This week we present two stories from people who ran into roadblocks trying to save the world.
Part 1: When pharmacy professor Lindsay Acree volunteers at a local needle exchange, her beliefs about addiction are challenged.
Lindsay Acree, Pharm.D., AE-C is an assistant professor at the University of Charleston School of Pharmacy. She received her pharmacy degree from the University of Charleston School of Pharmacy in 2013 and completed a PGY1 residency in academia/ambulatory care also with the University of Charleston. Dr. Acree provides patient care in several clinics throughout the Charleston area including the City of Charleston Wellness clinic and the Family Health Associates of South Charleston. Dr. Acree is a board certified asthma educator. Her involvement with the Harm Reduction Clinic located within the Kanawha Charleston Health Department includes teaching the naloxone training to patients, caregivers, and members of the community as well as assisting with Harm Reduction Clinic services. In addition to clinical services, Dr. Acree teaches several topics within the University such as substance use disorders, asthma, COPD, and tobacco cessation.
Part 2: Engineering PhD student Jeannie Purchase sets out to help a couple in rural South Carolina who have endured dirty tap water for a decade.
Jeannie M. Purchase is a PhD student in the Department of Civil and Environmental Engineering at Virginia Tech. Jeannie received her bachelor’s degree from Clemson University in Biosystems Engineering and her master's from Virginia Tech in Construction Engineering and Management. Her research focuses on examining the efficacy of point-of-use and point-of-entry filters when exposed extreme corrosion conditions and investigating the barriers hindering the widespread adoption of these technologies in at-risk communities. Her interdisciplinary work is at the intersection of citizen science, water quality, remediation, and public health. Through her research, Jeannie collaborates with residents to pursue solutions community-based problems. Jeannie switched between engineering disciplines in pursuit of finding ways to better serve communities through effective communication and collaboration when designing solutions to relevant everyday problems. She believes that it is important for engineers to communicate and engage with the community to understand their needs. Jeannie loves to teach, mentor and inspire students, and work with communities like Denmark, SC.
Part 1: Lindsay Acree
So on a November day, November 2009, I received a call from my brother. I was standing in my dad’s living room and he calls to tell me that a friend of mine had passed away from a drug overdose.
He and I had not been close in many years, probably I'd say at least three or four years the time that he passed away. He was probably the smartest kid in school. He was absolutely the sweetest person in school. I went to middle school and high school with him and it was kind of one of those things that if you had a question about any subject, you’d go ask him. If you needed help with something, you'd go ask him. And he was there for everybody.
Because of his passing, I realized at that moment that I wanted to help people. I wanted to help people that suffer from addiction because I thought is there something that I could have done differently? Could I have been a better friend? Could I have helped him at that point before then to get into recovery? But I didn’t really know how to.
But being in pharmacy school, I was in my first year of pharmacy school and I thought, “Well, maybe I'll learn something here that can help me help other people.”
So that was my first year of pharmacy school. Fast forward three-and-a-half years later. I graduate. I ended up working for the university that I went to school for. And, because of that, it gives me some flexibility with my job.
Well, in 2015, I heard that Charleston was getting ready to have a Harm Reduction Program, which is a syringe exchange program. I’m not sure what they call it here. But I thought, “Oh, my gosh. Finally!”
Because we needed one. It was long overdue. West Virginia has one of the biggest drug problems. We've been number one in overdoses for years because the state was completely flooded with pills. So pills came in and then eventually the pills slowed down. So when the pills slowed down, people started kind of going towards heroin, meth, anything they could get their hands on. So it was a huge problem in our state and we really, really needed something.
So I was so excited the program was starting and I really wanted to help, so I thought this is my way that I can maybe touch lives of people that suffer from addiction. I went to the planning meeting not knowing what to expect. I thought I'll probably try to volunteer at least for a couple of weeks and maybe pull my students in, help my students volunteer. I think I’m only going to be there for a couple of weeks and just kind of getting them into the groove of everything. Little did I know I was going to be there forever. You fall in love with patients and you just can’t stop seeing them.
But the planning meeting I was trying to figure out how is this logistically going to work? How are patients going to handle being interviewed in the room? Is this going to be a rough crowd? I didn’t know what to expect but I wasn’t going to let that stop me. I was determined that I was going to do it.
So first week, we were all excited. Want to see people come. Our health officer at the time, he stood waiting in the waiting room, like this, dressed in a suit, eager for people to walk in. He was so excited. The first group comes in led by this young lady.
She comes in with her friends. She takes one look at him and she's like, “Nope,” and she's out the door. She took off running back to her car. She thought, “He's a cop. This is a trap. I’m gone.”
So she runs out to her car, gets in, and our health officer runs after her, knocks on her window and begs her to come back in, and she did. And because of that day, she continued to come every single week. She brought everybody she knew, so all of her friends, random people that she had just met that she knew used heroin or meth or whatever it may be and needed help. She would bring them all to the health department.
The great thing about the Harm Reduction Program was it wasn’t just us handing out syringes. We were talking to them about being safe, so how to prevent spread of disease, how to use NARCAN to save people’s lives, and that gave them a path to actually getting to recovery. So everybody that she brought in was able to get that same education, which was awesome.
So the program kept growing and growing. And the more that I talked to people, the more I realized how like this stigma surrounding addiction really affects people. Within the first week or two of the program, I had a woman come in and she sat down in front of me. I just started chit-chatting with her and she just started crying.
So I gave her her moment, just let her kind of get it out, then I asked her if she was okay. What she said to me was, “You are nice to me. You're the first person that didn’t treat me like a dog in years.”
But that story was not uncommon. So the more I was at Harm Reduction, the more I heard the same kind of things. When people were new, they would come in and they would have their hoods up. Their heads would be down. They wouldn’t make eye contact. But the more they started coming back, the more they would kind of open up to us.
They knew us by name. We really didn’t know their names because it was an anonymous program. Sometimes they told us that. But more importantly, their heads would be held higher. They would have a little bit more self-respect. They’d have their hoods down and they would greet us. That allowed us that connection to actually help them, which is what we were there for.
Like I said, it kept growing and growing and growing. I really didn’t understand everybody’s path to addiction. We have this idea that everybody starts a certain way, but that’s not necessarily true. Some people’s path was with pills, some people they start with heroin or meth or whatever it may be.
But one thing I didn’t realize was that oftentimes people are forced at a young age. I think the most shocking age that I heard was six. So someone started using at six. Again, that has to do with a lot of issues in the family and being forced. It’s shocking. It’s the only word I can think to describe it.
I'd like to tell you about one patient. I went out to get this patient, to take her into the room and I had no idea how she was going to affect me. I had no idea what I was in for. But she comes in and she’s just hard. She's cold.
She sits down, she crosses her arms. She won’t look at me and she leans back in the chair just trying to act as tough as she could. I just talk to her just like I did everybody else, try to get her to open up and, eventually, she did. Then she started to cry.
She told me that she never really opened up to anybody because she didn’t trust anybody. So she had no one to trust, no one to talk to. This was really the first time that she opened up. So I sat there and watched her cry and it took everything in me to keep also from crying. I tried to talk to her. We tried to get her help.
Eventually, she left the room and I left the room. As soon as I left the room, tears. I just couldn’t hold them back anymore. So I went to the nurse’s station and I stood there and I just cried because I couldn’t figure out how I was going to go to the next patient. Like how do you move on from that? It’s not my life but it’s still someone else’s. Like how do you just go to the next person like nothing happened?
So I stood there and just thought about that. But then I realized that the next person probably has a very, very similar story, so does the next person. Then I never saw her again.
Like I said, everybody’s path is different. Then there's this idea I always hear people say that addiction is a choice. I disagree, obviously, but some of the stories that I've heard are the reasons that I disagree.
I've had people come in and tell me that they used to find syringes on the side of the road, clean them out in puddle water and use them. One guy had one clean syringe left and he sharpened it on the sidewalk because he didn’t want to use a shared syringe. Mothers don’t have custody of their kids, families losing their homes.
So all kinds of things that make me think that there's no way that this is a choice, because if it was a choice they would just stop using, right? So how could it be a choice? It has to be a disease.
Harm Reduction or Needle Exchange Programs, they're very controversial in my state. There are a lot of issues surrounding the program, a lot of people that didn’t really understand everything that we did, who thought we were enabling because we heard that quite a lot. There's a lot of things in the news, a lot of bad press and, eventually, the program was shut down.
But when it shut down, the first thing I thought is what’s going to happen to those people? Where are they going to go now? How are they going to get help? Never once did I think am I on the right side of the fence here, because there's a lot of things in the news that sounded pretty bad? But not once did I think that. Not once did I wonder if we were saving lives. Not once did I wonder if we were making a difference, because I knew the answers to those questions.
But am I going to hear about that same guy going back and cleaning that syringe out in a puddle of water? Am I going to see their faces or their names, which I usually, for the most part, didn’t know, but am I going to see them in the obituaries? Is it going to be this week? Is it going to be next week? I don't know. Thank you, all, for listening.
Part 2: Jeannie Purchase
I first met Ms. Pauline Ray Brown and Eugene Smith in September of 2017. I had first heard their story in my Engineering Ethics in the Public class and Dr. Edwards offer students an opportunity to visit Denmark, South Carolina on a family trip.
I volunteered to go mainly because I was nosy. The story was so bizarre that I wanted to see it for myself. Ms. Paula and Eugene are an African-American couple in their seventies and they have been complaining about their bad water issues for the past ten years. They have been collecting over 40 water samples, jars of dirty, smelly water from their taps labeled with dates and times since 2009, each a sealed time capsule waiting for the day when someone would listen.
They drive 20 miles roundtrip to Healing Springs to fill up dozens of water jugs to use for washing their hair, rinsing dishes, brushing their teeth and cooking. They have collected pictures and high-priced water bills, newspaper articles, letters to state reps, lawyers’ Cease and Desist statements, health records and even a consent order between Denmark and the state all in one binder, bulging with so much information in it it’s bursting at the seams.
But the question that baffles me is how do you have bad and expensive water for ten years and nobody is doing anything about it? The people in the town are so resigned to their fate they don’t even fight it anymore. I had to see this for myself.
But when we arrived, I wasn’t quite prepared. Despite their high poverty rates, Denmark was not in ruins. Paula and Eugene had this nice, clean, ranch-style home overflowing with Southern hospitality. They had this beautiful china cabinet across from the formal dining room table that no one actually eats at. They also had a formal sitting room that no one actually sits in with that couch that typically has plastic on it so you don’t mess it up, but in this case they had a sheet. They also had small black figurines of musicians and angels just placed carefully throughout the house.
Their house, it felt like home. They felt like grandparents I never met before.
Ms. Paula cooked us this huge dinner of fried fish, macaroni and cheese, collard greens, rolls and cake, and when you're finished eating she made sure you got more food than you had space for.
Dr. Edwards mentioned how good the greens were and asked her what they were seasoned with and she was like, “Oh, just some bacon grease,” but I knew it had to be something like that. It had to be more than herbs because there was nothing healthy about those greens. It had to be some turkey neck, some pig feet or bacon.
Paula and Eugene were just this loving couple and their house was filled with joy and stories and love in abundance for all of us, but they just had bad and overpriced water and learned to live with that.
I adopted Denmark for my class study after the trip and I went through that binder that were all the records Paula and Eugene collected. I was looking for evidence of historical documents to give some context to this injustice they experienced, but when it came to writing up my findings I began to freeze because I wasn’t writing a summary of Denmark’s water history. I was putting pieces together to create it.
But who was I to create that history? I’m just a 24-year-old engineering PhD student. Of course I spent hours and months doing research on this but, still, ten years ago when all of this began I was just 14 years old, a freshman, ninth grader at Cedar Grove High School in Southeast Atlanta when Paula and Eugene first started noticing brown and stinky water from their taps. Who was I to write up their history?
As a kid, I didn’t even grow up in Denmark. Did I have the right? I questioned whether or not I was even doing the right thing. It was an ethics class after all.
But what bothers me is that 14-year-old me wouldn’t have questioned it at all. I was a feisty little thing who would have helped these people no matter the cost. I wouldn’t have known how to help and nor would I had the power to do anything about it, but 24-year-old me has been trained as an engineer for the past seven years where engineers must be objective and impartial. We must present facts with hard evidence. We leave out opinions and minimize emotions because emotions make you biased. And if you're biased, you jeopardize your credibility. Essentially, I think that we’re taught to minimize our humanity.
But the real question is was I too emotionally involved? Was this ethical? As you can see, I struggled. I struggled to be objective as possible. I wanted to try to give the bad guys in this saga the benefit of the doubt while still honoring these citizens’ very harsh reality. But this responsibility seems so great and I was so young, like so over my head.
But I am a part of the Virginia Tech team that worked with Denmark residents to uncover the use of a pesticide HaloSan that was being used to treat their wells. It was used illegally and is not approved for drinking water and they've been using this pesticide for the past ten years, the exact same time Paula and Eugene first started believing that their water was making them sick. But we got to help prove that after all these years they weren’t crazy.
Last fall, we went to Minneapolis, Minnesota and we were asked to present on our work that we've done in Denmark, Flint, and other communities. We also accepted award for community engagement that we've done in these places.
When they first told me we were going on the trip and we were going with President Sands and we were taking the HokieBird, I was really excited. But I was a little confused like why are we taking the mascot? I’m all here for this school spirit thing but do we really need that big bird costume?
But the HokieBird is not just the university mascot. It is the university’s private jet. It’s a plane. So I was excited. It’s a plane that’s probably most frequently used to recruit football players but your girl was elated, probably a little too excited because my mom was like, “Calm down. Don’t act like you've never been anywhere before.”
“But, well, Mom, I never met President Sands before and I’m darn sure ain’t been nowhere on no private jet so I’m going to have me a good old time. Don’t worry, though, I’m going to send you pictures.”
Our presentation was amazing and compelling. And the best part was that Paula and Eugene got to go and present with us. They got to really share in the entire experience. They spent a couple of days in Blacksburg, at the Inn at VT, and they got to speak with the new ethics class and we had this awesome potluck for them.
They were catered to by everyone around them. President Sands personally went to go get Ms. Brown a chair when she got tired of standing and Dr. Edwards was running back and forth to get them anything they wanted from the minibar on the plane, except for alcohol, of course. They wanted to make sure I let you all know that part.
Paula and Eugene were truly the guests of honor, as they should be. On top of that, after we got back that night, I took them to their favorite restaurant Red Lobster after we got back. I don't know what happened but, for some reason, the waiter thought it was their anniversary and they got free ice cream and cake at dinner. It was like the perfect ending to the most amazing day.
They were going home the next morning and so I asked Paula and Eugene, “What was your favorite part of the trip?”
You know what they said? The shower.
“What? The shower?” I tried to hide the shock on my face as they continued to talk about this water. It was in this moment of fun and fellowship and laughs that I realized that the best part of the trip was the shower. It was this warm, clean ability to wash and the peace that they had after three days of not having to second guess what was coming out of the tap.
That night, I cried myself to sleep because I can’t fix their water. Then it dawned on me. They weren’t asking me to be perfect, to craft their history, primed and polished. They just wanted someone to listen and to walk with them on their journey, to share with them what I do know and provide clarity where I can.
But I was so concerned about being so young and inexperienced and feeling under qualified, even though I am, as I take on something so much bigger than myself, but I just can’t afford to do that anymore. To question myself, to freeze, to shrink back and wait for someone who is more fit to do this, because Paula and Eugene they already had to wait ten years for a 14-year-old girl to grow up.