“A few hours.” He winces. “It’s getting worse. I couldn’t pack the vaporizer.”
“I finally got the shipment of those sublingual CBD lozenges in—do you want to try one now?”
“Y-yes.” Mr. Gutierrez’s neck ticks to the right sharply. “Please.”
Nomi carefully places a small, rectangular lozenge under Mr. Gutierrez’s tongue. “These melt quickly, and the effects should hit quickly as well.”
He groans as Nomi props up his straining neck with pillows for support, then releases a small, broken sigh. “Thank you, dear. That’s better.”
“We’ll sit with you and monitor for impacts. In the meantime, Julian has something he’d like to say.”
Nomi delivers a sharp elbow to my side, snapping me out of my silent observations of Mr. Gutierrez’s state. Much of Nomi’s required reading dealt with Parkinson’s disease—not only how cannabis can help, but also the long-term impacts of levodopa, the standard course of treatment for it. I found the studies fascinating, grateful for the chance to slow down and dive deeply into a condition. Working in the ER, you become an expert in triage. Halting system collapse. Stabilizing the body’s core functions, then moving the patient off your floor and into the specialized unit where their long-term well-being becomes someone else’s job. There are countless ways to die, but those core functions that must be restored are all the same. It can be incredibly difficult to achieve when the damage is too great, but it’s still the ABCs of life. Breathing. Pumping blood. Finding the energy to do it all over again. But just as there’s more to language than ABCs, there’s more to life than survival, and the part of me that compulsively craves harder and more challenging work was unexpectedly satisfied by learning about the complexities of Parkinson’s disease.
I pull the letter from my pocket. “Mr. Gutierrez, I’m very sorry for how I behaved during your appointment. I treated you unkindly and worse, without the respect you deserve. I have much to learn about cannabis, and more importantly, how to treat people with compassion and a collaborative spirit.” I inhale before reading the last line Nomi insisted on: “Also, I’m a huge asshole.”
Mr. Gutierrez snorts, then straightens slowly from the pillow, his left arm unlocking from its pinned, cramped position against his chest.At some point in the last few minutes, it stopped thumping against his chest. He sags backward against the couch, relief slackening his clenched jaw. “Thank you, Dr. D’Angelo.” He reaches his right hand for the letter, which I pass to him, mouth slightly open at the fluid range of movement he’s exhibiting. I check my watch, then look at Nomi.
“Four minutes since dosage administration, and the visible dyskinesia has almost entirely abated.” I blink at her, then reach for the small bottle of lozenges to study them.
Her eyebrows raise in appreciation. “Well, the fast-acting claims appear legit. How are you feeling, Mr. G?”
“So much looser.” He breathes deeply for the first time since we’ve been here. “And completely exhausted.”
“After hours of dyskinesia that intense, I bet you are.” Nomi briefly runs through a list of questions about Mr. Gutierrez’s routines leading up to today, how often he’d consumed cannabis and in what method coupled with his current levodopa dosage and symptoms experienced. Each question is thoughtful, precise, with thorough follow-ups, and I marvel at the patience she has for his longer, more plodding answers. When she’s finished, she asks him if there’s anything else she can help him with, and unlike most people who ask that, you can tell Nomi means it.
“Yes, dear. There’s a tub of birthday cake ice cream in the freezer. Could you get me a spoon, and—and some Doritos?”
Nomi’s lips curve into a soft smile. “Does someone have the munchies?”
Mr. Gutierrez meets her smile with his own, sweet and silly and full of a personality I hadn’t yet seen. It’s lovely to witness, and I’m relieved knowing we’re not leaving him here in cramped agony to fight against the slow, miserable progression of his disease untreated, unhappy, and unwell. The wildest part is, we’ve been here for thirty-seven minutes. It took onlythirty-seven minutesto change his day from awful to bearable to maybe even good.
“Thank you, sweet Nomi. You, too, Doctor Asshole,” he adds, chuckling as he yoinks the spoon and ice cream that I’ve retrieved for him from my hands.
I glance at Nomi, and she smiles, shrugging.
“Well, they’re notstraightCBD.”
Another week passes at Stranger Coffee, making Nomi tea drinks, baiting her into delicious arguments, and going with her to appointments that rock my perception of medicinal cannabis. But today, for the first time, Nomi looks nervous.
“You know what? I’m having second thoughts. Stay in the car for this one.”
“What?” I twist in my seat. “I’ve been on my best behavior!”
“I know,” Nomi concedes, tapping her nails against the steering wheel, “but this is a very sensitive situation. I’m not sure you’re ready for it.”
“Readyfor it? I piece people’s bodies back together for a living.” I point at the small house, only a few blocks away from the small house whereIgrew up. “There’s nothing in there that’s worse than what I’ve experienced at Philly Gen.”
“It’s… a child, Julian. He’s twelve years old.”
I blink at her slowly, an avalanche of disapproval within me cracking, ready to bury everything in its path. “What couldpossiblyjustify cannabis at that age?”
“He has a severe form of epilepsy—over fifty seizures a day unmedicated. His mother was desperate and dropped everything to move to New Jersey to gain access to medicinal cannabis for him. I’ve been working with them for a few months. It’s very hard to witness, and if you can’t refrain from judgment, you need to—”
The last bit of what she says is cut off as I launch out of the car.
“Julian! Wait!”
“It’s one thing when it’s an adult, Nomi, but a child with that serious a condition needs real medical treatment!”
