By Dr. Anant Shukla, MD
On a cold, wispy December night in 2014, my high-school friend Jake and I were catching up at a quiet local bar in suburban Massachusetts, watching from a corner as a handful of regulars, along with college students and young professionals back for the holidays, caressed their beers and discussed upcoming plans.
The atmosphere exuded joy and reunion with Christmas music playing faintly in the background and red and green holiday lights dangling from the ceiling; it felt great to be home. For both of us, coming home gave us a reprieve from the hustle and bustle of Washington DC where Jake had just graduated from law school and I was in my 3rd year of medical school. We were meeting a fellow high-school classmate, Taylor who still lived in our hometown. We had all grown up in this quiet, picturesque, affluent New England suburb, which epitomized a utopian view of a successful community.
Doctors, lawyers, and executives lived in large gated homes in this town, where winding, perfectly paved double lane roads were scaffolded on either side with towering oak trees. Our town provided its inhabitants with the luxury of privacy and security by having no street lights and only one stop-light. The youth of this town, surrounded by driven and motivated parents, grew up with the expectation of success. Not surprisingly the local high-school had become one of the best in the country, secondary to the tremendous financial and social support afforded to it.
Graduates of the high-school went near and far for colleges, and then jobs. In that context, we eagerly caught up on class gossip providing whatever details we knew. As the bar started to close, Taylor brought up a fact that lay in the shadows, away from the joking, and class updates. He spoke hauntingly about the growing use of hard drugs within our community. Like any high-school in America, plenty of students used marijuana and grew out of it following college, but the stories of harder drugs surprised me.
I had, oddly enough, recently watched a documentary about the growing heroin epidemic in the US and specifically its prevalence on Cape Cod. Jake and I looked quizzingly at Taylor, stunned that such a reality could penetrate our picture-perfect neighborhood. We laughed it off making passing remarks about who would buy the next round of drinks if our town was ever featured on the show “COPS.”
Then in 2016, two years later, I learned about the first heroin overdose in my town; it was our high-school classmate, our lacrosse teammate and my art class partner from my freshman year of high-school. The multitude of personal messages, anecdotes, pictures, quotes and stories posted to his Facebook wall resembled a living memorial, and aptly demonstrated the heaviness that lay on our town. I sat from afar in a military hospital, now as a surgical intern unable to comprehend his death. I sent a message to one of my high-school lacrosse teammates just to confirm, and there was no doubt, our teammate had overdosed on heroin, in his parent’s home, alone. The exact details of his death were painful to read in the text message.
I remember being in class with this kid, talking about girls, working on lacrosse drills, and joking around with him. He had an infectious smile and went out of his way to help others. His friendliness and gentle heart always made him wonderful to interact with. Now he was dead. I went back into my Facebook messages to see the last time I had communicated with him was in January 2016 after I matched into residency. He had told me that he was going back to culinary school, a dream he had told me in high-school. Our paths had crossed on the sports field and a few classes, otherwise we had been largely acquaintances.
The last time I had a face-to-face conversation with this young man of 28 years was 10 years ago, in 2006, at our high-school graduation. I shook his hand, smiled and wished him all the best for the future and he wished me well. What happened in these 10 years since high-school? This question kept me up at night, though a natural response, I felt the gravity of the question bore more weight because of his youth and the dichotomy of where he came from to his present circumstance. He came from a loving home, great education, and every set up for a career as a successful chef.
The issue of him becoming a statistic for the growing heroin epidemic seemed unbelievable, but I couldn’t help but wonder if I could go back in time and shake his hand and say, “Hey man, in 10 years you’re going to die from a heroin overdose, so live your life so that doesn’t happen,” would that change anything? Afterall, no one wakes up and says that they want to do heroin, there is a gradual progression down that dark path. As I thought more and more about him, I thought about the forces of the universe that followed him after he graduated high-school.
At each moment and interaction in those 10 years where was the tipping point when the dark demon of addiction laid his hand on his soul. I had not stayed in contact with him frequently enough to have predicted this event or that he had fallen onto this path. When did the attack happen, and can we go back to that moment, with reinforcements, to withstand the assault?
I couldn’t fathom what his parents were going through. 28 years of seeing their son live, filled with trials and tribulations like any other life, confronted and overcome in his childhood home; what a tragedy. My naïve view of my home, my town, shattered the day I learned of his death. It proved to me that the disease of addiction, attacks the rich and the poor. I learned that it can attack in times of hope and in times of sorrow. I learned that the whispering voice of addiction afflicts everyone from celebrities to a kid with whom I took art class with.
I learned how devastating such a death can be to a community, to friends, and to his parents. I learned that the greatest enemy is one that hijacks the self, and slowly destroys the vessel, the body, through need and want, until the rumbling imminence of mortality, no longer rumbles and is no longer imminent but happens. It occurs in McDonald’s bathrooms, rest stops on highways, clubs, and in this case at home. Regardless of where it occurs, the question will always beg at that moment… “How did we get to this point?”
(Anant Shukla is a General Medical Officer in the United States Army. He grew up in Massachusetts and attended Boston University for his undergraduate degree. Prior to attending medical school at Uniformed Services University of the Health Sciences, CPT Shukla was an AmeriCorps teacher in the Baltimore City Public School system. In his spare time he enjoys hiking and writing.
The Author would like to thank Cindy and Dan Wolf, parents of the deceased, who reviewed and provided feedback on the piece. All names have been changed. The views expressed are those of the author and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.)