Johnny shrugged. “Yes.”
His immediate reply was sincere. I supposed one thing we had working in our favor was that Johnny didn’t deny being an addict. He had always been brutally honest with me about what he got up to.
“Johnny, what is your general drug of choice, and how often do you use?”
My chest tightened at the blunt question.
“Usually crank…um, meth.” Johnny coughed, and I gestured to the tub, silently asking if he needed it. He gave a slight shake of his head before continuing. “You say I had heroin in my system, but I don’t remember that. I’m not sure how—” He paused abruptly. Running a hand across his face, he frowned at the pull of the IV. “Anyway, I guess it doesn’t matter. It’s mainly meth, and I get high most days.”
Cori paled but remained quiet.
“Okay. I see you’re thirty. When did you start using?”
“I first tried when I was sixteen, I think,” Johnny answered. I winced, remembering the day. “But didn’t do crank much in the beginning…” His raspy voice struggled, and words came slowly, but I took his ability to answer as a positive sign. “Used to smoke lots of weed. Some pills… Molly… X… Less hard stuff. I had a good friend who died, maybe eight years ago. Tried to quit after that. It stuck for a bit. But the meth has been bad for a while.” He shrugged again.
Dr. Alvarez glanced at the clipboard in his hand, appearing to digest this information.
“I appreciate you being so forthright, Johnny. Many patients in your situation aren’t, which makes my job more challenging. So let me extend the same courtesy to you by being direct. Based on your test results, I would have guessed most of your history. The deterioration of your body, particularly your heart, suggests long-term substance use disorder. I need you to understand that if you don’t stop now, it’s not a question of whether you will die. It’s a question of when. And if you keep on like this, the answer to that question is that you will be dead soon.”
Cori squeaked as she caught a cry in her throat. She still held Johnny’s hand. I saw him squeeze her fingers, but there was no comfort to be had.
The bad news kept coming.
“Johnny, you have sustained severe heart damage. Quite frankly, you have the heart of an elderly person. You’re close to being in heart failure. You’ll never be able to heal your heart completely, but if you take control of your health now, you may hope to undo the worst of the damage and live a normal life. But for the time being, you need to refrain from drug use and any intensive activity.”
The good doctor certainly didn’t pull any punches. He paused, allowing the diagnosis to sink in for a moment.
I was sure Johnny, Cori, and I were all thinking the same thing—staying clean was nearly impossible for someone in Johnny’s situation, even under threat of death. This information essentially translated to the idea that Johnny needed to go to rehab. Or die.
“I know this is hard to hear,” Dr. Alvarez stated. “But unfortunately, there is more.” He leaned back in his chair. “Johnny, blood tests indicate that you are HIV positive. Were you aware of this?”
Cori’s jaw dropped. Johnny looked like he’d been hit by a truck as he shook his head. “HIV positive? Like AIDS?”
“HIV positive doesn’t have to mean developing AIDS, Johnny. Medicine has come a long way regarding HIV in the past few decades, and we have started you on several treatments. As with your heart disease, it’s possible you can still live a relatively normal life with HIV, possible even that the virus becomes undetectable. But you have to take care of yourself.”
It felt like we were at the bottom of a mountain. Heart disease? HIV? Get clean or die? I knew Johnny was headed in that direction, but hearing it out loud was still a gut punch.
Dr. Alvarez stayed in the room with us a few minutes longer, letting us know he’d be printing some materials and checking on Johnny later. He gave us the chance to ask questions. Cori had a few about the treatments that had been started and what would happen in the next few days. She mentioned paying for the hospital stay out of pocket, telling the doctor Johnny should have whatever tests and treatments were needed. Damn. Her brother had not been exaggerating when he said she was doing well.
But after the doctor stepped out, her facade broke.
Tears streamed down her face as Cori begged her brother, “Please, Johnny, let me send you to rehab. You can’t keep turning me down. We’ll find the very best place. I promise. You’ve got to let me do this for you.” She leaned forward to rest her head in his lap. Her muffled voice pleaded softly, “Please, Johnny. Please. I don’t want my big brother to die.”
He looked at me, and all I could say was, “She’s right.”
Johnny brushed his dirty fingers through Cori’s hair. “Okay, Sis. Okay.” He turned his face to the window, asking, “Do you guys mind if I have a few minutes alone?”
Cori nodded. We all needed a break after Dr. Alvarez’s bomb-dropping. She gave Johnny one last kiss on his hands as she rose, and I squeezed his shoulder.
As we exited the room, Johnny piped up, “I must have really been out of it if I missed your wedding.”
I glanced back and couldn’t stop my smile. “Only your dumb ass would have jokes at a time like this. You know it’s because of hospital rules.”
“I figured. Well, even if it took me almost dying, at least the two of you are talking again.”
“That’s not funny, Johnny.” Cori frowned. “Don’t downplay this.”
“Sorry, sorry.” He held up his hands. “Hey, Cor?”
