The Methadone Mile: A Case Study

I worked as a medical scribe in an emergency department (ED) after my undergraduate education and one loss that I found particularly harrowing was that of a young teenager who had drowned while swimming in a lake. Her friends were unable to perform CPR and she went at least 20 minutes before being resuscitated by the paramedics. Despite the CPR provided by the paramedics, her pulse was thready and barely palpable upon her arrival at the ED. Further aggressive resuscitation by her physicians could not compensate for the time that she had gone without CPR and she passed away a few hours later. Losing any patient is difficult and so was losing her, however, I was particularly distressed because the simple knowledge of CPR could have dramatically changed her outcome.

This changed quickly after I moved to Boston for medical school. On my walk to school every day, I cross an intersection that is part of what has been referred to as the Methadone Mile by the Boston Globe. This Methadone Mile refers to an area where a clinic for the homeless, a methadone clinic and an open air drug market exist in close proximity. For this reason, witnessing drug sales on my way to and from school is commonplace, and overdoses are not uncommon at this intersection.

I remember feeling quite puzzled by a sight during my first week in Boston; I walked by an individual someone who was lying down with eyes closed on the street and I was unsure as to whether he was just asleep, heavily sedated or unconscious. Even more disconcerting than this puzzling sight was the realization that I wasn’t confident in my ability to be of help if he was in fact in need of resuscitation. This disconcertion was taken care of in a few days when I completed a CPR course for all first year medical students at the end of our orientation