Suffering and Smiling

Suffering and Smiling

I am always a bit more cautious when I approach this place. It’s a double wide trailer, down a bumpy forest road in the mountains. Not many neighbours around. Spotty cell service.

It’s a mess out here. Everywhere you look, there is broken down junk. I’m careful as I make my way to the door. My eyes scan for dirty needles on the path. They are not intentionally scattered about, but when someone is high and stumbling around, sometimes they are dropped.

Things can get crazy out here.

Mix methamphetamine and sleep deprivation with backwoods isolation and the probability of Murphey’s Law increases exponentially. Someone took a shot gun to the trailer a few months ago. There is a smattering of holes around the front door from a 12 gauge blast. Judging from the large size of the holes and the relatively small blast radius, the ammunition fired was buckshot rather than birdshot. I know the difference because my sister’s ex-boyfriend, Stretch, once took a round of birdshot in the face.

Stretch was the president of the Liberty Riders motorcycle club back in Detroit. The shooter was in a rival gang. I remember visiting him in the hospital right after the surgery. The doctor said if he had been hit by buckshot (which contains much larger pellets), rather than birdshot (smaller pellets), Stretch would be dead.

Back in the present, I knock on the trailer door. There is a security camera perched above it.

My standard practice is to look right at the lens. I make sure my face is clearly visible (no mask) so the inhabitants can see who I am and that I pose no threat (there are many nuances to “safely” conducting this kind of support work).

I hear footsteps as someone on the inside walks across the trailer’s plank wood floor. A series of locks turn and slide on the other side of the door. Finally Blake opens it. He’s a little wobbly. We talk for a moment, exchanging stories of how it’s going, catching up on what has happened since the last time I was here three weeks ago. Blake tells me he has saved two lives from overdose with naloxone since that time.

I assess immediate needs: safer injection and safer inhalation supplies, vitamins, juice, some vouchers for groceries. While I go back to my car and get these things together, Blake is putting together a bucket of used syringes for me to take away.

Needle exchange.

His dog Lilly follows me out. She’s always a little fearful, but also compelled and curious. Lilly is a medium sized mutt, a combination that looks like an odd mix of brindled Pitbull, German Shepard, and Hound. I tell her she’s good dog and her ears slightly prick up. If I had a treat, I would give one to her. Lilly is skinny.

Blake and I reconvene at the door. He has a bucket in his left hand. I lay two large contractor bags full of harm reduction supplies, juice, and water beside the door. I hear a tap, tap, tap sound. I look for the source and see thick red liquid splattering on the lid of the bucket containing the dirty needles. It takes a moment for my eyes to make sense of what they are seeing. Blood is dripping from under Blake’s sleeve. Each droplet taps out a steady downtempo beat as it falls from his hand and strikes the bucket lid.

Tap…tap…tap

Images rise up from my past.

Visions of being eleven years old with my mom and my brother, Daniel. We are homeless, fleeing mom’s bad marriage and the collapse of Detroit’s auto industry. It’s the beginning of the 80s and mom had been laid off of her job in the auto factory. My brother (who is older than me but is still a kid himself at fifteen) is bleeding. He just ripped open an artery in his hand while trying to change the headlight on our Chevy Caprice. The sun was setting. We were in a gas station parking lot in the state of Tennessee. I was standing close to him as the blood spurted out. Such a deep red. My brother looked at his hand, somewhat confused at this sudden change that made everything different than how it had been a few seconds before. It was obvious he needed to be rushed to the hospital, but we had no money to pay for an ER visit. Our eyes met. He was smiling widely as he bled, just like Blake was doing then, in front of me.

Tap…tap…tap…

I have seen him smile like this before - the day after he had been attacked in his home. Someone broke in. They wanted whatever money Blake had. The attacker used a tire iron to get it. Blake said he saw stars, then everything just went black. There was a bandage on his head - made from a piece of fabric like a t-shirt, rather than an actual hospital dressing. I asked Blake if he had seen a doctor, but it was rhetorical. I knew he hadn’t.

“I’m fine-just happy to be alive,” Blake said, smiling.

It’s hard for most people to imagine why someone with a serious injury wouldn’t go see a doctor, but it’s often the case when you are poor. When I lived in the car with my mom in Los Angeles (circa 1981), I had an infection in my foot that went untreated. I limped down Sunset Blvd. beside my mom as she tried to find a pawn shop that would buy the few remaining pieces of jewelry she had left for a decent price. She was out of work and needed to pay for some food and gas. Even if we had money for the doctor visit, the risk of child protective services being called on us and the likelihood of me being taken away was enough to keep us from entering the hospital. To us, going to the doctor seemed like turning yourself in for the crime of being poor. So instead, my mom treated me with a safety pin sterilized by the flame of her cigarette lighter, some hydrogen peroxide to clean the wound, a cotton ball held in place with Scotch tape, and a hit of generic aspirin. And we prayed.

That was in the States. Here in Canada, healthcare is free. But for certain people, barriers prevent them from accessing it. For an injection drug user, it’s not as simple as just going in for medical help. In fact, sometimes just suffering and smiling through it on your own feels more safe. Blake does what he can for himself and he keeps quiet. At least this way he avoids stigma and embarrassment from the establishment. He saves himself from being judged, ridiculed, hated, and “othered” for his circumstances and life choices. *(This othering has also become quite common during the pandemic, especially around vaccination choices people make).

That’s how stigma works, it’s transmitted from the top down. It shames people for where they are at in life, without making any space to understand how that person came to be who they are, or why they are in a given set of circumstances.

Bringing attention to the obvious, I ask Blake what is going on with his arm. Instinctively he tries to hide it, albeit nonchalantly, by sticking his left hand into his jeans back pocket.

“No big deal,” Blake says. “Injection related.”

Injection related could mean many things. My first thought is an erupted abscess. Abscesses are common in people who inject drugs. Infectious agents enter the body at the site of injection. The body reacts, trying to defend itself. A mass of pus builds up under the skin. It swells, gets red, and will increase in size until it drains-either by bursting on its own, or being lanced. Left untreated, abscesses can lead to permanent tissue damage or, in extreme cases, even death.

“Want me to have a look,” I ask? My First Aid kit is in the car. It would be easy for me to go and grab it and, if necessary, do some basic wound care.

Blake says he’s fine. Whatever is making blood drip down his arm is “no big deal.” He’s still smiling as he shrugs me off, but something has changed. It’s a slight shift in energy. My 28 years spent closely following the way of the grizzly has sensitized me to very minute fluctuations in energy. Sometimes the shift isn’t visible or obvious, not something you can point to or describe in certain terms. But if you are paying very close attention, and have a solid base of experience, you can quite literally feel it. As you can imagine, responding appropriately makes all the difference.

With Blake that day, he doesn’t want to roll up his sleeve to show me what’s going on. On any other day, he might. Not today. He’s not outright saying it, but I can tell. I don’t push it. Instead I actually just back away, both energetically and physically-not that much, this is important with both bears and people-just a step or two back, barely noticeable, then feel into the energy again. I’m trying to create a tiny bit more space to smooth the frequency wave that has changed from sine to sawtooth. The whole point of what I am doing here is meeting people where they are at. Services are offered that can either be accepted or declined. I can help with some things, provide supplies, give some advice, connect them to available supports, but ultimately, whether or not they accept any of this is their choice. One of the most important lessons I have learned through the practice of harm reduction is that I have no right to infringe on anyone elses right to bodily autonomy. And no matter what they choose, even if radically different from the choices I would make, I strive to interact in ways that are equanimous and compassionate. This is the ideal. Sometimes I fall short of it. Sometimes I push too hard, or leave a situation feeling frustrated, especially when I know the circumstances could be made better with the particular support that I’m offering. Yet always I have to circle back around to a place of acceptance, reminding myself that regardless of whether or not I agree with them, a person must be free to make their own choices as they navigate the experiences of their life.

*Disclaimer: some names, places, and descriptives have been changed and reordered to maintain confidentiality.

**The title of this piece is an adaptation of Fela Kuti’s stunning track, Shuffering and Shmiling, which I listened to on repeat while writing this story.