By Tim Lahey
Two days ago, Jimmy stuck a used needle into the soft skin of his forearm, and released 20 milligrams of black tar heroin and a bolus of bacteria into his blood.
The bacteria floated from vein to artery as he nodded, eventually sticking themselves to the ragged edge of his aortic valve. There they multiplied and burrowed until each systole whipped a two-centimeters of snot back and forth in his atrium.
Fevers came first, which Jimmy ignored while buying more black tar at a rest stop on I-91. A day later, little red stigmata appeared on the palms of his hands as plugs of snot lodged in small vessels there.
When he couldn’t breathe, Jimmy went to the ER. My medical student and I met him there as he shook in bed. A snarl of IV lines snaked under the covers.
Jimmy gave one-word answers to my questions, and did not open his eyes…
Jimmy’s mother cries in the corner. She holds her hands up and open, the way you might receive a baby. Or, the way you indicate helplessness when your baby is now addicted to heroin and shivering in a hospital bed.
Jimmy’s heart is failing. Antibiotics alone will fail him. Soon a surgeon will open Jimmy’s chest, cut out his heart valve, and sew in a new one. I say this as gently as I can.
I also feel Jimmy’s pulse, and listen to his heart. I move the stethoscope over each of the valves of his heart. Pulmonic. Aortic. Tricuspid. Mitral.
The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.