At 7:37 a.m., Scott signed into the Milwaukee County Behavioral Services Division Access Clinic. The clinic served residents with no insurance or only GAMP, Milwaukee County’s public insurance. A sign on the wall announced: YOUR FIRST APPOINTMENT MAY LAST THREE TO FIVE HOURS. If you didn’t have the money, you would pay with your time. Nurses and social workers bustled past patients strolling the hallways, doing nothing while they waited. Scott wouldn’t mind working at the clinic, being one of the fast-walkers. But on that day, he was there for drugs. To him, what the AA converts didn’t understand, because none of them were heroin users, was that his body was physically in need of something that would give him a boost and kick-start his motivation. His fingers were crossed for Suboxone, which was used to treat opiate addiction. After almost three hours, Scott’s name was called. He stood up, relieved to be seen.
The psychiatrist was a skinny Asian man with a flattop and a voice just above a whisper. He led Scott into a drab, rectangular room that resembled an oversized closet. Scott sat on a couch and the psychiatrist bent over an old desk, reading Scott’s file. The desk was pushed against the wall so that when Scott looked up from the couch, he saw the psychiatrist in profile.
“How long have you been depressed?” the psychiatrist asked, staring at the file.
“A long time,” Scott answered.
“So, what kind of symptoms are you having?”
“I just really don’t have any energy….I’m thinking about looking into Suboxone. I can’t tell if I’m in post-withdrawal.”
“How long have you had trouble with the drugs?”
“I’d say about, about seven years.”
“And how long have you been clean?”
“Four months.”
After Scott filled him in about his drug use, the psychiatrist paused before the next question. “Um,” he continued, “it says here that you were sexually abused when you were younger.”
“Correct.” Scott sniffed.
“How old were you?”
“Young. From four to”—Scott thought for a moment—“ten.”
“Who was the perpetrator?”
Scott told him.
“So how did it end? Was someone told?”
“No. I never told anybody about it.”
“Have you ever got any treatment for that?”
“No.”
“You have any interest in that?”
“No.”3
Scott walked out of the clinic with two bottles of antidepressants. He was to take 100 mgs of Zoloft twice a day and 50 mgs of amitriptyline at bedtime.4 When Scott had asked, “Do you suggest anything to help with the cravings?” the doctor had mentioned treatment programs instead of Suboxone. Scott had been “a little bummed” at that response. But two out of three wasn’t bad. It was cold outside, –1° without the windchill. Under Scott’s boots, the snow squeaked.
—
Three months later, while rooting around for loose change, David and Anna Aldea’s twelve-year-old daughter found a syringe in Scott’s swimming trunks. Oscar, the Aldeas’ eldest son, who had recently moved back home, floated the possibility of it being an old needle, which was entirely plausible. When Scott had first moved in, he would periodically find paraphernalia in the pocket of a sweatshirt or pair of jeans he hadn’t worn in a while. He even found a crack pipe once, looking at it and remembering, the way you do when finding a faded ticket stub in the laundry. But David and Anna weren’t buying it. That night, after Scott had finished cleaning the Serenity Club, he discovered his things on the Aldeas’ porch with a note. He tried the door. Locked. Theirs had been his home for seven months.
Scott didn’t plead his case. He shunned confrontation, and David and Anna wouldn’t have believed him anyway. “It’s much easier for them to think that it was mine than his,” Scott reflected. Besides, this was no time for Oscar to detox, having just become a father. The unselfish thing to do, in Scott’s mind, was to allow Oscar to keep using so that he could be there for his girlfriend and baby daughter.
Scott knew the needle was Oscar’s because Scott had shot up with him. Scott wouldn’t use the term “relapse.” He would say, “It just made me normal.”
Several things had happened all at once. First, Scott learned that all those AA meetings he had sat through and all those group therapy sessions, which he hated even more, didn’t count toward his nursing license. The nursing board had its own procedure, and Scott hadn’t followed it. The board also had its own lab for urine screening, and since Scott hadn’t used it, all those clean drops he’d been racking up didn’t count either. “I went and pissed in the cup, and I did that for weeks and weeks and weeks. And finally, I contacted the board to make sure that it was all okay. And they were like, ‘No.’?”
Just days after hearing this defeat, Scott ran into Heroin Susie and Billy at a gas station. They offered, and he accepted, a quiet act of rebellion. That might have been an isolated incident, a small back-slip on his steep climb, but then Oscar moved in with a full-blown habit. The two began getting high on the weekends together. Scott would stop using by Monday so that he could piss clean on Friday. He was still going to counseling and AA meetings. But after a few months, he dropped the routine and started getting high whenever he could.
At two a.m., standing on the porch of the Aldea Recovery House with a sack of clothes and his memory box, Scott took the natural next step and called Susie and Billy. He spent that night in their trailer, right back where he started.
—
A few days later, as Susie baked an apple pie, Scott called his mom, Joan. He had decided to give methadone a try and needed two things: heroin in his system, which he had, and $150, which he didn’t. A month earlier, Scott had returned to his hometown for a two-day visit. He stayed at his mother’s small but dignified home, visited his grandmother in the nursing home, played video games with his teenage nieces, and watched his sister model her new wedding dress. It had been two years since Scott had seen his mother. “I would drive up to see you if I could drive in the city,” Joan apologized without apologizing. The visit had been pleasant. Scott was relaxed and calm, not like his last visit, when he seemed to Joan as nervous as a caged rabbit. “His legs would be shaking a mile a minute,” she remembered. Joan had organized a special lunch and a big dinner so that all the relatives could see Scott. He’d traveled back to Milwaukee feeling loved, and that memory helped him pick up the phone.
“It’s a methadone clinic,” Scott was saying. “Do you know what that is?…I’ll go to them every day to get the medication. And that’ll help me with the opiate addiction and depression….I’ve kind of tried to do all this and beat this without; I didn’t want you guys really to know the whole, you know. But it’s not working that way.” Scott drew a breath. “Mom, does this make sense to you?”
All Joan knew was that her son, who almost never asked for anything, was asking for help. She came up with the $150.
The next morning, Scott sat in the Tenth Street Methadone Clinic, waiting his turn. The clinic had four stations. Reception took your money, and Collections took your piss. The nurses greeted regulars by their nicknames or numbers. “Hey, Deano!” “Your lucky day, 3322.” The third station was the bathroom, equipped with a camera to make sure you weren’t swapping urine. At the last station, the methadone dispensers sat behind a thick door on which someone had clipped an article from The Onion with the headline EVERYTHING TAKING TOO LONG, accompanied by a photograph of a man staring impatiently at a microwave. Once buzzed in, patients stepped through the door and punched their number into a dispenser, which would squirt the bitter red liquid into a small plastic cup.
Scott thought the most diverse place in all of Milwaukee had to be the methadone clinic at seven a.m. Through its doors had walked a twenty-something white woman in full makeup carrying a designer purse, a grunting Mexican man leaning on a walker, a white woman holding a newborn, a tall black man with earrings whom Scott enjoyed looking at, a fat painter, a burly construction worker, a white woman in pressed slacks and a pink blouse, and a man in an accountant’s suit. When a bent-over Chinese woman who looked to be in her eighties shuffled into the clinic, a Puerto Rican woman with a cane walked over and hugged her.
“You new?” someone asked.
Scott turned around to find a young white woman who looked like she belonged on the East High School track team. She was maybe eighteen with a ponytail, freckles, orthodontic-straightened teeth.
Scott nodded yes.