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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