Rehab

June 3rd, 2006.  As previously mentioned, I was nearly dead and mad in the throes of delirium when my friend Mike found me at home and drove me to the emergency room; however, by the third day I was mostly lucid and on the fourth I started calling around to treatment centers to inquire as to availability and price (I'd be footing the bill myself since my health insurance wouldn't cover this eventuality).  My sister suggested the Sundown Ranch in Eastern Washington.  She was very familiar with the place since her then-husband Tony had gone through there a few times.  The rehab didn't take for Tony but that was no blight on its effectiveness: no treatment took for him because his "bottom" turned out to be death (and if he could have found a way to drink post-mortem he'd have done that too).   Still, I had no desire to travel across the country and was determined to find one in the local Philly area.   Finally, after a dozen fruitless calls from my hospital bed, I land on what I think is the perfect place: The Keystone Center in Chester, PA.  I liked the irony of its location: smack in the middle of the area where I used to buy cocaine in the late 80s and early 90s.  Plus it was relatively cheap at a couple thousand for a two week stay that I eventually extended into three for an extra grand.

I checked out of the hospital on Friday and into the Keystone Center the following Monday morning, June 12th. My sister had flown in and was staying at my house so she drove me down there in my car.  She'd be heading back to her home in Phoenix in a few days and I'd take a cab back to my place once rehab finished.   The Keystone Center organized its patients into four groups: two male, one female and a co-ed group called Freedom.  The architecture of this rehab was unique with a couple of relatively modern two-story buildings behind an old re-purposed stone and wood mansion.  The first floor of the mansion held the administrative offices that I only saw on check-in and check-out.  The second floor was home to the all-female group and the top floor was where Freedom men and women met for therapy and slept.  The more conventional buildings held the medical ward where prescribed drugs were dispensed and where new arrivals slept when going through detox.  The cafeteria, therapy rooms for the two male groups, a large conference room for all-hands meetings and the staff offices also called these buildings home.  There was another building across the alley which housed a group of juveniles.  These shared our cafeteria but otherwise did not interact with us adults, only really affecting us when they overstayed their lunch period, forcing us to wait longer in line. Well, the young punks were also responsible for the caffeine ban (only decaf sodas and coffee were available because they didn't want the tykes getting hopped up).  I hated them for this.

I ended up in Freedom Group.  It was, as I mentioned, co-ed.  It was also much smaller than the other groups and its members had less restrictions than the others.  For one, guys and gals could talk while in their meetings and in the shared TV room in our "penthouse" at the top of the mansion.   There were five bedrooms with either two or four per (these were obviously unisex and it was strictly forbidden to penetrate these walls if you were the wrong sex).   There was likewise two showers/toilets and a private laundry room. Finally, there were no locks on our doors or floor.  The women-only group on the floor below us had similar digs but the male patients not in Freedom lived in large dorm-style rooms with six to a dozen per room and the floors to these rooms locked after 9pm so if you wanted to grab a last cup of decaf or go for a walk, you'd better not get caught out after hours or there was hell to pay because you had to find somebody to unlock the doors, effectively ratting yourself out.  I know this because though I was assigned to Freedom, I didn't sleep there initially; at first, I was still sleeping in detox and then after I was declared clear was moved to one of the other buildings until a bed opened up in the Freedom "penthouse."   Naturally, the other groups resented Freedom and when we mingled together during meals there was no end to the name calling.  How did one rate such an advantage?  I'm not sure.  The people in Freedom were just as fucked up as the others, at least to my eyes.  I think it came down to money and choice.  The ones in Freedom were there by choice, mostly - at least the choice of parents in the case of the kids in their late teens and early 20s - and I think had the money and/or insurance to pay in advance.  Though that's not right either: we had more than a few who were there by court order and at least a few who were being gently/discreetly "reminded" by the staff to call their parents or spouse to arrange payment.   It certainly didn't seem to be divided along racial lines (Freedom had as healthy a representation of ethnicities as the other groups).   Maybe it was the luck of the draw but there was a pervading sense - at least on my part - that this was most certainly intentional.

So, Monday I arrive and check-in.  I pay up front and then after reviewing the medication I was on was told I'd be spending the next day or two in detox.  This confused me because I'd just spent a week detoxing to horrific effect in the county hospital and was quite sure I was as clean as I could possibly be.  The thing is, my gastroenterologist had several years ago prescribed me Nexium for my acid  reflux and Xanax to help me sleep but this latter drug is classified as an addictive benzodiazepine from which I must be weaned.   So they stuck me in a little private room off the Nurse's Station where I could presumably sweat out the withdrawal in close proximity to medical assistance.  There was to my knowledge only one actual doctor at Keystone, the department head, a psychiatrist, but plenty of RNs.  I only took the occasional Xanax so I experienced no withdrawal symptoms at all but rules were rules so I slept here fitfully, trying to ignore where others in rooms beside me were not so fortunate in their cold turkey dance.  During the day up to 9pm, I'd be allowed to go up to Freedom Group for the usual AA sessions/meetings, discussions/testimonials on addiction, and lectures by the various counselors assigned to us.

The Freedom group fluctuated between 10 - 20 people with about 70% heroin, coke or crack addicts, 29% alcoholics and one college age kid who was there for a gambling addiction.  The dude made a lot of money, so he says, but had been kicked off the college basketball team and eventually out of the school itself after the gambling ring he formed was discovered by administration officials.  Turns out Keystone Center had one of the few Gambling Addiction programs in the Philly area with our main counselor, Nick, himself a recovering GA.

The median age of my fellow Freedom riders was about 25, with several under 20 (the heroin and coke crowd).   Jeanie - 19, mother and white suburban upper middle class coke head who fancied herself an inner city gangsta girl - was the wildest, getting into fights during meetings with almost everyone of us and at lunch with the other groups.  She was bi-polar so of course we nicknamed her Tri-Polar.  I was closest with Charlie (a drunk about my age) and Eric (the college gambler), thanks to similar senses of humor.   We'd bust on people waiting in line to eat (an hour's lunch would generally consist of 45 minutes of waiting in line and 15 minutes actually eating thanks to the large population and limited cafeteria seating) but mostly bust on ourselves for being there.  We had no illusions about what we were and this placed us in the distinct minority in that regard.  Most were just now grappling with the fact that they had a problem of some sort, if only because of the fucked up circumstances which landed them in this particular rehab (for many, this was not their first rodeo).  But an addict?  An alcoholic?  "Well, I'm just not sure about that."

Typical weekday Schedule:

7am, decaf coffee available; 8am breakfast, 9 - 10am, AA meeting, 10 - 11am; sober living education, 11 - 12pm, psychodrama (Tue/Thu) or nutrition/dealing with stress (Mon/Wed/Fri); 12 - 1pm, lunch; 1 - 2pm, AA meeting; 2 - 5pm, exercise/swimming/free time (work on writing up post-rehab goals, amends, etc.); 5 - 6pm, dinner followed by reciting of Serenity Prayer in all hands meeting room; 6 - 7pm, evening with counselor Nick on surviving sober or whatever he happened to pontificate on (he was a Jersey-wise-guy-style hoot and could sermonize on AA 101 with the best); 7 - 8pm, guest testimonial/AA meeting; 8 - 10pm, sometimes free time but occasionally a movie in the Freedom common room with addiction theme.

For Freedom group, psychodrama took place twice a week.  This was very interesting.  We walked across the alley to the Keystone out-patient facilities where there was a large room with chairs arranged in a circle around a central chair.  Once seated, a specifically trained "certified psychodrama facilitator" guided us through the next hour and a half.  The process was focused on one member of the group for the entirety of the session.  This volunteer - we were all strongly encouraged to do this prior to completing our stay - would sit in the center of the circle and act out a tragic/pivotal event in his or her life that involved or triggered addictive behavior.  The central player would ask other group members to improvise with them in the guise of specific people in their lives.  It was part theater, part primal therapy.  I surprised myself by raising my hand my last week there.  I had previously watched guys and girls act out physical and emotional abuse, rape, and other unspeakably horrific tales, including one going through Fentanyl-spiked heroin withdrawal.  (While at rehab, there was talk going 'round about a strain of heroin on the street that had been spiked with lethal amounts of fentanyl and while this frightened some of the addicts, two arrived mid point during my stay who had been deliberately seeking out this poison in order to experience the "ultimate high.")

I chose, for psychodrama, to reenact my recent experience with alcohol withdrawal and the delirium that came along for the ride.  I was quite certain at some point about 6 hours into my hospital stay that I was dying of a terminal disease.  I screamed at the doctors and nurses to save me and accused them of murder after they insisted that I was experiencing alcoholic delirium.  Alcohol withdrawal can be fatal if not treated with medication, they allowed, but my withdrawal was in fact being treated.  Lies!   So I re-enacted this with members of the group playing the role of doctors, nurses, my sister, and some of my friends.  It was cathartic,  if more than a bit creepy.  And it brought me closer to a few members of my group, most of whom I'd kept at a distance (I'm not good socializing).  Turns out I was much better at consequential socializing than I am at the normal small-talk usually required.  At a rehab, most everything is emotional and there isn't as much a need to talk about sports or the weather or day-to-day life.  Of course, as I left I promised to keep in touch with all of my new "friends" and then never did.  I certainly regret that now as I'd like to know how they're making out.  I know the statistics say most drank or used again - and some end up in a recovery/relapse loop for years - but you always hope for the best.

I flipped out on the day before I was to depart.   The Remeron anti-depressant the Keystone medical staff had put me on wasn't available once at the nurse's station after waiting in line during evening med call (twice a day you'd line up to get whatever meds you were prescribed).  I went off on the nurse there and continued my tirade with the Keystone director, Deb.  I apologized to both when I cooled down.  I'd only been on the drug for a few days and yet was still horrified at the thought of missing a dose.  I'm sure now that I hadn't been on it long enough for it to have any discernible effect, so I'm sure it was purely psychological.

I only met with the actual staff shrink once.  He was the "chief medical officer" and only M.D. on staff so appointments were hard to come by.  Most were only granted one audience.  I explained to him that I did not believe in a higher power and though I understood the value of AA and the 12 step program for others, I would not be following it per se.  Not strictly.   I'd take what I need and leave the rest, as they say.  I'd already planned to join Secular Organizations for Sobriety (S.O.S).  I liked their philosophy, the tenet of which is the Sobriety Priority (in short, sobriety is #1 priority in your life and everything else flows from that).  Needless to say, this went over like a lead balloon.

I ended up extending from 14 to 19 days mostly because I was comforted by the structure and insulation from "real life."  But my bank account wouldn't let hide there forever so it came to pass that I "graduated" and was discharged the morning of July 1st after which I took a cab back home and into my newly sober real life.