This article appears in the January issue of JAAPA.
I ran my fingers over the solid lump in the young man’s leg, and the words scuttled through my memory. It was an infection; the red flesh and throbbing pain left little doubt of that. But conventional wisdom says if the matter inside doesn’t give just a little, if you can’t feel it fluctuate, then there is nothing to release.
And you keep your blade away.
“It’s my fault, isn’t it?” The man finally turned from his study of the blank wall to face me. The rest of his skin was a pocked minefield covered in the little scabs and scars of someone whose flesh often tried to crawl off the bone.
“These things can happen to anyone,” I said.
My finger settled on the center of the lump. It might as well have been painted with a bull’s-eye. I convinced myself the solid mass moved just a little.
“But I mean, the heroin,” he said. “It makes it worse?”
I opened my kit and cleaned the skin. There was stuff we both needed to get out.
“It certainly puts you at risk for a lot of bad things,” I said.
“I use clean needles.”
That wasn’t what I meant and he knew it.