You’re a mean one, Mr. Grinch

I’ve been struggling with how to broach this subject for several days. I lost a client. My struggle is mostly because this is the first client I’ve ever lost while I was their case manager. One of my clients, a well-known drug seeker and painkiller addict, overdosed on oxycodone over the weekend, and was pronounced dead at the hospital. Tonight (Wednesday) is the viewing, and I declined to go, though most of my team went. With how all over the place I’ve been, I knew I couldn’t do it. The funeral is tomorrow during the day so we won’t be able to attend- though I’ll be in the general area for the outlier loop we do on Thursdays, and could make an appearance if I were so inclined.

I mostly feel numb, because it was so sudden.

I just completed a crisis plan with him that Wednesday. We had been joking about his substance abuse history, and he stalwartly denied using, but we all knew he did. He had to admit it to himself before anything we said would matter. He was recently in the ICU for blood clots and has been very sick physically for myriad reasons long before I came along. I can’t tell you how many doctor’s appointments we went to, where I would pull the doctor aside and beg they not prescribe him benzos or painkillers, due to his addictions. One doctor had him on fentanyl patches, which is a pain patch you apply every three days and slowly soaks into your system through your skin. He would occasionally EAT them to get high. We all knew this was coming, eventually.

I guess we just didn’t expect it to be so soon.

Clients I’ve worked with in the past have passed away, of course, mostly from physical health problems. There is SERIOUS need for medical help in the mentally ill population, and if I don’t drag them kicking and screaming to the doctor, they don’t get help until it’s too late. A client at my old job who was non-verbal was diagnosed with end stage pancreatic cancer and died within a week. His case manager and group home operator noticed something was wrong when he stopped eating, and he was suddenly gone. His case manager and the case manager before her were with him when he died, holding his hands. He had no family other than us.

I wasn’t able to attend that funeral, either. He was very young. If he’d been verbal, we could’ve done *something,* I’m sure of it.

A client I worked SO hard with to keep alive, committed suicide four months after I left my old job. I had spent a year dragging him in to see me, trying desperately to convince him that the persecution he felt wasn’t real. He’d been drag racing with a friend, and he lost control and hit the other car, killing its passenger. He spent thirteen months in prison for vehicular manslaughter. He had his psychotic break in prison. Numbers related to the dates of the accident, the funeral, the trial, when he entered and left prison, they all tormented him, on license plates, on the TV, everywhere. I’m sure EVERY number was represented here or there, so convincing him that the world was not out to constantly remind him of his trauma. Getting more than a sentence out of him was like pushing a rope uphill. I learned everything there was to know about fishing because that was the only thing he still enjoyed, just so we could talk about it. He gave up without someone constantly reassuring him of his worth.

I didn’t find out about his death until it was too late to attend the funeral. I still blame myself a little for abandoning him, and I hope he’s finally at peace.

Being a case manager can be very, very painful. And I’m finally crying over my lost duckling. I was starting to wonder if I ever would, or if my soul has finally been replaced with Mr. Grinch’s.

Your soul is a appalling dump heap
Overflowing with the most disgraceful
Assortment of deplorable rubbish imaginable,
Mangled up in tangled up knots.

Good to know I still have a heart and it’s not a bad banana with a greasy black peel, I suppose.

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