This Is Addiction


There’s a distance professionals get when practicing medicine. It’s an aloofness that is both protective – to prevent burn-out – and necessary – to keep clinical judgments removed from emotional needs.

In the hospital environment, we used to call it “going clinical.” The idea was to throw an internal switch, one that allowed you to function dispassionately in an environment where you would otherwise freak out.

Instead of fainting at a patient bleeding out, a doctor might be visualizing the relationship between blood pressure and the structures beneath the skin to arrive at the best immediate response. There’s no place for the natural, “Oh my God, this kid’s dying!”

But “going clinical” has a serious downside.


Treatment procedures and policies are based on statistics and science. We very much want to do the best for the most. Evaluating in this way also tends to keep things conceptual and removed from actual people. At its worst, you get a kind of institutional coldness that treats patients as numbers or slot-fillers, or identifies them as if all heroin addicts were cookie-cutter stereotypes. What’s needed is a chance to revisit those connections to real people that brought someone into addiction treatment in the first place.

And this is what I find most powerful about The White Noise, a blog by Cassie Rodenberg, hosted on Scientific American.

The posts tell the tales of prostitutes and addicts living in the Bronx. It is described as “urban anthropology,” and Cassie brings a clear eye and an honest voice to the subject. Her collaborator, Chris Arnade, documents with photographs on his Flickr stream. This latter is essential because it connects names, faces and the reality of addiction in an urban environment.

While the pair has been criticized as not doing “real science” and not reaching a standard appropriate for publication in Scientific American, there is no denying the power of the combination and their ability to cut through the dispassion that comes with a medical license – giving us a chance to reconnect with the indispensable human element, the very thing that drew most healthcare professionals to the field.

Anthropology or Advocacy?

There are facts, figures and data on offer. But if anthropology is a “soft” science, here it is presented in an even greater postmodernist version where the researcher shares her opinions. This type of advocacy and commentary is extremely powerful when coupled with the documented case histories presented in story form.

Cassie states plainly that handling addiction through the criminal justice system is a failure. So too are most social programs because they do not address the very real cycle of abuse and poverty she outlines.

While the criticisms are valid, there are no magic solutions to the obvious despair. However, amidst the carnage presented, there is also hope. We come to appreciate the simplest successes and realize that remaking her subjects into some ideal citizen is not only impossible but also irrelevant. The chance to meet real addicts living the best lives they can manage is simultaneously heartbreaking and inspiring.

I invite you to read and follow her blog – as uncomfortable as it may be. We only fool ourselves when we turn away and “go clinical.”


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