Matt was 40, my sister’s age. He was training for a marathon and trying to talk his many friends into joining. He lay in bed with his three-year-old son every night to help him fall asleep. It’s hard to sleep train a toddler with a newborn to nurture at the same time, but he loved spending this time with his two kids and being the dad everyone counted on.
Matt’s best friend Ben organized his groomsmen to fly to Las Vegas for a bachelor party. They planned a crazy night out together, and a break from their busy home lives juggling long work hours and small children. This was a weekend to suspend responsibility. Las Vegas is a good place for that.
They found an Airbnb to rent near the Strip and set out for a night of drinking once they arrived. At some point, one of Matt’s friends asked him if he wanted to try cocaine. He hadn’t planned on it, but the party momentum was mounting and the Vegas attitude contagious. Matt decided to try some.
A friend of one of the groomsmen handed the cocaine out, and Matt snorted it soon after. He fell on the ground immediately, and his heart stopped. Ben’s friends desperately tried to resuscitate him with CPR. It took at least 20 minutes for them to call 911. The cocaine Matt snorted was mixed with Fentanyl, a drug readily available on the streets and hundreds of times as strong as morphine. Those are the 20 minutes that ended Matt’s life.
When EMS arrived, Matt still had no pulse, so they tried to stabilize him in the field before bringing him to the hospital. They quickly gave him Narcan, the opioid reversal agent that almost certainly would have saved his life if they had made it to him sooner. They put a breathing tube in him since he was no longer breathing on his own. They gave him drugs to start his heart beating again and shocked him several times with a defibrillator. Eventually, his heart started to beat spontaneously, and they drove him to our trauma hospital.
When I met him, he looked like a burly athlete who was sleeping connected to a breathing machine. His wife was sitting next to him after getting a call in the middle of the night to fly to Las Vegas immediately. She’d brought her baby and her toddler. She was petite, naturally pretty, completely in shock. She asked me if he was going to wake up. I wondered the same thing.
Our ICU team tried everything and talked to everyone – the ER doctors on call the night Matt came in, the neurocritical care specialist, the medical director of Las Vegas EMS. We went through every detail of his cardiac arrest, of the attempts to bring him back, of each medication given to him in the hospital. We checked his neurologic function over and over; we got second opinions, we sat in the room and listened to everyone cry. And still, he didn’t wake up. We went on like this for a week. Every day Matt’s wife came to the hospital after she breastfed her baby and sat by his bed holding his hand and waiting for his eyes to open. Every day she asked me if he was going to get better.
After a week, Matt’s wife was ready to disconnect him from the ventilator. This machine was keeping his breathing going while his brain, the essence of his personality, had left a week ago. She knew he would never want to be kept alive by machines, and she couldn’t watch him in this state anymore. She gathered her family together and explained as much as she could to her toddler, who’d been asking every day if his dad would help him fall asleep that night. Her raw personal suffering and her grief by proxy for her children were a hideous burden to witness. The resolution I felt knowing Matt would be spared an institutional existence tortured by devices was tempered by the nagging thought of his innocent children. They hadn’t signed up for this.
There is no redemption in this story. This is what’s happening in our country. Matt could be your lawyer brother, your college daughter, or the groomsman in your wedding. Narcan would have saved his life, but no one at the bachelor party had it, and no one called 911 in time for EMS to bring it. Fentanyl is a lethal substance concealed in drugs in your city. And no one knows who will be next.
This essay was originally published on KevinMD.
Dr. Marcia Glass is a hospitalist and palliative-care doctor working at University Medical Center, a public safety-net hospital in New Orleans. She has worked abroad with several aid groups, including Doctors without Borders and Partners in Health. She has been struck by the harrowing stories of her patients struggling with opioid dependence in New Orleans and troubled by the lack of an organized national response to this crisis.