by Robert Lanz, LCSW
I was hoping to think of a kinder euphemism for a pair of brothers from New York but I wasn’t able to do it. I’m sure some readers will take offense and attach some clinical label to their behavior that will somehow provide cover for their deplorable acting out. Wherever they went, everything they did was self-destructive. And expensive. Expensive jail time. Expensive “upstairs” in the hospital time. Very expensive ER time. They were unrelenting goofballs and in the end, both dead. No surprise to anyone.
If they could have gotten their money back for all the tattoos they paid for maybe they would have stayed indoors and lived a little longer. More likely they would have just gotten more stoned on whatever drug was available to them when they woke up. Indoors to them was jail and the hospital. Why spend their own money on food and rent when they could just spend yours? A good investment to you would probably be something safe like a muni bond that paid four percent. A good investment to them would be to get together enough money to buy a big chunk of black tar heroin — wholesale, so to speak. Not that they would have dealt any of it; they would just have had more to shoot-up at relatively cheaper prices.
But they never had that much money, certainly not enough to stay loaded on the tar. No problem. When there was no tar, there was Vicodin. No Vicodin, then there was Xanax or some other benzos. No benzos, no problem. Any anti-psychotic would work, or even alcohol in a pinch. It wasn’t so much where they were going to end up, anywhere was better than where they were when they woke up: sober. Sobriety was the worst place for them. Sobriety in jail. Sobriety in the hospital. Sobriety in the dumpster. Location meant nothing compared to sobriety.
They were too arrogant or too stupid or too stoned to realize, that sometimes the world in its perfection, needs to collect a debt for bad behavior. Someone owed a life or two, and it was time to pay. These pseudo-biker, over-inked tough guys had moved to the head of that line with bad choices and bad behavior. They were due to make a payment and everybody knew it.
Somebody smelled the decomposing body of the older one in the dumpster behind a convenience store on the east end of town. The needle in his arm was a not-so-subtle clue to the cause of death. The younger brother took it like he took his whiskey: hard. Drink enough-and he already had a near lifetime of practice-and your liver develops the scarring of cirrhosis which diminishes its filtering ability. Toxins build up in the body. The portal vein backs up and causes esophageal varices, which leak blood down the throat and into the stomach. Blood is such a strong irritant that outside of its vessels, it causes severe discomfort and irritations that leave the stomach in pain, and a frequent reason for alcoholics to come to the ER to get pain meds.
“I’ve knowingly drunk myself into alcoholic gastritis and now I want you to give me some synthetic heroin so I don’t have to feel my pain.”
The bleeding into the stomach causes the stool to look like, well, the tar heroin that killed the older brother. I believe that this may qualify as irony. After the liver stops working effectively, the pancreas gets involved. Much worse than alcoholic gastritis, I was told by several patients with pancreatitis.
When I was in the cancer hospital I met a couple of guys who had pancreatic cancer. Both had been heavy drinkers. Both were on high doses of opiates, addiction to drugs being the least of their problems. Oh yeah: both of them looked really sick. Context is everything. When you look really sick in the cancer hospital, it is ominous. Arms like spiders. A belly like a pregnant man. Sunken dying eyes. Skin the color of a banana or worse, like someone who tried to self-tan in a vat of carotene.
That’s how the younger brother ended up in our hospital. The resident caring for him in his death throes late at night called me up to his room. Just prior to my arrival he had mustered his last bit of strength to get out of bed, pull out his IV’s and blow chalky stool laced with blood all over the floor before the nurse could respond to his alarms. They were still cleaning him up, in restraints now, when I arrived.
“He’s fading fast, Bob. Not much left for us to do. Try to make him comfortable with some morphine. Does he have any family or anyone to contact?”
“No family I ever knew about. Just a brother who died in a dumpster a few months ago. No friends, either. Nobody liked him. But the morphine part, he’d like that.”
After about half a million bucks of jail and hospital time, that’s how he died. Slightly better than in a dumpster. Only slightly. Thanks to opiates, I guess they both died in peace.