Gabor Maté - In the Realm of Hungry Ghosts - Close Encounters with Addiction

“She gave me a perfect home—until I left to find my mother. That’s how I came down here, to look for my mom.” What this poor woman calls a “perfect home” becomes devastatingly clear as she continues her narrative.

“Had you not met your mother before?”

“Never.”

“Had you used before?”

“Not till I got down here to find my mother.”

Apart from the movement of her right hand as she dabs her eyes, Serena sits motionless. The sunlight streaming into the office through the window behind her leaves her face in merciful obscurity.

“I had my daughter when I was fifteen. He was my auntie’s boyfriend, whatever. He was molesting me and if I said anything, he vowed to beat my auntie.”

“I see.”

“Maté, you would not believe my life story. Everything I’m saying to you is true.”

“You think I would not believe it?”

In the brief silence that follows, I recollect how ever since that fictitious report of her grandmother’s death two years ago, I have dismissed Serena as a manipulator, a drug seeker. I am prone to that human—but inhumane—failing of defining and categorizing people according to our interpretation of their behaviours. Our ideas and feelings about a person congeal around our limited experience of them, and around our judgments. In my eyes, Serena was reduced to an addict who inconvenienced me by wanting more drugs. I didn’t perceive that she was a human being suffering unimaginable pain, soothing it, easing it in the only way she knew how.

I’m not always stuck in that blind mode. I move in and out of it, depending on how I am doing in my own life. I’m more subject to deadening judgments and definitions that restrict my view of the other when I’m tired or stressed and most especially when, in some way, I’m not conducting myself with integrity. At such times my addict clients experience the power imbalance between us most acutely.

“I was fifteen years old when I came down here to Hastings,” Serena goes on. “I had five hundred dollars in my pocket I’d saved for food until I caught up with my mom. It took me a week to find her. I had about four hundred bucks left. When she found that out, she stuck a needle in my arm. The four hundred dollars was gone in four hours.”

“And that was your first experience with heroin?”

“Yes.” A long silence ensues, broken only by the throaty, weeping sounds Serena is trying to suppress.

“And then she sold me to a fucking big fat huge motherfucker while I was sleeping.” These words are uttered with the helpless, plaintive rage of a child. “She’s my mom. I love her, but we’re not close. The one I call Mom is my grandmother. And now she’s gone. She was the only one who cared whether I lived or died. If I died today, nobody would give a damn…

“I need to let her go. I’m holding her back.”

Serena can see by my look that I don’t follow. “I am not letting her go,” she explains. “In our tradition, we have to let the spirits go. If not, they’re still with us, stuck.”

I suggest that it’s almost impossible for her to find release, since she felt her grandmother was the only one who’d ever loved, accepted and supported her. “But what if you found someone else who really loved you and cared for you?”

“There is no one else. There is none.”

“Are you sure of that?”

“Who? Myself? God?”

“I don’t know. Both, perhaps.”

Serena’s voice breaks with grief. “You know what I think about God? Who is this God that keeps the bad people behind and takes away the good people?”

“How about yourself? How about you?”

“If I was strong enough for that, I’d let her go. I have a drug problem and it’s hard for me to help myself. I’ve tried so many times, Maté. Tried and tried. I’ve quit for four, five, six months, a year, but I always end up coming back. This is the only place I know where I feel safe.” Here in Canada, “our home and native land,” the reality is that the Downtown Eastside, afflicted by addiction, illness, violence, poverty and sexual exploitation, is the only spot where Serena has any sense of security.

Serena has known two homes in her life: her grandmother’s house in Kelowna and one or another ramshackle hotel on East Hastings. “I’m not safe in Kelowna,” she says. “I was molested by my uncle and my grandfather, and the drug is keeping me from thinking about what happened. And my grandfather was telling my grandmother to tell me to come back and to forgive and forget. ‘If you want to come back to Kelowna and talk about it in front of the whole family, you can.’ Talk about fucking what? What? Everything is over and done with already. There is no turning back. He can’t forget and change what he did to me. My uncle can’t change what he did to me.”

The sexual abuse began when Serena was seven years old and persisted until she gave birth to her child, at fifteen. All the while, she was looking after her younger siblings.

“I had to protect my brother and sister, too. I’d hide them in the basement with four or five bottles of baby food. They were still in diapers. When I was eleven years old, I tried to refuse my grandfather, but he said that if I didn’t do exactly what he told me, he was going to do it to Caleb, too. Caleb was only eight then.”

“Oh, Jesus,” escapes from my lips. It’s a blessing, I suppose, that after all these years working in the Downtown Eastside, I’m still capable of being shocked.

“And your grandmother didn’t protect you.”

“She couldn’t. She was drinking so much until she quit. She began drinking every morning. She was drinking until my daughter was born.”

Years later, Caleb was killed—beaten and drowned by three cousins after a drinking bout. “I still have trouble believing my brother is dead, too,” Serena says. “We were so close when we were kids.”

So this was the perfect home Serena grew up in, under the care of a grandmother who, no doubt, loved her grandchild but was utterly unable to defend her from the predatory males in the household or from her own alcoholism. And that grandmother, now deceased, was Serena’s sole connection to the possibility of sustaining, consoling love in this world.

“Have you ever talked with anyone about this?” In the Downtown Eastside this is almost always a rhetorical question.

“No. Can’t trust anybody…Can’t talk to my mom. Me and my mom don’t have a mother and daughter life. We live in the same building; we don’t even see each other. She walks right by me. That hurts me large.

“I’ve tried everything. There’s no point. I’ve tried so many years to see if my mom would get close to me. And the only time she gets close to me is if I have some dope or money in my pocket. It’s the only time she’ll say, ‘Daughter, I love you.’”

I wince.

“The only time, Maté. The only time.”

I have no doubt that if Serena’s mother spoke about her life, an equally painful narrative would emerge. The suffering down here is multigenerational. Almost uniformly, the greatest anguish confessed by my patients, male or female, concerns not the abuse they suffered but their own abandonment of their children. They can never forgive themselves for it. The very mention of it draws out bitter tears, and much of their continued drug use is intended to dull the impact of such memories. Serena herself, speaking here as the wounded child, is silent about her own guilt feelings regarding her neglected daughter, now a crystal meth user. Pain begets pain. Let those who would judge either of these women look to themselves.

As always when I spend an unexpectedly long time with a patient, the waiting-room crowd erupts in noisy protest. “Hurry up,” someone shouts coarsely. “We need our juice, too!” All of Serena’s hurt and rage now explode out of her in a full-throated “Shut the fuck up!” I poke my head out the door to calm the anxious multitude.