The Interventionist

Prologue

We’re used to the chaos, my husband, Brian, says to Dr. Phil McGraw (the popular psychologist who hosts Dr. Phil, a daytime television talk show) on the set of the prime-time special Escaping Addiction, which we have flown to Los Angeles to tape.

You don’t get it, man; you’re going to bury your wife, Dr. Phil replies. Where were you last night at four a.m.? He continued to hammer at Brian. I am relieved that the focus is off me.

Downtown L.A., looking for syringes for Joani, Brian answers sheepishly.

I pipe up and say, I forgot my syringes, foolishly thinking this will make Brian’s actions seem more respectable. Dr. Phil just looks at me like he cannot believe what he is hearing.

Focusing his attention back on me (I’m now thinking I should have kept my mouth shut), Dr. Phil says, In fact, isn’t it true, Joani, that you just shot up in my green room right before this interview? Before I can answer, there it is in full living color, evidence of me injecting myself with buprenorphine prior to the show.

Trying to defend myself, I say, You don’t get it, Dr. Phil. If I hadn’t shot up before coming out here, there would be no show or interview. I would be too sick to do it.

Which is a lie. Junkies active in their disease rarely tell the truth; protecting the addiction is our number one priority. I had plenty of sublingual Suboxone, the oral form of buprenorphine, on me. I just wanted the jolt of the needle before doing the interview.

When Brian and I flew to California to tape Dr. Phil’s yearly special, I knew we would discuss my addiction, but my main focus was to get help for our four-year-old son, whose behavior had me increasingly concerned. I didn’t expect the intervention that was to come.

I had never seen the Dr. Phil show in its entirety. Some glimpses here and there, sure, but I had no interest in reality talk TV. My life was hard enough without watching other people’s train wrecks. I don’t think I would have had the nerve to do a show if I had had a better idea of the tough opponent I was to face in Dr. Phil.

But here I am now, and frankly, I am too stoned to run. The crew has done my makeup, but even the industrial-strength stuff they use is no match for my constant tears. I rarely cry at home, but now, on the set with Dr. Phil, I cannot stop weeping. It’s as if years of fear and anguish about my addiction have bubbled to the surface at lightning speed. Dr. Phil has a wonderful gift of getting right to the heart of the matter, and it is his gift that saves my life.

"I think you are here today because you want me to document your life and death for your children. This is your eulogy," Dr. Phil says.

As I break into a fresh puddle of tears, I feel like Ebenezer Scrooge looking at his own grave in A Christmas Carol, and, like Scrooge, I hope I’m not too late to save my life. The addiction, however, is not done fighting. I will not go to boot camp rehab, I hotly tell Dr. Phil.

Well, I’m not sending you to some spa in Florida to get well, he retorts. I have some good folks here from La Hacienda treatment facility in Texas. I think this treatment facility is one of the best rehabs in the country, and that’s where you need to go.

Now it’s my turn to stare at Dr. Phil in disbelief.

He adds, You know why you need to go to La Hacienda? Before I can answer, he continues, Because you don’t want to.

I will steal that line from Dr. Phil over and over in my own intervention practice. His voice and wisdom resonate in my head when I least expect it and when I need it the most—when I am alone in the field trying to get addicts and alcoholics into treatment.

But the process of getting well and getting back to work is not easy, quick, or pain free. My path has twists and detours. My recovery is not perfect, and I’m a work in progress. I gain many things during my journey of recovery from severe prescription drug addiction. If you look closely, you also see what I have lost.

Addiction is a thief on many levels. Spanning generations, it will pop up and take those you love through tangled emotions and dysfunctional upbringings, and family will disappear. Professionals in the field of chemical dependency are aware of a sad but frequent phenomenon: when a person gets well, some loved ones can no longer relate to him or her. The ingrained family dynamics shift, perceptions and relationships alter, and sometimes the connections between people end.

In telling my story, I leave out my sister. She has her own story to tell, and it’s not my place to tell it. In the end, I am left with an empty place that she used to inhabit, and to this day I have a hard time accepting her absence.

The story that follows chronicles my family’s history of addiction. As I write my early story, I see through the lens of a child. But as my story matures, so does my view of my childhood and the people in it. Some of that maturity has come through being a parent who has not done things perfectly with her own two children, which has allowed me to see my parents in a much more forgiving light. I see more and more in shades of gray—no one is either all good or all bad. While writing this book I learned two important things: humans aren’t perfect and to forgive others is to forgive ourselves.

Finally, this story is a wild ride through the interventions that I have been involved with. Each, like a little gift, embodies some memory from my own life, and I tell my story through those experiences. In the end, I am an adrenaline junkie, with a big heart for other addicts, alcoholics, and their families. I have found my passion in my life’s work, or, more accurately, it has found me.

CHAPTER 1

A Beautiful Mess, and Near

Death by Adderall

I am late this morning. My GPS has taken me to a downtown D.C. address. I need to cross the bridge into Arlington, Virginia. Feeling frazzled by the delay, I pull up in front of a lovely, early 1900s craftsman-style stucco home. The man who lives here has told his wife I’m coming. Technically, this is called an informational intervention.

Stacey is huddled on the end of the sofa. She is blond and sweaty, with menstrual blood smearing the bottom of her long skirt. She is unaware of this. Her feet are curled underneath her as she clutches a tissue, mascara under her red, swollen eyes. She is scared.

She does not get up to greet me. I look her way and instantly take in her misery. Oh, honey, you feel like shit, don’t you? are my first words to her.

She smiles, laughs lightly, and the tears fall from her eyes. She is relieved. Someone finally knows. The truth does set you free.

I sit and gently take her hand. I gauge her comfort level with my physical proximity. She is accepting of my presence. I push back her bangs from her forehead as I whisper reassurance to her: It will be okay.

I am filled with intense protectiveness toward my new charge. Without overwhelming her with too much information, I share my experience with addiction and recovery. My darkest past has become my largest asset, and I am eternally grateful for this opportunity.

Her home is filled with all the usual artifacts of family life. Pictures of her children grace the walls and the refrigerator. It is a warm home.

The call came, as usual, when I least expected it, disturbing my own mundane motherhood duties. The voice on the other end is always urgent and laced with deep sadness and concern. All the calls are similar in this regard, but the details differ, and I listen with my whole being. I listen as if it’s the first time I am hearing the pain. I leave my shoes untied. I stop. I know this world. It is my passion, my responsibility, my duty as one who has lived through it.

The husband is articulate and educated, and has done his research. It’s quick. We discuss options to proceed.

Then silence. His voice falters: My wife is dying…. We have two small children. We can’t lose her.

He pleads to me for her life, a stranger on the other end of the phone.

I take control. I gently and firmly lend him my confidence. I am a poker player at heart. I bluff when my own doubts consume me, which is with every intervention I do. No matter how many times I achieve success, my doubts hound me, yet I forge forward.

The devil is a powerful adversary. I respect the enemy. And I hate him, and I will win. My prevailing doubts are his weapons, and I will not back down. I am in the battle for someone’s life. And I love it.

As I prepare for tomorrow’s intervention, it’s late summer. The air continues to be heavy with humidity and last-chance thunderstorms. The rain slows, and I hear the melody off my side porch. I follow the song and look out the window. A faint light appears as the clouds break up.

This could be the last night this woman, this mom and wife, has to live with this hell. And I am filled with purpose.

She and I walk together as one on this night. God is near. And it is this way every time for me before an intervention. A stranger consumes me.

Three years earlier:

I am also a mom of two small children, my little boy still in diapers. I am a wife and a registered nurse. I work weekends at an alcohol and drug rehab facility where I am the supervisor.

It is cold and just six days before Christmas. Historic Annapolis, Maryland, abounds with colonial holiday festivities. It is beautiful in a way that only old America can be at Christmas. Our homes, in their old age, ooze memories of Christmases past, whispering of carols sung and candles lit.

I wake up early. Fear of death is my constant companion. Today he will come to me, though I do not know this…. All I know is, the joints in my hands are so sore I can’t make a fist without crying out. I need a shot.

I walk quietly downstairs. I’m the first one up. I’m trailed by my four-and-a-half-pound Chihuahua, Lucy. She is my ever-present friend, the only breathing thing that is witness to my 24/7 suspended state of consciousness.

She will lick the blood off my arm, exhibiting both her primal instincts and what I think is a gentle and fierce love of me. Frequently, tears fall from my chin onto her back, as the evidence of my injection disappears onto her tongue. I am grateful for her presence. I am not alone. She follows me.

In my bathroom, high on a shelf, nestled in an antique bowl my aunt gave me, is my salvation and my gun. And above the shelf is a picture—a finger-paint print of my son’s three-month-old feet and his sister’s three-year-old hands.

I see the picture as I reach for the syringe.

Addiction trumps everything. Even love of my children.

This hard fact is difficult to comprehend, but it is very true. It is not personal. Addiction trumps everything. On this morning, I love my children as much as any other mom waking to a new morning with her babies. And I cannot stop the addiction.

I have drawn up the liquid opiate the night before and gently placed it in the bowl with a tourniquet that I stole from the nursing unit at work.

I love the tourniquet. I miss it still. It is the perfect stretchy rubber, easy to wrap around my arm. In the early years of my needle addiction, I would attempt to tie off with ordinary household implements—blow-dryer cords and winter scarves.

I am wearing a floor-length, pure white cotton nightgown. I push up the long sleeve of my left arm to past my elbow. The nightgown’s wrist has elastic in it, keeping the sleeve in place above my antecubital, the soft spot in the crook of the elbow.

I am right-handed, so the left arm vein is preferable. Taking the tourniquet, I apply it tightly around my arm, using my mouth to tug it ever tighter.

I examine the vein. It’s plump this morning, but I tap it with my middle finger, teasing it to fill even fuller with blood. You never want to miss the vein. If the liquid drug seeps into the tissue, the high is missed. The sickness will slowly abate, but there will be no euphoric payoff. This is a universal truth known to all junkies: do not miss the vein.

Satisfied with my vein, I reach for the syringe. This will be the best part of my day. Another universal truth among the walking dead: the first hit is the best.

I draw up the liquid opiate but will inject only half with the first shot. The whole load makes me too sleepy. As Lucy gazes at me with love that I cannot comprehend, I prick my skin with the needle. I anxiously wait to see the blood return to the syringe. This tells me I have achieved my goal of hitting the vein.

Seeing the blood, I slowly depress the plunger, injecting half of the liquid. Releasing the tourniquet, I take the needle out. While bending my elbow to stop the blood flow, I recap the needle. Gently, I replace the remaining drug and needle back into the antique bowl, to be used later in the day.

The ritual complete, I sit on the toilet, lid down. I watch Lucy, and my joints loosen up as my head is filled with a sense of well-being. The lie complete, I begin my day.

I will come close to dying in four hours.

The house fills with the usual noises. The coffeepot gurgles. The kids tumble down the stairs. I let the dog out. Mary watches SpongeBob Squarepants in the background.

My mind is drawn to the medicine cabinet above the coffeemaker. I have a new lover.

I always thought I would be faithful to the opiate narcotics Percocet, Vicodin, Lorcet, OxyContin, fentanyl, Tussionex HC, morphine, Demerol, Dilaudid, and buprenorphine. I’m sure I’ve left somebody out.

But like all long-term loves, I suppose the luster wears thin and a little pick-me-up is needed. Along comes Adderall, also known as mixed amphetamine salts. I love the sound of that. Oh, the possibilities. Mixed amphetamine salts. I will spend hours at the nurses’ station desk reading the PDR, the Physicians’ Desk Reference, the bible of prescription-drug addicts, looking up lovingly all the names of the mixed amphetamine salts.

I had a problem.

The opiates made me so tired. With two small children and a dope habit, I was barely able to keep up or, more accurately, to stay awake. At times I would have to put the van in park at red lights for fear of falling asleep. Kids in the car seats, I was in danger of rolling out into the intersection.

I needed a solution for the fatigue. No one must die.

D. J. Shay, a counselor at La Hacienda treatment center, used to tell us inmates the story this way. Normal people have a solution for the problem. They give the drug up! What? A motley crew of faces in the lecture hall would look up at him.

No! we all seemed to shout, as we openly stared in response to his remarks. We simply didn’t understand. It seemed somehow insane to us drug addicts. Give the drug up? Nope, just need to tweak the drug habit a bit. I needed to get some amphetamines. That was the solution. It seemed sane at the time.

My first dose of Adderall felt as if fireworks had gone off in my head. The euphoria enveloped my mind and body in a way I am at a loss to describe. It completed me. I would lie awake in bed, utterly still into the early morning hours. In my motionless state, I was at peace. My mind awash in a false serenity, I just lay there. I would spend the next few months doing everything possible to get my hands on a prescription for Adderall. It was far more difficult to obtain than opiate narcotics.

The first two Adderall pills were the first and last medication I diverted—a nice term for stealing—from the rehab facility at which I worked.

Armed with books on attention-deficit/hyperactivity disorder (ADHD), I convinced my psychiatrist that I was clinically in need of Adderall—and I needed higher and higher doses. He obliged me. This was no fault of his. My skill at conning physicians was my job, and I performed well.

I called it the housewives’ speedball. On the street, a speedball is heroin and cocaine. For me, it is buprenorphine and Adderall. Valley of the Dolls: one takes you up, and the other takes you down.

Reaching into the medicine cabinet on this morning, I retrieve two Adderall caplets. Washing them down with coffee, I contemplate my day.

I have Christmas shopping to complete, and Max’s preschool holiday play to attend in the evening. He is to sing Rudolph the Red-Nosed Reindeer, complete with a red nose. We have been rehearsing all week.

But I have a new problem, and no solution—yet.

I am unable to control my use of Adderall. To a certain extent, I was able to take a constant level of the liquid opiate narcotic buprenorphine. Adderall is different. My compulsion for amphetamines is even greater than my addiction to opiate narcotics. This has surprised me. I’ve been popping pill after pill, many times forgetting how many I’ve taken.

So on this hectic morning, my obsession begins. As the euphoria from the amphetamines takes over my brain, my head tells me I need more and more pills. It is this abnormal response to drugs that is the hallmark of the addict’s brain. Our brains are not normal in this regard. We have no more control over our response to drugs and alcohol than the type 1 diabetic has over his or her pancreas and insulin reactions. It is this so-called phenomenon of craving that sets us apart from nonaddicts and nonalcoholics.

Three hours later:

It is Christmas cold. I am to pick Mary up at her Catholic school, Saint Mary’s, at 2:40 p.m. Max will stay later at his school, St. Anne’s Preschool for the Arts. I have a few minutes before picking up Mary. Popping another Adderall, I stop in Chico’s to look for something to wear to Max’s performance.

Skimming the sales racks of clothes, I need to pause and take a deep breath. Death is hovering, and I am still unaware. Is my heart beating too fast? A fleeting thought that is to be a harbinger of what’s to come.

Leaving the car at the bottom of Main Street, I hurry to walk the incline to Mary’s school. I can hear the constant ringing of the Salvation Army bell and stop to deposit a small amount of money.

I continue on up Green Street, passing our 150-year-old public elementary school. Maybe halfway up the hill, what is essentially the length of a city block, my first symptom of distress appears: excessive sweating.

Then, in lightning-fast succession:

Shortness of breath.

Heart beating wildly fast.

Chest pain that radiates down my left arm.

Crushing anxiety.

Nausea.

I need to puke badly. I bend over and gag onto the sidewalk. I look over at a planter by our friends Laura and Glen’s house. The familiar is suddenly ominous.

In another lifetime, I sat on that planter.

But now I need medical attention, and I know it. I do not have the luxury of denial. Yet I also don’t have the good sense to stop and let my heart drink in the needed oxygen. A deep sense of urgency is making me react irrationally.

I am overdosing on Adderall and am experiencing a cardiac incident as a result. Death is a real threat, and I am painfully aware of this, but I must reach my child. My two prevailing thoughts are this: One, I must get medical attention, or I’m going to die. And two, I must pick Mary up at school. She’s waiting in the school parking lot at the top of the hill.

The more prudent thing to do would be to stay put and call 911 or knock on Laura’s door. But my overriding concern is not to abandon Mary in the school parking lot, so on I climb, in spite of my physical symptoms and extreme fear.

I reach the parking lot, where hundreds of children have been released from school. A sea of young children in their school uniforms surrounds me. I feel dizzy as I take in the sight. They all look the same. I am disoriented. Oh, God, help me.

Mary, I mouth her name in a mute prayer, please appear to me.

I need help. I am drowning in nausea and arm pain. I fear I might pass out.

I speak directly to God, clearly in my mind now: Dear God, take me, take me like my parents before me, but please not today, not in my child’s school parking lot, five days before Christmas. Do not make this her last memory of me. Do not do this to this child. I deserve this death, God, but Mary does not deserve this. Please … please … please …. It is my mantra, my prayer.

I am not afraid to die. I am afraid for my children. They are too young to lose me. They need me. They love me.

I do not negotiate or barter with God; I have nothing to offer up in return for my life. I have no hope that this will never happen again. I am a pragmatist at my core. I know my genetics and feel fucked.

My anxiety mounting, Mary appears. She sees me before I see her.

She is happy, like all children as Christmas approaches and school nears an end.

She is excited about something in her book bag that she made for the Christmas tree. I remember this moment more than any other. She is eager to dig her treasure out of the book bag to show me.

Over and over, I tell her I cannot look at it now. She does not understand. This is unlike me, so she persists in trying to show me her craft.

I feel extreme guilt as I recall this moment in time. I failed her in my inability to be engaged in this Christmas moment. It will never come again. Addiction is a thief.

Finally, with quiet urgency—talking is difficult for me at this point—I tell her I’m not feeling well and I need to get back to the car. She looks up.

What’s wrong? she asks in her little first-grade voice.

Mommy has a tummy ache, I barely whisper.

Will you puke? she wants to know.

I don’t know.

We walk in silence now, thankfully downhill. I feel the chest and arm pain lessen as we go down. My cardiac load has decreased, I think. This is good.

I fish out my cell phone. I call my husband, Brian, in his home office.

Hey.

Hey.

I’m not well. I need to get to the cardiologist right away. I have Mary with me, I say in a matter-of-fact way. I don’t want to alarm Mary.

Silence. He knows. The other shoe has finally dropped.

Max will need to be picked up, he counters.

Call Margaret, I add quickly, not elaborating.

In the short time it takes us to reach home, my aunt Margaret has arrived. Leaving quickly, Brian gives her instructions about picking up Max.

Brian has called the cardiologist’s office and given them what little information he knows. They are expecting us.

Brian and I drive in silence. No, I don’t know what’s wrong is all I say. Sweat drips from my forehead, and the nausea is overwhelming. Please hurry, I think.

As Brian parks the car, I look over. Drop me at the door, I don’t think I can walk. My hand is gripping the dashboard.

Slowly, I walk up to the office. The door is so heavy. Approaching the desk, I weakly tell the staff I don’t feel well at all. They immediately take action. I hear one staff member whisper how pale I look.

I’m escorted to an examining room; Dr. Kennedy is already there. Wrapping the blood-pressure cuff around my arm and placing the pulse oximeter on my finger, he starts firing questions at me. Accurate information is vital to diagnosis and ultimately to treat. I’m guarded with the truth. I am ashamed.

Dr. Kennedy listens to my chest for a long time.

Okay, he says, and continues what feels like an interrogation. I hedge. He starts the process of having me take a stress test. Hooked up to an electrocardiograph, which will measure the effects of the test on my heart, I am instructed to walk slowly on a treadmill. Almost immediately, the doctor stops me. The EKG tracing is showing what my body already knows. Sit down, please, and stay still, he instructs. We’re transporting you to the cardiac-care unit at the hospital.

Fuck, is my first thought. It was not just an anxiety attack.

The doctor informs me there are EKG changes associated with ischemia to my heart. Ischemia is a fancy word for lack of oxygen to the heart. We need to determine why this is happening, he tells Brian and me. Shit, I think.

For a moment, imagine that I was having a seizure related to an underlying medical condition. Would I withhold the truth of the underlying condition from my doctor? Of course not. That vital information is lifesaving.

But drug and alcohol addiction are different. Although they are recognized by the medical establishment as brain disorders, deep stigmas continue to surround them. Many people continue to believe we have a choice when it comes to our abnormal reaction to drugs and alcohol. We do not. In 1939 the book Alcoholics Anonymous (commonly known as the Big Book) stated what is still true today: We have lost the power of choice in drink. No one would choose this hell. But misconceptions continue, and addicts and alcoholics feel ashamed.

So I stay quiet. I stare death in the face, and I am mute.

During transport to the hospital, my mind is racing. How will I conceal my addiction while hospitalized? It takes me only a short time to come up with a new and improved standard story.

First, I am addicted to opiate painkillers as a result of chronic back pain associated with spinal surgery. That will easily cover my addiction to buprenorphine. Second, I take Adderall for ADHD. As long as a blood-level toxicology is not done, I should be okay. If a blood level had been drawn on admission to the hospital, it would have been readily apparent that I was abusing drugs. The problem with middle-class drug addicts is this: we don’t look the way people expect drug addicts to look. We blend in too well. Our education and economic level allow us to continue on for a long time with the disease.

Okay. Third, I have huge holes in my arms where I shoot my drugs. Track marks. Fuck…. Think, think, think.

Got it. I am allergic to latex. I donated blood, and my arms reacted. Bingo. Covered.

These four things together—opiate dependence, amphetamines for ADHD, track marks, and ultimately chest pain for unknown reasons—could have been a huge red flag that shouted possible addiction. But no one approaches me, and I continue to die, my addiction undetected and undiagnosed.

I am hooked up to an IV with morphine. I will undergo two cardiac catheterizations during my stay in an attempt to figure out my mystery condition.

I sleep deeply. I’m in amphetamine withdrawal. I can’t stay awake. Huddled in a ball in the middle of the hospital bed, I’m slumped over and snoring.

And I miss Max’s holiday preschool play. He is three years old. Mary is five.

Brian reports to me that Max stood on the stage but would not sing.

There are moments of time in our lives that we can look back on as turning points, or times when grace is near. My baby boy will deliver a gift to me on this night. My heart will break and ache in a way that science can never cure. In this pain, in this glimpse of time, I will begin to heal. But I do not know this now.

Visiting hours begin, and the noises and routines change in the rooms and corridors. The light has long faded on the December evening. I glance outside and see the twinkling of white Christmas lights strung around the hospital grounds. And I am deeply sad.

The kids and Brian bounce into the room. Dressed in their holiday best, they look so cute. Mary has on a red velvet dress with a small white bow on the empire waist. Max has on big boy pants with a collared shirt. Polished oxford shoes complete his little-man outfit.

How was the play? I ask, with false cheerfulness. Mary’s standard, Good, with her signature inflection, is the first response.

Max is quiet, standing at the foot of my hospital bed. Hey, buddy, how was it?

Then, oh so gently, Max touches his still-red-painted nose! What is he doing? Moving his head up and down, he starts to get the tempo! With endearing awkwardness, he gently and clearly sings Rudolph the Red-Nosed Reindeer … to his mom who’s in bed from an overdose of amphetamines.

Thank you, Max, I manage to say. My feelings are incomprehensible. Mary claps. Brian looks proud. We had our own private concert.

Max then crawls into my bed. For the next four days, he barely leaves my side. With him cuddled against me, I am secure for the moment. I am not dead yet. For months afterward, Max associates the hospital with security. He wants me to go back with him and stay there. Watch cartoons in bed, he says, every time we drive by.

I am discharged from the hospital. The discharging cardiologist’s parting words are Your ischemia is a mystery. It’s determined that I had coronary artery spasms that blocked blood flow to my heart. Spasms that were caused by an unusually high dose of amphetamines in my system. That is my unspoken truth.

I’m given a prescription for nitroglycerin tabs, to be placed under my tongue for future chest pain.

I’m home for two hours when I take my first capsule of Adderall.

Addiction trumps everything.

My story goes on like this for a few more painful months. I will be rescued by the most unlikely of saviors: Hollywood and the Dr. Phil show.

Still sitting on the couch with Stacey, I show her the glossy brochure for the rehab facility she’s scheduled to be admitted to. Somehow I always think the shiny pages will entice my patients to spring out of their slumber and immediately agree to go with me. It never works like that. I don’t think they give a rat’s ass about the brochure at this point. I didn’t. But still I try.

All the families say the same thing when I show them the brochure: "Wow, I wish I could go there for twenty-eight days!"

Somehow they think alcohol and drug rehab is Club Med. I assure them that if you need rehab it will not be fun at all, especially in the beginning. It’s sort of like being in hell, actually, although the scenery is nice. And you don’t even see the scenery for the first two weeks. Then, just as you start to get comfortable, you become scared shitless to go home.

As we are pretending to look at the brochure, Stacey’s husband says, Why don’t you two girls go upstairs and pack? He seems to be in a hurry, which I appreciate. Once the patient agrees to go, I generally start rattling my keys. Best to get on the highway before any changing of the mind sets in.

As we walk up the stairs, I’m taken in by all the photographs of the children on the walls. I do not pause or point them out, though. I don’t want Stacey dwelling on her children at this time.

Moms are the least-represented group in rehab. Mothers feel that no matter how sick, no matter how bad the chest pain gets as they climb those hills, they must not abandon their children.

So I say nothing about the beautiful photographs to Stacey.

From the bedroom closet, Stacey pulls out a tiny suitcase.