I Had No Idea You Were Such a Fucking Skank

We get a call to a sober living house for an overdose. This is a very common call, but I’m still new to this area and it’s my first time going to this facility.  It looks like a small apartment complex and my Field Training Officer knows to go straight to the back and upstairs where the sleeping quarters are.  Sleeping quarters are a giant room with 30+ twin beds.  It’s dark, but it looks full.  Law enforcement is with us and we’re using flashlights to navigate to the bathroom where the patient is.  The bathrooms look like restrooms in a train station or office building. We arrive at the patient who is lying under the door of a stall.  He’s awake but extremely groggy. Staff tell us another guy found him, narcaned him, and then called 911.

The patient says, “I’m fine, I’m just tired, leave me alone.”

“You’re lying on the bathroom floor.” The supervisor from the facility says. “We’ve got the ambulance here.” He has his arms crossed and seems so disappointed he’s verging on anger, his affect is stern.

The patient sits up and climbs independently onto his walker with a seat, which I hadn’t noticed till then behind the stall door. He’s about my age. He lets me get his vitals but it takes a lot of convincing.  He starts to nod off and his breathing slows whenever he’s not engaging.

“Hey! Stay with us man, talk to me.” I say.

“I’m fine.” He’d say as his head would start to droop, his eyes close, and he starts to slump.

He’s clearly not safe to be left alone and the supervisor wants him gone, “It’s sober living,” he says, “We keep giving this guy second chances.  It’s not fair to everyone else here. They don’t need to be waking up to pee and finding people on the floor.”

When we try to get him on the gurney he gets extremely agitated but is too groggy to do much about it.  I start to buckle him in and he tries to get up.

“I’m not going to the hospital!” He says, “I didn't do anything. I'm just tired, let me go to sleep. You guys are trying to get me kicked out, let me go back to bed.” He suddenly looks a little more awake. 

Law enforcement steps in, “You’re not staying here.  The supervisor is right here, he’s saying you have to go.  You’re going. Do you want to go to jail or the hospital?”

“You’re trying to get me kicked out, you fucking pigs.” he says.

We talk to law enforcement to decide what to do with this guy.  I can’t take him against his will since he's answering questions now, legally that’s kidnapping. Law enforcement could take him, but I think he’ll need more narcan and someone to monitor his breathing. We decide if we stop keeping him awake by engaging with him he’ll nod off, and he’s already on the gurney. If he's out I do have a medical reason to take him, so we’ll take him to the hospital. We wait. The EMT preps the wrist restraints so that should I need them while I’m in the back they’re easy to get to. He nods off.

En route to the hospital I watch his breathing slow and his oxygen saturation start to drop.  I give him a little, “Hey!” when this happens and his breathing increases sometimes, sometimes it doesn’t and I give him a sternal rub.  I don’t want to narcan him because I know I have an angry man on my hands, and I’m in the back of the ambulance with him, which I know won't make him happy to wake up to.

“Prep the IM narcan and we’ll give it to him right before we go inside.” My F.T.O. says.  I prep the IM narcan, which takes a little longer to hit than the nasal spray, which will buy us the time it takes to get from the ambulance bay to the ER room.

His oxygen drops to the low 80’s and I give him the shot.

He comes to as we’re about to transfer him to the hospital bed.  I’m giving report to the ER doctor and nurse as we’re doing this.  The patient suddenly yells, “Did you just say you gave me narcan? No you didn’t! You’re such a fucking skank, you’re just trying to get me kicked out!”

He sits up and starts swinging at me.

I had been grabbing the sheet under him ready to slide him over so I throw my hands up, step back, and back out to the door without getting hit.  

The ER has had enough, “Now you fucking listen to me,” the doctor says, “I have someone dying in the next room and they don’t need to listen to your bullshit.  Your oxygen was dropping to the low 80’s which means if you leave here you might die and you are more than welcome to do that, but do not talk to my staff like that.”

The patient starts arguing with him.

The doctor turns to his staff as he walks out the door and says, “He can leave against medical advice if he wants.” 

This is the first time I’d heard a doctor cuss at a patient. It honestly surprised me. 

I wondered about the patient the doctor was going back to in the next room. I wondered about the guy’s roommate in sober living who found him - I wondered how many people he’d walked in on unconscious, how many people he had saved, and how many times he’d been revived himself. I wondered how our patient messed up his knee, which is why he needed the walker at 35-years-old. I wondered how many times lying about his habits had worked for him, to keep him in a safe place to sleep, to keep him in relationships with people who wanted to help him, wanted to believe him, wanted to keep giving him second chances, saw the good in him.

We watch him walk toward the exit while the ER staff hold their hands up, he’s gone before we are.

We walk back to the ambulance bay, “Are you OK?” the EMT I’m working with asks.

“Yeah, I’m good, thank you for asking.” I say.

“I had no idea you were such a fucking skank.” My Field Training Officer says to me.

I laugh and say, “I didn’t either, but I’m learning new things every day.”

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Review

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This story is gripping, honest, and deeply reflective. It captures the messy human reality of addiction—how it tests empathy, strains professional boundaries, and yet, against all odds, evokes compassion. It doesn’t just tell the story of a single call; it lays bare the complicated humanity behind every overdose response. A powerful, necessary narrative that deserves to be heard.

The tone here is gritty, tense, and quietly compassionate. It balances moments of professional detachment with flashes of humanity and frustration. From the disappointed sober living supervisor to the overwhelmed ER doctor, this story illustrates how addiction fractures not just the individual suffering but everyone around them. The story doesn’t glamorize or villainize—it presents the chaotic, exhausting, and emotionally layered reality of dealing with addiction-related emergencies.

The narrative pulses with an undercurrent of anxiety, particularly in the decision-making moments—whether to narcan him, how to handle the aggression, and how to ensure safety without escalating the situation. The use of humor at the end, with the “skank” comment, effectively breaks the tension and reveals the camaraderie that helps first responders cope with emotionally exhausting situations.

Despite dealing with aggression and chaos, the professionalism and humor shine through. The story emphasizes how first responders must juggle their own emotional well-being with the demands of their job.

We are left with questions like what happens when one person’s safety and recovery jeopardizes the group’s well-being? How many chances are too many? The compassion fatigue theme underscores how repeated exposure to trauma can erode empathy—even among those who care deeply. At its core, the story highlights the relentless cycle of addiction—the push and pull between those trying to help and those caught in the grips of substance dependence.

It doesn’t demonize the patient but instead offers space for their frustration, denial, and fear. It’s powerful not just because of the events it narrates but because of the nuanced way it captures the intersection of human vulnerability, frustration, and survival instincts.