There Should Be A Lifestyle Magazine

He had been up all night pulling out intravenous lines and making a mess of things. Because he was getting lots of lactulose to bring down his blood ammonia levels and therefore crapping his brains out to get rid of that noxious stuff, it was better that we just placed a mushroom-tipped tube into his rear than to have him spread loose and foul frequent runny stool all over the place.

Wrist restraints weren't enough so the night shift nurses (it took three of them to hold the guy down and sufficiently restrain him,) put a posey vest on him and shot him full of enough Ativan to subdue the entire student population of a small northeastern college.

An anonymous rescue squad call was made and the crew found him down on the street. The caller said the guy "fell." This word, of course, is simply an abbreviated way to say instead that he had been beaten and pulverized by his friends. Maybe it was the sidewalk that gave him that spongey lump on the back of his head. My feeling is the sidewalk had a little helper.

Though his drug of choice was heroin, at the scene they checked his wallet which contained information indicating he was getting methadone, and it appeared he had switched to alcohol to finish off what was left of his very bad life.

There is no medical or surgical cure for a bad life, and mere palliative treatment is often dismal and the failure rate is high.

He would eat if I fed him, but I couldn't let him do this himself because he just spilled everything all over and would reach for other restraints if I gave him a free hand. The night shift nurse had replaced the rectal tube once because he'd found enough wiggle room in his left wrist restraint to ease it out, mushroom tip inflated, and fill his bed with diarrhea flooding.

He thought he was in a different hospital and he got the day and date wrong by half a week. That was probably baseline orientation for him. "That's pretty good," the resident said when I explained the patient's response to questions about day/date/place.

The patient's speech was difficult and disorganized but he was fluent in two languages. At least, he could fluently moan and slur in two languages. Like they say about Bush, "he's illiterate in two languages." (Thanks Molly.)

He told me he wasn't confused. He told me he wasn't sick. He said he wanted his wallet "because it had everything in it, even his Social Security card." His things were double-bagged in clear plastic, sitting on top of the cabinet. I showed him that his wallet was there. He asked me, after looking right at it when I held it just a few inches from him, "what color is it?" meaning the wallet.

It was brown. I used gloved hands to open the outer bag, thinking that I wanted to see if his Social Security card, poking up out of his wallet ready to deploy, was all zeroes. The inner bag was too smelly so I just put it all back on the bedtable without reaching inside.

He nodded affirmatively and satisfactorily that his wallet was brown, then he faded off again for a while. Detoxification.

This metropolis needs more liebesraum. Open the border and let the sprawl creep all the way south to the Sea of Cortez. Put in a light rail line. Let's go to the beach.

Maybe in a day or two we'll cut back on the lactulose and the restraints, then we'll be able to discharge him to some skilled nursing facility for "rehabilitaion," and when he can walk to the bathroom and back without falling over they in turn will discharge him "home," to the streets.

If I had Bill Gates' money and Paris Hilton's time I'd buy the Statue of Liberty and move it to Sonoyta.