Running in a storm

I lace up my running shoes as my worries threaten to bubble over. Outside, the blue sky is diamond hard. Sweat sliding down my back, my feet fall in time to bubblegum pop. I reach a downhill stretch, my favourite part, today with a tail wind. I’m just a middle-aged, overweight woman, jogging slowly, but I feel like I’m flying. Little bits of happiness bury themselves in transmembrane receptors, like a cool mist on my boiling brain — a runner’s high. Why was I agonizing over that email anyway? Cold winter air burns my lungs, but the sun warms my legs. The further I go, the better I’ll sleep.

I pull up hard, the metal spikes on my shoes scraping against the ice. A new white cross is planted in the snow. This cross, just off the trail, blends into a stand of white birch, save for the red plastic flowers adorning it. I work at Sudbury’s supervised consumption site, but I don’t recognize her name. Her photo smiles at me through a sandwich bag taped to the cross. Bright blue eyes, light brown hair, faded freckles, just like me. Here I am, chasing endogenous molecules. There she had been, chasing exogenous molecules.

***

In my first or second year of medical school, I got a free textbook, Managing Pain: the Canadian Healthcare Professional’s Reference. As I dutifully crafted slides to present to my classmates — pain, the fifth vital sign — I began hearing whispers about family and friends and neighbours back home, dying. And yet I remained an unwitting participant in my community’s downfall, parroting pharma’s marketing lies about oxycodone on my clerkship rotations. In 2012, street fentanyl replaced oxycodone, and then the whispers became a roar too loud to ignore.

***

Another day, another run, dodging dog waste and spring puddles. The sun has not yet risen but it has announced its presence, turning the sky fluorescent orange. I huff slowly up a hill. The trash bag on my right shifts. Tucked behind it, a young man, frothy bubbles of saliva around his mouth and nose. I tap my pockets, finding only my keys and phone. Why don’t I have naloxone? I call 9-1-1. He’s hauled unceremoniously onto a stretcher, his change falling onto the sidewalk. I want to apologize that he had to look for comfort here, alone on the cold sidewalk, behind a garbage pile. I want to explain that we would keep the supervised consumption site open all day and all night if we could. But we can’t, so I don’t. Instead, I run home and get ready for work. The sun now overhead and my morning encounter still on my mind, I arrive at the supervised consumption site. Inside, it is bright and warm. Mr. Y is here, requesting HIV and hepatitis C testing. His eyes stare through me.

“Out of the frying pan, into the fire,” he says.

I must look confused.

“They don’t got clean needles in the pen,” he explains.

Pen, short for penitentiary, where Mr. Y was short on space, but long on time on account of criminal negligence causing death, on account of sharing his methadone, thinking, “Just a drink for buddy to keep his job, keep his house, keep his kids.” If only he had been wearing a white coat, I thought. If only he had charted: “Patient counselled and consent given.” Weren’t we both trying to practise compassion? A framed copy of the Hippocratic Oath hangs in my office: “I will remember that I remain a member of society, with special obligations to all my fellow human beings.”

***

It’s winter again. Running by four lanes of traffic, more if you count turning lanes, air so thick with exhaust you can taste it. On one side of the road, more crosses. On the other side, the Office of the Chief Coroner, my workplace before the supervised consumption site. Its piles of files — friends from high school, acquaintances I would talk to in line at the grocery store, my summer camp counsellors. A headline from the CBC: “Northern Ontario’s five largest cities continue to have highest opioid death rates in province,” although no one south of the French River seems to care. Snow begins to fall. No wind. Cotton wads the size of your fist dropping onto the sidewalk. I run by a woman wrapped in a sleeping bag. Snow’s falling faster now. I run home, warm. She stays put, cold. I’m so sorry, my love. I stare at the flakes falling outside my window and wait for the plough. For someone to dig us out of this disaster.

***

Mr. X visits the site every morning before his shift. Today is his last visit, because today, Mar. 29, 2024, Sudbury’s supervised consumption site will close. Today, there’s a point in his pocket and his arms are gooseflesh. He tells us he will slip that fetty into his vein just one last time, like all the other last times. I want to tell him: Don’t. Don’t use the dope to push through pain. Nothing will stop them from using your body to build their houses, to dig their mines, to harvest their trees. Don’t use the pills to stop the nightmares. That man, your uncle, will have hurt little boys, hurt you, no matter how high you get. Don’t use that needle to stitch a hole, the one shot through your heart when your buddy drowned. That pit is bottomless. But I don’t say anything, because what alternative do I have to give?

***

The Hippocratic Oath still hangs in my office: “I will prevent disease whenever I can, for prevention is preferable to cure.” I reread it sometimes, but I still don’t know how to end this.