Silent Epidemic (Book 1 - Carol Freeman Series)

by Jill Province

  “We will have to move the remainder of the study away from here," Sam interjected.  “She and the rest of the staff will be far less likely to pick up on anything suspicious if it isn’t right under their noses.” 

  “Don’t you think that moving the study will raise suspicion?" Jeff inquired. 

  “Sure, but it is the lesser of the evils.  We’ll tell everyone that the study was becoming too costly.  That certainly is the truth.  Especially with the delay it caused us in marketing Suprame.”  

  The more Sam thought about it, the better he liked the idea.  Not only was the study a continued expense, but now that they were at the end stage of the study, moving it would be much more cost effective.  He wished he had thought of this sooner.  Sam remembered the little matter of a bank loan he had to finagle to buy them more time. 

  “Your doctor friend has been very cooperative so far," Sam ventured, “and lucky."  

  Jeff just looked at him with tired eyes. 

  “Lucky the medical examiner didn‘t do a more thorough investigation of Angela Porter’s death,” Jeff added. 

  “Well, we returned the favor," Sam stated.   “We managed to intercept a letter our friend, Carol Freeman, wrote to the medical board.” 

  “How’d you manage that?"  

  “We have had someone there looking out for us for a long time," Sam stated, proudly.  “Just another one of my safety nets." 

  “Very impressive," Jeff agreed.

  “So, the doc should be happy about the interception," Sam ventured.

  “Yeah, but the letter would never have been sent in the first place if he hadn’t been helping us out."  

  “You think he’ll help us out again?"   

  Jeff looked up at the ceiling, and said, “Well, there’s only about five weeks left in the study.  Everyone has started the process and we only need for the remaining volunteers to complete Phase Two. Yeah, I think he’d be okay with it." 

  “Good," Sam concluded.  “And while you’re at it, take him out for dinner.  Dominex owes him big time."

  * * * * * * * * * * * * * *

   

  Down the hall from the fire fighters meeting, Jerry Owens read his email.  Thank you, God!  He had been keeping meticulous records of the volunteers’ activities.  He had contacted every one of them and had them all listed by name.  He had documented every conversation, as well as the volunteers’ continued statuses.  He knew which ones had completed the study, and which ones had dropped out.  He had documented whether or not the volunteer had gone to see Dr. Donovan, whether they had taken the “vitamins,” and who had decided to return to the medication.  He had no idea what Sheila was going to do with all this information, but it was solid and complete.  Jerry placed the information into his briefcase and carried it to the elevator.  He had taken the incriminating documentation home with him every night, and now he was removing it permanently.  Its next home would be in Sheila Montgomery’s apartment.  He was glad to be done with it.

   

   

  Chapter 17

   

  Carol was sitting in Buck Speer’s office, trying to control her emotions.  This was her least favorite place.  His office had once been a place of creativity and inspiration.  Now it was a war zone.  Spears had begun to look for any opportunity to discredit or embarrass her. 

  Today, she was accompanied by the entire addiction recovery staff.  Carol had originally conducted these weekly manager’s meetings with Spears one on one. The purpose had been to resolve any problems and to keep Spears up to date on the department’s issues.  Now, with Carol out of the manager’s seat, there had been no newly appointed honcho.  Spears had decided that it was a good way for the center to save money, at least for a while. 

  So, here sat the entire department, moving through the process with the grace of congress.  No one could agree on anything.  Today’s topic: their means of assessment.  Carol had devised the process and the forms they used to assess each patient upon admission.  She had developed this based on her years of addiction experience and the guidelines used nationally by the American Society of Addiction Medicine.  Known as “ASAM," the structure was becoming the most universal language for diagnosis and determined level of treatment within the addiction recovery community.

  It was not a complicated process.  There were always a multitude of options when it came to recommended treatment.  If a patient presented with heavy substance use, suicidal thoughts, and their entire household revolved around drug use, the patient was in need of in-patient treatment.  In English, John Doe needed to be hospitalized, watched carefully, and his return home reconsidered.   If baby John Doe smoked marijuana, felt remorseful, and had Ozzie and Harriett for parents, he probably only needed some outpatient groups. 

  Carol’s assessment process had covered all the symptoms of addiction and all the criteria of ASAM.  Spears had helped her develop it and had applauded the final package.  But since her demotion, the group had been working on a shorter version of the process.  Carol was all for simplicity, but she had found the new version to be so incomplete that she had to use the back of each page for the information the process failed to capture.

  She had just voiced her concern about the new version and the room had become silent.  Carol looked at the other members of the department.  Most of the individuals had been completely clueless about assessment and diagnosis when they came to Newberg Mental health and Carol had personally trained each and every one of them.  The fact that they had an equal voice in this process now was a joke as far she was concerned.  But she understood the new hierarchy and “lowerarchy,” and had been willing to play by the new rules.

  Finally Spears looked directly at Carol, and said, “So, why is it that everyone else seems to be able to use the new format and you seem to be the only one having difficulty with it?"  

  Carol was sick to death of the pissing contest Spears had come to enjoy.  Her immediate thought was that the other staff’s version of “successful use” was questionable at best.  

  Instead, she squared off at Spears and said, “I guess I must have a learning disability." 

  She could hear gasps from the other staff members.  No one ever spoke to Spears that way.  Carol continued to stare at the Center Director, who now appeared to have smoke coming out of his ears. 

  “The meeting is over," Spears said finally.  “Except for Carol.  The rest of you can go."

  Everyone quickly left the room.  When the door had been closed behind the last person, Spears glared at Carol.  She steadied her gaze on him, refusing to back down.  “What the hell was that?" he said finally. 

  “That was a ridiculous response to a ridiculous statement.  You know full well that the staff doesn’t know squat about assessment."  

  Spears did not respond. 

  “You also know,” Carol continued, “that I am the most experienced person in our department." 

  “You are the most careless person in that department," Spears retorted. 

  “Fine," Carol said, standing to leave.  “I may be a lot of things, but my assessment skills are above reproach, and that is what the hell that was all about."  Carol was about to walk through the door, when Spears stopped her.    

  “This is your final warning," he said.  

  She stopped and turned to look at him.

  “What does that mean?" 

  “It means that your insubordination is going to be documented and placed into your file.” 

  “My insubordination was provoked by an attack," Carol said incredulously. 

  “Doesn’t matter," he retorted.  “This is the third and final report.  It’s all I need." 

  “All you need for what?" 

  “To avoid a fourth one," Spears said.  “Now you may go."  

  Carol hesitated at the door and thought about continuin
g the argument but even an inkling of her current assessment of Spears would assuredly bring on the final reprimand.  Instead, she glared at the Director and closed the door behind her.

  Carol was so exhausted and achy her teeth hurt.  She dragged herself back to her office and sat down heavily on the patient’s couch.  She didn’t want to cry or seek justice.  She wanted to lie down and sleep for a solid week.  She sat back and rested her dizzy head on the back of the couch, trying to control the spinning.

  The light knock on her door came a few minutes later.  Carol lifted her head off the back of the couch and said, “Come in."  

  A tall thin woman peered around the door. 

  “Is it safe to come in?" 

  “Linda," Carol said.  “Of course it’s safe." 

  “I am so sorry about what Spears said to you in that meeting," Linda said, soothingly. 

  “Thanks. This has become a regular game with him." 

  “We know," Linda responded.

  Carol sat up and looked at the woman. She had hired Linda herself and had worked with her for only a short time, but knew she was a person of integrity. “Linda," she began.  “Would you be willing to document your view of what took place in that meeting?" 

  “Is it going to come to that?" Linda asked in surprise. 

  “It could." 

  “Well, if it does, I guess you can count me in." 

  Linda Mestry was a nurse.  She could pick and choose her places of employment and had always danced to the beat of a different drummer.  Carol felt sure she could count on her if necessary.  “You are a good friend," Carol said.  “And I won’t forget this." 

  “No problem," Linda said.  “You look fried.  You should go home."    

  “Don’t have to twist my arm," Carol laughed, grabbing her head to convey the painful effort. 

  “As sick as you have been, I really don’t know why you put up with this." 

  “I have begun to seriously question it myself," Carol answered.  She stood and put her arm around Linda. “Let’s both get out of here."

   

  Carol walked Linda to her car, both of them laughing about the antics at Newberg Mental Health.  Carol told her to go on.  She had forgotten something inside. As she watched Linda drive away, Carol slowly turned on her heels, and went back to her office.  The building was fairly empty now, except for an evening substance abuse group that was self-contained in the back of the building.  Carol began to wander the dark hallway, thinking about everything that had led her to this point in her life.

  She had always been driven to succeed.  And despite her terminally rebellious attitude, she had some milestones to be proud of.  Carol had assumed that the counseling field would be a caring and compassionate place to settle in.  But it had not turned out that way.  Just like any other place in the world, there were good people and bad.  The only thing noteworthy about the mental health setting was that the bad ones were full blown lunatics. 

  It was time to re-evaluate her life.  She knew that there was no perfect situation.  No matter where you were, you always had to factor in the human equation. People were capable of such greatness and such destruction, depending on their demons.  She just didn’t feel she had the life force to absorb anymore.  Maybe it was the illness that had drained her, but she thought it was more. 

  She had remained so driven by the proverbial carrot in front of her nose that she had never stopped to think about the capture of the prize.  What would she have, once the target that remained forever-just inches from her grasp was suddenly realized?  The approval of one Mr. Buck Spears?  Was that the final reward?  No.  It had to be more than that.  Carol’s vision of true success was the intangible that could only be evidenced by the people around her.  It would have been nice to feel accepted by her co-workers, even respected, but her greatest measure came from her patients. 

  Recovery within the addiction population is statistically one in ten.  That is a generous prediction.  Carol’s odds had never been in her favor.  She knew that.  So, what was the biggest issue here?  Maybe it was that she couldn’t remember a time when she had not been all consumed by her job.  There was no time that belonged to her.  She had worked so hard for a system that seemed to absorb every waking moment of her time without showing the slightest acknowledgement of her presence. 

  The mental health system was a crowded entity, fighting to stay afloat among the needy, and justifying its presence by going through the motions of treatment. The hard copy evidence of treatment and “well thought-out” plans of action that were required by licensing entities received more time than the patients.  It had to be this way, when annual audits by these bureaus demanded individual documentation for each person, notating their every move, as well as a step-by-step outline of the person’s goals.  These beautifully executed treatment plans were about as applicable to reality as the grand idea of the unicorn.  Realistically, a patient’s only goal was to begin putting one foot in front of the other without falling on their face.  The stream of paper on each patient was a grand illusion that maintained a facility’s license, and most of a mental health worker’s time was required to maintain it.

  In addition to all the paper, the system lacked the manpower and the talent of its workers to ever provide any real change.  Its ineffectiveness not only failed its population, but also blocked them from hope through the tangled mess of their bureaucracy. 

  So, was the problem Newberg Mental Health, or was it something bigger?  This job aside, all jobs had drained her.  When engulfed in full-time employment, she eventually lost the ability to discern where the job left off, and she began.  It was a never-ending cycle.  She got up, went to work, crawled home at the end of the day, drifted off in front of the TV, and then went to bed.  The following day, she would get up and do it all over again.  The weekend would be a time to recover from the endless cycle of the previous week, catch up on all the responsibilities that had been neglected, and would end early Sunday night, because tomorrow was a workday.  And the one question that continued to pop up in her mind was what did she have to show for it?   An aging, lifeless face, and an empty heart.  Was this due to some character defect in herself, or did everyone secretly feel this way?

  Sedative withdrawal had stopped her dead in her tracks.  It had captured her.  The extent of its grip on her soul went beyond her current physical and mental disability.  In her altered mental state, she felt as though it had wiped out her entire existence and her identity.  She had experienced a complete loss of self.  All the things that had made her who she was were gone. In psychology, this was called de-personalization.  She now knew the true meaning of that term. Her sharp wit, her creative energy, even her compassion had been stripped from her. Through this void, she had been forced to search for a new identity.  She was still going through the motions and relying on her memory of who Carol used to be, but she was now sure of one thing: this life made no sense.  She only had a limited number of active years left and she was wasting them. What was the alternative?  She didn’t know.  She just knew that she didn’t want to fight for this anymore. 

  Carol walked into her office and composed a letter to the Center Director, giving him two weeks’ notice.  After she had slipped it under his door, she walked back out of the building and got into her car.  She didn’t put the key into the ignition.  Instead, she stared at the building and felt one final emotion.  She absorbed the realization of how hard it was to let go. 

  * * * * * * * * * * * * * * *

   

  Sheila arrived at Hartsfield Airport in a thunderous downpour.  When the plane finally touched the ground, the entire airplane population applauded the pilot. “Thank you for the vote of confidence," came the overhead announcement.  “But our safe landing was always in the hands of a Higher Authority."  The people cheered even louder and the pilot waited for
them to finish their celebration.  “Welcome to the sunny south," the pilot continued.  “If your destination is Atlanta, I hope you brought an umbrella.  For those of you continuing on to Dallas / Fort Worth, you have one hour to enjoy the weather.  I have been informed that the current weather condition in Dallas is blue skies and the current temperature is seventy-two degrees."  A few individuals clapped, while others groaned, collecting their belongings.  Sheila was standing in the isle, ready to fly when they finally reached the terminal and opened the door.

  Jerry saw her first and waved when she entered the baggage area.  

  “Thanks for picking me up," Sheila said, as she climbed into the passenger seat of Jerry’s Toyota pickup. 

  “No problem," he said, checking the side view mirror and pulling away from the curb.  “Getting you back here in one piece was my personal goal."  

  Sheila knew that Jerry had been keeping close tabs on Dominex.  They had not continued regular communication once they had established the company’s pattern and motive. They had just agreed to deal with it once Sheila returned home.

  Now that she was here, she wasn’t sure if she was ready to hear all the messy details. The past month had been happy and peaceful.  Sheila fiddled with the radio, while Jerry navigated out of the airport.  The rain had turned an already busy Atlanta Friday rush hour into a disaster area.  “If we ever get out of here," Sheila offered, “I will buy you dinner.” 

  “You’re on," Jerry said, zipping into the turning lane that would free them from the airport traffic.

  Heading up I-85 towards the city, the traffic was much lighter.  The two chatted about Dominex in Newark, the great staff, the sales contest, and Jerry’s recount of his parents’ trip to Florida.  The topic of the study did not come up during the drive.  There would be time for that later.  When they hit Midtown, Sheila directed Jerry to the restaurant.  “You’ll love this place," she assured him.  

  It was still fairly early in the evening, and Jerry pulled into a space close to the restaurant’s entrance.  The rain was still steadily pouring down, but the two made it in without too much water damage.

  “So how bad is it?" Sheila finally ventured, after the waiter had taken their orders.