Wednesday, May 27, 2015

"We have met the enemy, and they are ours"

There is great opportunity for practice while working in an emergency department.

For example, some of my greatest teachers have been people who come into the ED specifically requesting narcotics or other controlled substances. I learn more about my own biases with each encounter.

I do feel that in certain times and in certain people, these medications are necessary, or at least quite helpful to alleviate suffering. However there are people that come to us requesting them specifically either due to addiction to them, wanting to sell them on the street to make money (often for even more addictive substances), or for reasons unknown. There's nothing that sparks judgmental mind for me faster than a "drug-seeker", as they're known at work.

Having worked in emergency medicine for thirteen years, I can spot someone with unskillful intentions pretty quickly. My own anxiety kicks in as I anticipate the eventual confrontation that  comes about when I say, "No, I am not going to give you a prescription for xxxxx". Sometimes the person realizes they've been caught (as we have ways of seeing what prescriptions people receive) and gives up without a fight. More often, there's some sort of a fight. It may be lies, tears, or belligerence, or all of the above. Usually it's an uncomfortable situation no matter what.

So recently this scene played out at work, and I realized later that there was no compassion present in me at all at the time (and we won't even talk about equanimity). A teacher and friend had made a comment online about having compassion for a snake, and I realized that compassion for a snake arose much more easily than compassion for this particular person I had just dealt with. I can wish this person well without much difficulty, but compassion was much harder to bring to mind.

Looking at this today, I put myself in this person's shoes. What horrible kamma they must have to be addicted to a drug, and spend their time going to various emergency rooms (and waiting for hours in the waiting room) to attempt to get prescriptions they can use or sell for another. Each time risking getting caught, risking getting thrown in jail, or risking death if they take too much drugs. What a hell realm!

I also remembered that we all are looking for things that we think will make us happy. They may not be narcotics, but whatever conditioned things they are, they make us "high" for a period of time, but inevitably there's the crash, and all the suffering that comes from our unskillful ways of seeking them out. I realized that many of the things I've sought in life have been very transient, and that my unskillful habits of seeking them out have brought a lot of suffering in my life. For example, I think many of us have that desire to be liked by those around us. Where has holding on to that as something we "must" have brought us? I don't think I'm alone in suffering for that one.

So in a way, I am also a "drug seeker". I am this person, grasping for something that I think is going to make me happy. While I thankfully have the kamma to know that the unconditioned is there, and is a much better "fix", I still find myself in samsara.

As I reflected on some of these things, compassion began to arise. I'm not going to say that my compassion for the patient is yet up there with a cuddly puppy, but it's a start. Hopefully this process will come to mind the next time there is another patient like this at work. We shall see. I probably won't have to wait long...

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