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What is it like to be a heroin addict in withdrawal and in jail - and to be the parent receiving the call from your son! I want to share Chapter 2 with you - to allow you an opportunity to experience it!

Also, as a new author and an "old" doctor, I wish to extend my sincere thanks to all of you (established authors, fellow physicians, dedicated social service folks & more) who have offered support to my goal of becoming an established author - but even more importantly thank you for your support as it relates to getting the message out that the disease of addiction is an equal opportunity disease, that it has no socioeconomic boundaries! I hope that by creating a medical murder mystery/legal thriller readers will be enthralled and educated, but without the encumbrance of heavy scientific jargon. In this way, I hope to attract and inform readers who might not otherwise choose a book about the disease of addiction,  And now if you read on, you will know how Jimmy Sedgwick felt in the Prescott County Jail . . .

C H A P T E R 2

Jail

Adam was led into a sterile, white, windowless room approximately ten feet square. Jimmy was in the far corner of the room behind a cold metal table. Seated on a low wooden stool, he had the appearance of a small boy who could barely see above the grown-ups’ table. Jimmy’s head was bowed as he nervously picked at an excoriated lesion on his left palm, having removed the bandage that the nurses had previously placed over it. He scratched back and forth with the raggedly bitten nails of his middle and ring fingers of his right hand, digging progressively deeper into the layers of tissue until fresh blood mixed with dried scabs from prior scrapings oozed out and trickled on his blue jeans. This was a vile habit that paralleled his drug use. It did not matter whether he was high from drugs, in withdrawal from waning drug effects, or just dreading the discovery of his drug use, he would pick at the thick muscle below the thumb where it merged into the hollow of his palm, burrowing until it bled, as if this self-mutilating behavior would heighten his awareness of the painful path of drugs he had once again chosen. When he was clean from drugs, the bleeding stopped.

Jimmy Sedgwick had spent Sunday, June 6, his third evening behind bars at the Prescott County Jail, drenched in perspiration and shaking with chills while retching and doubled over with stomach pain. As a teenager Jimmy had been incarcerated briefly, but he had avoided run-ins with the law for the last eighteen years. Jail was quite a different experience as a thirty-six-year-old heroin addict. He repeatedly asked to see a doctor as he struggled to cope with the increasingly severe symptoms of heroin withdrawal. He was exhausted from his physical condition and lack of sleep, making the barrage of questioning, first by the police and then by his court-appointed attorney, intolerable.

Upon arrival at the jail on Friday night the nurse had performed a cursory physical exam. The initial medical report stated that Jimmy was experiencing mild symptoms of opiate withdrawal, with pupils slightly constricted but reactive to light. He had a wound on his left palm. Vital signs were within the normal range. On medical recheck Saturday afternoon the daytime nurse simply noted that his condition was stable.

“Stable my ass,” thought Jimmy. He was not an angry sort, but had become much more irritable and anxious since the prior evening. What a difference twelve hours had made. He did not want to have a confrontation with the nurse; but he needed medication to combat the well-documented debilitating symptoms of withdrawal. He had lived through this before. Jimmy knew after the first eight hours or so the restlessness, nausea, sweating, and mild abdominal cramps would progress and peak in about three days. At that point the vomiting, diarrhea, racing heart, fever, chills, and diff use muscle pain would reduce him to the fetal position. Then all he would think about was how to get his next “fix,” which would be impossible to achieve while behind bars. It was at this moment, practically jumping out of his skin with fear and anxiety, that he placed the call to his father—the only person he could turn to for help.

The Prescott County Jail was not a place for hardened criminals or for emotionally unstable prisoners. For most, it was just a way station on the path to a probationary sentence. Adam was as uncomfortable in this setting as a psychiatrist would be in a surgical operating suite, but he intuitively understood the need to suppress both his disappointment and self-blame. An overprotective or defensive approach to Jimmy’s mistakes would do nothing to ameliorate the current state of affairs.

When Adam had tried to garner information from the sergeant working the desk at the West Haven Harbor Police Station that morning, he began to understand the rules by which he was playing. Being Dr. Carter Adam Sedgwick was of no help at all. Here in Downeast Maine the locals quickly stripped one of any presumed superiority, while still remaining respectful. The sergeant was adept at never directly responding to Dr. Sedgwick’s request to speak with Police Chief Bergeron. Adam did not know at that point that Chief Bergeron had just been urgently called away by the two policemen who had been assigned to investigate circumstances pertinent to Jimmy’s arrest.

The jail guard who led Adam into the room to meet with Jimmy was a petite woman in her fifties. Jimmy looked up and smiled through clenched teeth as his father entered. Adam did not utter a word or look at his son directly until after the guard explained the rules.

“Alright, Mr. Seddick, you've got twenty minutes and then I’ll be back. If you need anything, just push the button here on the wall.”

Adam chose not to correct the guard’s pronunciation of his name. “OK. Thank you.”

“I want to remind you again that this room is video monitored.”

The guard departed and the harsh clicking sound of the door being locked from the outside echoed in the white painted cinder block room. Adam slowly turned toward his son, who was now standing behind the table. Jimmy’s frail appearance and sunken eyes resembled the final days of a cancer patient. His thinning black hair had not been brushed in days; scattered oily strands hung heavy over his forehead. Adam moved his head ever so slightly to one side and Jimmy responded as he had done for years. This was the same nod he would receive from his dad after his Little League baseball games. It simply meant “I am proud of you son, come get a hug.” The hugs were never correlated with the number of hits or errors Jimmy had made; they were always unconditional. This embrace was no different. Adam held his arms out wide to welcome his son; but this time Adam knew his sphere of protection was not enforceable.

Jimmy started to cry, breaking into uncontrollable sobs as his father held him tight. The son rested his head on Adam’s shoulder, “Oh Dad, I’m so sorry. This is not what I wanted. I just don’t know what happened to me. I need you to help me.”

Adam’s thoughts returned to Missouri. He remembered vividly from twenty-five years ago the conversations, actually lectures disguised as chats, he had listened to from Suzanne’s sister-in-law, Elizabeth. “Aunt Betty,” with her soft rounded torso and commonsense love, was a comfort to Jimmy and all of the neighborhood kids as well as to her own. She was the only one who called Adam out on his parenting skills, insisting that Jimmy needed more boundaries. Adam knew she meant well, but was determined to do it his way. Having been raised by parents with an ironclad approach, Adam was not going to make the same mistake. But somewhere in Aunt Betty’s message was the voice of Suzanne, whose essence he continued to feel as strongly as the very first day he had met her. Sometimes he thought Betty was put on this earth simply to provide, in Suzanne’s absence, a female challenge to his male thought process. Adam tolerated Betty’s badgering with calmness and respect, but the nagging did not change his parenting.

Adam slowly released his firm embrace as Jimmy wiped away the tears on his cheeks.

“Jimmy, look at you. Can’t you ask to take a shower?”

“I know. I need to. But it’s been really hard even just to Walk. The doctor finally gave me some medicine last night.”

“What did he give you?”

“Some Clonidine.”

“Anything else?”

“No, they refused. I’m still feeling pretty awful. I gotta get some methadone or something. This Clonidine stuff won’t do it and it makes me feel like shit.”

“OK, but you need to get yourself cleaned up and brush your teeth.”

“I know father.”

“Have you eaten anything? You need to stay hydrated—drink lots of water.”

“I know! I know! I’m not fifteen. But my stomach cramps are awful and every time I eat or drink anything I throw it up. I feel like shit!”

“Sorry, Jimmy, just trying to help.”

It turned out that beyond Jimmy’s physical discomfort, he felt betrayed by his attorney, who had assured him that he would get to see a doctor and receive the necessary treatment much sooner. The delay in getting medication only served to magnify Jimmy’s agony and paranoia.

Due to the promise for more timely treatment, Jimmy had agreed not to contest the delay in his arraignment, scheduled for the Monday morning docket. Although that meant a few more nights behind bars, Jimmy was so confused, frightened, emotionally drained, physically pained, and desperately consumed by his need for medication, he thought he was making the best choice. He would have agreed to almost anything in exchange for some pharmaceutical relief.

“I know! I know you’re here to help; but they could care less about how sick I am.”

Jimmy related how the prior evening the nurse had said, “Here, take this. It’ll make you feel better for a little while.”

“But this is Clonidine, right? Can you ask the doctor if I can get something stronger?” Jimmy countered.

The nurse quickly responded, “You seem like you have some experience with drugs. I don’t think you’ll get anything else, so you best take what the doctor prescribed.”

“Hey, wait a minute. I have rights too. Th is pill might take away some of my sweating and stomach cramps, but it makes me dizzy and doesn't do anything for my shaking and it never stops my vomiting. You’re a nurse — you ought to know that Clonidine only treats the symptoms a little bit and your blood pressure can drop and make you feel dizzy all the time.”

“Young man, I think your rights were put on hold when you got yourself arrested,” the nurse snorted. “You’re lucky you’re getting anything!”

Adam, as an Emergency Medicine physician, understood all too well the ironies of medical treatment of the incarcerated drug addict. Once the addict is behind bars, the criminal justice and penal systems, despite their mandate to rehabilitate, turn a blind eye to adequately treating the prisoner. The result is an uncooperative, agitated, disoriented inmate, who upon release back to society returns to drug abuse, creating the revolving door of crime.

There was much for Adam to understand and Jimmy was not helpful in this regard. Adam assumed Jimmy’s arraignment had not yet taken place, and as a result did not ask his Emotionally fragile son about it. Jimmy never mentioned the conditions set forth by the judge at the hearing that morning, to which Adam was oblivious as his early morning phone message to the attorney had not been answered.

Adam reassured his son that he would not leave the island until there was clarity on the issues and a plan in place, but as Director of Emergency Medical Services at Kansas City Memorial Hospital he had responsibilities he needed to return to, especially after having left on such short notice.

“Now, Jimmy, you know not to speak with anyone without your lawyer being present.”

Jimmy acknowledged the succinct advice but his emotions overcame his reasoning, “Yes father, but I don’t think the lawyer knows much of anything. I don’t like him and I don’t trust him.”

“I’ll speak to him. Remember, don’t talk to anyone!”

Adam was confused and irritated by the legal Procrastination. Possession of drugs in quantities determined to be for personal use, which was what Jimmy had told him was the basis of his arrest, was not such an unusual or egregious act to justify the delay of an arraignment for three days.

Jimmy, trying to control his spasming muscles, apologized again, “Dad, I’m so sorry for causing you this inconvenience. Please forgive me.” They embraced one last time before Adam pushed the red buzzer on the wall.

On the way out, Adam overheard the jail guard talking on the phone, “This guy from away is in the clink for selling drugs. You should see him. He’s a mess.”

Adam paused as he registered the comment: was Jimmy being accused of being a “drug pusher”? It would not be long before Adam would have welcomed as a blessing the charge of possessing drugs for distribution as the most serious accusation against his son.

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As a new author and an "old" doctor, I wish to extend my sincere thanks to all of you (established authors, fellow physicians, dedicated social service folks & more) who have offered support to my goal of becoming an established author - but even more importantly thank you for your support as it relates to getting the message out that the disease of addiction is an equal opportunity disease, that it has no socioeconomic boundaries! I hope that by creating a medical murder mystery/legal thriller readers will be enthralled and educated, but without the encumbrance of heavy scientific jargon. 

Unfortunately, Amazon does not allow you to read a chapter to get to know Shawn Marks, so here are some snippets of that egotistical yet likable Boston big shot lawyer who can juggle an array of female companions without taking his eye off the legal challenges of his work . . . and now may I present to you Attorney Shawn Marks . . .

Pages 117-119

           The brass name plaque next to the door of Attorney Shawn Marks’s grand office was the polar opposite of Rob Hanston’s faded sign. The big city lawyer looked the Bangor attorney straight in the eye with a “you have my full attention” look while Hanston relayed the details of Jimmy’s case. Occasionally Marks glanced Adam in an attempt to convey his empathy for a father in an unenviable predicament. But Marks was really thinking about the splendor of summer and fall on Mount Desert Island and the borrowing of a sailboat from an indebted client to provide some additional enjoyment.

At age forty-dreading forty-five like most people dread sixty, Shawn Marks had never been married and had never fathered any children that he knew of. He kept his six-foot frame slim and his heart fit by taking weekday jogs from his waterfront office to the Back Bay. His routine never varied. He left his office promptly at 10:00 a.m., and ran mostly along the Freedom Trail, passing by Paul Revere’s House, the Old State House, the site of the Boston Massacre, and then the current State House on Beacon Hill before heading across the Boston Commons and finally across the Public Gardens to the Ritz-Carlton where he met his Harvard law school classmate. From there they always walked to the same quaint coffee bar for their jolts of espresso while standing and chatting at the bar like long lost friends. Then they hit the pavement again for the return jogs to their respective law firms—one in Cambridge near MIT overlooking the Charles River and one on Boston’s waterfront.

Since Marks’s day started at 4:00 a.m., when he woke to his blaring alarm, by the time of his jog he had already put in nearly five hours of rigorous work. A midmorning endorphin rush was a prerequisite to successful completion of his remaining eight hours of work. It is hard to get anything accomplished in less than thirteen hours was his motto. After returning from his jog, he almost always headed directly to the private exercise room within the law firm suite. After a hundred sit-ups and forty push-ups, and a quick shower, he settled back into his desk chair before noon to enjoy a low-fat yogurt drink—always peach flavor—as he disappeared back into his legal world.

Sundays Marks worked from his Swampscott, Massachusetts, home, but Monday thru Friday he took the thirty-minute commuter train ride and five-minute taxi trip to his office. Sometimes he walked to the office from the downtown Boston train station, but it generally made more sense to take a brief taxi ride: at 5:00 a.m. there is not much traffic in Boston. On Saturdays he always drove his 1987 Porsche 911 Cabriolet convertible to work, leaving the house at a luxurious 7:00 a.m. for the exhilarating ride to downtown Boston, arriving at his leather office chair in twenty-five minutes, door to door. The Saturday workday had no intermissions and no jogging escapes, just yogurt and nine nonstop hours of mental grinding. He arrived back home by 5:00 p.m. for one hour of yoga and a long Jacuzzi before a social evening: first to wherever paying clients were treating him to a superb dinner and thereafter, more often than not, he was free to chase one of several women he fancied around the Saturday night dance floor of life.

Marks was a man who left nothing to chance. He never outright lied but rarely did he volunteer information in his relationships with women or in the courtroom—always maneuvering, constantly working to get the upper hand. He was a master of manipulation as was evident from the second one entered his office. The coffee table in front of his office leather couch was adorned with original drawings of Marks at the helm of a sloop at least forty-five feet long, next to photographs of Marks with Bill Clinton and Tony Blair, and of course the obligatory copies of the Harvard Law Review. Not just a couple of copies, but a dozen or more, dating back a decade or so, with each copy carrying an article his legal staff had authored but that always listed Marks’s name first.

 Pages 162 – 163 

…Marks had not considered a first-date sleepover as an available option and therefore was not prepared for the morning race to the airport. He had felt a paralysis as he looked at Samantha Kotts, the former and never to be referred to again, Ms. Snoot. He had enjoyed lingering in bed next to Samantha, still asleep, lying on her side facing him, soft auburn hair draped gently over her forehead and sheet clinging to her mid back, exposing her youthful velvet skin. It was very difficult leaving Samantha Kotts behind, as he dreamt about spending a morning in bed with this spunky lawyer, especially after a night like the one from which he was recovering. Marks was at peace with his frustration of having to leave; he knew he had laid more groundwork than ever anticipated. After a peck on her cheek and with coffee in hand, he headed down the steps to the cobblestone sidewalk and into his waiting Porsche. The parking ticket under the passenger windshield wiper served as a reminder that everything good in life comes at a price. He had never wanted to pay the price of a day-to-day monogamous relationship despite the positive benefits. But what Marks felt that morning as he looked at Samantha made him uncomfortable. The $60 parking ticket was a small price to pay compared to the emotional price of a committed relationship. Marks avoided being distracted by his feelings, as he wanted to focus on the euphoria of the moment. He seamlessly slipped back into denial, as he regressed to a prior stage, putting the convertible roof down to celebrate a great evening with the rest of the world. Shawn Marks was thirty again!

Marks had to abruptly shift gears when he became aware that the extra time he had spent next to the sleeping Samantha had left him running later than he first thought. During his unnecessary drive to Swampscott, he called the pilot and delayed departure. Marks did not have a clue that Samantha would soon end up as a factor in an approach-approach conflict, complicating his life further. In psychological terms, an approach-approach conflict occurs when one is presented with two apparently equal and favorable options, but can choose only one. Marks always seemed to be able to balance life’s many options, and by doing so avoided or at least postponed being tormented by the need to make choices, especially those of the approach-approach variety. If anyone could have their cake and eat it too, it was Shawn Marks...

 Pages 177- 178

         “Hello, James, I am Attorney Shawn Marks and I am here to introduce myself and to let you know that I, along with Attorney Robert Hanston, and with the assistance of your devoted father, plan to defend you and attain an acquittal of the murder charges that have been wrongly placed upon you. However, in order to reach the desired verdict, we must have your complete cooperation. You must not hide any facts from us and protecting yourself or others will put your freedom in jeopardy.”

Then Marks broke with the niceties and leaned forward across the small table and placed his nose about ten inches from Jimmy’s. “Really what I’m saying, Jimmy, is your ass is on the line and where they’ll send you if you’re found guilty won’t be pretty . . . So now that we've cleared up that issue, let’s clear up the issue of your honesty. You cannot lie to us. If you lie to us, you may spend every remaining day of your life in jail. Do you understand?”

Before Jimmy could respond, Attorney Marks reiterated as if questioning a witness in court. “Let me repeat the question. Do you understand that if you lie to us, if you do not tell us the entire truth, we will not be able to appropriately defend you and you will probably end up spending the rest of your life behind bars—cooped up in a jail cell about half the size you’re in now, with a cell mate, a cement floor, no windows, and a toilet in the corner? Is this what you want?”

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Okay, here we are the baby boomers (let's call ourselves the "BB's"), as we are not so much babies any more - we range in age from  49 to 67... and yes, that includes me.  We, the BB's, according to the data, use significant amounts of illicit substances – and no I don't mean just "pot" which is a whole other topic.  Drug abuse is surging among BB's - for adults aged 50 to 54, use of illicit substances more than doubled from 3.4 percent in 2002 to 7.2 percent in 2012. For those aged 55 to 59, it's at about 6.6 percent. And what is the most commonly abused drug in the over 50 age group – not weed but a combination of opiates (codeine, oxycodone, other pain pills), and benzodiazepines (valium, ativan, other tranquilizers) with alcohol.

So that's our problem and we better deal with it or expect an array of medical complications!  But how about our kids when they were teenagers?  What messages did we send?  We were influenced by Vietnam, Woodstock, the Free Love Era of the 60's – you know – to hell with the establishment!  Did that carry over to how we raised our kids? Did you ever struggle with your kid's best friend's parent buying or smoking weed with your own kid? Did you openly smoke some pot yourself, so the messages you gave to your kids were confusing at best and duplicitous at worst? And now, how are our kids raising our grandchildren – what messages are now being sent?

Even if we are not partially to blame for the current drug use, that does not mean we should just sit back. Heroin is so pure, you can snort it and get high; no need for needles. Molly's (MDMA) the party drug is ubiquitous. Our grandchildren are stealing our codeines and valiums from our medicine cabinets – and do we even have a clue this is happening?  We all talk about the financial deficit we are leaving our grandchildren. How about the health deficit.  It is time to get out of our rocking chairs and take some action – to hell with "I just don't like confrontation" – take that expression to the grave with you!  Grammy, Gramps: the time to act is now.  Just saying "No" doesn't work – never did!  Get involved and stay involved – and count your pills every day – for your sake and for the sake of your kids' kids!

Please pass along your thoughts – we are all in this together!  And if you read Addiction on Trial: Tragedy in Downeast Maine, let me know if you think Dr. Sedgwick made the right decisions of how he raised his son Jimmy, who became a heroin addict and later in life was accused of murdering Annette.

Thanks for reading this,

Steven Kassels, M.D.

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Read about Mental Health Parity and Addiction Equity Act (MHPAEA) at:  Link for article

“MHPAEA intended to level the playing field by equalizing coverage for mental health and addiction disorders with that provided for other chronic diseases”  Click here to comment