Caitlin Burritt  00:00 

Thank you for listening to the Unsilencing Stories Podcast. We are in the midst of a public health crisis. More than 32,000 people in Canada have died from fatal opioid overdoses since 2016 according to Health Canada. Previously, this podcast featured interviews with bereaved people in smaller towns and communities in BC and Alberta who have lost loved ones to fatal overdose. In this phase, we're sharing interviews with seven harm reduction workers, also known as peers, in different parts of BC. 

Caitlin Burritt  00:27 

The BC Centre for Disease Control Harm Reduction Services defines harm reduction as support services and strategies that aim to keep people safe and minimise death, disease and injury from high risk behaviour. Peers face a lot of challenges. This has been documented by many researchers including Zahra Mamdani and colleagues in BC. In their 2021 paper they outline significant challenges peers face including financial struggles, difficulty finding housing and stressors at work. We wanted to explore these themes with peers and find out more about their experiences and share this information with the public. So we conducted multiple remote interviews with harm reduction workers and invited them to talk about the stressors they face. 

Caitlin Burritt  01:06 

Please note this podcast contains information about substance use, overdose death, grief, trauma and stressors that peers face and this may be distressing to listen to. The podcast is part of a research project led by Aaron Goodman, PhD, faculty member at Kwantlen Polytechnic University in Surrey, BC, and conducted under the auspices of a grant known as the Chancellor's Chair Award. I'm Caitlin Burritt, a researcher with the project. A number of researchers including Giorgia Ricciardi and Chloe Burritt, who happens to be my sister, and a number of students have played key roles in the study and you'll hear many of their voices in this podcast. 

Caitlin Burritt  01:40 

In this episode, you'll hear Louisa Akai and Esther Cheung interview Lily about her experiences with death and trauma as a peer worker. Lily also discusses the amount of trauma and death she witnessed working in supportive housing, she reflects on the normalisation of loss and death amongst peer workers and discusses her coping strategies that allow her to continue her peer work.  

Lucas Akai  01:58 

Yeah, I was gonna say last week but no, it was just yesterday. We had said, you know, previously that death and trauma was next on the list. So maybe setting some foundation.  

Lily  02:08 

Mhmm. 

Lucas Akai  02:09 

How often do you personally face death or the related trauma, whether that's someone overdosing and then being saved, or whatever it might be? 

Lily  02:17 

It was wait more regularly before when I first started housing buildings. When I started [bleeped], back then like six years ago, we have what's called panic alarms on the floors, where if there is an overdose or fight or something happening, they can hit the button and it sends off this do-do-do-do-do. It's like a really intense alarm, and just have to be like all hands on deck when that happens. We were probably dealing with like four to five panic alarms a day, every day, which were all overdoses. There were days where we hadn't even finished one overdose before another one would happen.  

Lily  02:56 

So we were learning to have extra bag valve masks on hand, so that we can change out our gear as we ran to the next one. So that's how busy it was when I first started, it was like that for at least, almost that consistent, to that degree for about two, the first two or more years I worked there. 

Lucas Akai  03:14 

Right.  

Lily  03:14 

I can't say under control is the right word. But for some, whatever reason. We were just having less ODS happening. I mean, at that point, I guess we had a safe consumption or overdose prevention site is what they called them at that time. Opened inside the building. One big negative to the overdose crisis was the start of COVID, where they took away the ability for us to use oxygen at all. That was a really hard maybe half year until they were able to lighten up on some changes but because of when COVID hit that March, it was like, it was also just this like, horrible thing that you felt in the building where, I mean it was really painted like we were all gonna get it, like people are gonna die. It's like 

Lucas Akai  03:57 

right 

Lily  03:58 

quite a frightening thing when it first started, right? We're like taping everything up and disinfecting six more times even though we were already like already overworked with cleaning to begin. They're like "okay, let's just clean even more" because this black cloud is coming. It added a lot of anxieties to my work when you work with a community of people. Yeah, and COVID's like take all these precautions and people didn't want to wear masks or wash their hands. And you know, we probably worked in the most high risk population for doing that. So that was a scary time. But the worst was that we went from being able to use 15 litres of oxygen per minute to zero at all. We were not allowed to do anything but don full PPE, and give Narcan and stand back and watch until 911 arrived. So that was really horrible because, as you know, air is more important than Narcan and it was like watching people die right in front of your eyes, where there was nothing you could do due to the like re-aerosolization of if you put air in and a bag valve masks and air comes out so we'd be like immediately too close unless you had a fitted n95 respirator and PPE like hazmat style, we weren't able to do anything.  

Lily  05:06 

So thankfully, like the residents were aware of that too. And I remember they were really critical ODs during COVID, where some of our residents would just jump in and give mouth to mouth because they didn't care. They knew that we couldn't as staff and it was breaking our hearts. And they just went in and did it because they love their friends and they would take that risk. So that was really honourable to kind of witness in some of them. I've done a lot of like street ODs as well, like we were in especially at night, we were in a community called [bleeped] downtown ,where a lot of people would run to our building. We were like pretty much the main hub and open 24 hours of course with expert overdose responders on site and people would run in and be like, there's an overdose right there at the corner 711. We'd grab our gear and like just run out and, you know, having to watch for traffic and shit. And we're like responding to people and resuscitating them right in the street in front of people and saved a few lives doing that.  

Lily  05:59 

I did CPR in the middle of intersection once, It's really gone down, I've probably responded to about six, six to 700 overdoses, I would say since I've started. All of which, but maybe four, I've saved, all but four of those six to 700, there were about four to five, I either found deceased at the scene or attempted CPR and continued CPR until paramedics told us to disengage. That was sad. I've found two people hung by the neck. Walked into a room to see them hanging and have to cut them down. They did make a policy change on one of those afterwards. Because at that time, we were, there was some confusion of what was, so we like called 911, obviously, and the person was like blue and in rigour mortis, basically. So like in our minds, we kind of knew there was no point in doing CPR but we were being instructed by 911 to do compressions. And they later, with the agreeance from the doctors, made a policy change to that were as professional overdose responders we are allowed to say, it's within our protocol, but like, "Please standby, we've got those just get help on the way." And now for clear signs of that, I think within reason obviously we're not just not doing it, but it was more traumatising to the first responders to be doing CPR on somebody that had been dead for hours than to have not.  

Lily  07:15 

So that was a policy changer on that one. I wasn't the one that had to do that CPR but um, my coworker was really, really affected by that one. She would see him in her dreams and stuff. And it was really sad. It's also really eerie. I've been in that building a lot, right? I don't work there anymore. But going back into those rooms after is a really eerie feel because we do what's called room checks and housing buildings. Like every day, we have the resident list and we initial and check off every human we've seen. And if somebody hasn't been seen by 6pm, we do a room check. So it's okay, if they're away, like they're going out of town, they should let us know. It's okay. If they're not there. That's fine.  

Lucas Akai  07:54 

Right.  

Lily  07:54 

Like if we go in the room, and they're not home, we just say "okay, not seen." We don't get concerned until about three days for like a missing person. But sometimes you do those room knocks and you find a deceased person. So that happened more than a few times in that building. And we were prepared a staff when we're trained to know that that is a factor. We always do wellness checks in partners so you're not alone dealing with something like that. [i've] had two people found hanging by the neck not building one was framed as a suicide that residents are convinced it was actually a murder. But police and coroner's don't really look too far into the deaths of our population. It's just like, "yeah, overdose, done." I don't think if it was anybody else in the world, there might be more, more looking into that. You know what I mean?  

Lucas Akai  08:40 

Right, yeah.  

Lily  08:42 

There got to be a point too, where we weren't even able to keep up with the amount of memorials happening for the people we'd seen die. But I think it was that almost normalisation of how many people we'd lost. People just started a wall in the kitchen at the back on the brick wall, just writing all the names down. At the start, we did a lot of memorials. At the start, they mentioned to us the after hours crisis line that could come in, you'd just call like night or day and they'd come in and debrief with the team. All of that kind of fizzled away into becoming very normalised to the amount of death we were seeing. So that's kind of sad, because I think not everybody kind of got that memorial that they would have deserved or, and again, not a lot of our folks, not all of them have a degree of community or family or anything like that. But um, 

Lucas Akai  09:27 

right 

Lily  09:28 

anyway, I remember them all. Now in my work, because I've kind of said like, [I] feel like I live the kind of more like retired life of harm reduction. [I] do you consider myself a harm reduction warrior. Because now I'm working where I see the positive change and the help and the good that we do. I see that we are a solution to the problem. Still doesn't mean that people aren't dying on the toxic drug supply, but we're at least making a positive impact with safe supply, right? And being part of interviews like this and other ones that I've recently contributed to, just means that I'm doing whatever I can to spread the message of how those are good thing and be able to increase the ability for us to have more of them in Canada and the world. Happy to share that knowledge. 

Lucas Akai  10:11 

And so when you were, well when you were responding to the overdoses [at bleeped], witnessing, you know, the death? Did you find that that impacted you on an emotional level or a physical level? Was there psychological things that came up as a result? 

Lily  10:26 

I've always been a little surprised at how I have been able to handle it versus what I like can witness in some of my coworkers like, there were things that were hard, there were times I've shed tears. But um, I'm somebody that has always been drawn to emergency first response. For a very long time I was planning on, I had been practising advanced medical first response, looking towards going into paramedics. It was like an EMR level, under primary care paramedic. I'm somebody that took a great passion in emergency first response. And just  the basic, like, basic but learning advanced skills. I didn't apply for that, in the end when I got into art therapy, and also kind of realising paramedics would be like, very burnout, hard career. At this point in time, I'm still maybe considering nursing as an additional thing. But um, how did I get impacted? 

Lucas Akai  11:23 

If at all, if at all?  

Lily  11:25 

Yeah, I'm a tough cookie. I really think I had a good ability to leave work at the door, especially things to do with their lives. I found the things that I brought home or that affected me more was more when you'd get like the personal attacks, you know, like somebody would call you like these horrendous names that would like trigger something deep in you from like, early childhood. But seeing somebody die or finding a dead body that didn't haunt me as much as my own triggers. I love the folks very much, but I don't take that home with me. Whereas I've had coworkers I've seen literally take like six month mental health leaves and end up not even being able to come back because they're torn up about people that have died. I don't find I'm that person. So I think, but maybe it's just because I'm more prone to being drawn to and able to [handle] like emergency crisis like that. Like I'm somebody with pretty bad anxiety and depression. But, and my life can be a struggle or triggers can be a struggle, but then put me in front of an emergency situation and I'm the coolest cucumber, has got it totally under control. I know exactly what I'm doing and I'm calm, right? Don't really know how to explain that, but I guess that's just who I am?  

Lucas Akai  12:34 

Right, right. 

Lucas Akai  12:35 

And so, of course, we've talked about over these past couple weeks, kind of the night and day differences between your work bleeped] and the current clinic, like the safer supplies. So do you find that the way you think about work with the trauma and death that you have experienced or witnessed has changed? Or has it affected your willingness to come into work?  

Lily  12:36 

Has it changed me or changed the way that I show up to work? 

Lucas Akai  12:56 

 your willingness to come into work, the way you, the way you see the work you're doing? 

Lily  13:00 

No, I mean, I think I don't think that changed it. Like I think I've said in prior interviews, it was never like the work that made me like struggle with how I took care of myself in my life, which would affect how I came to work. It was just like all about my self care and my days off, which whether it's unconsciously affected by that stress?  

Lucas Akai  13:19 

Right.  

Lily  13:20 

I think there's a different degree of stress with like being yelled at and screamed at and dealing with like violent situations that are more frightening than that, then dealing with overdoses for me. But at the same time over a couple of years and wasn't directly work related, but getting introduced to a friend circle where I was really exposed to a lot of drugs that caught up with me, led to me really starting to struggle not be able to show up to work on time or while rested. If I was coming into work without sleeping, it'd be way harder for me to handle emotional crises situations would just break me down a lot easier. So for me, it's all about how you take care of yourself in your home life. That's how I'm going to show up to work feeling fit and rested and able. It was never the job stress, except for maybe personal attacks, violence and like noise and screaming, I'm sensitive to that stuff. So.  

Lucas Akai  14:07 

Right, right. And so are there any specific instances of like, the trauma you've witnessed or the death that you've witnessed that you'd like to share in particular? 

Lily  14:16 

I can tell a few stories.  

Lucas Akai  14:18 

Go for it, go for it.  

Lily  14:20 

Well, I've told you the story of the poor kiddo that took his life, hanging. There was another person that had just got engaged with girlfriend that was fun hanging. The first, first person I over saw die at my first hand, [I] was called to a panic alarm. And we dragged this guy out of his room into the hallway and [he] was blue and purple and pretty stiff. Started overdose response, multiple shots of Narcan, oxygen right away. This was before COVID, thank God. When we start oxygen and they're completely unresponsive we put on the AEDs, so we cut open his shirt, put on the AED and [it] instructed us to start compressions, that there was no pulse. And between me and my best friend at work, my coworker at that time, we alternated three minutes of CPR compressions for, I think about 12 minutes before paramedics got there, unfortunately.  

Lily  15:10 

It is absolutely exhausting to do real life CPR, I'll tell you that. I felt it in my body for about two to three days later, and my shoulders and my back. And that was hard to because he had died, I was physically feeling in my body, the efforts to try to save his life. So that was hard. Yeah. And his girlfriend and his dog were there at the time when he died and it was also really heartbreaking to see, to witness somebody watching their partner be unable to be resuscitated. Sometimes that's like, almost more the aftermath of the pain, you see in the people that live past those that have died. That's really heartbreaking. Like every time I'd like even walk up and down there, you just remember, like, you almost see that spot on the wood floor, where you know, somebody has left this world. So I had spots like that all around the building for myself. He was generally just a meth user, and had started dabbling in fentanyl, but was too afraid to admit it to his friends.  

Lily  16:12 

So he hid in his room to do it and then he overdosed and died. So there's a lot of shame and stigma around that. And using alone where nobody can get help. So that sucks. He was a gem and he was just like, honestly, like one of the kindest of our residents to staff as well. I really, really thought a lot of him and again, having to have his best friend find him and start dragging him out of the room as someone runs to the panic alarm and calls us. It's just horrible seeing that panic of people like "wake up!", freaking out, we just go into our medical response. So I did CPR on them both and they did not return. Yeah for [bleeped] too, we had been doing CPR for about 12 minutes. Me and [bleeped] were just getting exhausted, still going. Firefighters got there first, and [then] paramedics. And like we had a timer on and they said, "Just keep going, guys, you're doing it as good as we would." So they didn't even take over on our response.  

Lily  17:02 

They just started setting up their computers and other tools, right? Like to start assessing him, but didn't even feel the need to make us stop because they said the quality of our compressions were just as good as they would be doing. So after about three to five more minutes of them being there, they told us we could stop and then they let him go. There was a really messed up one. Well, one girl lived and is still walking, I don't know how. She was going through meth psychosis and was in her room and said the shadow people told her to go out the window. She put on a helmet first, which is really interesting, and then dove headfirst out her fourth floor window to the concrete below. She's alive and walking and talking, and that's freaking amazing. Someone else in meth psychosis that I believe was being bullied. This one was really messed up. Because the story kind of came together in different pieces.  

Lily  17:51 

We became alerted by a member of the public, that there was somebody on the ground appearing to be unconscious at the backside of our building against the sidewalk. So basically it's like the building at the back and then [an] enclosed little courtyard area. They had big, gated iron fences, kind of security for the building. But between the building and the fence where like the sidewalk's over here, it like, it dipped down there were like steps like this  

Lucas Akai  18:15 

okay 

Lily  18:16 

and like the courtyard was lower than the level of the sidewalk. This woman went headfirst out a fifth floor window to her slow death, where she wasn't discovered for about 20 minutes. She lied there suffering, not able to get help, and slowly died. Which was awful. People from the public walking by the whole time on the sidewalk. Nobody could see her because it was dipped down. So she was down here, horrible. And someone eventually saw her and like, I had to review all the, there's tonnes of cameras in these buildings. And anytime anything becomes like, a police matter, we have to review and save the footage. So I've had to not only deal with these experiences, but then review the camera footage and make recordings of what happened to hand to police. And some of that's almost just the worst to have to relive as well. So we had to, I had to watch the video of the body just hit the ground. And then literally watching, like, 20 minutes go by of people walking by and nobody seeing her.  

Lily  19:14 

And then eventually someone kind of stops and looks were like "oh my god, oh my god!" and they're trying to climb this giant gated fence. We were told there was somebody unconscious in the back courtyard and me and my team ran all the way to the back to like literally find her head, like, broken in on the ground and she was dead at that point. We didn't do much for medical response at that point because obviously there was concern of like spinal injury and called 911 and that was probably one of the more like, complicated awful things I've seen there. One of my coworkers like, one of the more direct responders was pretty much just done and had to go home at that point.  

Lily  19:46 

Me being a bit one of the tougher cookies, so to speak, I opted to do the video recordings for police and had to, like, watch. We had to find like where she came from as well. So I had to watch video footage from the window she went out, like check floors 2, 3, 4, by time I got to the top one because I just had this feeling, for some reason I started low, but, so we watched the footage of her walk down the fifth floor hallway, go out a window and like not return. So all that was really hard to watch, including seeing somebody literally like, hit the ground in a video. Yeah, just really awful. That was [bleeped]. She was kind of bullied towards the end of things. Just recently, I had someone die that was probably one of my favourite residents. And he was an, he's an identical twin. And his brother is now left as a single twin. They're both fully, fully street entrenched on fentanyl, and meth and crack and everything you could ever name. Those guys are, you know, like I say it's, it's a miracle that a lot of our people ever make it out alive, I think. They're more likely than not to not making it out.  

Lucas Akai  20:58 

Right  

Lily  20:58 

again, another reason why it's really nice to work, work where I work. But I also know that we were the first safe supply place in the world in Canada, there are very, very few safe supply clinics. So although I'm not still working in housing, and I'm not working in a place where I'm dealing with overdoses all the time, it's like, doesn't mean that it's not still happening. That's not to say I wouldn't still go back to that work and do it. But I really like where I'm working right now. And I really like being a part of the positive change and help. And I really would love to see more of this happen because safe supply saves lives. So.  

Lucas Akai  21:29 

One thing you had mentioned was that with that one individual where you applied CPR for 12 minutes, is you were starting to feel like the physical strain of having to do that because it is quite a strenuous process. Did you find throughout your work at [bleeped] that you were being impacted by like a physical strain, was there physical stressors going on, because of that work that you're doing? 

Lily  21:50 

It was an exhausting day in those buildings, straight up. They were 12 hour shifts, and the building was the length of a city block and five storeys high. And we were, like, some of my coworkers put on pedometers, they like got their steps in, and we [would] do 12,000 steps a day or something, but we would walk about 10 kilometres a shift. Like that's how much physical movement we were doing, which is really tiring. And you just factor in rarely ever having a break, like what's slow in a building of 150 people, where they all have friends over too, like? 

Lucas Akai  22:17 

Right. 

Lily  22:18 

Dealing with a couple 100 people a day and the different relationship between [bleeped] and their residents was, not everyone treated us with respect, right? Like, I remember someone threw a crowbar through the office window at once. We didn't see it coming, we just heard it hit the ground on the tile floor and like [sound effect], like the sound of a giant metal object hitting a tile floor behind you when you don't know it's coming. That was rattling, for sure. Just kind of those like immediate sudden loud noises.  

Lily  22:49 

Yeah, just like, there was just a lot of chaos. There's a lot of violence in that building, there was a lot of anger and aggression and screaming and fighting and mess and dirt and garbage and oatmeal and pudding thrown at the walls and like, we do our best to clean everything up. The building is so freaking huge and there's only so many of us and we're over worked. Like it was never fully in a state of clean, which really like, added to that kind of grim effect on the building and all the writing on the walls everywhere and...  

Lucas Akai  23:14 

And so when you would go into kind of like your response mode, was that, like a, just like you were in the zone? Or were you blocking off certain emotions to handle these situations or maybe elaborate on that a little bit? 

Lily  23:27 

Always on alert, I think is all I can say, always on alert. But um, we became whether it's desensitised or became expertise in this building. I became the supervisor there for a few years. 'Cause there's a question here I noticed that said, where was it? Due to the different experiences and environments you've been confronted in your career, do you feel that certain aspects of your personality, your sense of self have changed? If so, in what ways? And I feel like I feel that having worked there, I went in there probably a lot more of a shy, timid person, with maybe the less confidence than when I came out of there, that I could describe myself in a comical way probably more boss ass bitch. Like, I could handle like gangs with knives in stairwells. I've held somebody's intestines back in their body in an elevator, they were slashed by a machete.  

Lily  24:15 

We like learned the ins and outs of the building and when the bad guys, so to speak, would be in the building and find ways to get them out safely.  

Lucas Akai  24:24 

Right. 

Lily  24:25 

Just kind of learning the different nuances that could totally go over someone else's head. I gained a very thick skin working there, the ability to stand up for myself and kind of find my voice, be able to assert boundaries.  

Lily  24:38 

Right.  

Lily  24:38 

Yeah, so I became a very tough cookie and just learned how to like, I don't take shit, I can stand up for myself. I can tell them when they gotta go. I'm also, describe myself as somebody [who] was totally raised on the Care Bears and, the original Care Bears. I'm a bucket full of love with a lot of compassion, but I've also gained some, some leather to the skin, you know?  

Lily  25:02 

Yeah, I mean, there's a reason I worked there full time for so long and I was sad to actually even go. I thrived in that high stress environment. Maybe some of my co workers would think I was probably emotionally overwhelmed at points but it was just when I started losing the ability to manage my self care and my drug use was slipping, that's when it became a lot harder to show up at work and be my best. And I love those people like family, people in that building, you know, were like, "I love you, man, I miss you." Like, it's pretty rare, you get to be on those terms with people. Or if something bad was going down, someone was being held hostage in a room, tortured for debts, they would come get me and say I need to talk to you in the basement, I need to talk to you in private where no one can hear.  

Lily  25:43 

And I'd be that person they'd feel comfortable divulging things too, because you can't just trust everyone, you need to know how to deal with that, where if I said something to the wrong person, now they're gonna get outed as a rat, and then they could get their fingers cut off. You know, like, that's the way it works downtown here. So it's pretty scary.  

Lucas Akai  26:00 

Yeah. 

Lily  26:00 

Yeah, so I learned a lot of things. 

Lucas Akai  26:03 

And so maybe working off of that question that you raised, do you find that that's affected the way you work at your current position that you're at, or?  

Lily  26:13 

It's just so different, it's like, happy and friendly and like, people treat us so nicely and with respect and they're grateful to be part of the programme. And they know that they're of a very, I don't know, very small group of people, that um, they get to be a part of a programme like that. So. Sometimes, I've noticed the other day, I was talking to my friend about something that was, kind of, made me kind of angry, upset. And my dog just came over and was like, like, stared at me and just came forced himself on me like that. So sometimes, it's that he's aware of shifts in my emotions. But anyway, what else? What else? 

Lucas Akai  26:51 

Yeah, absolutely. So how did you find yourself? And what ways did you do to manage critical stress or the workplace trauma? 

Lily  26:59 

At work, after work?  

Lucas Akai  27:00 

At work, after work, you know, it can be a bit of both.  

Lily  27:03 

Cigarettes. Horrible, but smoke breaks, like we'd have to communicate with our team, if we just needed a minute or two to. Yeah, [I] started, like, I started my job there. I'd been quit smoking for four years, I started there and just started smoking again. I was like, "Oh, God, I better quit while I'm ahead" and six years later, I'm still smoking. So. 

Lucas Akai  27:23 

With the current clinic, how often do you face like the death and trauma aspect, if at all? I mean, it is a totally different environment, as you've described. 

Lily  27:30 

Yeah, not much, not much. We have done a few overdoses. But we do work with nurses right on hand. So one thing is that, if we do have like an actual overdose in the clinic, I'm not the one directly responding anymore. And that's only because we have RNs and LPNs on shift. So they automatically take over just because they're nurses, and nurses have different overdose response protocol than first responders do and it's their licence in the end. So they're the ones managing this clinic and people's lives. So if an overdose happens, I'm more like, I may draw up Narcan, I may prep the oxygen and turn it on, I may start taking very detailed notes foe the chart, because they're tracking things like minute by minute. So I'll be that. There's just a different, it's different how we respond to overdoses when you're working with nurses and doctors.  

Lily  28:19 

We even, have we have a doctor on site twice a week as well. So kind of cool. I'm just more in a much more like medicalized setting now, which has inspired me to almost get back into my thought of nursing. So not as directly responding to that, a few like overdoses, like fentanyl overdoses, but more of the time, we're seeing things like benzo overdoses, which  

Lily  28:39 

aren't nearly as fatal. They're not like turning blue. They're just like on browseable looks very different. Fentanyl overdoses are much different. But death and trauma, yeah, no, not nearly to the same degree. Now it's a bit sad, we have one of our clients who's maybe 71. He's went into hospital about two weeks ago with just like the nastiest, like mucousy cough, and they determined he had pneumonia. And he went into our respiratory Unit Two weeks ago, and it looked like he was making a bit of progress and now, there were some things that took a pretty bad turn. And I think now we're all just kind of waiting and really hoping but  

Lucas Akai  28:39 

right  

Lucas Akai  29:20 

right 

Lily  29:22 

I really hope he pulls through because if he didn't, that would be a really hard loss. Come on [bleeped]. He's just such a sweetheart. He's one of our guys that's in the clinic every day like clockwork, like you know, but he's 71 and just really frail and doesn't eat enough and completely addicted to fentanyl and meth. So his pneumonia is hopefully going to get better. So yeah, let's hope for that. But other than that, I haven't seen I have not seen death and I have not seen a lot of trauma working in safe supply. We see the good. We see how we're helping people and saving lives 

Lucas Akai  29:59 

That is very positive. So, so maybe in regards to both the [bleeped] and the clinic. When you went into say, [bleeped], did you feel as if you had enough training  

Lily  30:08 

hell no! 

Lucas Akai  30:09 

to face those challenges? Or was it kind of like a learn on, as you go type of situation? 

Lily  30:14 

Hell no!  No freaking way. You learned on the fly, you learned from your coworkers, even as somebody that did the training for a couple years. Sometimes it's just too busy to even like finish a sentence in the office, you start explaining something, "I gotta help someone, now someone's freaking out." Like, it never stops there. It really doesn't. And there isn't much training, no. I mean, I was lucky to a I have a lot of personal experience, and drug use. I [indiscernible] mean, I quickly kind of, I learned is, easy to know, maybe like the etiquette of street culture, in a way, the do's and don'ts. Some things were still a learning experience. Like don't describe something as goofy or there's certain terms you wouldn't want to use, or it would send people into a flurry.  

Lily  31:03 

'Cause I have a degree in psychology and a master's in therapy, I had a lot of training already in the de-escalation techniques and our own presence of what, how do I need to be in my body and myself, in order to not trigger someone else with our body language with our tone of voice? What energy are we putting off? So that self awareness was already ingrained into me. And I'd had trading and crisis de-escalation, suicide intervention, and clinical assessment and all of that. But there's a lot of things I don't know if you [can] really be trained to prepare for in that world, except for learning from my coworkers. And just when, when it rains it pours. And when something's gonna happen, you deal with it, then and you deal with it as a team. You don't have to deal with things alone. But yeah, fires and floods and knives and guns and SWAT teams and hangings and murders and deaths and ODs and violence. 

Lucas Akai  31:03 

Right. 

Lucas Akai  32:06 

 Right. And so, in regards to the way you processed and handled the critical stress, did you find you had enough support? Or do, or was there areas of support that you wanted or needed, but did not have access to? 

Lily  32:21 

We were offered 12 free counselling sessions a year. At one point, I did use some of those, after about a year and a half of that counsellor, I just like was kind of like, kind of done with it at the time. So they do offer you that which is good. Right now in my current job, I get offered six free counselling sessions a year, but [bleeped] it was 12, which I think is correct. They didn't tell us that we can phone this kind of like a Island Health emergency response team for the first responders, where we could call if you'd dealt with a critical incident and they would send in, like, social workers and support teams to debrief with the team. I think we used that maybe once. Not sure why. But. 

Lily  32:59 

Our manager would debrief with us, but it became very normalised. It wasn't a shock on the day if you came in at shift change and learned that somebody had died or there was a stabbing or like, this was things that were happening every week. So I think it just became a part of the job and it definitely affected more people worse than others, that's for sure. But you certainly get desensitised and normalised to it, which isn't good, but.  

Lucas Akai  33:27 

Right, right. Do you maybe want to elaborate on what the like, the debriefing would look like when it was happening, when it did occur? 

Lily  33:37 

Just kind of like us taking a minute to close down the office and telling people [that] they need to wait a few minutes while they're banging on the window while we're trying to have a debrief. The world never really stops in this building. And just checking in with people, seeing how everyone was doing. Did anybody need anything? Do they need a break, do they? After, after a death we were, everybody was always offered to be able to leave shift with pay. You were allowed to go home and they would phone in other people. The, the head managers would also come in whether it was four in the morning or not. You would call the head manager and they would show up and then they would start doing call outs for casual shits, for folks that identified they wanted to go home. Not all of us did. A lot of us were okay to still be there. If you choose to go home, you're more than welcome.  

Lily  34:22 

And debriefing was yeah, just kind of checking in with what people needed, [a] break? And saying "how did everyone feel about that? Was there anything we could have done differently? How did you feel that went?" Reviewing footage from police and writing log notes. Trying to find my photo album on this phone of pictures from back in the day. Funny stuff. There was one kind of cool one in there, it'd be a good wrap up. Do we have time? 

Lucas Akai  34:46 

Yeah, absolutely. Absolutely. 

Lily  34:48 

You see that it's writing on the wall?  

Lucas Akai  34:51 

Yes. I can see that it's writing on the wall, yeah. Yeah.  

Lily  34:54 

Okay, so this is graffiti  

Lucas Akai  34:55 

okay  

Lily  34:57 

of a wall with a whole bunch of words. It's taller than me, that big.  

Lucas Akai  35:04 

Okay, yep.  

Lily  35:05 

 So you read it from the top, line by line 

Lucas Akai  35:08 

mhmm 

Lily  35:08 

 and then it says "read it line for line from the bottom up." So you read it forwards, and then you read it reverse.  

Lucas Akai  35:15 

right 

Lily  35:15 

so I was like what is this crazy thing, that's wild. So it says, line by line. "Drugs control my life. So don't try to convince me that I can be sober because at the end of the day, I can't do this. I'm not gonna lie to myself by saying I will prosper and succeed. So I will remind myself that I am a terrible person, and nothing you tell me will make me believe that I deserve a good life, because no matter what, I will always be addicted and I wonder if things will get better? Because when I look in the mirror, I will always think, can I recover?"  

Lily  35:46 

So that is reading it top to bottom  

Lucas Akai  35:50 

right  

Lily  35:50 

taller than me, full size wall, covered in graffiti by one of our folks. So then it says at the bottom, "now read bottom to top," so you start at the bottom, read that line for line 

Lucas Akai  36:01 

right 

Lily  36:01 

"Can I recover? Because when I look in the mirror, I will always think things will get better. And if I wonder if I will always be addicted, because no matter what, I deserve a good life. And nothing you will tell me will make me believe that I am a terrible person. So I will remind myself that I will prosper and succeed. I'm not going to lie to myself by saying, I can't do this because at the end of the day, I can be sober. So don't try to convince me that drugs control my life."  

Lily  36:28 

Isn't that frickin' cool? It's like [this] thing that's written down one way that reads one way and then you read it backwards. And it's like the whole [other] reverse meeting so, and to have that written in somebody's like, handwritten print on a wall, like, full scale size like that. It was just like, "Wow!" Sounds like a nice wrap up. Do you know what I mean, like? 

Lucas Akai  36:49 

Yeah, absolutely. And, it is! 

Lily  36:51 

 Right? Yep, and the purple chair. 

Lucas Akai  36:53 

Yeah.  

Lily  36:54 

Purple chair I was telling you about. This is beautiful, eh? But  

Lucas Akai  36:56 

yep 

Lily  36:57 

in a horrible way. Yeah. So that, I guess that kind of leads into, I can tell the story of how we had to find [bleeped] and  

Lily  37:04 

with his mother, awful dat. That, we can do the next one. Because that's like, that's like overdose in my direct family and life. So this was like the work talk.  

Lucas Akai  37:04 

yeah  

Lucas Akai  37:18 

Right, right. Yeah. So next week, we'll definitely, we'll talk about your own personal experiences and family life.  

Lily  37:25 

Yeah. 

Caitlin Burritt  37:25 

That brings us to the end of this episode of the Unsilencing Stories Podcast. To listen to more interviews in the series, please go to www.unsilencingstories.com, and if you'd like to share your thoughts on the episode, message us at unsilencingstories@gmail.com. Thank you for listening.