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Under My Thumb

Updated: Nov 17, 2021

CW: Disgusting descriptions of infection; pus is involved

Back in 1991, MSRA hadn’t yet hit the San Francisco IV drug-using population, but for about a week, I watched in fascination as three different manifestations of healing overexpressed themselves on my left hand. It happened very quickly, they were relentless, and after several days of this advancing atrocity exhibition, a panic set in that made me feel like I had some kind of flesh-eating dope in my system.

The skin on my left middle finger had started to peel. As the top layer found its meniscus, a second layer started to open up as if someone had taken a tiny emery board and abraded it in two decisive strokes.

The pinky finger on my left hand had a small scab on it. As the scab scabbed, a second scab began forming on top of the first scab.

The whorl on my left thumb had an infected hole in the middle of it. As the hole healed over, an iridescent mixture of pus and Pan-African flag−colored fluid began to accumulate underneath the newly sealed skin.

Two of them had started out as hangnails. No, nicks. Was one a burn? How did I puncture my thumb? Questions like these were useless, because it’s not like I was going to stop what I was doing to contemplate the origins of these minor maladies.

The scab on the pinky kept getting higher and higher, eventually becoming something that could be measured with a metric ruler. At last count, there were six layers of skin peeling themselves away on my middle finger, each thin membrane promising to be the last before retreating enough to reveal the next layer.

But what finally got me to go to the ER was the thumb, which was exponentially larger each day. At least for a thumb. At its greatest, it was approaching the size of a pingpong ball, swollen and sore, with the swirling mass of angry liquid pooling under a millimeter of scar tissue. Imagine a 110 lb. woman walking around with a pingpong ball sticking off the end of her hand while trying to score little blobs of Mexican brown or flagging down a trick. It was fucking ridiculous.

I tried poking it with a pin and slashing it with a razor. The razor worked for about a day, providing much-needed relief that couldn’t be soaked up by a big shot of heroin. However, the skin healed over with magnificent speed. Now why couldn’t my tracks disappear as quickly?? Some trick-turned-asshole also had a go at the thumb, then robbed me a couple days later of my dope. If I ever see him again, boy I’m gonna…!

Meanwhile, Chevrolet Paul was dealing with his own self-made crisis. Oh right. Chevrolet Paul had moved in with me and Sevven David. I was back living with Sevven David after being kicked out of Sycamore. Haha, doesn’t all of that sound like something mutually negotiated and agreed upon? Poor Sevven David, this was probably the final indignity. Moving Chevrolet Paul in.

No, actually the final indignity was me selling our expensive turntable for $40 to buy some dope. Sevven David came home one day and it was gone. Shortly thereafter, I came home one day and all the CDs were gone. Sevven David had bought a storage unit and moved them out to prevent me from selling them. As if!

Well, yeah.

OH NO, the final indignity was when Whitey stole Chevrolet Paul’s copy of our door keys and swiped Sevven David’s leather jacket one day when no one was home.

As hardcore heroin addicts went, Chevrolet Paul was pretty compliant. He shot dope quietly in 'his' room. Of course, anything that happened to one of us was certain to affect the other since we shared our drugs on the daily.

While I was dealing with Frankenhand, Chevrolet Paul was contending with a hole in his left arm. He wouldn’t show it to me but every day we didn’t attend to our ailments had him looking more and more distressed, ashen. Even for a drug addict. He finally showed me once, quickly. This was a hole on his forearm that he could stick his entire thumb pad in, like partially submerging yourself in water. It was filled with pus, which obscured its depth, but Chevrolet Paul would tell me about digging into it and trying to expel the pus while in the shower, hoping that a healing would occur. It only ever got worse.

NO! The final indignity was the forged check. One hundred dollars American.

We tore ourselves away from the block and drove to SFGH one bright sunny day. The triage nurse took one look at his arm, which he thrust into her face with alarm, and ordered us to have a seat in the waiting room.

Have you ever noticed how the average emergency room looks nothing like what’s portrayed on television? There are no gurneys bursting through double doors with doctors in scrubs screaming orders and whooshing their writhing patients toward the nearest OR, a mere hallway length away. There are no firefighters bursting through double doors with limp children in their arms, screaming orders and rushing their unconscious charges toward the triage nurse. And there are certainly no gunshot victims bursting through double doors in bloody street clothes, screaming orders and lurching toward the nearest doctor, firefighter, or triage nurse. No average emergency room has any of these things going on.

The triage nurse had Chevrolet Paul and me sit down with the sea of humanity, of which we had to accept we were a part. Homeless men slept atop their soiled possessions. A detoxing addict or two rocked and stared and flinched and grimaced. One man held his hand to his bloody head; another to his bloody arm. Innocent family members were riveted to the television set in order to shield themselves from our collective wreckage.

We were finally called in, but taken to separate rooms. Chevrolet Paul later said that they treated him like a filthy drug addict and didn’t even want to clean out his wound or give him antibiotics. They did eventually but not after each service provider took turns looking down their noses at home. Odd, because in an adjacent room, I was looked over sympathetically and talked to gently, a type of care I would dearly love to experience today, in the age of police murdering Black men, Black people earning less than 70 cents on a white man’s dollar, and an orange-haired thin-lipped buffoon advocating for violence against all who do not look like him or his followers.


About three years after I quit using, I was nearing the end of my two-year tenure working in the jail as an office manager slash drug counselor. I worked exclusively in the office for the first few months because you had to have a year clean to enter the pods without being dressed in either orange or green. I recognized many of the inmates’ names when I updated the program roster on the office computer or as my future fellow counselors talked about the women in their caseloads and the progress they were making or not making. I couldn’t wait to get in the pod, to work with the women. I wanted to be in there, seeing those whom I knew from the street, not so that I could floss or ridicule or shame them, but so they would see that if Green Eyes could get out, they could too. Finally, I graduated from admin to orientation counselor. I was elated!

One of our jobs was to go to the other open pods in the new program facility at 425 7th Street—as well as around the corner to the bars and cells of 850 Bryant—to see if any women wanted to come to the SISTER Project. A couple of us would make the rounds twice per week, clipboards in hand, the easiest entry questions in the world ready for potential applicants.

On one particular visit, we saw this white girl from the Mission. She was a skinny, cracked-out blonde, still detoxing from her secret mix of opioids and stimulants. She was telling us the story of her most recent arrest, complete with waving arms and character voices. Toward the end of the story, she did something that shocked and horrified me, which was hard to do because I’d seen a lot of shit in a short period of time. This, however, was something new and menacing.

She pulled up her pant leg all the way to the top of her thigh, because she was that skinny and the pants were that baggy, and showed us the area on her leg where skin, muscle, and meat used to be.

A hand-sized portion of her leg was laid practically to the bone—a normal hunk of thigh on one side, the sharp, rolling ravine down to the bone, a normal hunk of thigh on the other. It looked like the parting of the Red Sea. As if on cue, we two counselors gasped, our eyes wide. We’d never seen anything like it. “WHAT HAPPENED TO YOU??” we demanded, incredulously, offendedly, hurting for the girl long after the physical damage was done.

“I got this flesh-eating dope,” she said matter of factly. She looked down at her leg instinctively, at the space where skin, muscle, and meat used to be. The hospital hadn’t bothered to stitch her up or make any attempt to close the gap. Well, if they weren’t going to do it on an abscessed bicep, they certainly weren’t going to be bothered with a flesh-deprived leg.

This flesh-eating dope was, quite literally, consuming addicts at a frightening rate. Now, frightening in the normal sense could mean tens of thousands of people in, say, a single day. But among the addict populations it meant…tens. Maybe even fives or threes. Per week. Whatever increment you use, one was too many (and some would argue that a thousand was never enough <snicker>). And as humans tend to do in such situations, I personalized this girl’s moment and claimed it as my own while thinking: Thank God I got clean before this shit came out. Because, surely, I would have not only been carved up by it, but would probably have succumbed entirely from its ravishes. I was that addict, the one who was going to keep shooting and smoking and ho’ing even when a bacterium was eating me alive.


The doctor looked over my thumb as gingerly as he could. He numbed it up, which, if you’ve ever been numbed up in the hospital, is almost as painful as the pain you brought in with you. Soon, however, my thumb was finally quiet. When the doctor was convinced my thumb was numb, mostly by plunking and poking at it, he grabbed a scalpel and sliced it open! I mean, he laid it out, securing the cut ends with forceps on each side. I couldn’t look. It was gross. Haha. The irony. At one point, I observed him pulling out, I don’t know, dead nerves, dead blood vessels, dead strands of E. coli? Whatever it was was white and stringy and necessitated him raising his pincer arm like he was pulling magic scarves out of a black top hat.

When he was done, he cleaned and bandaged the thumb patient. As with the girl’s quartered leg, he didn’t bother stitching it up.

I received antibiotics but no pain medication. I was honest with him about my drug use—haha, as if he couldn’t tell already—so anything he prescribed me short of morphine or dillies would do no good. Sure, I’ll take some aspirin if it starts to hurt. He asked me to return the following week, both for follow-up and also to show a group of med students what a good job he did. I emphatically agreed to return.

Yeah right.

Eventually, a little chevron of scar tissue formed on the pad.

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