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Invisible Illness

Andrea Long

MS3, St. George’s University School of Medicine

I do a shift in the emergency room. A woman in withdrawal comes in with her newborn baby, birthed this morning at home. The doctor leans over and says to me after we wheel her up to Labor and Delivery, “People like that should be sterilized”. I take a slow, deep breath behind my mask. It is snowing outside but I feel overheated and nauseous. I want to tell the attending that my brother recently died of an overdose. I feel an irrational urge to defend him, tell her what an excellent dad he was, how much his life mattered. Instead, I bite the words back so hard that my lip bleeds into my mask, and I say nothing.

I rotate on the inpatient medicine floor. I update the attending on my attempts to reach a patient’s methadone clinic so we can find out his dose, obtain his paperwork, and make sure he continues his treatment. The attending complains about how much extra work we must do. He says, “He’s just replacing one addiction with another”. He asks, “How soon can we get him out of here?”. My fingers tighten in frustration around my notebook. His sentiments are not echoed when we spend an afternoon calling every pharmacy in the area to find the best price for COPD medications. This patient made a “choice”. I want to shake him and tell him that addiction is not a choice any more than our cancer patient’s disease is a choice. I want to tell him that I would give anything for my brother to be able to make the “choice” to go to a methadone clinic every day instead of me toasting his grave once a year on his birthday. Again, I say nothing.

I eat lunch with my friends, also medical students. They recount a patient they had who had “major crackhead energy”. They laugh at him. They make fun of his mannerisms. The subtext is clear: there is no sympathy here. One says, “How can anyone live like that?”. My fingers twist over the tattoo on my arm, the one inked with my brother’s ashes. I have nothing to add to this conversation. It is not like they know about my experience, my family history. If they did, I doubt they would say things like this in front of me. That thought doesn’t reassure me. This illness is not inked into our skin; it is not as obvious as a missing limb. These students are going to add to a system that already looks down upon and mistreats people who use substances. But I say nothing.

One day, I will speak up.

About the author:

Andrea Long is a third year medical student whose goal is to be an Emergency Medicine physician. She is passionate about harm reduction, nature, and finding the perfect chai latte, wherever it might be in the world.

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