Notes from the Shitshow

When I took a drug/alcohol rehab job as an entry-level Behavioral Health Technician (better known as “Tech”) , I expected screaming, brawling, freak outs and – what scared me most – throwing up. The projectile vomiting, thankfully, never came (although I narrowly missed “The Screamer” becoming “The Pisser”). There was no trading of fists, although snide comments were known to fly.

Social outcasts as they were, here in rehab their abnormalities were normal, with a non-addict like myself as the outlier. Being able to drink socially without going to excess, having smoked weed and even tried, cocaine, but able to walk away from it, I’m what the addicts call a “normie.”

I learned that, while addicts and alcoholics stripped of their drugs and booze look a lot like us and sound a lot like us, they will never be normal. Their minds work in stupefyingly different ways, and they will be on guard every moment of every day, lest a “trigger” send them back into the hell of slamming poison into their veins, or drinking all day/every day. Continue reading “An Introduction to Rehab”

After about three months on the job, I got my first airport pickup. It took a while to get there, the regular van was out so the BH III had me drive my own car to the Welcome Center (not very welcoming, but ..) and pick up the company’s rental car, a pretty-new SUV. The BH III gave me the number of KW, the pickup, so I texted her a few times to give her updates on my arrival.

She texted back, “NO hurry I was totally claustrophobic freaking out on the plane so I need the fresh air.”

When I pulled up, she had her suitcase open on the sidewalk with several items splashed about. She was kneeling on the ground next to it, shoving things around. I told her who I was and she said she was about to lose it, and I believed her. I helped her get her stuff back in the suitcase and a backpack as a security guard told us we really weren’t supposed to be there … Continue reading ““Screw me three times…””

Most of my fellow Tech’s “com logs” were brief, cut-and-paste jobs. Some of mine were, too, but I tried to be more descriptive, and document complaints. Not sure why, I doubt any of them were read by people in positions of power …

On one of my weekend shifts at a PHP house (where they spend weekdays at the Clinic), a couple of guys were pissed off and ready to go home Against Medical Advice (AMA), due to “lies” told them by the sales company that my company used. I heard these complaints by too many of the residents to suspect they were made up…

COMMUNICATION LOG Shift: PM 16:00-24:00 Date: 3/18/17 Continue reading “Lies, Lies, Lies”

I was off the next day, and when I came back for a swing shift, JB was in full-on complaint mode. He came to the Tech office to ask to make a phone call, and I made the mistake of asking how he was doing. “Pretty horrible, if you want to know the truth,” he said.

He said he hadn’t seen a doctor the whole time he was in the program, and that his Case Manager was supposed to try to get him to the doctor the next day. Then he went into his story, which I would hear a few dozen times – with slight variations – over the next few days.

“For the last 20 years, I been drinkin’ steady every single day. I started messin’ around with hard liquor, then for the last 10 years I been drinkin’ 48 beers a day. I like my beer cold but I start with my first beer before I get out of bed, it’s right there on the night table. Then I keep right on goin’ till I go to bed.” Continue reading “48 Beers a Day”

I was on the morning/day shift, and he got dropped off just a few minutes before the end of my shift. Seemed like a nice guy, my first impression – later to be proved wildly wrong – was “gentle giant.” Looked about 6-foot-2, 220, not bulging out of his white T-shirt but still looking very powerful. Very red face, and I don’t remember noticing it at the time, but some sores on his nose and cheeks that he had ointment for.

We didn’t have new Clients sign this Consent for Services form when I started, as far as I could figure out, we had only been doing this for a few weeks. They had already signed a similar version when they entered Detox, this one gave permission for us to do UA’s, Breathalyzers and a few other things. In a classic “bury the lead” – or, perhaps, “hide the grenade” -, the last section outlined costs: $100 per UA, other tests in the hundreds of dollars range, and Residential services of $3,000 per day. Continue reading “$3,000 a Day”

JW, I soon came to realize, was really good at two things: Complaining and bragging.

He was a pill guy, and liked to boast about how he learned how to work a bunch of doctors. “It’s not tough, they’re crooks.”

White guy, about 6-1, bright blue eyes but a long, sad face. A little on the chubby side, never seemed to help with the group cooking – but never missed a meal. Maybe he thought telling stories was his way of pulling his weight …

He sure told me a lot. About how he got into pills because of all the surgeries he had, car wrecks and getting shot three times. “But the ones who shot me, they’re not shootin’ anymore.” Continue reading “Pill Bragger”

Content of service: Information gathered from client concerning goals, objectives, perception or progress of what actually happened (include reported interventions used in session).

“Clinician met with the client for an individual session. The client reported that he is having a lot of cravings that he is struggling with. The client reported that he feels very uncomfortable in his skin right now, and it feels like things are crawling on him. The client stated that he would have left treatment an went and used already if he had his money in his pocket. The client stated that he wants to be sober but is struggling with the idea because he is “dope sick” all the time. The client stated that he believes that life would be simpler for everyone if he was no longer here. The client reported that he had some suicidal thoughts earlier today but doesn’t have any right now.

Continue reading “Dopesick”

PHP – I think it stands for Partial Hospitalization Program, no one really knows and it’s misleading anyway –  is supposed to be a good thing, where you “step down” from Residential where you almost never leave the house, do all your group meetings there, eat there, shit there – literally and figuratively.

RB and BN both weren’t happy campers, when they first got to RR, the house where I usually worked. RB, coming off heroin and cocaine, predictably had some attitude issues with several of his peers, and several techs complained he would snatch meds away from them, angrily and aggressively. Granted, they were his meds, but still.

And he had thrown some serious disrespect in my face. On one of my first shifts, JS the super tech told me to address the group at closing, emphasizing the house rules – no food or drink in rooms, up at 7, curfew at 11, make your own breakfast and lunch, communal dinner, etc – for the two new guys. As soon as I started with the rules, RB stood up from one of the comfy couches, tossed a vague curse in my direction and stomped away.   Continue reading “Welcome to the Shit Show”

I was pretty nervous the first time I had to do a “search.” It was AJ, and he wasn’t feeling much better.

White guy, 5-11, 220, bearded and balding, looks a little like the actor Paul Giamatti. Even has something of a corner-of-the-mouth delivery. Funny, upbeat guy.

Now.

First day in he was nervous, sweating and even crying – I had to go through his bags, and what set him on a crying jag were pictures his kids painted. Instead of saying “It’s all right” or something, I just focused on going through his stuff and acted like I didn’t see him crying. He apologized, and I told him no worries, it’s all part of the process or something similarly dumb. Continue reading “Rehab: Facing the Music”

After a few days of dreary training at the corporate office in Fountain Hills, on Jan. 19 I had my first on-site training, working the swing shift at a mansion in Scottsdale. I knew the area pretty well – it was about halfway between my apartment and Old Town Scottsdale, where I liked to hang out (not for the party scene that it is known for, more for the coffee scene).

I was given a tour of the big house, starting with the all-important Tech Office, outfitted with a computer to take notes, check emails and access the system that had a file for each client; locked cabinets where the clients personal items, medications and UA collection kits were kept; blood pressure cuff, finger oxygen sensor and thermometer for morning and nightly vitals; phone where clients would come in and make monitored calls. Continue reading “Rehab: Day One”