Eva and Dr. Brent

Rural Kentucky has been the epicenter of the opioid crisis
in the USA. This is the story of a woman and a former coal miner turned gynecologist, who fought his own prejudices to treat patients no one wanted.

(London, Kentucky) Until the sixth month, Eva Bennett was able to hide her pregnancy. She had had a boy two years earlier and her husband had warned her: “If you’re pregnant, I’ll knock you out on the stairs.” »

At the time, the couple was stuck on oxycodone 24/7. “It was an ongoing scam. We found someone to be prescribed opioids. We drove to Georgia or Florida [dont les systèmes ne sont pas connectés avec celui du Kentucky]. The guy said he was in pain, the doctor prescribed him pills. I went with the guy to the doctor’s office, I said that I was the cousin and that I supported him psychologically. I just wanted to be sure that we would have all the prescription, and then at the pharmacy, all that… The whole operation could cost $600, $700. »

At the same time, one of her friends was also pregnant and wanted to have an abortion. “She had slept with her brother-in-law, and she was afraid her husband would find out. Afterwards, we learned that the guy was vasectomized, so ultimately the father was her husband, but anyway, we went to Tennessee for the abortion. »

Prior to 2022, abortion had not been recriminalized in Kentucky. But even legal, there was only one clinic in the state, and again, good luck getting there without getting intimidated in the parking lot.

In 2022, the Supreme Court overturned the decision Roe v. Wadewhich made abortion legal in 1973. But even before then, a doctor told me that Canadian colleagues who had already performed abortions refused to give the abortion pill, for fear of being intimidated or attacked by “pro” demonstrators. -life “.

Republican lawmakers recreated the crime of abortion in Kentucky two years ago. They then attempted to amend the state Constitution to include the crime, but in a referendum, the people of this most conservative state rejected the proposal.

So Eva is in Nashville with her friend, both pregnant, on their way to a clinic – Tennessee had not yet recriminalized abortion at the time either.

“We did three clinics, we were afraid to go in, everywhere you were waited by shouting demonstrators, there were some who threw paintballs at the car, the whole thing… Inside, my friend had to say that she had been raped, she made up a whole story, yadiyadiyada… I kept the baby, I couldn’t. »

She was doping at the rate of 8-10 oxycodone pills per day. “800 mg… It’s huge. When the D^r Brent took a blood test, he wondered how I could not be in a coma, he had never seen that. »

But before arriving at the D^r Brent, he had to go down the spiral again. She, who had managed to keep a data entry job all this time, was almost on the street. The electricity had been cut off. She had sublet her apartment to a friend. This friend’s boyfriend was arrested there for a murder.

“My head was full of lice. »

She runs a hand through her long hair, on the balcony of her mother-in-law’s pretty house, where she now lives, in London, a small town of 8,000 souls.

“My mother sat in the sun, it took her 16 hours to take them off… That was the last straw. »

She’s crying.

“Excuse me, I never cry, I’m a bad bitch, you know. » Laughter mixes with the tears of the 41-year-old woman.

Brent Carson worked in a coal mine, like his father and grandfathers. He was going to make a career there, but his father convinced him to do what he himself had dreamed of before being mobilized to fight in the war in Vietnam: study medicine.

Brent was destined for a traditional gynecology practice here in London, not far from where he grew up in Appalachia. This was before the OxyContin era…

The southeast region of Kentucky and West Virginia are among the poorest in the United States. People in this hill country, backed by the Daniel Boone National Forest, have the highest disability rate in the country. Coincidentally, it is here that the epidemic of opioid poisonings and overdoses hit hardest in the early 2010s. It is “ground zero”, and “by far the most serious public issue serious” faced by local Republican Representative Hal Rogers, 86, who has served in the United States Congress for 45 years.

In 2010, the midwifery clinic that cared for drug-addicted mothers closed, and pregnant women addicted to opioids began flooding into the hospital.

“No one wanted these patients. It’s a lot of trouble, they lie to you, manipulate you to get drugs, etc. »

He himself wasn’t too hot. Until one evening, over a bourbon, a young French intern finally convinced him that addiction is an illness, not a reprehensible moral choice.

“Most of the nurses refused to take care of them. They didn’t want them in the waiting room with the other patients. I use the example of racism: it is discrimination against a group based on prejudice. People here aren’t addicted to coke or heroin, they’re addicted to painkillers. Often it started after a car accident. Or just because we offered it to them one day. »

The goal is not to “rehabilitate” the mother. They have all more or less been in rehab, all relapsed. The goal is to reduce doses, substitute the most harmful drugs, and save both mother and baby.

The Drug Enforcement Administration (DEA) monitors any mass drug prescription program.

“When I started, I told the DEA people, ‘I think I can get 10 percent of women sober.’ The agent said to me: “If you can do that, you will make a big difference. But you’ll be lucky if you reach 1%.” I have treated probably hundreds of women and 1% of them have been able to stop using completely; 99% of people relapse. I don’t measure my success like that.

“My success is the stability of the mother, because babies do better if the mother is stable. Imagine growing a garden, and it’s 40 degrees one day, and 5 degrees with wind the next day, it’s very difficult, you need a minimum of homeostasis to raise a baby. »

His clinic’s protocol has become a standard in several other states.

Eva went through withdrawal. His daughter too, when she was born. She replaced OxyContin with Suboxone (a mixture of buprenorphine and naloxone, less dangerous for the fetus). From four tablets per day, it increased to 0.75. She is proud. Thirteen years after giving birth, the D^r Carson treats her again.

Most patients are on “Medicaid”, which provides access to care for the most disadvantaged. Not Eva, who found work. “Obamacare” has helped millions of Americans get health care, but as soon as you make a little money, you’re shut out. Eva has insurance through her job, but the deductible is $5,000. “I pay cash for my visits. I make $11 an hour, but I work a lot of overtime… To be eligible, they told me it was a maximum of $9.50 over time. »

“The D^r Brent once told me that he had to deliver two dead babies because the mother continued to smoke opioids. “I don’t like getting up at night to give birth, but even less a dead baby. And since these women don’t care, it doesn’t make me want to take care of them either. But when I think of you, Eva, and all the years you tried, it makes me want it again.”

“Sometimes I screw up and I say to him, ‘I screwed up, you know?’ He doesn’t judge me. Everyone judges you. I had all 32 teeth pulled, and when the dentist saw I was on Suboxone, he refused to give me painkillers. Do you know what it’s like to have 32 teeth pulled? »

During a visit when his daughter was an infant, Dr.^r Carson noticed that the baby, whom she was breastfeeding, had lost weight.

“I told him I was less hungry because I had stopped smoking jar. Otherwise, social services were going to take the children away from me. He said, “I’ll take care of social services.” When the baby tested positive for jar, he told them it was his decision. »

The children were still placed with his sister a few years later.

“My sister is older, she’s had 10 miscarriages, and when we were little, I told her: ‘Don’t worry, I’ll make you lots of babies…’ I didn’t think it would happen like that. I see them often, they are doing well, my son is having difficulties, but my sister is homeschooling him. My daughter, she moves a lot, she speaks with her hands, like me… I was made to have babies, I’m like the pioneers, it’s nothing for me. »

“We have a thing with birds, the D^r Brent and I. He put me on this app, Merlin. Every time he sees an owl, because I’m crazy about owls, he writes to me. One day, I stopped my car to look at a deer, and in broad daylight, an owl arrived. And a second. A grand duke. He had the most beautiful feathers I have ever seen in my life. He told me: “Go home quickly, record everything you saw!” I did it, I do everything he tells me.

“He often tells me: “I couldn’t write my story without you in it.” Me neither. »