A very pregnant woman needs transportation to go home. She gave me an address and I checked the computer and decided to look at the discharge note. She was living at a drug treatment facility and had used heroin about a month before. 

I asked about the treatment program and if she wanted to go back. She said no. Mom was nervous and twitchy. Her eyes darted off in different directions which made me dizzy. What’s the program and the staff like? I always ask this question because I want to know how drug users are treated. She didn’t like it was all she would say. She was in the methadone program for pregnant women an didn’t want to be taking methadone because she believed when the baby was born they would take it away from her. I told her infants aren’t taken away for that reason and methadone for pregnant women is indicated for pregnant drug users, is safe, and is the most effective treatment for heroin addiction. She seemed skeptical.

I called the transportation company SCR. She asked how long it would take because her daughter was coming to the ER and she didn’t want to see her.

Oops, in walks the daughter with her boyfriend. The daughter is obese and wearing a brand new, brown leather bomber jacket with round patches that say things I can’t understand. She asks what’s going on. Mom is really nervous now. They want her to go back to the treatment center, she refuses. We are in the hallway having this conversation and as I listen I get the back story. Mom has been using for 16 years and relapsed many times, she has 3 other children, all were born drug addicted and taken away by DCFS. Including the daughter standing right in front of me. Wow! They are trying to convince her to go back to the program. They tell her they love and care about her and the baby but she needs to be in drug treatment.

 I take the daughter aside. I tell her if mom really doesn’t want to be in treatment trying to convince her probably won’t work. She starts crying. She plans on taking care of the baby when it is born. It will be her sister.  

I realize what the patient is doing. Over the years I have met women with drug addictions that have one child after another. DCFS always takes custody. The cycle continues. They believe they will get it right with the next baby. Get off drugs, get housing, a job, get stable. And crucially, give and get love from a tiny infant. A new baby is hope, a fresh start. 

There is another dynamic at work. Being pregnant brings attention, concern, and a role, a job. Something to do, to focus on. These woman have one identity, addict – being pregnant and mothering brings another identity. It’s one that society respects and reveres. But not if you’re pregnant and using drugs. That’s the part these women forget. Pregnant women who use drugs are despised. They are considered to be child abusers. Then they get the opposite of what they crave: punishment, incarceration, coercive treatment, kid taken away, and doctors, nurses, social workers, family and friends, judging them harshly and telling them what to do. Or else!   

There was no question this baby was going to be taken away from the mother and she knew it.

The driver from SCR arrives to pick up the patient. For a few minutes we all argue about where mom will go. I change the address on the form 3 times. Finally it’s agreed mom will go back to the drug treatment program.

I saw a man dressed all in black, Johnny Cash-like, with a Stetson hat walk into the waiting room. I recognized him immediately. It’s Marcos Raya, one of my favorite artists. He’s in my waiting room! I’ve seen dozens of his paintings and found art objections. I’ve seen his shows at the Cultural Center and at galleries. His work is weird, engaging, full of pain and mystery. And women’s assess. He went through a phase and was painting los traseros de mujeres. Not my favorite paintings. I read interviews with him and he used to be a heavy drinker, but doesn’t drink at all now.  He’s been down there with the booze, gone to places most of us will never go. The paintings are extracts of those places. I see Raya driving around the hood in his vintage, scrappy Jaguar convertible and drinking coffee at the Jumping Bean.  I had to introduce myself and have a chat but there were several patients I had to see first. No problem, he wasn’t going anywhere, he’d be waiting for hours to see a doctor. I saw that he was with a woman. They sat together and he had his arm around her.

I’m back at the counter in the ER and I spy Raya. He’s standing by himself near the front entrance. I walk over and say you’re Marcos Raya. He says yes, I’ve seen you around haven’t I? Yes I say, I live in Pilsen. I tell him I love his work and he thanks me. He’s shy, humble. He asks me if I can change a $20, he needs change for the parking meter. I don’t have a nickel. Will they ticket me he asks? Mosdef. How long will I have to wait?  Hours. His friend who needs to see a doctor is an artist, too. Artists are never insured. He asks me how long I’ve been working in the ER. A couple of months and it gets pretty crazy. Raya’s done crazy and then he asks, you see a lot of alcoholics? Yes I reply.

I told him I’ve been looking for his studio and can’t find it. I know it’s on Halsted, but where? Right across from the Skylark Lounge. He hands me his card and shares that he is working on a self-portrait. He tells me to come by anytime. Dream come true, Marcos Raya telling me I can come by his studio anytime….