2003, Milwaukee, Wisconsin

By Mia Whitcomb

Little girls race across the pool, skinny arms and legs flailing against the choppy water. But I don’t really see them. I see a child I pray will have this chance, or any chance. Reasonably, I know it isn’t likely.

When I met Sam, she was perched stiffly on the edge of a dirty, orange-brown, torn and patched vinyl bench, of the type that clutter waiting rooms where the indigents seek help. Her feet swung back and forth, barely grazing the stained linoleum. Her eyes flitted around the room before coming to rest on her mother’s ravaged, tear-stained face. It wasn’t Sam’s straight carroty orange hair, cut in ragged shingles that fell in a tousled thatch to her shoulders, that caught my attention, though that was an unusual sight in this crowded inner city free clinic. It was the smile that slipped fleetingly across those solemn features, dispelling for a moment the terror that crimped her small face.

When I was asked to participate in a family drug intervention meeting, I was prepared to be a disinterested observer, offering my opinion only if needed. I was just backup support. In my work, I see the usual spectrum of life, people with physical ailments that twine through their jobs and families until it is difficult to separate physical, psychological, and emotional. So, when a close friend asked if I would be willing to be present when he and his family dealt with his sister’s drug addiction, I agreed.

I was prepared to assist them in sorting out the often confusing advice of the physician, and stand beside them when they made the tough choices I knew they would face. Then I met Sam, and all my preconceived ideas about tough love solving our country’s drug abuse problems came cascading down around me.

During the hour or so that we sat together, I stole furtive glances at Sam, admiring this three-year-old’s ability to push her fears into some back recess of her mind as she sat beside a strange lady in an unfamiliar place while her mother disappeared behind the heavy wooden door for yet another “Well Mommy Checkup.”

Mostly, Sam’s eyes lingered on the door, but once when her gaze whipped around the room, she spoke. “So many strangers here,” she intoned flatly. Then she became quiet and listened to the problems of Curious George, the little monkey whose life was in a constant flux. Looking up from a picture of George in a hospital bed, she whispered, “If it was me, I’d scream.” Her little voice confirmed what I’d heard about the way she dealt with the chaos of her life.

By the time Meg returned, shaking and in tears, I found myself wondering how I could protect Sam from the terrors that filled her days. The doctor who led Meg into the room explained that since she had been off drugs for four weeks, Meg was no longer a candidate for acute inpatient care. She was being referred to an innovative women’s facility specially suited to her needs. Her appointment was scheduled for the following morning. Her brother, who had taken her into his home, had finally recognized that Meg’s problems were greater than his ability to solve with an open door, time, and love.

Lacking both employment and insurance, Meg was dependent on public aid. A brilliant woman, with a borderline personality, she was adept at steering the series of interviews toward the result she sought: a comfortable place to live, preferably with a family member who would care for Sam while Meg attended periodic outpatient counseling sessions and pursued her “spiritual recovery.”

Unable to handle Meg, her brother asked if she and Sam could spend the night with me. I reluctantly agreed.

While Meg gathered their meager belongings, I spoke with her brother and Meg’s grown daughter. Pregnant, Meg had run away from home at 16. Her first child was followed rapidly by two others. Her grown daughter sobbed as she described her mother’s daily stoned affect, dating back to her earliest memory. Though they ultimately divorced and her husband gave up the merry-go-round of weed, LSD, cocaine and alcohol, Meg continued in her addictions.

When she was 46, Meg met an older man with four grown children. Once again she became pregnant and remarried. The honeymoon was short-lived; an alcoholic and part-time plumber, her second husband was frequently gone from home for extended periods while Meg remained, coping with a small child, his absence and lack of funds with drugs and alcohol. Time was marked by his sudden reappearance, violent temper, and physical abuse. In desperation, Meg turned to her family.

The first days were punctuated by tears and promises, but the situation rapidly disintegrated. Sam regularly wet her pants, undressed in public, and succumbed to screaming tirades while Meg lay on the couch in tears. This had become a ritual. Throughout her adult life, when things got bad, Meg called home or arrived on her family’s doorstep, remaining until she got the money she wanted and then vanished. Her family had sent her money for a certified nursing assistant program, but she spent the tuition money on drugs. Tough love, the doctor assured the family, was the only chance of making a difference for Meg.

The next morning I accompanied Meg and Sam to the women’s shelter where her brother and grown daughter waited, looking shell-shocked and desperate. This was their last chance. If admitted, Meg and Sam would live at the center, receiving health care and drug counseling, education and career training for Meg and day care for Sam. Before she went in to be interviewed, Meg whispered, “I’ll say what they want this time so they’ll have to take me.”

She returned in tears. She had been accepted into the program, but there was a wait time of one to four weeks. In the meantime, the program director wanted Meg to stay in a nearby homeless shelter where she would get food, daycare for Sam, and outpatient counseling. This, the counselor said, was best for Meg. She explained that while her family wanted Meg to enter the program, it was Meg who must make that commitment. Residing in a homeless shelter would strengthen Meg’s resolve. She would be nearby, begin counseling and check in every few days until there was an opening. One of the key ingredients of the program, the woman explained, lay in helping women take ownership not only of their addictions, but of their lives. This was the first step.

“What about Sam?” My heart lurched wildly as I looked at the counselor. “Couldn’t I take her?”

“And what will that do to Sam?” The woman’s voice was soft, her empathy palpable. “Meg may be here for up to a year. If Sam becomes attached to you for the love and care she needs from her mother, it will be much more difficult for her later. Sam will be Meg’s reason to succeed,” the woman spoke confidently, “and Meg will become the mother Sam needs.”

The counselor repeated the words she’d spoken countless times, “You have to give her that chance. Sometimes the only thing you can do for someone you love is to let them go through their pain, until the pain of remaining the same becomes greater than the pain of getting help.” She stood. “Meg, you must attend all outpatient meetings and check in daily, or you will be removed from the list. Good luck.”

Before entering the homeless shelter, Sam and her mother spent one more night with me. Sam had taken to following me from room to room. Dragging my children’s discarded toys with her, she would plop at my feet to play, her childish chatter a delight to my ears, so accustomed to the quiet imposed by children long gone from home. I knew I would have to put some distance between us. I set Sam at the kitchen table with crayons while her mother lay down to rest on the couch, and I occupied myself with my normal routine: a quick call to check on my elderly mother, a return call to a friend inviting me to dinner, and a review of my next day’s schedule.

Sam must have sensed that something had changed, because when dinner was over, she snuggled on my lap for a moment, then went to stand next to her mother’s chair.

“Jena’s a bad baby,” she announced. “I take good care of her, but sometimes when I change her, she pees all over - on purpose.” She prattled along, her thin fingers moving rapidly through the air as she changed the imaginary child. Meg leaned back in her chair.

“Jena and Tina are her imaginary children,” she whispered over Sam’s bent head. “She hasn’t talked about them in a long time.” She shrugged tiredly as she closed her eyes.

The next morning, they were gone. Not to the homeless shelter. Meg called a friend before I woke and talked him into giving her the money to leave. She said she would return to a city where she has friends. A place where she claims there’s a promise of a new start. A new start that is just one in an endless stream of new starts for Meg, but could be the beginning of the end for Sam.

Meg cried when she left, begging me to have faith in her. She vowed that while she was returning to her old friends, she believed this was a spiritual quest and she would be able to withstand the inevitable temptations and remain drug free. Even though she is a high school dropout, she assured me she will get a good job, and after a little while, find a small house with a garden for herself and Sam. Her glance out of lowered eyes was defiant; her words, half-whispered, were meant to sound convincing.

I wanted to gather Sam into my arms and keep her safe. Instead, I watched as Meg buckled Sam, shrieking, into the backseat of a taxi. If I had ignored the counselor, and taken Meg and Sam into my home, if Meg hadn’t felt cornered, Sam would be here with me. But somewhere, sometime, Meg would have found the money. She and Sam would have vanished once again. Tough love. Her only chance, gone.

Today is Saturday, my day to help at the local pool. I sit in the bleachers watching the little girls shivering as their mothers swaddle them in oversized towels, brightly decorated with ocean scenes and mermaids. I study the look of pride that flashes in their eyes as they hold up their ribbons. Instead of these strangers, I see Sam. I try to block her carroty orange hair, freckle spattered face and bright green eyes, from my mind, but she is always there and I wonder, when will it be Sam’s turn?

Mia Whitcomb is a physician living in Mequon, Wisconsin. She enjoys writing and reading and plans to celebrate her 50th birthday by running a marathon.

Posted by Elizabeth Armstrong Moore on Wednesday, March 28th, 2007 | Email This Post

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