Managing medical detox: A speech about compost

This is a speech I gave recently at our local hospital when I was given a “physician of the year” award for my work managing medical detox in our community for 20 years.

At first, when I was told about this honor, I was really unsure why my clinical work in medical detox would warrant “physician of the year.”

I am not as skilled a diagnostician as many of you. I’m not as good at surgical procedures, nor am I a wiz at administration.

What I am good at, as a part time farmer when I’m not doctoring, is making compost, which is really what I’ve done when I’ve taken care of thousands of chemical dependency inpatients over the last twenty years.

As a farmer, I spend over an hour a day cleaning my barn, and wheel heavy loads of organic material to a large pile in our barnyard which composts year round. Piling up all that messy stuff that is no longer needed is crucial to the process: it heats up quickly to the point of steaming, and within months, it becomes rich fertilizer, ready to help the fields to grow grass, or the garden to produce vegetables, or the fragrant blooms in the flower beds. It becomes something far greater and more productive than what it was to begin with.

That’s how I see the work of intensively managed detox and treatment of addictions.

As clinicians, we help our patients “clean up” the parts of their lives they really don’t need, that they can’t manage any longer, that are causing problems with their health, their families and jobs, and perhaps least obvious to them, their relationship with their Creator.

There isn’t a soul walking this earth who doesn’t struggle in some way with things that take over our souls and lives, whether it is work, money, obsession with sports, food, gambling, pornography, you name it. For the chemically dependent, it comes in the form of smoke, vapor, a powder, a bottle, a syringe or a pill.

There is nothing that has proven more effective than people who struggle with the same issues “piling up together” — learning what it takes to walk the road to healthy moderate living — “heating up,” so to speak, in an organic process of transformation that is, in many ways, a spiritual treatment process. When a support group becomes a crucible for the “refiner’s fire,” it does its best work melting people down to get rid of the impurities before they can be built back up again, stronger than ever. They become a sort of human compost, newly productive, ready to grow something of great value.

This work I’ve been privileged to do with a spectrum of individuals of every background, race, religion or lack thereof, professional and blue collar, rich and homeless, has been transforming for me. I have worked with incredibly gifted nursing and counseling staff, some recovering themselves, who have dedicated their careers to this work.

As scripture says: “I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me.”

We as clinicians must fight the impulse to turn away from these patients who may look and smell terrible, who may crawl with lice and maggots, who are our most vulnerable and weak and clearly need our help the most.

I certainly could not turn away over the past twenty years because I’m used to what compost looks like, before and after.

Perhaps by my accepting this award, it acknowledges the farmer-doctor that I am, and for that I am most grateful.

Emily Gibson is a family physician who blogs at Barnstorming.

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  • John C. Key MD

    Congratulations on your award. It is honorable work.

  • Rob Burnside

    A very inspiring post, and a “good read” for this time of the year, in this harshest of winters in recent memory. We long for spring, personal renewal, and the opportunity to begin again–what you’ve been making possible for a challenging group of patients all along, for twenty years.

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