mean i i lo so look i complained to the the person who really offended me i complained to their boss on the shift when it happened and the boss was like oh okay well you know we’ll we’ll do something about it we’ll talk to him and i said okay well where’s the next step i want to make sure i put this in writing like a written complaint and she was like oh no there’s no next step you just told me that’s all there is okay yeah [ _ ] that so i went ahead and found the next step anyway and i and i wrote to the hospital oversight board and they wrote back like two months later i’m like well we’re going to make sure they have trainings i’m like yeah that’s not [ _ ] cutting it this guy’s had 40 years of experience his trainings aren’t going the beast you’re trying to stop a behemoth from like this is the american medical system and you’re trying to stop it from doing what it does every day to every it happens to every hospital um i always tell people right to ceo if people if the ceo cares about their hospital writing them directly will make things happen apparently there’s some like so i wrote the maryland hospital oversight board and then i got in contact with some hospital regulatory board that’s in ohio i don’t even know who the [ _ ] they are or something but i was like yeah whatever just write whoever you can yeah that’s basically what it is and the other thing is i always recommend and this does make change it creates a lot of static but it makes change is getting um a bunch of people to write your local newspaper the editorial section uh they won’t post anything i i wrote the cecil wig and heard absolutely nothing about it hey just bombard them get everybody right like honestly it’s i know that kind of stuff happens in harford county and eventually it will make it through just editorial wise just write to the editorial department so you have you just want to state something it’s you basically embark the editorial department with stuff and it will get posted at some point something will um so and this is kind of a little bit off but or is anything better so we’re seeing a lot of these like urgent care little shops opening up are things better there i don’t think they’re necessarily affiliated with this particular hospital where are they just extensions of bigger hospitals most of them are um like i i work for the eurasian maryland system and they’re popping up everywhere a lot of it is a it’s a chess match so you’ll see like there’s a hopkins one up in the town i live like one of those medical centers and it’s a feeder line so basically then they’ll feed to the hopkins thing the fact that an outside of the state hospital bought your hospital is a chest i mean that that’s like a checkmate because everything north of the susquehanna is now going to go to the out-of-state hospital they’re going to feed everything upstream to you know to delaware um i know that maryland was looking at this one too because they didn’t want to so they’re dumping all the money into the one in aberdeen now it’s all chess matches to try to garner the most amount of people to feed them into the the mouth down in the city like hopkins or university of maryland for all their specialty care interesting that’s how uh the drug policy alliance tracy from the drug policy alliance that’s how she described the uh criminal justice system was the same way it’s looking it’s a giant you know mouth and it’s just looking for feeders well and partly it’s how they get funded there’s a lot of money involved with um like the glo there’s so many different things in maryland that are different than other states as far as our budget goes for hospitals like each hospital in the state of maryland gets x amount of dollars per every five years for medicare and medicaid patients and that’s they call it the global budget so it doesn’t benefit you to see more people because it’s based five years back so your numbers like today are going to be used five years from now to get money for the hospital so basically what it’s doing it’s supposed to make you make your community healthier so you see a lot of these initiatives like hey this is heart health month come into the hospital get free heart checkups blah blah blah it’s to get those people healthier but medicine isn’t made like that like we that that’s the whole affordable care act that it tried to change us through an about-face but it really brought out like the insurance portion of it and it didn’t about face the care yeah so and just i guess from that whole idea it’s interesting because as people we say oh well the criminal justice system is there to help when people break the law and when we need you know some form of punishment for people that’s all it exists for and the health care system is there to help people when they need help you know with their health care but to the people who run these industries that’s not the outlook right right the criminal justice system is we need to make money and get funded by having more criminals yep and arresting them and locking them up and the health care system says we need to get funded by seeing more people and being involved with more insurance and getting them out the door so you have the bean counters that are the ones the financial end and i can say that the doctors in my experience the doctors are like oh you know i was green lit to do x amount of procedures i did them in the first three months i don’t care we’re going to keep doing it because in five years these numbers are going to matter so let them yell at me so there are there are [ _ ] in the system trying to screw it up too i’m trying to put a monkey wrench into it it makes me feel good then there’s also other ones just like ah you know like go let’s just get out get out get out all i can picture is like and i know i’m dating myself but the jetsons and like this conveyor belt of people and they’re just like grabbing them by the head and putting them in the different categories and like there’s no like you said there’s no compassion or personalization in that it’s just oh these signs and symptoms look like this throw them over in that pile and we’ll you know shove whatever in their face like we do everybody in that pile so this is this is something that’s near and dear to me um hospitals i learned this when i was managing the wound center there’s a nasty thing called productivity and productivity is the same way that you manage production lines exact same and we use it in medicine it’s rampant medicine all the computer programs will produce your productivity and what it is is like the the one that we have now we’ll look at your staff your staffing that’s on on the shift currently and every 15 minutes it uploads the people that are in your department like patient-wise and if if the number drops it’ll tell you to send people home so you’re never going to be ready for an influx of patients so you’re always you’re it’s like how toyota builds their their industry they buy enough to do for the week from the manufacturers that make the parts at the end of the week they buy for the next week they never have a surplus of extra stuff sitting around and it’s a very lean mentality so i mean there’s days where we’re recovering people in the lab when we’re doing what we do where they shouldn’t be so we stick a nurse with this person they have to monitor them constantly waiting for a critical care nurse to be called in so a bed can open up shouldn’t be that way like we’re an emergency team of people but that’s the way it is and we’re told that’s the way it is wow like i when i started doing what i do we started with four-person rooms and like like at least 13 people on a shift we’re now down to 10 and the next schedule coming up we have nine now we we can’t do that physically so that means the person that’s in charge everybody is going to start having to be in a room and that’s to keep productivity up wow yeah it sounds like when i managed to mcdonald’s forever ago it’s totally if you have any management skills whatsoever and you’re judged on making something that’s all it is and it doesn’t award you for complicated patience it doesn’t award you for compassionate care if you screw it up when they send you the survey that you didn’t give them compassionate care it comes out that you you’re a terrible human right it doesn’t say that oh you know but you kept your productivity up right and then if someone writes in and says how good of a human in it you are everybody bells and whistles go off you get cupcake to your department or some crap like that and you know it’s like look how great we are we love everybody we come in contact with but the reality is it’s not you don’t get it the rewards actually sit with high productivity being told you’re non-productive is the worst word to ever use for someone that is not in the production world they give you a cupcake if you’re compassionate they give you a raise if you’re productive yeah no honestly but they also cut your staff so you’re looking around and the people you started with aren’t there anymore because they had to move on or they they left for one reason or another and not replacing them so i i was still doing uh some work here regularly at voices when you started on and i think it was like the first trip you went out or maybe the second or something somebody came back in and they were like oh my god look they just sent these pictures over that he took of the wounds and this could totally be my stuff at that point in time right and especially because look you described the guy with the foot you could put the fingers in and i was like yeah that’s [ _ ] gross um so i know i have thought about the medical field and i’m like i’m not a gore kind of guy like i don’t want to see any of that so that’s why i would never make it there but when i heard about these pictures the first thought was hey i don’t want to see that but something really felt off about it i was like why the [ _ ] are we taking pictures of people who are compassionately helping right like that just sat a little weird with me now after that i found out a lot of your picture taking uh at least the premise of it is kind of like hey we want to take pictures of you today when we come back and see you again we want you to see that there’s been improvement or if things drop off the face of the planet right right so things along those lines and so i can definitely see that there is valid medical purpose in it right yeah the initial hearing of it it kind of sat a little funky with me i was like yeah that seems kind of exploitative or weird or or maybe we have a coffee table right right dr pimple popper right uh um so have you ever questioned that practice have you ever thought man this is kind of sketchy somewhat or has anybody you’ve dealt with thought it was weird no everybody they don’t care they actually send me pictures um which is even weirder like i’ll get a text message hey we got this new person that that wants to want you to slide by we’ll set up an appointment they texted me pictures of their wounds so they’re sending these like people and voices that aren’t wound people and like all of a sudden my i’m getting the text of people’s wounds um for me it gives me a marker because seeing more than two or three people like i can identify your wound i don’t know if it’s healthier or not though so when i look at pictures like i’ll go back through the one with the hands i’ll go back through and look like i’ll flip back and forth between them or actually open up my tablet and open up the computer and look at the wounds to see if we’re healing or not um or what’s getting worse and i can say two i’ve seen some of the pictures and stuff as well and at least the way i’ve seen them or the way they’ve been presented is informative or training for voices of hope stuff they don’t include people’s faces no they don’t have they’re just the wounds themselves they’re still don’t identify the individual you know and they’re used for like i mean there could be a legitimate shock to like if i were on a call with you and we went into someone’s house and i saw someone that looked like that i would be like oh my god you know what i mean and that’s not the response you want to give when you’re going there too right provide trauma care right you don’t want to be like wow what is that you know that’s the last thing you want to want to walk in there well at the time of covey so that’s the first thing the guy with the arms he’s like i bet you’ve never seen anything i was mouthing [ _ ] when i saw it like really everything was coming out of my mouth um and it was like that’s a thank god for mass but it’s there’s no exploitation like the stuff is only accessed by the director here um the director of medicine here i i think there’s only two more people that have access to that whole database of that and it’s really just for quantification of what we’ve been doing what we’re seeing and god forbid if someone gets pulled into the hospital and they want to see what we’ve been doing i write every note like i’m seeing them in the hospital like my notes are somewhat involved i’ve been trying to streamline them but so if someone asks hey how long you’ve been seeing this person i could pull off a database all the stuff i’ve done all the stuff i’ve seen and photos from those each visit um so that’s something for like future hospital stuff because i know as a wound nurse in a hospital when people come in like oh i’ve been treated by you know health care for the homeless what they’ve been doing i don’t know like that is the worst thing because you don’t want to all you don’t want to change what they’re doing and at the same time you want to know what it is so you can see if it was helping making it worse or whatever so it’s all here we haven’t had anybody have to tap it for that but it’s all there for it so instead of unsolicited dick pics you’re getting unsolicited wound picks yeah 100 and like you try to get like is this on their arm what is that oh that’s a groin oh [ _ ] it’s a couple of those have you ever thought like a and and probably not like realistically i i don’t i think uh some of us thinks kind of sick things and not like act like we’d actually do it but just we randomly think have you ever considered like as a fantasy in your head maybe i should get people to sign off on this so one day i can make like a a youtube channel of weird ones that’s all me like i i have like this stuff half these folks don’t like they’re so shy that it would kill me to know that stuff got out to other people right it’s one of those things it’s like i don’t know there’s everybody has a code of law they live by that’s one of them for me it’s like dignity and stuff it’s simple be nice to people and treat them with dignity and i wouldn’t want stuff like that getting out that’s beautiful i think i on the flip side though you said something earlier like this would be an awesome this would be an awesome documentary if you cut out the wound portion and just saw the people interaction and and just cut away the wounds where you didn’t see them because the people interaction this has been some of the most wholesome conversations i’ve had in medicine in like a decade wow as folks because you get to see them a couple times like once a week once every other week and you start learning more about them then you can you can actually like assess their full health like how you been eating do you eat like how do you eat what do you eat you cook dinner here like how do you cook you start there’s a willingness to be honest yes and everybody’s like really opened up about stuff and you can actually like this is and that’s what harm reduction is i mean in a nutshell is to bring people to a better place than when they started um oh my god hear this listener yeah this gentleman goes out and works with the earthlings and the normal people of the world in the medical field all week long and then needs to go out and work with substance use people with terrible infections for it to be refreshing it is that’s the sad part i tell everybody this fills my cup up like i had a horrible week unreal and like to fill my cup up is like i don’t treat people differently than i do if i see them in the hospital or here it’s just there’s much more compassion and caring from the people i’m treating here than in a hospital setting too even they don’t want me around like i’ve met a couple people that are like i just need to get away now like well here i had somebody tell me that they’re basically their cat was going to change their dressings for him um i was like well here’s the stuff to give to your cat you’re telling me pat this but this was another one of those dumps from the hospital up here healed by a [ _ ] yeah might have happened before so are you looking for recruits to help you i have no clue i i honestly don’t know um i’ve been always telling people like oh wound care is great wound care is great for the voices employees i’m starting to get a feel for who can handle what and where they can go um and the volunteers the same way there’s some people there gung-ho they just want to go out and like heal the world they want to cut abscesses open and stuff like that it’s not that’s not what this is about really um then there’s other people that are there for the compassionate side like i’m i i’m hyper sensitive to stuff going on around me when i walk into a place so when the voices people step up like hey what’s up you know so and so or hey how you been you look good today you know like that kind of stuff that warms me up inside because it means the person with me cares and everybody up here cares about the people we’re going to but it’s a different level of like i don’t know but as far as von like people want to do wound care i have it’s very few and far between um the wound care you’d have to wrangle them in like happened to you you know hey will you come check this out what are you doing saturday the certified wound care nurses in maryland are are more active in this field than i thought they were um and that’s happened in the past like two or three years bayview uh hopkins bayview got involved with the maryland harm reduction coalition thing and like i started seeing people’s names on like formulary lists like stuff they use i’m like i this is something we used at the hospital before it just seems slightly augmented and then i found out that the woman that got me into it was actually teaching hartford county nurses some harm reduction stuff i was like it’s such a small world and they’re like it’s not a small world you’re just a small group of people so um there’s not many of us most hospitals have one or two um and that’s only for legal purposes to cover like wounds like pressure ulcers and stuff hopkins has a bunch but they’re all surgical nobody i haven’t found anybody i want to volunteer i’m trying to fail out stuff up here and maybe come up with a weekend to do like like a whole weekend or like a saturday of wound care or foot care for homeless like get them socks shoes clean their feet check them out i’m still trying to feel out a couple nurses they only take like three or four willing to do it but the you should have some wound care experience we’ll see something for the summer the fall yeah so when we talked to a couple people about what to do about this hospital they said really the best thing to do is if you have people who care like you uh to just start kind of building around it and if you eventually build a large enough system of your own that the hospital kind of gets forced into having to get better right and so i didn’t know if you had any plans of like like billy said involving more people expanding the service like have you fantasized about that absolutely 100 right now um with what i do i work for days a week uh 10 hour days and i’m on call i don’t like i don’t like 15 days a month um and that’s on the weekends is 24 hour call and during the weekdays obviously it’s from 5 to 5 30 in the morning so those days i’m out of commission completely i can’t come up here there’s nothing i think i do i don’t do anything i live at the exact you have to be 30 minutes from the hospital for heart attacks i am at 30 minutes traffic i’m over um so i just i basically live and just wait for the pager to go off so if i if i could figure a way to work more up here like voices has me for 10 10 hours a week um most of it’s spent like on one day going around and visiting as many as we can up here and then kind of coordinate crap behind the scenes right um so it would it would involve me having more hours up here i don’t know if they’re working on that in the pipeline um i was told possibly but it’s i need to find a break with my like work life and stuff like that yeah that’s awesome yeah do you have anything awesome i i really appreciate you coming on jason and more more than coming on here which has been fun but i just appreciate what you do for the community um you know i think a lot of people that work with voices or around voices like we do we all give a [ _ ] and it’s just nice to meet more people that do and especially one that doesn’t really necessarily have those ties and doesn’t really have a reason it kind of restores my faith than just people i don’t know that’s why i was i didn’t think about i i came up here for a meeting um midway through the pandemic and i realized i was the only person that wasn’t in recovery i was sitting in the garage i was like oh [ _ ] and they’re like i was the last person i was sitting at like the kids table i’m all shrunk down with this little chair and um they’re like a little bit about yourself and while you’re here i was like well my whole story has changed from like the 30 people we went around like these are the paid employees up here i was like look i’m not in recovery and i guess i didn’t realize everybody was like i didn’t think i don’t think about people that way i mean either you’re nice you’re not it’s white or black for me there’s a lot of gray but it’s what you did in the past doesn’t make you who you i mean it makes you who you are but doesn’t make you good or bad now right and um i was like [ _ ] like this is these are all like people that struggled way more than i ever have in my life to get to a better place now they’re just taking all the energy and redirecting it back to the community to help other people out everybody’s going to be out of a job like there’s a lot of kinetic energy within this group that you’re just gonna like you’re gonna fix this county then what you know like there’ll come a point where you’ve done a lot and you’ve brought people into recovery you got them into like special care and whatever they need you’ve healed the broken parts of it and um yeah i don’t think of it the way i appreciate when people say it but like i see it the other day i saw it in a dad’s eyes it was a new guy never met he had his little girl with him and we were talking in code about everything and and the little girl went to go play with the dog and he turned around he had tears in his eyes he’s like thank you guys so much for doing this like like nobody cares about us and it’s i don’t understand why you guys are here but thanks wow i’m like i don’t i don’t know how that kills me inside knowing someone thinks that right yeah yeah i know and i i think that is the sentiment and that’s why historically like the addiction community has predominantly been filled with other addicts because it seems like most of society or mainstream medicine or people that aren’t uh boundary pushers have been like ah those people you know they’re not worth it and so it’s really is nice to see people that think addicts are worth it you know it’s like and people see us you know jason’s now with a degree and doing therapy and i have a career and i volunteer whatever and you know we become these productive people but yet we were those same people that you’re going out to see now you know that you’re seeing now in a few years or you know if they continue to get better can become healthy productive members of society because that’s why i tell everybody they’re like i don’t know what to do with my life and like no no like i like i was one of the volunteers i work with is getting her master’s for to become a therapist like no no like and she had like an eight-year hiatus from college yeah she was saving money like it’s like you can do it like anyone can do it we all can do it and it’s so there’s markers when i see folks in the worst part i’m like oh [ _ ] like everybody’s been in a bad part like and everybody’s got crazy stories like i the stories i have are nothing like the stories people share with me just coming up here like you did what oh yeah the forehead you could definitely hit a vein in a forehead like the crazy stories well we thank you so much for all that you do and for coming on and and people out there uh if it’s not substance use that like warms your heart or calls out to you take your talents into the world and give back to whatever community you feel called to give back to and like let’s just be better people to each other and just try to i don’t know that’s what i got amen so yesterday was jason’s birthday oh my jason’s not supposed god be eating cake it’s not healthy for his diet we got birthday cake that i’m gonna hopefully not try so how old are you 41. awesome so really things change i don’t know i when i turned 4 like 40 i was like ass that old 41 i started like re revamping my life 42 is where i came up with the crap i said in the beginning like it’s a short life you don’t get a lot you don’t have a lot of like productive times to just do the best at living and making sure everybody else can live and run the same race that’s 42. so like i’m 44 and i’m like i feel like an old man now yeah i get it i get it it’s a it comes at you fast this is what this is you know you’re getting the point where you can actually change people’s lives now like this is i think you got the tools available to do it like in in your 40s is when i was like oh there’s something to this right right and and yet i don’t want to go on a kick we’re good all right so don’t forget to celebrate your 40 year old people who are changing the [ _ ] world yeah ain’t all about you know after you’re 22 you’re stupid or anything uh we’re out there making a difference in lives to the best of our ability so i inspire inspire and encourage you to do the same i hope and we’ll see you next week share this podcast with people in your life who might enjoy it check out recoverysordub.com to find our episodes and link up with us on facebook twitter and instagram we’re always looking for new and interesting ideas for topics sort of if you have any ideas for episodes or think you have something to come on and talk about reach out to us

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