809: The Call

Mary Harris

The call on this story took place a few years ago.

Mary Harris

It's a call to a hotline of sorts, though one I'd never heard about before and was surprised to learn existed. This is the music you hear when you're waiting for an operator.

Mary Harris

The woman taking this call, her name's Jessie. She's a nurse, and she's taken thousands of these.

Mary Harris

The hotline is called "Never Use Alone." And the idea is, if you're going to inject heroin or do a speedball, something like that, and there's no one around, you can dial them up. Someone will stay on the line, make sure you're OK. If it seems like you've overdosed, they'll call the paramedics.

Mary Harris

Jessie gets the caller's phone number and address, just in case she has to call the ambulance. The caller, Kimber, is in Massachusetts. Jessie is down in Georgia.

Mary Harris

I spoke with Jessie, the nurse.

Mary Harris

Small doses are one way to try to stay safe when you're using a drug like heroin or fentanyl. But the truth is, you really have no idea what you're getting if you're buying drugs off the street.

Mary Harris

Sometimes a person will call in wanting to talk. With the regulars, Jessie knows the names of their pets, keeps track of their birthdays. But her main job is just to stay on the line and check in every now and then. For this call, she was sitting at her kitchen table. Her husband walks in at some point for help with a Ziploc bag. But every minute or so, she's trying to get a read on Kimber.

Mary Harris

About 60 seconds later, Jessie checks in again?

Mary Harris

Jessie stays on the line. And then after a little while, you can faintly hear in the background, over the phone, someone shouting, "Anybody home"?

Mary Harris

The ambulance got there just 3 and 1/2 minutes after Jessie disconnected from 911.

Mary Harris

Jessie hears him say, "You awake"? Then, "move that suitcase."

Mary Harris

And then she hangs up.

It's easy to read the statistics and still not be able to imagine what the overdose crisis looks like in this country. More than 100,000 people die from an overdose each year. That means that Americans are now more likely to die from an overdose than from a car accident. This hotline's purpose is simple and very single-minded. It's not to get people sober or push them into treatment. It's just to keep people alive, one injection or snort after another.

I wanted to know what it was like for everyone, the callers and the people like Jessie, who sit there while someone uses, knowing they could die right there on the phone. Jessie talks to people week after week, and sometimes they just stop calling. Maybe it's because they're not using anymore. Maybe it's because they're gone.

Actual overdoses on the hotline don't happen that often. And Jessie had no way to know what went on after she hung up that day with Kimber. She kept answering calls on the line, tried to distract herself. She says she probably walked around her yard, poured herself a Sprite. Then she got a text from a pretty close friend of hers, a guy named Stephen. He's a paramedic, so he sees a lot of overdoses. She has him in her phone as "Bruh."

Mary Harris

Stephen works in Massachusetts.

Mary Harris

Immediately, her phone rings. It's him. Like, instead of texting, he wants to talk. She answers.

Mary Harris

Act 2, Stephen. Stephen Murray, the paramedic who responded to that overdose call Jessie took, he had a lot of jobs before working in an ambulance, each with a very different uniform. The first was a black t-shirt. He was in a metal band. Then a suit and tie. When he was in college, he ran for a seat on the village council and won. Being a paramedic meant wearing a button-up with S. Murray on one pocket and a badge above the other. He carried his dispatch radio pretty much everywhere, which is how he got the call that day.

Mary Harris

It was right up the hill from the ambulance station, basically on the same street.

Mary Harris

He bangs on the door, doesn't hear anything. Then he sees a little stairway, runs up, finds another door, which is unlocked. He lets himself in.

Mary Harris

At the end, there's a little bathroom.

Mary Harris

If they'd gotten there a few minutes later, it might have been too late. But now they had a chance. Stephen's got a particular way he likes to handle overdoses, that he feels is easier on the people being revived. Because-- he's thought about this a lot-- if they do come to, it's going to be a very strange experience, some random guy leaning over you, face upside down.

And if you just give someone a big dose of Narcan, it'll throw them into withdrawal. People sometimes wake up angry. They'll have a massive headache because they might not have been getting oxygen to their brain. That lack of oxygen, that's what will kill you in an overdose. So Stephen starts by fixing that.

Mary Harris

He has the police stand in another room while he works.

Mary Harris

So Stephen's kneeling over Kimber's head, squeezing oxygen into her lungs, one breath at a time. Then he gives her the smallest dose of naloxone, just to see how she'll react.

Mary Harris

Upset, despite all his effort, but alive. There's a conversation Stephen sometimes has with people he's revived. He doesn't remember where it happened with Kimber, but often, it's in the back of the ambulance where the driver can't hear. The patient will say something like, you're so much nicer than the other EMTs. And then Stephen will explain, I've been in your shoes.

So Stephen, the person who revived Kimber from her overdose, he'd also survived an overdose. Let me tell you what happened. Stephen started using drugs sometime after he stopped touring with that metal band. He'd been straight edge then, so no alcohol, no drugs. But then he went to college, University of Miami, and academics had never been his thing.

Mary Harris

A friend of the group named Kelly had died recently. She'd fallen off a balcony. It really kind of rocked Stephen's world.

Mary Harris

So drugs became part of Stephen's very busy life. He's going to school, working a campus job. He'd also won that seat on the local village council.

Mary Harris

He used in his car before talking to TV news. Before bed, he would lay out lines of oxy for when he woke up at night in withdrawal. It was the only way he'd get back to sleep. And he was getting way too skinny.

Mary Harris

Stephen thinks he probably OD'd twice somewhere in there, but luckily, he came to on his own. None of that stopped him. His family, at some point, had an intervention, which he said you could see a mile away. Like, he walked into the room, and everyone was sitting there, and no one was saying anything. And he was like, oh, I know what this is.

But he felt relieved to be found out. He only had to go to rehab once, but recovery was a long process. Stephen tried various jobs, ran out of money, went back to living with his folks. They were retired in Western Massachusetts, where he noticed they were looking for volunteer firefighters. So he signed up. And for some reason, it stuck.

Mary Harris

Eventually, he became a paramedic. Stephen's experience with addiction is not what made saving Kimber so emotional for him though. It was something else. Back when Stephen was using, his drugs were coming from pain clinics known as pill mills. But by the time he became a paramedic, many of those had been shut down.

More and more people were getting drugs off the street. That's when fentanyl entered the scene. Fentanyl can be 50 times stronger than heroin. It was causing these cluster overdoses. Stephen would see them from his ambulance. He'd have days where he'd go to five ODs, one after another. He was seeing more people die too. One case stuck with him. Everything went wrong. They were at the station when he got the call.

Mary Harris

This isn't that uncommon, but usually, someone hears the sirens and comes out, says, we're over here.

Mary Harris

A little while later, a different call comes in, a call about a dead body, a woman. Stephen hears the location and realizes this was the overdose victim from that original call. In fact, Stephen had knocked on her very door. Whoever called 911 the first time, they'd mixed up the numbers. So it wasn't 313. It was 133, something like that. So when Stephen and the cops fanned out, went house to house, Stephen had craned his neck to look in the window of the right building, but he just couldn't see the woman who needed his help. She was just out of view.

Mary Harris

Stephen played this over and over again in his mind, looking for ways it could have gone differently. He understood that whoever called 911, they were doing what they could to keep this woman alive, but they were also scared, scared that when someone like Stephen showed up, there would be trouble. So they left. And in the end, it was leaving this woman alone that killed her. It meant Stephen couldn't find her. That overdose call solidified something for Stephen.

With the drug supply getting more dangerous, keeping people who used drugs safe meant making sure they weren't left by themselves. It was sometime around then that he heard about the Never Use Alone hotline, and it immediately made sense. So he got involved-- Zoom meetings, stuff like that. That's how he met Jessie. To get the word out where he was, he made these little cards.

Mary Harris

He convinced programs that give out clean syringes to include these Never Use Alone cards in their kits. Stephen had no idea if any of this was really working. A lot of times, he'd talked to drug users who said, what? I'm going to call up some stranger, tell them I'm about to inject dope? Are you kidding?

But a few hours before he revived Kimber, she had gotten one of these cards bundled up with the stuff she'd picked up at a needle exchange. That was why she called. That was the thing that saved her life. Stephen didn't know that though. When he dragged her out of the bathroom that day and started giving her rescue breaths, there was a cell phone right next to her. He just didn't put two and two together.

After Kimber opened her eyes, Stephen told her she had to go to the hospital for observation. That meant she had to do this walk of shame down her front steps and climb into the back of the ambulance. It was nearly summer, but she put on a big winter coat, pulled up the hood. Stephen started packing up. Before he left the scene, he went to check in with his crew.

Mary Harris

"Oh, my God," he thought. When he got back to the station, that's when he started texting Jessie, and that's when it all kind of came out of him.

Mary Harris

Stephen says, over his time as a paramedic, he pronounced maybe 30 people dead from an overdose. All of them were alone. Kimber was alone too, but she had the line. The line had worked. It's so rare to find something that actually protects people once they're dealing with an addiction. But even when you save someone from an overdose, it doesn't mean they'll stop using. In fact, usually, they don't.

The morning after Stephen revived Kimber, Jessie sent her a text. "Hi," she wrote. "I am so thankful you called." She sent this with a little smiley face and a green heart emoji. Within a couple of hours, Kimber wrote back. She thanked Jessie, asked how many times she got Narcanned. Then, Kimber says, "I want to use again this morning, but I'm terrified." "If you use again today," Jessie replied, "the likelihood of you OD'ing again is almost guaranteed."

Ira Glass

Mary Harris. Coming up, what's Jessie's deal? Also, a fight in a Krispy Kreme parking lot. That's in a minute from Chicago Public Radio when our program continues.

Ira Glass

It's This American Life. I'm Ira Glass. Today's show, "The Call," the story of one phone call to one telephone hotline and its aftermath. So Kimber did keep using and kept calling the line. And a lot of times, she was connected with Jessie, which brings us to Act 3 of our program, "Jessie." Again, here's Mary Harris.

Mary Harris

Jessie's kind of the backstop for the entire hotline, the whole operation. If none of the other operators are available, the calls automatically go to her. And she pretty much always picks up. Sometimes she'll even give someone her cell and say, just call me directly. She did that with Kimber. It's like she can't help herself.

Mary Harris

I went down to visit Jessie at her home in Georgia to watch her work.

Mary Harris

From the second I walked in, she was taking calls, still in her housedress and mismatched socks. The vibe was organized chaos. She takes in strays, seven cats-- one is missing an eye-- a chihuahua, and more chickens than she can count.

Mary Harris

They laid their eggs in the garage. I wanted to know how Jessie, a nurse, had ended up spending so much of her time on this line. And at some point, in a pause in the conversation, she said this.

Mary Harris

She was talking about Kaylen. Kaylen's 23, her only kid.

Mary Harris

Kaylen has overdosed a dozen times and counting.

Mary Harris

Watching her daughter nearly die again and again is kind of how Jessie came around to a whole new way of thinking, and the hotline, too. She tried for years to force her daughter to change. She wanted her to finish school. She wanted her to go to rehab. She wanted her to come home. But wanting all that never made anything go differently. It just made Kaylen push her away.

Now, for her daughter, she really only has one goal. It's the same goal she has for her callers-- don't die. Jessie's serious about this goal, and this one goal only. She literally has a tattoo on her forearm that's a bird taking flight. It's carrying a banner in its beak with a single word on it, "fucks," as in, "I don't give a fuck." My fucks are flying away.

Jessie told me this one story about a time Kaylen pulled up in front of the house with a bag of dope and a couple of friends. It was late at night, just Jessie and her husband at home. Kaylen called her from the driveway.

Mary Harris

They came in, and she watched as her daughter injected herself at her kitchen table. I had so many questions about this approach. I'm a parent. I know how hard it is to stop wanting things for your kids, stop protecting them, stop pushing them towards some imagined, better future. The implications of abandoning that wanting were so radical to me. I asked, what if Kaylen never stops using drugs?

Mary Harris

Remember, Jessie was on her way to work when all this happened.

Mary Harris

She told them exactly what had just happened. After that fight in the parking lot, Jessie started getting needles for Kaylen. Then she ordered Narcan. She got a big box to distribute around town. And inside was a Never Use Alone card. Jessie saw it and thought, huh, good idea.

I heard about Never Use Alone when I ordered my own Narcan from the New York City Department of Health. You have to go to a training before they'll send it to you. The training tells you how and when to reverse an overdose, and one of their PowerPoint slides mentioned the hotline. At the time, I imagined Never Use Alone was some official thing, like 911.

But it's nothing like that. It was started, as Jessie puts it, by a bunch of drug users who were tired of watching their friends die. When she first volunteered to answer calls, the screening process to be an operator consisted of talking to one guy to see if you were a fit. The very same day, she picked up her cell and got connected to someone who was about to get high.

Mary Harris

In the years since, Jessie's set up a whole system, a script that operators can use, a training regimen. But this organization is still basically run on a Google Doc and a prayer. I hung out while Jessie took one call after another over two days.

Mary Harris

The calls were intimate, sometimes joyful. One guy talked to Jessie for like half an hour about his life, where he was going over the weekend, his girlfriend, his health.

Mary Harris

Another guy felt guilty for taking up Jessie's time. He tried to have everything ready to go when he called, and he apologized afterward.

Mary Harris

He told her he tapes Narcan to his arm and sits on his porch after getting high in case he passes out. He hopes his neighbors will find him. There was no recovery talk. Sprinkled throughout these conversations were little reminders of how scary things are for the people who need this line. Jessie gently admonished one caller who told her he'd used on his own, a few hours before, without letting her know.

Mary Harris

"I know that," he says. "I know."

Mary Harris

It's notable that everyone in this story has some kind of connection to addiction-- the people who started the hotline, Stephen, the paramedic, Jessie with her daughter, and actually, Jessie herself. 20 years ago, she had a real problem with opioids.

Mary Harris

For Jessie, there was no rock bottom moment. But after a couple of years, she started running out of pills. And she didn't want to risk her nursing license to get more. She quit cold turkey, spent three days sick on her bathroom floor. Then it was over. Jessie says her daughter Kaylen started using years later when a boyfriend introduced her to heroin.

Jessie wonders about why a lot. Everyone has a why, Jessie says. Kaylen's why, she thinks, sort of has to do with her, their particular mother-daughter relationship. Jessie can be a hard ass. Kaylen, too. When Kaylen got pregnant at 15, Jessie thought Kaylen's boyfriend was bad news, so she blocked him and his family from calling Kaylen's cell. Kaylen was pissed. She threatened to move out. One morning, Jessie told her to go ahead and do it, so she did. They'd see each other every once in a while, but it wasn't the same.

Mary Harris

Over the years, Jessie has watched Kaylen go back and forth. She'll have months of sobriety, then return to use. Kaylen's been picked up by the cops, had her photo posted on the local police department's Facebook page. While I was visiting, Jessie called Kaylen up. Kaylen said she'd come by to talk, but she never showed. I think Kaylen's part of why Jessie takes so many of these Never Use Alone calls. It's people like her daughter on the other end. She told me as much.

Mary Harris

When Jessie took that call from Kimber, listened to her OD on the line, she knew better than to expect that moment to change Kimber's life. And the next day, when Kimber thanked Jessie for saving her and then quickly followed that up with, "I want to use again," it didn't surprise Jessie. In fact, for Jessie, this was good news. It meant she could encourage Kimber to keep using the line, and it was an invitation to stay in touch.

So she did. She friended Kimber on Facebook, texted her for no reason. A few months after her OD, Kimber started calling Jessie "Mama." But Kimber would also drift away. When she did that, Stephen and Jessie would try to keep track of Kimber online, what she was liking and commenting on. "Messenger shows her active 6 minutes ago," Jessie texted Stephen at one point. "She hasn't even read my message. I text her phone-- nothing." "Yeah," he replied. "She's been leaving me on read," like she'd seen his message but hadn't replied.

A month later, Jessie tried Kimber again. "Hey, I haven't heard from you in a while. I hope that means you're good," she texted. Two days later, "hello? Are you good"? A day after that-- "hi, this is Jessie B., in case you lost my contact. It's not like you not to respond. I'm growing concerned." She added a heart emoji, pressed send, and hoped for the best.

Mary Harris

Act 4, "Kimber." While Jessie was checking in with Kimber by text and Facebook, Stephen, the paramedic, he was trying to help out IRL. After all, he and Kimber lived in the same town. Stephen got Kimber back into rehab. Then he offered to get her into job training. A few weeks after her overdose, he posted a picture of the two of them on Twitter. Kimber had shown up at Stephen's July 4th barbecue.

A few months after that, though, is when Kimber went silent for Stephen and Jessie. Weeks went by, then months. And then Jessie got a text from a number she didn't recognize. It read, "hey, Jessie, it's Kimber. I just wanted to give you my new number." Jessie replies, "oh, hey, hi," four exclamation marks. Kimber was alive.

[KNOCKING]

Mary Harris

This, of course, finally, is Kimber. Kimber lives in Vermont now. She's been sober for one year. The place she calls home is a tidy duplex where she lives with her little gray dog, Luna, and not a lot else. She didn't bring anything with her when she left Massachusetts, where she OD'd two years back. There aren't any family pictures on the wall, not many mementos. Kimber is growing plants, though. Nature has always been her thing. As a kid, she was the one who was always bringing creatures home.

Mary Harris

In her new apartment, there's a little sunroom off the kitchen. Kimber wanted to make it into a greenhouse, but the radiator started leaking there, and the floor got soft. Still, this is a fresh start.

Mary Harris

It was different, being on that side of things.

Mary Harris

On that first day she called the line, the day Jessie answered and Stephen revived her, Kimber remembers waking up to a cold shiver rolling down her spine. She was looking down the hallway to the bathroom where she last remembered being, a bathroom now filled with cops. There was the suitcase she'd just lugged home from rehab. And then she got really, really sick.

After Stephen forced her to go to the hospital, she checked herself out within an hour and walked home, puking along the side of the road. She picked up more drugs pretty much right away. The whole idea of Never Use Alone's approach is that, as Jessie puts it, you give the callers time, one more day to fight their demons. And Kimber had a lot of demons. She says her parents both used drugs. When she was 17, her brother was killed by a drug dealer. The whole family kind of crumbled after that, Kimber included.

Kimber went to rehab on and off for years. She'd use a ton of drugs, realize things were getting a little out of control, and check in for a couple of weeks to "spin dry," as she put it. She'd get clean enough to go back to work and pay her rent, and then the cycle would start back up again. So the call with Jessie was not the moment things changed. That moment came over a year later. Things had gotten bad.

She says the sheriff had kicked her out of her apartment, the one where Stephen had revived her. Her car had been stolen and totaled. She was carrying around a backpack with her passport and birth certificate in it. But then it disappeared. Her cell phone was gone too. She had a friend who would let her crash, but the friend had a condition. Kimber had to call detox every day and try to get a bed, which eventually she did.

The hotline is called Never Use Alone, but walking into rehab, Kimber was utterly and completely alone. And maybe for this part, you have to be. When she arrived, the nurse asked if she wanted medication. Methadone? To make getting straight a little easier? For the first time, she said no.

Mary Harris

Kimber remembers all the details because she's really proud of what she did. Four days after she checked in, she sent Jessie that text from a new phone. "I feel like I'm in a stable enough place right now to reach out and let you know I'm back," Kimber wrote tentatively.

Jessie said, "everything that you've been through has prepared you for today. You haven't been wasting time. You've been getting ready. I'll support you however you need me to, every step of the way." For Kimber, it's been a year of big changes. She's in a new town, but she still doesn't really trust herself around her old crowd.

It's interesting how this one call brought these three people together. Stephen told me when he first met Jessie, they didn't really like each other-- too similar maybe. But the call bonded them somehow. And Kimber, right after that call, she avoided Stephen, even though he kept reaching out. She was embarrassed. He lived in her town, knew all the police. She said she got to this point where she knew other people were sick of her bullshit because she was sick of her bullshit.

That passed eventually. Kimber took a trip with Stephen's family to the beach this summer. There are these photos of them, hanging out in the sand. Jessie, to this day, hasn't met Kimber in person, but they text all the time. On Mother's Day, Kimber sent Jessie a card. There was a picture inside of it, an ultrasound. Kimber is pregnant.

Mary Harris

Kimber's got a partner, Mikey. She met him in AA. They moved in together. This pregnancy was a surprise, but a happy one.

Mary Harris

Kimber still dreams about using drugs. These are absurd dreams, vivid dreams, dreams about smoking dope that turns into vanilla frosting. And most of the people she went to rehab with, they've gone back to using. These days, Jessie's still taking calls, sometimes 10 calls a day. She doesn't hear from her daughter Kaylen very much, but I did reach Kaylen. She told me she's trying to use less. Mostly, she said, she's sticking with weed.

As for Stephen, he says reviving Kimber changed his life. He'd been having nightmares about all the people he failed to save. After Kimber survived, he realized he didn't have to be the one pumping oxygen into someone's lungs to keep them alive. He could work more on the hotline instead. So he's doing that. He's even started taking calls.

Stephen and Jessie wanted Kimber to come work on the hotline too. So she went through the training and just took her very first call. Now she's one of the voices on the other side of the phone, saying, put me on speakerphone, lay out your Narcan, unlock your door.

Ira Glass

Mary Harris, she's the host and managing editor of Slate's daily news podcast, What Next. They were our collaborators in making this story. If you liked what you just heard, Mary is such an amazing interviewer. And her daily show gets into the news in ways other people don't. You might check it out.

["TALK TO ME" BY CAVETOWN]

Ira Glass

Mary Harris's story was produced and edited by David Kestenbaum. Our show was produced today by Alix Spiegel. The people who put together today's program include Bim Adewunmi, James Bennett II, Zoe Chase, Michael Comite, Sean Cole, Aviva DeKornfeld, Cassie Howley, Valerie Kipnis, Seth Lind, Katherine Rae Mondo, Stowe Nelson, Nadia Reiman, Alissa Shipp, Christopher Swetala, Matt Tierney, and Diane Wu.

Our managing editor is Sarah Abdurrahman. Our executive editor is Emanuele Berry. Special thanks today to Alicia Montgomery, Paige Osburn, Susan Matthews, Elena Schwartz, Aymann Ismail, Jeffrey Bloomer, Dan Kois, and the entire Slate and What Next team, whose work you can find at slate.com. Our website, thisamericanlife.org, where you can stream our archive of over 800 episodes for absolutely free. Also, you'll find merch. We have the incredible Torey Mala-t-shirt. Check it out. Again, thisamericanlife.org.

This American Life is delivered to public radio stations by PRX, the Public Radio Exchange. Thanks, as always, to our program's confounder, Mr. Torey Malatia. He got fired from his job as an ambulance dispatcher because he was just way too chatty for the gig.

Ira Glass

I'm Ira Glass. Back next week with more stories of This American Life.

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