When Addiction Medicine Hits Home: a 24 Year-old Friend ODs

An old friend of mine died a few days ago from a drug overdose. He was 24 years old.

He lived just up the street from my home. I knew him for most of his life, and he was sparkling as a child. My wife and I have been friends of his parents for decades, and I worked as a nanny for “the kids,” as my wife and I called them.

My first stint was when he was two, and his brothers were four and six. He was cutest two-year-old I’ve ever known. He was happy, funny, sensitive, and had a remarkably developed personality for that age. He loved to laugh and play, and one of his most amazing features was his sense of empathy, which I’ve seldom seen in a two-year-old.

A great example of this was when I first started nannying for him. I was learning the kids’ schedule routine, and on day one when it came time for him to take his mid-day nap, I had no idea how that process worked. So he showed me.

He went to his crib and stood ready to be hoisted in, so in he went. But I could tell as he stood and looked up expectantly that clearly there was more to this whole thing. He sensed my unsureness and cheerfully said “binky!” His blanket was on the floor of the bedroom, so I quickly fetched it and presented it to him. But there was more.

He again looked up at me with his eyebrows furrowed, in need of more from me. “Bobby!” he said enthusiastically, and away I went to get his bottle. He took it from me, laid down in the crib, got himself cuddled up in his blanket, put the bottle in his mouth, and beamed up at me. He looked proud of me, and his smile seemed to be a look of reassurance for me, a signal from him that I had done a good job.

I continued to be around him and his brothers frequently over the years, and while I loved them like my own, they certainly could be a handful. I later did another nanny stint, and the little guy was six or seven. He was still happy and chipper, and early on he developed what sounded like a New York accent, which was amazing because no one is in his life had a similar accent.

He was earnest and engaged, and often offered hilarious observations. Once we were all watching TV, the kids, his dad, my wife and me. We had a habit of turning off the volume during commercials, trying to avoid the annoyance that they create. After a few times doing that, the little guy strongly objected, making an emotional appeal “If we can’t hear the commercials, how am I supposed to know about all the products?” We all burst into laughter, but he was very serious about this.

When I nannied for them the second time around, we’d traipse around the city trying to find ways to keep them engaged and occupied. Sometimes they were impossible to corral, particularly in the car. He was annoying his brothers in the back seat, and after about the fifth warning, I said “OK, that’s it, no TV this afternoon for him,” and he burst into the most dramatic tears I’ve ever soon, sobbing uncontrollably. One of his older brothers quickly weighed in, saying “Jim, I think that’s unfair, I don’t think what he was doing should result in such a strong punishment.” All of this coming from kids between five and ten. I weighed the testimony, and agreed to reverse the no-TV edict. The little guy looked so happy to hear the news that his sentence had been stayed. And on we went.

We introduced the “high-five, handshake, or hug” exit process at some point, so when I left every day, the kids had to choose one. They liked it, and they’d often mix it up, it was up to them. I’d be ready to leave, and walk up to them and he would beam at me, usually opting for a high-five.

As the kids got older, they wanted to play on the local youth football teams. We kicked it around with his parents, and it was decided that they could do this, but that to do so they would have to sign contracts, agreeing to do specific tasks around the house, tasks that they, like most kids their age, were not anxious to perform.

So I typed three contracts, each spelling out the obligations that playing football would mandate. I met with each one individually, and got to the little guy last. The older boys were glad to sign the contracts, and when I made sure they clearly understood what they were agreeing to, they had no problem. But the little guy was a little more hesitant. As we went over it, discussing each item, he started to look a little worried. “You mean if I sign this and play football, I have to help put laundry away every single day?” “That’s right,” I replied. “You don’t have to sign this, but if you want to play football, this will be necessary.” He paused, looking down at the piece of paper, then smiled and said “OK Jim!” and signed the contract, leaping up from the table and running back out to the yard to play.

The contracts were all kept in a little black binder, and when the kids would balk at helping with chores, I’d have them sit down with me at the table, and would pull out the contracts. “As you see here, you made an agreement to do this” I’d say sternly, and the little guy would grimace, shake his head and exclaim “man!” But he’d get up and get to the chores.

I work in addiction medicine in a methadone clinic, with people who are addicted to heroin. Most of them get better, stop or reduce their heroin use, and become more functional. But the saddest ones are those who are not able to get better. Some of them die, and it’s hard to deal with that.

But it’s nothing like dealing with the death of my old friend the 24 year old. Nobody is born with addiction, and it’s so hard to think of him as a sparkling, vibrant, happy little dude who taught me how to put him in the crib. I think the same thing sometimes about my patients, and try to imagine them as little children, and wonder how they ended up sitting in front of me in a methadone clinic. But I didn’t see them then, so there is more distance that with the little guy, who I still see laughing or crying so quickly, who I see running athletically through the park, who I see riding his bike for the first time with a look of determination and glee, who I see ice-skating like a champ the first time he put on skates, and who I see coming up to me as an adult, and enthusiastically saying “Hey Jim!” with the deepest voice you can imagine, looming over me with his notable height, and with his arms extended wide for the mandatory hug.

And now he’s gone from a drug overdose, and it’s just hard to accept. So I pledge to keep him in my mind every day, and make my work with others who suffer from the same disease dedicated to him, the coolest little guy I ever knew. See ya in heaven Lu, and when I do, it’s your choice: high-five, handshake, or hug.

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