An old friend of mine died a few days ago from a drug overdose. He was 24 years old.

He lived just up the street from my home. I knew him for most of his life, and he was sparkling as a child. My wife and have been friends with his parents for decades, and I worked as a nanny for “the kids,” as my wife and I called them.

My first stint was when he was 2 years old, and his brothers were 4 and 6. He was the cutest 2-year-old I’ve ever known. He was happy, funny, sensitive, and had a remarkably developed personality for that age. He loved to laugh and play, and one of his most amazing features was his sense of empathy, which I’ve seldom seen in a 2-year-old.

Continue Reading

When I first started nannying for him, I was still learning his routine. And on day 1 when it came time for him to take his mid-day nap, I had no idea how the process worked. So he showed me.

He went to his crib and stood ready to be hoisted in, and so in he went. But I could tell as he stood and looked up at me expectantly that clearly there was more to this process. He sensed my unsureness and cheerfully said, “Binky!” His blanket was on the floor of the bedroom, so I quickly fetched it and presented it to him. But there was more.

He looked up at me again with his eyebrows furrowed. “Bobby!” he said enthusiastically, and away I went to get his bottle. He took it from me, lay down in the crib, got himself cuddled up in his blanket, put the bottle in his mouth, and beamed up at me. He looked proud of me—a signal from him that I had done a good job.

I continued to nanny for him and his brothers frequently over the years, and while I loved them like my own, they certainly could be a handful. I later did another nanny stint, when the little guy was 6 or 7. He was earnest and engaged, and often offered hilarious observations. Once when we were all watching TV—the kids, their dad, my wife, and me—we had a habit of turning off the volume during commercials. After a few times of doing that, the little guy strongly objected, stating, “If we can’t hear the commercials, how am I supposed to know about all the products?” We all burst into laughter, but he was very serious about this.

When I started to nanny for them the second time around, the kids and I would traipse around the city to find ways to keep them engaged and occupied. Sometimes they were impossible to corral, particularly in the car. Once when the little guy was annoying his brothers in the back seat, and after about the fifth warning, I said, “Okay, that’s it, no TV this afternoon,” and he burst into the most dramatic tears I had ever seen. One of his older brothers quickly weighed in, saying, “Jim, I think that’s unfair. I don’t think what he was doing should result in such a strong punishment.” All of this coming from kids between 5 and 10. I weighed the testimony, and agreed to reverse the no-television edict. The little guy looked so happy to hear that his sentence had been stayed.

We introduced the “high-five, handshake, or hug” exit process at some point, so that when I left every day, the kids had to choose one. They liked it, and they’d often mix it up. It was up to them. I’d be ready to leave, and the little guy would beam up at me, usually opting for a high-five.

As the kids got older, they wanted to play on the local youth football teams. It was decided that they could participate, but if they joined the team they would have to sign contracts agreeing to do specific tasks around the house—tasks that they, like most kids their age, were not anxious to perform.

So I typed out 3 contracts, each spelling out the obligations that playing football would mandate. I met with each kid individually, and I got to the little guy last. The older boys were glad to sign the contracts, and when I made sure that they clearly understood what they were agreeing to, they had no problem. But the little guy was more hesitant. As we went over it, discussing each item, he started to look a little worried. “You mean if I sign this and play football, I have to help put laundry away every single day?” he asked.

“That’s right,” I replied. “You don’t have to sign this, but if you want to play football, this will be necessary.” He paused and looked down at the piece of paper. Then he smiled and said, “Okay, Jim!” and signed the contract, leaping up from the table to run back out to the yard to play.

The contracts were all kept in a little black binder, and when the kids would balk when they had to help with the chores, I’d have them sit down with me at the table and I would pull out the contracts. “As you see here, you made an agreement to do this” I’d say sternly, and the little guy would grimace, shake his head and exclaim, “Man!” But he’d get up and get to the chores.

I work in addiction medicine in a methadone clinic, with people who are addicted to heroin. Most of stop or reduce their heroin use and become more functional. But the saddest cases are those who are not able to get better. Some of them die, and it’s hard to deal with that.

But it’s nothing like dealing with the death of my 24-year-old friend. Nobody is born with addiction, and it’s so hard to think of him as a sparkling, vibrant, happy little dude who taught me how to put him in the crib. I think the same thing sometimes about my patients. I try to imagine them as little children, and I wonder how they ended up sitting in front of me in a methadone clinic.

But I didn’t know them as children, so there is more distance than I have with the little guy, who I still see laughing or crying so quickly, who I see running through the park, who I see riding his bike for the first time with a look of determination and glee, who I see ice skating like a champ the first time he put on skates, and who I see coming up to me as an adult, enthusiastically saying “Hey Jim!” with the deepest voice you can imagine, looming over me with his notable height, and with his arms extended wide for his mandatory hug.

And now he’s gone from a drug overdose, and it’s just hard to accept. So I pledge to keep him in my mind every day, and to dedicate my work with others who suffer from the same disease to him, the coolest little guy I ever knew.

See ya in heaven, Lu, and when I do, it’s your choice—high-five, handshake, or hug.

Jim Anderson, MPAS, PA-C, DFAAPA, is a physician assistant in Seattle.