I only went to one heroin overdose this week and one PCP overdose. The heroin overdose was on Park Street in the South end and the PCP was on Capen in the north end. You get get called for an overdose on Park Street and it is pretty much always heroin. You get called for an overdose at Garden and Capen, it is going to be PCP. The North end is mainly black, the South end Hispanic. The blacks control the PCP trade, the Hispanics most of the heroin. There is some mixing, but that is pretty much the divide. You go to Keney Park in the north end, and you find lots of tiny empty clear plastic baggies with no markings. PCP. Not too many heroin bags. You go to Pope or Colt Park in the South and you will find empty glassine envelopes with stamps on them marking the heroin brands. In just one month of looking, I have already counted 96 different brands (some of the envelopes are likely months old (one was branded Super Bowl 50), others freshly tossed from the car window where the junkies sit low in the seats shooting up, and chilling before driving off). Some brands I have only found one of, others are scattered everywhere, often in clumps of five or more bags. I find it fascinating to see what brands are the hottest. Black Jack gave way to OMG, which gave way to Chief, Public Enemy, and now to Fastrack, which we found in nearly every location we looked last week. Who knows what next week's hot brand will be?
The heroin overdose I went to was a woman I had treated before. She had gone into a public restroom and not come out. When the first responders got there, she was unresponsive and blue. The fire department gave her 2 mg of Narcan IN. By the time we got there, she was already in the back of the BLS ambulance, breathing on her own, and rousable with a good shake. She was in her thirties, wearing a short skirt and a low cut top with a pushup bra. At one time had obviously been good looking, but there were hard miles on her. She had cellulitis and abscesses on her arms and a bad ankle that had never healed right from a fall. When we put her name in our laptop, her address came up in as a Hartford suburb, but she said she was now homeless. I tried to ask her some questions about what brand she had used, but she kept nodding off. She was at least able to identify the Fastrack brand from the picture I showed her on my iPhone and say she heard it was dangerous. She told me she bought from her usual dealer. I asked her again what brand she had used, and she said she was trying to remember, then she nodded off again. I let her sleep. Her ETCO2 was 42 and her SAT was 96 on room air, her respiratory rate was 14. Power to her. At the hospital, they said they were going to give her more Narcan. I guess they were pretty full and didn't have a sitter to watch her sleep in case she started hypoventilating again.
The first time I picked her up was in front of the shelter at Hungerford and Park. The police officer who flagged us down said she was drunk. She was motherfucking him to beat the band. My BLS partner said he would tech the call, and after having teched the first nine of the day, I let him. I drove to the hospital and saw him typing the PCR on the computer. When we hit the hospital, and pulled the stretcher out, she was cyanotic, and breathing maybe four times a minutes. I shook her shoulder and she roused enough to tell me to fuck off. I saw the fresh needle mark on her right hand then, the pin point pupils, and was upset with myself for just assuming she was drunk and not taking a closer look just walking to get in the driver's seat when my partner offered to do the call.
I debated pushing the stretcher back in the ambulance and giving her Narcan then, but since she was rousable we just brought her in. Unfortunately the triage line was long. Every couple of minutes I had to shake her hard to get to breathe. After awhile, she stopped swearing at me, and I had to cut to the front of the line and ask the triage nurse for either Narcan, an ambu bag or permission to go back out to the truck to get my gear and treat the patient in the their waiting line. They wanted us to bring her to the critical room, but I said she just needed a little Narcan so they finally gave me an ambu bag and a room down the hallway where a nurse practitioner asked us what the dose was. We told her to start low. They gave her 0.4 IM, and took over bagging. I thought next time I would just go back out to the ambulance and get my gear. We saw our patient later smoking a cigarette in front of the ED, the hospital ID bracelet still on her wrist. She didn't recognize us.
I wanted to go back and talk to her after we left her in the room this last time, but we didn't get back to that hospital till four hours later and she was already gone. I went back to the restaurant where she had ODed in hopes I could find the wrappers in the bathroom, but they had a men's and a women's bathroom, and you had to get the key from the guy making the sandwiches. I chickened out and asked for the men's room key after buying a turkey sandwich. I suppose I should have just come out and said I wanted to look in the woman's room to try to identify the brand the woman had ODed on. I did find two wrappers in the men's room, but they were blank. Not all the bags have stamps on them.
I have seen her a few times walking along Park Street, particularly in the early morning when the bakeries are just opening up. They sell pressed bologna sandwiches real cheap and there is often a line out the doors. One of the bakeries sells a pernil (pork) cubano for only $3. I try to get one if the line isn't too long. Some mornings they sell homemade tamales wrapped in corn stalks. $0.75. They are run by honest people, and feed many in the community. There is drug dealing close by but that comes with the territory of Park Street. Everyone likes sandwiches and cheap coffee and a friendly smile in morning. Cops eat there, EMS eats there, working folks eat there and drug dealers, junkies and the homeless eat there. We all have our roles. Such is the community of Park Street, the community of Hartford.
