“Snow” – a short story by Michael Fine

By Michael Fine, contributing writer

Copyright© Michael Fine 2019

This is a work of fiction. Names, characters, businesses, places, events, locales, and incidents are either the products of the author’s imagination or used in a fictitious manner. Any resemblance to actual persons, living or dead, or actual events is purely coincidental.

They were getting creamed in New York and DC but it wasn’t snowing in Rhode Island yet. Jack Holland hunched over a cup of black Dunkin’ Donuts coffee and watched the auditorium fill up around him. Another wasted Saturday.

The early arrivals were mostly Asian medical students who clustered around the coffee table in the back, talking to each other. The organizers and speakers stood at the podium in front, loading PowerPoints and making sure the remote for the projector worked. The mayor wanted Holland to come, so he came, but it wasn’t clear what he was going to get out of being there. The doctors were all there to learn how to prescribe Bup aka suboxone, the drug of the month; the new silver bullet that was supposed to stamp out drug addiction. Right. Like Bup wasn’t already available on the street. These bright young doctors were going to get rich running Bup clinics, a hundred bucks a patient, twenty patients a day, five days a week. That’s what, ten thousand bucks a week, and half a mill a year. While they pretended they were so much better than the dealers on the street.

But not Jack Holland. Jack Holland was an EMT.  He was never going to get rich, not on Bup, not on nothing else.  He ran Rescue in Washington City, the poorest city in the state. His squad specialized in drunks, psychotics and ODs. Drug overdoses were the new hot thing in health care because now everyone was dying of them; the rich and the poor, the urban and the rural, the suburbs and the city — people were dying like flies all over now. Washington City was the capital city of ODs, one or two a week, forever infinitem.  Man down.  Run over hot. The bodies slumped over on the toilet, the works on the sink, sometimes the needle still in the vein. Or just laid out in Jackson Park under one of the big copper beach trees like they were taking a nap.  If the body was still warm, they’d start CPR and run them to the ER.  If the body was cold, they’d just call the medical examiner and wait until someone came to take the stiff to the morgue. ODs had been Holland’s life for the last twenty-three years, as long as he’d been on the squad, and he knew the drill.

But new mayor, new priorities. Hard to predict how much the world changes. Washington City had been all Irish and Canuck with a little bit of Polish, a little bit of Syrian and the first couple of Columbians when Holland was growing up.  He himself was half and half – Irish and Canuck, despite the name, but he was third generation American already. It was his great-grandparents who came here to work in the mills. They all died young, before Holland was born, so he didn’t even remember anyone with an accent. Maybe his family had been Irish and Canuck once but his people were one hundred percent American now. Yeah, make America great again. That’s real. All the rest is bullshit.

The new people were all Spanish. Seventy percent of Washington City was now Spanish.  More if you counted the illegals, who you can’t ever count because you are not supposed to know they are here. The mayor was Guatemalan. Most of the City Council was Latino. The stores on Main Street were now all bodegas, Central American restaurants or Spanish barbers and hairdressers. The goddamn pizza place was run by Salvadorans. The old people in the high rises were still Irish and Canuck, but they were the poor Irish and Canuck who had been left behind, the millworkers who had lived their whole lives in triple-deckers and now had no other place to go when their kids moved to the suburbs or to Texas or Arizona for jobs in real estate, logistics or computer software.

The police and the fire department and rescue, they were still mostly Irish.  Now those boys all lived in the suburbs. The union was pretty good, but the union knew, and Holland knew, that the days of the Irish working for the city were numbered.  The new recruits were Spanish and African American.  Some, too many, were women. Even so those new kids trained up pretty good, and they came out looking just like the Irish kids looked, wiry and strong, the men with crew cuts and the women with their hair pulled back behind their heads. They all had the same kind of can’t surprise me or wear me down attitude. They all knew that people who were sick were going to die anyway.  Most of their calls now were frommpeople are just trying to get over, just calling rescue to build a good story, so the ER docs will give them Percs or Oxys to sell. It didn’t matter that the new kids were a different color or that they could actually speak to the people they picked up. Everybody still knew the score.

Addiction is a Disease. Recovery is Possible. Treatment is Available. The first slide was up on the screen. The auditorium was three quarters full now.  People were settling into their seats. A woman came into Holland’s row and settled herself one chair over. She was a large woman, dark skinned, with neat dreadlocks.  She also had a cup of Dunkin’ Donuts coffee. She folded her coat into the seat between them and put her hands around her coffee cup to warm them.

“Snowing yet?” Holland said. “They are calling for four to six.”

“Six to ten where I live,” the woman said. “Along the coast.” She had an accent, something a little British, maybe Caribbean. Barbados or Jamaican, something like that.

“You work in South County?” Holland said.

“No, in Washington Park, in the health center,” the woman said.

“Hey, I work in Washington Park. Rescue. I’m your EMS director. Jack Holland,” he said, and put out his hand.

“Joanna Briggs,” the woman said. She shook Holland’s hand. Her hand was soft and moist but she had a good grip, for a woman. “I’m one of the doctors in the health center. You’re here for a suboxone permit?”

“Naw,” Holland said. “I’m here because the mayor and my chief made me come. EMTs don’t prescribe. Drug overdose is the disease of the month. The politicians think the sky is falling because somebody put a picture of a syringe and a baby on the front page of the newspaper. I’m supposed to learn what you people are doing with suboxone and to network, right? You and me, we live like this. We see that some people live and some people die. You do dope, you die. That’s the way it was thirty years ago. That’s the way it is today; and that’s how it’s going to be tomorrow, next week, and next year, until the next disease of the month comes along.”

The lights dimmed. The speakers began speaking.

First the politicians spoke, naming one another so everyone in the room would know which of them was there.  They each congratulated one another for each other’s great leadership, reading the talking points about human suffering and hope that their communications people had prepared for them.

Then the Department of Health and the CDC came on with charts and graphs, talking about how the sky is falling. Then the experts spoke, taking all day to say what they could have said in fifteen minutes, using language they thought only they knew about a problem that, if you listened closely to them, they thought only they could fix. Holland was warmer now and unzipped his jacket.  He got ready to drift off.

Joanna Briggs, Holland thought. Dr. Briggs. Dr. Joanna Briggs. Dr. Briggs. Couldn’t be. That was twenty years ago. Common name. Holland had never met that Dr. Briggs. He always thought Dr. Briggs was a guy. English. And white.

“Where are you from, Dr. Briggs?” Holland said when they were between speakers.

“I’m from Rhode Island,” Dr. Briggs said. “I was born in Nassau, in the Bahamas, and that is where my accent is from, but my parents came here when I was small.  I grew up in Pawtucket. Yourself?”

“From Washington City. Half Canuck, half Irish. Here all my life,” Holland said.

The speakers began again.

They got their start at Lupo’s when it was still on Westminster. In those days there were a bunch of them, white guys, Irish and French Canadian, a Polack or two, and sometimes an Italian from Johnston or Cranston, who hung together. They moved around at night, between Lupo’s, the Met, that Irish bar on Dexter in Pawtucket across the street from the skating rink and the Ocean Mist in Matunuck.  And all the bars in between. They were cops and firemen, EMTs and cable guys, a plumber and an electrician or two. Lots of the cops and firemen did house painting or contracting on the side, and came after they were done in the summer, hot and sweaty and needing a beer.

Mostly they came for the music and stayed for the beer. Or maybe they went for the beer and the music was there anyway. Or maybe they went to hang out and there was music and beer and on a good night, women.  Lots of women who came and went, all trying to worm their way into the scene, but none of them ever completely succeeded. It was after Desert Storm but before 9/11, and a bunch of them were in the Guard, mostly as MPs from a unit out of Quonset, and those guys got called up for Kuwait but were in and out so quick there wasn’t time for them to be missed. The guys in the MP unit came back with good stories to tell even though no one got shot up bad or hurt, so they were stories without pain. Not like what happened to the guys in Afghanistan or good old Iraqi Freedom. By and large the Rhode Island guys lucked out then.  Not always though.

Maureen was a foxy little thing from Fairlawn, Jimmy Moses’s sister, blue-eyed with straw colored hair that she wore pulled back into two little ponytails that hung to her shoulders. She chewed gum, even when she was dancing, and she liked tight jeans and tank tops that let you see her boobs which were plentiful and also a decent run of cleavage, so your imagination didn’t have to work too hard when she came into the room. She was smarter than most – she was an x-ray tech at Rhode Island Hospital, and she made good money – better than most of the guys – so she could have done better for herself, a doctor or a lawyer or an accountant, maybe, which was just to say she didn’t have to run with them, but she ran with them anyway, and was always dancing when there was music, always ready for a good time. She bounced from one guy to the next and she always danced with different guys, even when it looked like she was with one guy for a couple of weeks. Holland wasn’t sure but he had the idea that she never went home alone.

But Holland wasn’t a dancer. He’d sit at a table with his hurt leg up on a chair or he’d hang out on the bar, watching, and he figured she was only interested in guys who danced. The guys drank some but not usually too much. Some nights, more. They were cops and EMTs and firemen, so they always kept an eye out for each other. Friends don’t let friends, hell, you know the drill.

But one night at Lupo’s before the music started, when Holland was sitting at a table and a couple of the guys who had just come in were still at the bar getting drinks, Maureen came over and put her hand on his shoulder and then on his arm. She sat down next to him.

“Í don’t dance,” Holland said.

“I can teach you,” Maureen said.

“I’ve seen you work the room,” Holland said.

“I don’t work the room,” Maureen said. “I like people. I like that everyone is a little different, and I like to learn what makes each person tick. So, what makes you tick?”

“I don’t tick. I tock,” Holland said.

The lights dimmed and the band started, loud, funky and electric. Holland couldn’t see or hear Maureen for a couple of seconds, and Holland didn’t know what the hell to think.  And then he noticed his brain was racing, and that he wasn’t thinking at all but there was a shit-eating grin on his face.

“Stand up,” Maureen said, as soon as the band was between songs. “And don’t you dare dance. I’m going to dance for both of us.”

So, Holland stood with a beer in one hand while Maureen danced in from of him, and eventually he began to sway and move his head. She made him smile, that Maureen, in spite of himself. She was just a kid. Jimmy Moses’s sister.

Then there was a slow dance. She had a tight little body, that Maureen, and it felt too damn good to have her pressed up against him as he stood there, as she moved for both of them.

There was a fifteen-minute coffee break.

Dr. Briggs was looking at her iPhone.  It didn’t make any sense.  All that stuff with Maureen was a long time ago.  Most of the guys had moved away.  Some had already retired.  Nobody remembered that old stuff.

Then, Dr. Briggs looked up, and she started to scan the room as if to see whether anyone she knew was there.

“So, you ever spent any time at Rhode Island Hospital?” Holland said.

“Not for a long time,” Dr. Briggs said.  “A little time when I was a resident. Family Medicine. We did pediatrics and some electives there. That was twenty years ago. They treated us poorly. I guess they treated everyone poorly. I’m on the staff of Memorial now. But I never go there either. We don’t take care of our own patients in the hospital now. Hospitalists do that. I go to the hospital for meetings now, but only once in a while. You work there?’

“Naw,” Holland said. “I spent a little time there when I was doing an EMT course back when I was just a fireman. In the Emergency Department. Learning to take blood pressures and start IVs. Now I’m in the ED every day. At Memorial and at Miriam. Sometimes Rhode Island. I know all the nurses and the techs at Rhode Island. I knew somebody…”

The speaker at the front tapped her finger on the ball of the microphone, and a loud BUMP BUMP BUMP echoed in the room.

‘Let’s get started,” the speaker said.

The room went dark. A new slide was projected on the screen over the head of the speaker.  Bright yellow font on a navy background, with pictures of kids scattered around the text.

Holland looked out a window. The sky was so grey it was almost green. Holland could feel the snow coming, but nothing was falling. They were calling for four to six. Nothing yet though.

And then they were a thing.  Jack Holland and Maureen. 

It was a wild time but it was a good time. A couple of weeks. It would be a good time for a couple of weeks. Nothing gambled nothing lost. She never stuck with any one guy for long, so Jack was always ready to be dumped, and was always jumpy when he called, if she wasn’t home. But I can ride with the punches, I’m tough enough. I can ride this one out, it’s worth it, Holland thought.  What do they call it now, no strings attached?  Stupid to get your emotions wrapped up in something like that.  Enjoy it while it lasts.  It was pretty good.  Maybe even really good.

That was back before cell phones. So you called. And maybe you got the voice mail, but then you didn’t know if the person was out or if maybe they were there and screening their calls, unless they picked up. And maybe you drove by their house if they didn’t pick up to see if their car was there, and just to see if there was any other car you knew in the driveway or parked across the street. What do they call it in the emergency management world? Situational awareness.

But she was really into him, that Maureen.  Didn’t make any sense.  She could have had any guy she wanted, cop or fireman or doctor or lawyer.  Anyone, and it was really cool that she wanted him, Jack Holland, although it never quite made sense. Maybe she liked it that he didn’t talk much, so she could do all the talking and he’d just sit there, looking at her, taking her in, enjoying her and every second and only half listening. He liked to look at those smart eyes because she was so much smarter than Jack would ever be, and he liked to think about that hot little body, and he liked to rest one hand on her thigh under the table when they sat together drinking, just holding that warm flesh, as if it would be there for him forever, there to keep him juiced up. Maybe she liked his hurt leg. She would stroke it when then were in bed together, and handle the hard knob where the bones had come together, and where you could feel the steel screws deep in his flesh, as if she were reaching for a place she’d never be able to touch, as if she wanted to hold what was hot and cold at once and feel a feeling she’d never felt before.

They drank a lot. Too much, looking back. But they were young, they could hold their liquor and it let them be loose and free.

Two weeks turned into two months.  Jack never thought it would last.  He had never been into a woman like he was into Maureen. Two months turned into six months.  Six months turned into a year.  She was wild and free, that Maureen.  Always doing crazy things.  Thinking crazy things.  Wanting crazy things.  And Jack, he was totally into her, even as he waited, expecting to be dumped, and then every day he wasn’t dumped was kind of a celebration, a completely different life, a life he could never have imagined, and certainly never could have imagined for himself.

One late afternoon in March of 1999 Jack called her and got her voice on the answering machine. It was after she was done with work, at the end of the day but while there was still light, though the light was thin and yellow. He was coming off an overnight shift. He was supposed to go home and sleep until eleven, and then they were going to meet up at a piano bar downtown, over at Davol Square, which was classier than the kind of place they usually hit.

But Jack couldn’t sleep. He called her again. Maureen still wasn’t picking up. If she wasn’t home where the hell was she? Jack thought. Yeah, it was just a matter of time, but he wasn’t done, not yet. Maybe he could find her before she hooked up with someone else. Maybe he could head her off at the pass. Who the hell did she think she was, getting to him like this, and then moving on?

He got into his car.  You don’t always think straight when you didn’t sleep the night before. He’d find her. There were only a couple of places she could be. He’d find her and have it out with her.  Truth is truth.  He could take it. They were adults.  No need for anybody to be sneaking around.

Her car wasn’t in front of her house but he rang the bell and banged on the door anyway. He drove to the Green Bar but she wasn’t there, either. A bunch of guys were there so he had a beer, as much from habit as from thirst, and then an Irish whiskey and waited to see if she’d show and who she’d come in with. Then he headed to the East Avenue and parked in the back.  He sunk down into his seat and just sat in his car, waiting for a few minutes, but no one he knew came in or out.

She wasn’t inside. He had another beer and sat at the bar, looking at his watch. Tommy Cairns came in with Jill Puleo, and they were joined by a couple of guys from the Providence squad, so he had another beer with them, and then Jill said something about going out to the car to do a couple of lines but Jack wasn’t ready to be zoned like that. He was awake and on edge, and just settling into a mean drunk so he had a Scotch and waited until Tommy and Jill came back from the parking lot. Then he had another Scotch. Then he shoved off.

He drove over to Blackstone Boulevard and then down to Pitman, and over to Gano, and then to Wickenden. The Coffee Exchange was closed and dark. There were college kids walking on the street near the Indian restaurant and the pizza place, but no sign of Maureen.

The piano bar was empty. The piano was there, in the center of the room, but no one was playing it. Jack sat in a booth and drank. It sucked to be losing Maureen. What was he thinking in the first place? He knew from the beginning they’d end up like this. It was nine-thirty. Then ten. Then ten-thirty. Jack was sitting so he could see the door but he wasn’t looking at the door or anyplace else. He was working hard not to think about her or himself or them and he wasn’t looking at the door at all, except when he was.

Then there she was. Maureen bounced in, all business wearing a skirt and a sweater and her straw-colored hair swept to one side, looking fresh like she had just stepped out of the shower. Chewing gum. Damn her.

When Jack didn’t stand, Maureen leaned over and kissed the top of his head.

“I brought you a present,” she said, and put a small, wrinkled brown paper bag on the table. “Man, we’re going to have fun tonight. You ready for something different?”

“Where the hell were you?” Jack said.

“What do you mean?” Maureen said. “It’s eleven o’clock. Like on the dime. We were supposed to meet here at eleven. What’s with you?”

“I mean where were you before? I called you. You weren’t at your house and you weren’t anywhere else.”

“You came over to my house?  Didn’t you just get up?”

“I couldn’t sleep. I drove by your house. No Maureen. You weren’t at the Green Bar or the East Avenue. No Maureen any of them places. Where the hell were you?”

“Out. You know what? Fuck you. I brought you a present. You can go fuck yourself.  I’m going to the Ladies Room.”

Maureen stood, her jaw clenched and her eyes squinty, like she was bound and determined not to give an inch and not to cry. She swept the wrinkled brown paper bag off the table.

“I don’t need you for this,” she said, and Jack took her to mean only that she didn’t need him to give her shit about just trying to live her life.

I’m being stupid, Jack thought as soon as she was gone.  It’s all in my head.  He ordered another drink.  I’ll fix it when she comes back.

But she didn’t come back.

I’m a fool, Jack thought.  He got a strange empty feeling in his stomach. I better go fix it.  Apologize and all that shit. I’ll drive over to her house. I got to own this one. This one is all on me.

But her car was still in the parking lot.

Where the hell is she, Jack thought. In the Ladies’ Room all this time? What the hell is going on?

So he went back in the piano bar, more confused than drunk and more drunk than pissed off at himself for fucking this one up.

Then somebody was yelling for help.  That yell came from deep in the bowels of the place, near the kitchen.  Jack ran hot, full steam towards the yell, which turned out to be coming from the Ladies’ Room.

Maureen was in a stall, slumped over and blue. There was a set of works on the blue tile floor next to her. A waitress and a cook were in the stall, holding Maureen up, yelling for help, but they had no fucking idea what they were doing. Or what they were dealing with.

He knew she was dead as soon as he touched her.  When he lifted her, she was light and heavy at the same time – easier to lift than most of the bodies he had lifted, but dead weight, and so not Maureen. Her body was still warm, but not hot like Maureen’s body was. He carried her out of the stall, lowered her to the ground, and started CPR.  He heard the sirens and then he heard them get closer. But they just weren’t close enough. Not then.  Not ever. Would never be close enough, ever again.

Providence showed and pushed him out of the way. First they took over CPR. Then they stuck on AED pads like there was something left to save. There was a rhythm so all they did was bag her.

 Maureen got a little color back but she stayed waxy and white, her skin cool to the touch.  He prayed that they weren’t too late.

But he knew.  In the back of his mind, he knew how much time had elapsed.  Twenty, maybe thirty minutes before he got out of his seat to go find her.  Another five or ten in the parking lot.  Brains need oxygen. Jack was no rocket scientist, but he could add.  And subtract. And multiply.  And divide.

They rushed her into the truck, but Jack knew the game was over.  He drove his own car right on their tail as they ran hot.

 It was just a couple of blocks. They got her tubed in the ED and sent her straight to the ICU.

He stayed three days straight until they ran the EEG. He knew. No brain activity. Nothing left. Her skin was white and her flesh, her face, her arms and her legs got bloated. Then he couldn’t stand to look at her anymore.

So he called every day. She was twenty-seven, goddamn it, and you don’t just turn off the ventilator on a twenty-seven-year-old who was so full of life. Her parents and Jimmy stood guard.  She was theirs again.

He called every day and he talked to the resident in the unit that month.

Dr. Briggs.

They broke for lunch.  Dr. Briggs went back to looking at her phone.  Then she stood without looking at Holland and walked to the back of the room to get her boxed lunch.

The snow had started to fall, big broad flakes that drifted to the ground with determination.  A thick fog of falling flakes.  A blanket hanging in the air, too dense to see through.  Holland imagined that the people outside were hurrying to get home, hurrying to the store to get their batteries, milk, and bread and then go home and hunker down for the storm.  He imagined that people had turned up their collars and were covering their heads because the snow was thick and moist, the kind of snow that coats your hair and falls into your eyes and works its way under your collar and onto the skin of your back and chest and sends a chill right through you, into your core.

Wish I had the four-wheel drive, Holland thought. Looks like the weatherman was right this time. At least four to six. Six to ten on the coast.

Dr. Briggs was in the back, talking.

That other Dr. Briggs, the one for Maureen, the guy Holland knew only as a voice on the phone was a white guy. Holland was sure of it. He listened to the voice again in his mind, the voice he hadn’t thought about or heard in twenty years. He wasn’t so helpful, that Dr. Briggs, although there was nothing he could do.  He didn’t seem to remember Jack from call to call.  He didn’t get what Jack was going through.  Her condition hasn’t changed.  Her vital signs are stable, at first. That was all he would say, that Dr. Briggs.  Like Jack was some distant cousin, calling for a weather report. And then, she’s hemodynamically stable, after Holland told Dr. Briggs he was an EMT. No spontaneous movement.  No evidence of brain activity. There’s always hope, but we are being realistic and talking to the family about options. Then, chronic vegetative state. That Dr. Briggs was always in a hurry, his voice clipped and precise. Common name. Probably just a coincidence.

The speaker tapped on the end of the microphone with her hand.

“Would everyone get lunch and return to your seats?  This is an eight-hour course, and we have to do eight hours for you to get credit. But because of the snow we want to get started again as soon as we can, so we can get you out of here before the roads get worse. Five minutes.”

Holland got up. There were only a few boxed lunches left.  Turkey on rye or vegetarian. 

Dr. Briggs caught his eye again as they were sitting down.

“Snowing at a pretty good pace now,” Holland said.  “I hope they do get us out early. Even though it’s Saturday. 95 is going to be a bear.”

“I don’t know the people on Rescue in Washington City,” Dr. Briggs said. “Your guys help us out two or three times a week. Perhaps we can collaborate a little more.”

“Good idea. Hey Doctor. So you didn’t work in the ICU at Rhode Island in the late nineties?  I had a friend there.”

The lights dimmed, the projector came on, and the speakers began to drone on again. The PA system was louder than it needed to be. There was feedback which made the speaker shrink back from the microphone for a moment until the amplification was adjusted.

Dr. Briggs looked like she was going to answer but stopped and turned her head to the front so she could see the slides.

A year later, it was Dr. Briggs who told Holland the plan.  Maureen had been on the vent for a year.  Dr. Briggs came back to the ICU every few months, and he would take Jack’s calls when he was there. Jack called in every day, but he couldn’t stand to go there. His hands would shake before each phone call. This was him. His. He had done this. For a year, Jack spoke mostly to nurses. Then they took Maureen out of the ICU, and she spent ten or eleven months on a vent unit in Jane Brown, waiting for a bed at Eleanor Slater.

Then one day she was back in the ICU when Jack called, and it was Dr. Briggs on the telephone again.

“Do you want to be here?” Dr. Briggs said.

“I call in,” Jack said.

“Her brother said everyone wanted to be with her. The plan is for extubation at about eight thirty tomorrow, right after morning rounds.  There’s a surgical team standing by. Hard decision,” Briggs said.

“What decision?” Holland said.

“Extubation.  Organ harvest. Very hard. Very sad. The right choice.”

For a moment, Holland felt like they had extubated him. No air. Room spinning. Can’t tell up from down.

“You’re the fiancé, right? Okay for you to be here. Probably better, psychologically.  Closure. Tough case.”

He went then. Right then. Just after dark.

It was only barely Maureen. He recognized her by the way her hair was parted in the middle and tied on both sides of her head. That reminded him of the ponytails and the way she chewed gun while she danced. Her face was white and waxen, almost a little blue, like ice. The respirator whooshed in and slowly out, lifting Maureen’s chest for her with each incoming breath, her chest and lips rising and falling like the incoming tide, the sound of expiration like the water draining out among the rocks at the shore, so clear and final that Jack pictured the rocks and the shells at the beach tumbling over one another as the tide receded and he heard the water rushing and crackling through the rocks.

Only barely Maureen. There was peace in the room, a great holy peace.  He stood with her for an hour, and held her hand, which was cool and flaccid, as if she had already withdrawn from her body. He watched her chest rise and fall.

And then he felt her presence, like she was next to him, talking. Or standing in front of him, chewing gum while she danced. Only lighter than that.  He had the sense that she wanted him there, that she had been missing him and wanted to talk to him, to be with him.  And now here he was.

Maureen was peaceful.  The sun was setting. The room filled with light.

She didn’t talk, of course. She didn’t move or blink. But he heard her anyway. Have a life, she said.  Find someone who loves you. I didn’t mean to hurt myself that night. I only wanted us to be together more intensely.

Jack stroked her cheek and leaned over and kissed her forehead, and he felt his chest start to shake, so he backed out, stifled his shaking and he blocked a goddamned tear.  He stuffed all that he was feeling back into his chest, and he walked out of the ICU cubicle where she lay dying while he was still a man, before he lost that, too.

He checked at the ICU desk.  Dr. Briggs was gone for the night.

The talk ended.  The last slide was of the speaker’s three children waving on a beach surrounded by palm trees. There was polite applause.

The lights came on.

A moderator came to the microphone.

“We’re going to cut this short,” the moderator said. “It’s snowing hard now. It’s two forty-five. If everyone goes on-line and reviews the last slide set and completes the post-test, that will give you your required eight hours. Then you need to apply to the FDA for a waiver and set up your own offices to do suboxone. We have assembled a list of mentors to help get you started.  We hope you will all begin prescribing and help us get the thousands of people dependent or addicted to opiates on medication-assisted therapy. Good luck, and thanks for coming out on such a lousy day.”

People began to stand. There was the bustle of voices, the smack and clacking of desks and chair seats being closed, the rustling of clothing and the stamping of feet.

“My ex-husband worked at Rhode Island about twenty years ago,” Dr. Briggs said. “He was an internist who trained in pulmonary critical care. He rarely left the ICU. Maybe he knew your friend.”

“My fiancée,” Holland said. “She died in the ICU after a prolonged hospital stay.”

“I’m sorry,” Dr. Briggs said. “I’m sorry for your loss.  I hope they took good care of her and took good care of you. My ex-husband is a very smart man. He is very good at what he does. But sometimes he can be a little brusque. Sometimes it is hard for him to listen.”

“It was okay,” Holland said.  “Everyone was okay. It was a long time ago. Seems like in another world. Hey, hope to work together a little bit. Lots of ground to cover. I figure we’re better if we all talk to each other.”

“I’m looking forward to it,” Dr. Briggs said, and she held out a gloved hand. “Stay warm and dry. There’s nothing we can’t do if we do it together.”

The snow was falling in big slow flakes that coated Holland’s hair and eyebrows and fell inside his collar. There were already six inches on the ground so after a few footsteps there was snow in his shoes. Holland could only see a few inches in front of him. The city was white and quiet. Cars were moving very slowly through the streets, which had not yet been plowed.

I should have brought the goddamned four-wheel drive, Holland thought. It’s going to take me hours to get home.

Addiction is a disease. Treatment is available.  Recovery is possible.


Maybe not.

From Rhode Island Stories, the book scheduled to be released in September.

We lost 382 people to drug overdoses in RI last year.  Now the numbers — 30-40 a month — are more than we are losing each month to Covid. 


Dr. Michael Fine

Michael Fine, MD is currently Health Policy Advisor to Mayor James Diossa of Central Falls, Rhode Island and Senior Population Health and Clinical Services Officer at Blackstone Valley Health Care, Inc. He is facilitating a partnership between the City and Blackstone to create the Central Falls Neighborhood Health Station, the US first attempt to build a population based primary care and public health collaboration that serves the entire population of a place.

He has also recently been named Health Liaison to the City of Pawtucket. Dr. Fine served in the Cabinet of Governor Lincoln Chafee as Director of the Rhode Island Department of Health from February of 2011 until March of 2015, overseeing a broad range of public health programs and services, overseeing 450 public health professionals and managing a budget of $110 million a year.

Dr. Fine’s career as both a family physician and manager in the field of healthcare has been devoted to healthcare reform and the care of under-served populations. Before his confirmation as Director of Health, Dr. Fine was the Medical Program Director at the Rhode Island Department of Corrections, overseeing a healthcare unit servicing nearly 20,000 people a year, with a staff of over 85 physicians, psychiatrists, mental health workers, nurses, and other health professionals.

He was a founder and Managing Director of HealthAccessRI, the nation’s first statewide organization making prepaid, reduced fee-for-service primary care available to people without employer-provided health insurance. Dr. Fine practiced for 16 years in urban Pawtucket, Rhode Island and rural Scituate, Rhode Island. He is the former Physician Operating Officer of Hillside Avenue Family and Community Medicine, the largest family practice in Rhode Island, and the former Physician-in-Chief of the Rhode Island and Miriam Hospitals’ Departments of Family and Community Medicine. He was co-chair of the Allied Advocacy Group for Integrated Primary Care.

He convened and facilitated the Primary Care Leadership Council, a statewide organization that represented 75 percent of Rhode Island’s primary care physicians and practices. He currently serves on the Boards of Crossroads Rhode Island, the state’s largest service organization for the homeless, the Lown Institute, the George Wiley Center, and RICARES. Dr. Fine founded the Scituate Health Alliance, a community-based, population-focused non-profit organization, which made Scituate the first community in the United States to provide primary medical and dental care to all town residents.

Dr. Fine is a past President of the Rhode Island Academy of Family Physicians and was an Open Society Institute/George Soros Fellow in Medicine as a Profession from 2000 to2002. He has served on a number of legislative committees for the Rhode Island General Assembly, has chaired the Primary Care Advisory Committee for the Rhode Island Department of Health, and sat on both the Urban Family Medicine Task Force of the American Academy of Family Physicians and the National Advisory Council to the National Health Services Corps.