I have not made a secret of working in a substance abuse treatment facility, although I have generally not gone into detail about the work I do there. For one reason, most of that work is the mundane administrivia that keeps an organization–particularly a nonprofit organization that has contracts with state governments–going from day to day and week to week. Detailing my experiences with QuickBooks or billing insurance companies would not likely make for engaging reading, and, as should be clear, my writing already struggles to develop and maintain readerly interest.

Another reason, and more important in the event, is that the work done at my agency is quite sensitive and personal. Although my organization offers only outpatient treatment, it still sees people at close to their worst. It’s usually only close to the worst, though every so often, one comes in who’s not close, but at their worst. It’s never a good thing to see happen, and it’s not something for which I am trained; all of my degrees are in English, after all, and if it has been the case that a lot of people have confided in me, I am (emphatically and explicitly) not a counselor.

Thus, when I got called in to observe a client who had said some things on which we had to act, I was…unprepared. While the counselor did what needed doing–I am deliberately being vague, thank you–I kept watch on the client. So I got to see the many open sores and several healed-over ones on the client’s exposed skin, the cracked flesh at the side of the client’s mouth, the twitching and picking at nailbeds and eyebrows, the irregular outbursts of weeping that may have been genuine but which ceased so suddenly as to appear performances abruptly cancelled. And, because I am not a counselor and do not want to be in a position of having said something I ought not to have said, I kept my silence throughout, even as the client tried to work up into a rage and pleaded to speak with their mother. I do not think it helped the client feel better, though.

In the event, the client received the needed assistance and has been discharged from our program; we recommended they go to an inpatient facility that handles what we do and the other factors with which the client must contend. Whether or not the client does so is not up to us; although we work with government agencies, we are not ourselves such an agency, and we have neither power nor desire to compel behavior. I am glad that the client was offered the needed help; I am also glad, more now than in the moment, of the reminder of what my organization does. I am often isolated from the actual work as I do my portion of the support work; the display of the problem we seek to treat is something I need to see, at least every now and again.

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