Transcript

809: The Call

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Prologue: Prologue

Ira Glass

OK, so you call a hotline, and then a complete stranger tries to figure out how to help you, on the spot. That idea seems to have begun in the 1950s. The first suicide hotline in the United States was created in the early '60s by a guy in San Francisco, who was a priest and also a journalist. And it was just him answering the phone at first.

Ads on matchbooks and sides of buses said, "Thinking of ending it all? Call Bruce," which, by the way, was not his real name. His real name was Bernard Mayes. But of course, the power of anonymity is so important to any hotline. People would call. And sometimes he could help them precisely because he had no connection to their life at all. Like, they could say anything to him. In those pre-internet days, that was completely new, to harness that kind of anonymity, the intimacy of it, this way, over the phone.

These days, of course, there are all kinds of hotlines for people in all sorts of situations-- prayer hotlines, psychic hotlines, also hotlines for homework help, for new moms. There's a hotline for owners of three-legged dogs, and another one specifically for anybody who swallows one of those-- you know those little, round button batteries? That one also handles any kid who pushes it up their nose.

Today we're going to devote our entire show to one phone call that happened on one hotline, a very unusual hotline. And then we have everything that followed from that one call. It takes you inside this world that I think either you're already in this world, or it's totally invisible to you. Like it's all around you. You don't even register that this world is there.

Mary Harris tells what happened. She's the host of Slate's daily news podcast, What Next. One quick note, some parts of this phone call might not be great for young children to hear. I suppose I could have given you this warning before mentioning that part about pushing batteries up your nose. But anyway, here's Mary with Act 1, "The Call."

Act One: Jessie

Mary Harris

The call on this story took place a few years ago.

Operator

Thank you for calling.

[MUSIC PLAYING]

Mary Harris

It's a call to a hotline of sorts, though one I'd never heard about before and was surprised to learn existed. This is the music you hear when you're waiting for an operator.

Man

(RAPPING) I tried to break free. You tried to keep me bound. I tried to live right. You tried to keep me down. But now I'm going--

Jessie

Never Use Alone. It's Jessie.

Kimber

Hi. My name is Kimber.

Jessie

How are you?

Kimber

Good, how are you?

Jessie

I'm good. Let me catch your name one more time.

Kimber

Kimber.

Jessie

That's what I thought, OK.

Mary Harris

The woman taking this call, her name's Jessie. She's a nurse, and she's taken thousands of these.

Jessie

All right, let me get my book, Kimber. I've never talked to you before. I'm glad you called. Have you called us before?

Kimber

No, this is my first time.

Jessie

Oh.

Kimber

I just got out of rehab yesterday, and I don't want to use by myself.

Jessie

OK, all right. So what are you going to use, Kimber, and how are you going to use it?

Kimber

I'm injecting heroin.

Jessie

OK.

Kimber

Probably fentanyl.

Jessie

Probably fentanyl, OK.

Mary Harris

The hotline is called "Never Use Alone." And the idea is, if you're going to inject heroin or do a speedball, something like that, and there's no one around, you can dial them up. Someone will stay on the line, make sure you're OK. If it seems like you've overdosed, they'll call the paramedics.

Jessie

All right, let me get some information, OK, baby? All right, give me your callback number in case we get disconnected.

Mary Harris

Jessie gets the caller's phone number and address, just in case she has to call the ambulance. The caller, Kimber, is in Massachusetts. Jessie is down in Georgia.

Jessie

You got your door unlocked?

Kimber

Let me check. Hold on. Yeah, it's unlocked now.

Jessie

OK, so make sure I'm on speakerphone.

Kimber

Yep.

Jessie

All right, you're by yourself in your home, in your apartment?

Kimber

Yeah.

Jessie

OK, do you have Narcan?

Kimber

I do.

Jessie

Set it out for me. And if you've got anything else extra that you don't need to do your job-- if you just picked up, if you got some extra rigs, put away anything you don't need, OK?

Kimber

OK.

Jessie

Because God forbid I have to call the ambulance-- they'll take your shit when they leave, and I don't want them to do that.

Kimber

OK. Hold on. Let me put everything away then in the bathroom. There's like a bunch of stuff out.

Jessie

Yeah, just close the door, you know, or whatever. Just don't leave it right where you're at. How long have you been abstinent?

Kimber

About a month.

Jessie

OK. So you know your tolerance is in the dirt, right, baby?

Kimber

Yeah.

Jessie

OK. All right, so listen, so I'll stay on the phone with you. If you want to just-- I mean, if you want to do points at a time or half a point at a time, we'll take it as slow as you want. If you would feel better video chatting me, we can do a Jitsi or something, OK?

Kimber

OK.

Jessie

OK.

So you can hear like in the beginning, I'm upbeat. I'm happy to talk to her.

Mary Harris

I spoke with Jessie, the nurse.

Jessie

But you hear my voice change. Like, I--

Mary Harris

Yeah, what is that?

Jessie

She was speaking with some speed, with some urgency. I just-- I knew she wasn't going to be careful. My mama spirit kicked in immediately. It's a sixth sense that you develop when you do these calls.

Mary Harris

She's not connecting with you. She's like, just, I'm here to get this done.

Jessie

She was there to do a job.

So all I ask you to do is you let me know as soon as you push your first dose. You let me know that you're done.

Kimber

OK. Well, I have to hold my breath for a second because I have to do it in my neck. So I'm not going to be speaking for a second, but I'll let you know.

Jessie

OK.

Mary Harris

So her neck?

Jessie

Mm-hmm. She's doing it-- you can inject in your external jugular vein. But to do that, you have to hold your breath.

Mary Harris

Is that-- like, you do that when your other veins are blown out?

Jessie

Mm-hmm.

Mary Harris

You're using terminology I don't understand, like half a point, a point. What does that mean?

Jessie

When they hopefully weigh their dope-- hopefully when you weigh your dope out, they're using a scale. And they measure it out in grams. 0.1 is a tenth of a gram, 0.2. I mean, that's drug user lingo for, we'll nickel and dime it right on in there.

Mary Harris

Small doses are one way to try to stay safe when you're using a drug like heroin or fentanyl. But the truth is, you really have no idea what you're getting if you're buying drugs off the street.

Kimber

I said, I just need a second because I got to find a vein.

Jessie

That's fine. We're in no rush.

Kimber

I just have really bad eyes, so it's like really hard to do.

Jessie

Oh, god. Oh, yeah.

Kimber

But like all the veins on my arms are like shot.

Jessie

Yeah.

Kimber

OK, I'm pushing it in.

Jessie

All right, slow and easy, baby.

Kimber

All right, I'm pushing, and I'm letting the tourniquet go.

Jessie

OK, baby.

Kimber

OK, I think I'm OK. I'm good.

Jessie

All right, well, we're gonna stay on the phone for about five minutes, OK?

Kimber

OK.

Jessie

And then if you want to do more, then you can do a little bit more, OK?

Mary Harris

Sometimes a person will call in wanting to talk. With the regulars, Jessie knows the names of their pets, keeps track of their birthdays. But her main job is just to stay on the line and check in every now and then. For this call, she was sitting at her kitchen table. Her husband walks in at some point for help with a Ziploc bag. But every minute or so, she's trying to get a read on Kimber.

Jessie

You good?

Kimber

Yeah.

Jessie

OK.

Mary Harris

About 60 seconds later, Jessie checks in again?

Jessie

You OK, honey? Kimber? Kimber? Kimber? Kimber, I'm going to call your name about one more time, then I'm calling an ambulance. Kimber. Kimber? You better answer me. Kimber.

Mary Harris

What are you thinking in this moment?

Jessie

I'm hoping that she just walked away from the phone. I try to give them 30 seconds, 30 of the longest seconds of your life. I try to give them 30 seconds to, oh, shit, I'm sorry. I walked away from the phone. Or my earbuds disconnected, or I hit the mute by accident. That's what I try to do-- 30 seconds.

Operator 1

North Adams Public Safety. This line is recorded.

Operator 2

1251 from North 911, transferring a operator from the Overdose Prevention Crisis Line, requesting ambulance in North Adams, Massachusetts. I have the address of [BEEPED], Apartment 1, upstairs.

Operator 1

What's the nature of the request?

Jessie

The caller became unresponsive while on the line with me.

Operator 1

OK, do you have any reason to believe they may have taken any narcotics?

Jessie

We're an overdose crisis line, so it's possible.

Operator 1

OK, ma'am, can you give me any specifics in terms of the age of the potential patient?

Jessie

It's a female. Her first name is Kimber, K-I-M-B-E-R.

Operator 1

We're going to get help en route, ma'am. If you happen to get them back on the line or gain anything further, please call us right back, OK?

Jessie

OK, yeah, I've got the call merged in. Yeah.

Operator 1

OK, can you hear anything in the background, ma'am?

Jessie

No, no.

Operator 1

I'm not picking anything up on my end.

Jessie

No, let me call her name again. Kimber? Baby, answer me. Kimber? No.

Operator 1

OK, I'm going to get multiple agencies en route to assist, OK?

Jessie

OK, her front door is unlocked.

Operator 1

OK, thank you for letting us know.

Jessie

All right, OK.

Operator 1

Bye.

Jessie

Kimber, baby, I got you some help coming.

Mary Harris

Jessie stays on the line. And then after a little while, you can faintly hear in the background, over the phone, someone shouting, "Anybody home"?

Man

Anybody home?

Mary Harris

The ambulance got there just 3 and 1/2 minutes after Jessie disconnected from 911.

Man

You awake?

Mary Harris

Jessie hears him say, "You awake"? Then, "move that suitcase."

Man

Move that suitcase.

Mary Harris

And then she hangs up.

It's easy to read the statistics and still not be able to imagine what the overdose crisis looks like in this country. More than 100,000 people die from an overdose each year. That means that Americans are now more likely to die from an overdose than from a car accident. This hotline's purpose is simple and very single-minded. It's not to get people sober or push them into treatment. It's just to keep people alive, one injection or snort after another.

I wanted to know what it was like for everyone, the callers and the people like Jessie, who sit there while someone uses, knowing they could die right there on the phone. Jessie talks to people week after week, and sometimes they just stop calling. Maybe it's because they're not using anymore. Maybe it's because they're gone.

Actual overdoses on the hotline don't happen that often. And Jessie had no way to know what went on after she hung up that day with Kimber. She kept answering calls on the line, tried to distract herself. She says she probably walked around her yard, poured herself a Sprite. Then she got a text from a pretty close friend of hers, a guy named Stephen. He's a paramedic, so he sees a lot of overdoses. She has him in her phone as "Bruh."

Jessie

He said, what up, homie? I said, I was just living the dream, taking some calls, some NUA calls. What you doing? He said, oh, you know I'm at work today, right? And I'm like, oh, I forgot today's Saturday.

Mary Harris

Stephen works in Massachusetts.

Jessie

Texting back and forth, and I was like, oh, yeah, I had a Never Use Alone call. I had an overdose call in Massachusetts today.

Mary Harris

Immediately, her phone rings. It's him. Like, instead of texting, he wants to talk. She answers.

Jessie

He said, where? I said, hold on. I don't remember. He said, bitch, where? I said, bitch, I said hold on. I got to go get the book. Damn. I open the book. North Adams, Massachusetts. The sob that left this man's chest, I'll never forget. He said that was me.

Act Two: Stephen

Mary Harris

Act 2, Stephen. Stephen Murray, the paramedic who responded to that overdose call Jessie took, he had a lot of jobs before working in an ambulance, each with a very different uniform. The first was a black t-shirt. He was in a metal band. Then a suit and tie. When he was in college, he ran for a seat on the village council and won. Being a paramedic meant wearing a button-up with S. Murray on one pocket and a badge above the other. He carried his dispatch radio pretty much everywhere, which is how he got the call that day.

Stephen Murray

So it came in as an unresponsive possible overdose. That's all we really got. And when I heard the address, I was like, oh, that's really close by.

Mary Harris

It was right up the hill from the ambulance station, basically on the same street.

Stephen Murray

We're only like 0.4, 0.5 miles away. So I like jump in.

Mary Harris

How many people?

Stephen Murray

It was one engine company, three police cruisers, and two ambulances. We get there, and I'm looking at the building, and there's multiple units within this big house.

Mary Harris

He bangs on the door, doesn't hear anything. Then he sees a little stairway, runs up, finds another door, which is unlocked. He lets himself in.

Stephen Murray

I'm like, hello? Anybody here? Like, EMS. With the cops there behind me, they're yelling out, and I'm looking around. And I get down this hallway.

Mary Harris

At the end, there's a little bathroom.

Stephen Murray

And I find a girl laying on the ground, or a woman laying on the ground. But she's very small, and she looked really young. And she was blue. And so I was like, crap.

Mary Harris

Why? Hold it. Why?

Stephen Murray

Well, because nobody's there, and she's blue. When someone's blue, I know they're not breathing.

Mary Harris

You thought you were too late.

Stephen Murray

Yeah, that's where my mind went immediately was that, here's somebody who's alone. She's blue on the ground. And I find her pulse, and it's quite slow. So it's like in the 40s. So I turned to the cop and said, she's got a pulse. The bathroom is quite small, though, and I am big. And it's really hard to work on somebody when you can't kneel down next to them.

And so I put my arms under hers and I drag her into the living room, down the hallway to the living room. And at that point, the rest of my crew had brought all of our equipment upstairs. So they were like-- they came up and put down our bag next to me.

Mary Harris

If they'd gotten there a few minutes later, it might have been too late. But now they had a chance. Stephen's got a particular way he likes to handle overdoses, that he feels is easier on the people being revived. Because-- he's thought about this a lot-- if they do come to, it's going to be a very strange experience, some random guy leaning over you, face upside down.

And if you just give someone a big dose of Narcan, it'll throw them into withdrawal. People sometimes wake up angry. They'll have a massive headache because they might not have been getting oxygen to their brain. That lack of oxygen, that's what will kill you in an overdose. So Stephen starts by fixing that.

Stephen Murray

So I grabbed the bag valve mask out, hooked up to oxygen, and start to breathe for her. And in the meantime, I directed one of my staff members to draw me up-- to pull out Narcan and put a needle on it, because I like to give it intramuscularly because I can control the dose better.

Mary Harris

He has the police stand in another room while he works.

Stephen Murray

Well, because the thing is, I've seen people come out and vomit and feel unwell. And when I first started EMS, I remember the police would be standing over them, like what did you use, like yelling at them. I started to think about, like, what is that environment like when they wake up? If there are too many people in the room, I will tell people to go wait outside.

Mary Harris

So Stephen's kneeling over Kimber's head, squeezing oxygen into her lungs, one breath at a time. Then he gives her the smallest dose of naloxone, just to see how she'll react.

Stephen Murray

Her color improves. Her oxygen saturation comes up. And she then wakes up.

Mary Harris

Do you remember what she said to you?

Stephen Murray

She looked upset.

Mary Harris

Upset, despite all his effort, but alive. There's a conversation Stephen sometimes has with people he's revived. He doesn't remember where it happened with Kimber, but often, it's in the back of the ambulance where the driver can't hear. The patient will say something like, you're so much nicer than the other EMTs. And then Stephen will explain, I've been in your shoes.

So Stephen, the person who revived Kimber from her overdose, he'd also survived an overdose. Let me tell you what happened. Stephen started using drugs sometime after he stopped touring with that metal band. He'd been straight edge then, so no alcohol, no drugs. But then he went to college, University of Miami, and academics had never been his thing.

Stephen Murray

The people that I fell in with, my group of friends, we all met at the tables that were outside the dorms. And we would smoke cigarettes outside. It was like this thing. And the guy that used to sell us our weed, he was great. He was just like this really cool-- I can't even describe him. He was like-- he would show up with a fishing tackle box full of drugs. It was like a menu, right? And he knew that I had been struggling a bit.

Mary Harris

A friend of the group named Kelly had died recently. She'd fallen off a balcony. It really kind of rocked Stephen's world.

Stephen Murray

And so he was like, oh, if I remember right-- he was like, oh, you should try these. It will make you feel better. And that was like oxycodone.

Mary Harris

So drugs became part of Stephen's very busy life. He's going to school, working a campus job. He'd also won that seat on the local village council.

Stephen Murray

At the time, they were saying I was the youngest elected official that had ever happened in South Florida. I don't know if that's like verifiable, but that's what people were saying about me. And here I am, using drugs the whole time.

Mary Harris

He used in his car before talking to TV news. Before bed, he would lay out lines of oxy for when he woke up at night in withdrawal. It was the only way he'd get back to sleep. And he was getting way too skinny.

Stephen Murray

I used to wear baggier clothes when I would talk to my parents. This is the era when Skype was a thing. And I used to put under-eye concealer on my eyes. I have naturally dark circles under my eyes. But because I had lost so much weight, it was so sunken in. They were very like pronounced. And so I would put under-eye concealer on before I would go on camera with my parents.

Mary Harris

Wow.

Stephen Murray

And actually, the camera would be faced backward, where I had all of my accolades on the wall, like certificate of election from the Board of Elections. And I got a letter from a congressman congratulating me on being elected. And just those sorts of things were behind me. But on the other side of the camera, my life was chaos. So, yeah.

Mary Harris

Stephen thinks he probably OD'd twice somewhere in there, but luckily, he came to on his own. None of that stopped him. His family, at some point, had an intervention, which he said you could see a mile away. Like, he walked into the room, and everyone was sitting there, and no one was saying anything. And he was like, oh, I know what this is.

But he felt relieved to be found out. He only had to go to rehab once, but recovery was a long process. Stephen tried various jobs, ran out of money, went back to living with his folks. They were retired in Western Massachusetts, where he noticed they were looking for volunteer firefighters. So he signed up. And for some reason, it stuck.

Stephen Murray

In my head and in my mind, I'm like, I'm Stephen the addict. And now, I'm Stephen the firefighter. And it was like, I'm a firefighter. That's pretty cool.

Mary Harris

Eventually, he became a paramedic. Stephen's experience with addiction is not what made saving Kimber so emotional for him though. It was something else. Back when Stephen was using, his drugs were coming from pain clinics known as pill mills. But by the time he became a paramedic, many of those had been shut down.

More and more people were getting drugs off the street. That's when fentanyl entered the scene. Fentanyl can be 50 times stronger than heroin. It was causing these cluster overdoses. Stephen would see them from his ambulance. He'd have days where he'd go to five ODs, one after another. He was seeing more people die too. One case stuck with him. Everything went wrong. They were at the station when he got the call.

Stephen Murray

And the street address that was given, we'll say, for example, that was 313, like 3-1-3. And we get there, and there is no 313.

Mary Harris

This isn't that uncommon, but usually, someone hears the sirens and comes out, says, we're over here.

Stephen Murray

And so in this particular case, that didn't happen. And so we just start to go knock on doors and look. And so that went on. We knocked out a bunch of doors, and nobody ever came out. And so the other thing that dispatch will try to do is they'll try to call the person back repeatedly. Nobody answered on the call back. And so, eventually, we have finite resources. And so the next calls are coming in, and we have to move on.

Mary Harris

A little while later, a different call comes in, a call about a dead body, a woman. Stephen hears the location and realizes this was the overdose victim from that original call. In fact, Stephen had knocked on her very door. Whoever called 911 the first time, they'd mixed up the numbers. So it wasn't 313. It was 133, something like that. So when Stephen and the cops fanned out, went house to house, Stephen had craned his neck to look in the window of the right building, but he just couldn't see the woman who needed his help. She was just out of view.

Stephen Murray

She was right around the corner from the door that I had looked in. And I just thought to myself, I was like six feet from her. And when I got there, she was probably-- we could still have saved her. That was actually somebody that I had reversed an overdose on in the past. I hadn't stayed in real touch, but she worked in the community, so I would see her sometimes.

Mary Harris

Stephen played this over and over again in his mind, looking for ways it could have gone differently. He understood that whoever called 911, they were doing what they could to keep this woman alive, but they were also scared, scared that when someone like Stephen showed up, there would be trouble. So they left. And in the end, it was leaving this woman alone that killed her. It meant Stephen couldn't find her. That overdose call solidified something for Stephen.

With the drug supply getting more dangerous, keeping people who used drugs safe meant making sure they weren't left by themselves. It was sometime around then that he heard about the Never Use Alone hotline, and it immediately made sense. So he got involved-- Zoom meetings, stuff like that. That's how he met Jessie. To get the word out where he was, he made these little cards.

Stephen Murray

I made this simple design on Vistaprint. And I'm not a web designer or a graphic designer, so it looks terrible. But basically, it was like, this is the Massachusetts line. Here's the number. This is what we do. And so I used my credit card and bought like 5,000 of those.

Mary Harris

He convinced programs that give out clean syringes to include these Never Use Alone cards in their kits. Stephen had no idea if any of this was really working. A lot of times, he'd talked to drug users who said, what? I'm going to call up some stranger, tell them I'm about to inject dope? Are you kidding?

But a few hours before he revived Kimber, she had gotten one of these cards bundled up with the stuff she'd picked up at a needle exchange. That was why she called. That was the thing that saved her life. Stephen didn't know that though. When he dragged her out of the bathroom that day and started giving her rescue breaths, there was a cell phone right next to her. He just didn't put two and two together.

After Kimber opened her eyes, Stephen told her she had to go to the hospital for observation. That meant she had to do this walk of shame down her front steps and climb into the back of the ambulance. It was nearly summer, but she put on a big winter coat, pulled up the hood. Stephen started packing up. Before he left the scene, he went to check in with his crew.

Stephen Murray

So they had the back doors of the ambulance open. And I stepped up into the back to talk to them. And it dawned on me again, like, oh, she was alone. So I said something along the lines of like, whoever was here with you called and left. You need to tell them never to do that again. They need to stay with you until we get here. And then she said, I wasn't with anybody. I was alone. And then I said, well, then, who called 911? And then she said, I called the Never Use Alone hotline.

Mary Harris

"Oh, my God," he thought. When he got back to the station, that's when he started texting Jessie, and that's when it all kind of came out of him.

Stephen Murray

When she told me that she was the operator, I started crying. I couldn't believe it. We sobbed on the phone together. I was in my office. There was this conference room thing that I was in, and I had the door closed. And I was talking to her, and I'm sitting there crying with her. And it was just-- it was like, wow.

Mary Harris

Stephen says, over his time as a paramedic, he pronounced maybe 30 people dead from an overdose. All of them were alone. Kimber was alone too, but she had the line. The line had worked. It's so rare to find something that actually protects people once they're dealing with an addiction. But even when you save someone from an overdose, it doesn't mean they'll stop using. In fact, usually, they don't.

The morning after Stephen revived Kimber, Jessie sent her a text. "Hi," she wrote. "I am so thankful you called." She sent this with a little smiley face and a green heart emoji. Within a couple of hours, Kimber wrote back. She thanked Jessie, asked how many times she got Narcanned. Then, Kimber says, "I want to use again this morning, but I'm terrified." "If you use again today," Jessie replied, "the likelihood of you OD'ing again is almost guaranteed."

Ira Glass

Mary Harris. Coming up, what's Jessie's deal? Also, a fight in a Krispy Kreme parking lot. That's in a minute from Chicago Public Radio when our program continues.

Act Three: Jessie

Ira Glass

It's This American Life. I'm Ira Glass. Today's show, "The Call," the story of one phone call to one telephone hotline and its aftermath. So Kimber did keep using and kept calling the line. And a lot of times, she was connected with Jessie, which brings us to Act 3 of our program, "Jessie." Again, here's Mary Harris.

Mary Harris

Jessie's kind of the backstop for the entire hotline, the whole operation. If none of the other operators are available, the calls automatically go to her. And she pretty much always picks up. Sometimes she'll even give someone her cell and say, just call me directly. She did that with Kimber. It's like she can't help herself.

Jessie

Oh, I got a call. OK.

Mary Harris

I went down to visit Jessie at her home in Georgia to watch her work.

Operator

You have an incoming call.

Jessie

Never Use Alone. It's Jessie.

Mary Harris

From the second I walked in, she was taking calls, still in her housedress and mismatched socks. The vibe was organized chaos. She takes in strays, seven cats-- one is missing an eye-- a chihuahua, and more chickens than she can count.

Jessie

Look at our eggs.

Mary Harris

Eh! Oh, those are from your chickens?

Jessie

Yes, those are the eating eggs. We've got eating eggs.

Mary Harris

They laid their eggs in the garage. I wanted to know how Jessie, a nurse, had ended up spending so much of her time on this line. And at some point, in a pause in the conversation, she said this.

Jessie

My child has called this line before.

Mary Harris

She was talking about Kaylen. Kaylen's 23, her only kid.

Jessie

She's the most magnificent creature I've ever met in my life. She's also the raggediest bitch I've ever met in my life. She's magnificent. She is magnificent.

Mary Harris

Kaylen has overdosed a dozen times and counting.

Mary Harris

Have you picked up the phone and it's your daughter?

Jessie

No, she would let me know that she was calling. "Hey, Mom, I'm going to call the line." Thanks for letting me know. I think-- I know that I could cut it off. I could cut the Mama off. I could keep the Mama cut off if she become unresponsive. I know I could do what I have to do. But what if I couldn't?

Mary Harris

Watching her daughter nearly die again and again is kind of how Jessie came around to a whole new way of thinking, and the hotline, too. She tried for years to force her daughter to change. She wanted her to finish school. She wanted her to go to rehab. She wanted her to come home. But wanting all that never made anything go differently. It just made Kaylen push her away.

Now, for her daughter, she really only has one goal. It's the same goal she has for her callers-- don't die. Jessie's serious about this goal, and this one goal only. She literally has a tattoo on her forearm that's a bird taking flight. It's carrying a banner in its beak with a single word on it, "fucks," as in, "I don't give a fuck." My fucks are flying away.

Jessie told me this one story about a time Kaylen pulled up in front of the house with a bag of dope and a couple of friends. It was late at night, just Jessie and her husband at home. Kaylen called her from the driveway.

Jessie

I said, what are y'all doing? She said, well, Mama, we just picked up from a new guy, and we're not real sure if it's safe or not. I said, so y'all are going to sit in my front yard and use dope in a car? I said, how the hell-- I said, what I'm gonna do for y'all in a car, Kaylen? And I heard her. She said, I told y'all we could go inside. I said, yes. I said, you're either going to come inside, or you're going to get out of my yard. I said I can't--

Mary Harris

Her friends didn't believe her.

Jessie

Mm-mm.

Mary Harris

They came in, and she watched as her daughter injected herself at her kitchen table. I had so many questions about this approach. I'm a parent. I know how hard it is to stop wanting things for your kids, stop protecting them, stop pushing them towards some imagined, better future. The implications of abandoning that wanting were so radical to me. I asked, what if Kaylen never stops using drugs?

Jessie

If what she wants to do is continue to use, she should be alive and healthy to do so. If what she wants to do is one day kick and go on and do something else, she should be healthy and alive to be able to do so.

Mary Harris

Do you even see her like no longer using permanently as a goal?

Jessie

I don't know. I honestly don't think about what Kaylen will or won't do, and I honestly don't-- I don't mean this to sound like it's going to sound-- I really don't care what Kaylen does. As long as she don't die, that'll be great. That's it. We can work with anything but death.

Mary Harris

It must have taken you so long to get there.

Jessie

It took a fight in a Krispy Kreme parking lot one morning, right there where y'all stay. You go down to the end of Dawson. I bet y'all go to the end of Dawson and take a left to come to my house. It's a Krispy Kreme donut shop right there. It took a fist fight in the Krispy Kreme parking lot for me and her to come to this place.

Mary Harris

What happened? What was it over?

Jessie

I hadn't seen her in weeks. I hadn't heard from her. She was hiding from me. Because every time I talked to her, I was giving her the business, you know? You're going to come home. You're going to do this. You're going do that. I was yelling at her, making her feel like crap. People who are using substances who are in the place that she is, they feel bad enough about themselves. They don't need us to help them. OK?

So she would change her phone number. She would hide from me. I wouldn't see her. I'd ride an hour every morning before work. I'd ride an hour at lunch. And I'd ride an hour and a half every afternoon when I got off. I would ride 3 and 1/2 hours every single day, Monday through Friday, to try to catch a glimpse of my baby.

Mary Harris

You would just literally ride around town, looking for her?

Jessie

Literally ride around town in the places that I knew she was, trying to catch a glimpse of my baby. One morning, on the way to work, I saw her. She doesn't remember this. She was that altered. But I saw her walking across the Krispy Kreme parking lot, and I drove across five lanes of traffic, me in that little Jeep.

And I ran up on her, and I was excited. And I guess I ran up real fast. And she had her earbuds in, and I touched her. I grabbed her shoulder. I meant to touch her shoulder, but I grabbed her shoulder. And when I did, she turned around and hit me. And being from West Tennessee, I hit her back. So for a few seconds, she forgot I was her mama, and I forgot I was her mama. And when we got through fighting in the Krispy Kreme parking lot, we were both bleeding.

She threw her hands out to the side, and she said, Mama, what the fuck do you want from me? And I threw my hands out and screamed back, what I've said a thousand times to you today. If you could just not die, that would be great. And that's when it hit me. Just don't die. That was literally the moment, the moment my brain shifted. Because even standing there bleeding, I was looking at my baby, and she was OK. And in that moment, that was all that mattered.

Mary Harris

Remember, Jessie was on her way to work when all this happened.

Jessie

I was in my nursing uniform going to teach-- I teach collegiately. I was going to lecture. I was going to stand at my podium, looking my very best, my very best professional nurse that I could possibly look, going to teach all these baby nurses.

Mary Harris

Did you go to work?

Jessie

I did.

Mary Harris

Wow.

Jessie

I did.

Mary Harris

What did you say?

Jessie

The truth.

Mary Harris

She told them exactly what had just happened. After that fight in the parking lot, Jessie started getting needles for Kaylen. Then she ordered Narcan. She got a big box to distribute around town. And inside was a Never Use Alone card. Jessie saw it and thought, huh, good idea.

I heard about Never Use Alone when I ordered my own Narcan from the New York City Department of Health. You have to go to a training before they'll send it to you. The training tells you how and when to reverse an overdose, and one of their PowerPoint slides mentioned the hotline. At the time, I imagined Never Use Alone was some official thing, like 911.

But it's nothing like that. It was started, as Jessie puts it, by a bunch of drug users who were tired of watching their friends die. When she first volunteered to answer calls, the screening process to be an operator consisted of talking to one guy to see if you were a fit. The very same day, she picked up her cell and got connected to someone who was about to get high.

Jessie

I said, hello? And he said, I'm trying to reach Never Use Alone. And I'm like, oh, shit, I guess you did. [LAUGHS] Because I didn't know what to do. I mean, I knew I needed to get his address. I mean, that was kind of a no-brainer, right? But outside of that, I was like-- he was like, are you going to get my information? I'm like, what information do I need? He's like, oh, god. He said, you're going to let me die. And I'm like, well, I mean, it seems that way right now, so help me out.

Mary Harris

In the years since, Jessie's set up a whole system, a script that operators can use, a training regimen. But this organization is still basically run on a Google Doc and a prayer. I hung out while Jessie took one call after another over two days.

Jessie

Never Use Alone. It's Jessie.

Mary Harris

The calls were intimate, sometimes joyful. One guy talked to Jessie for like half an hour about his life, where he was going over the weekend, his girlfriend, his health.

Jessie

You do good. You're drinking an ounce of water for every kilogram of body weight, aren't you? Didn't we figure that out the last time I talked to you?

Mary Harris

Another guy felt guilty for taking up Jessie's time. He tried to have everything ready to go when he called, and he apologized afterward.

Jessie

Listen, if it wasn't for people like you calling, people like me wouldn't have nothing to do. I'd be bored as hell. I am so glad you called me.

Mary Harris

He told her he tapes Narcan to his arm and sits on his porch after getting high in case he passes out. He hopes his neighbors will find him. There was no recovery talk. Sprinkled throughout these conversations were little reminders of how scary things are for the people who need this line. Jessie gently admonished one caller who told her he'd used on his own, a few hours before, without letting her know.

Jessie

You didn't call me. You know my heart would be broke if something happened to you.

Mary Harris

"I know that," he says. "I know."

Jessie

OK. OK. Just call us. It's not a bother. Even if it's a tiny amount, OK, even if it's a tiny amount, it's OK. You're worth it. You're worth it every time, OK?

Mary Harris

It's notable that everyone in this story has some kind of connection to addiction-- the people who started the hotline, Stephen, the paramedic, Jessie with her daughter, and actually, Jessie herself. 20 years ago, she had a real problem with opioids.

Jessie

I did, back in 2002. I'd had a surgery. And my doctor put me on oxy 30's. I'm a nurse. Anytime I called for a refill, I got one.

Mary Harris

For Jessie, there was no rock bottom moment. But after a couple of years, she started running out of pills. And she didn't want to risk her nursing license to get more. She quit cold turkey, spent three days sick on her bathroom floor. Then it was over. Jessie says her daughter Kaylen started using years later when a boyfriend introduced her to heroin.

Jessie wonders about why a lot. Everyone has a why, Jessie says. Kaylen's why, she thinks, sort of has to do with her, their particular mother-daughter relationship. Jessie can be a hard ass. Kaylen, too. When Kaylen got pregnant at 15, Jessie thought Kaylen's boyfriend was bad news, so she blocked him and his family from calling Kaylen's cell. Kaylen was pissed. She threatened to move out. One morning, Jessie told her to go ahead and do it, so she did. They'd see each other every once in a while, but it wasn't the same.

Jessie

I found out I was a grandmother through a text message, when I had been at the hospital for two days with her while she was in labor. But she sent me home and said, I'll be fine. I'll let you know when something starts happening. And I found out the baby was here through a text message.

Mary Harris

Oh, that's so hard. That's so hard because it's like, you go back, and you're like-- I don't know. Like, what should we have done?

Jessie

I don't go back and have any regrets. I did the best I could with what I had at the time. That's all I got.

Mary Harris

Yeah.

Jessie

When it became overtly obvious that I was really not doing my best, that I was making things worse between me and her-- because we were always so incredibly close-- and when I realized, all right, you're fucking this up, you got to find a different way. You got to do something else because this right here is not working.

Mary Harris

Over the years, Jessie has watched Kaylen go back and forth. She'll have months of sobriety, then return to use. Kaylen's been picked up by the cops, had her photo posted on the local police department's Facebook page. While I was visiting, Jessie called Kaylen up. Kaylen said she'd come by to talk, but she never showed. I think Kaylen's part of why Jessie takes so many of these Never Use Alone calls. It's people like her daughter on the other end. She told me as much.

Jessie

I didn't want her to die. This whole thing is about-- every, every, every fucking thing I do is about her not dying. About her not dying, then about her and her homie not dying, and then about her and her homie and their homies dying. And now it's about the entire town not dying.

Mary Harris

When Jessie took that call from Kimber, listened to her OD on the line, she knew better than to expect that moment to change Kimber's life. And the next day, when Kimber thanked Jessie for saving her and then quickly followed that up with, "I want to use again," it didn't surprise Jessie. In fact, for Jessie, this was good news. It meant she could encourage Kimber to keep using the line, and it was an invitation to stay in touch.

So she did. She friended Kimber on Facebook, texted her for no reason. A few months after her OD, Kimber started calling Jessie "Mama." But Kimber would also drift away. When she did that, Stephen and Jessie would try to keep track of Kimber online, what she was liking and commenting on. "Messenger shows her active 6 minutes ago," Jessie texted Stephen at one point. "She hasn't even read my message. I text her phone-- nothing." "Yeah," he replied. "She's been leaving me on read," like she'd seen his message but hadn't replied.

A month later, Jessie tried Kimber again. "Hey, I haven't heard from you in a while. I hope that means you're good," she texted. Two days later, "hello? Are you good"? A day after that-- "hi, this is Jessie B., in case you lost my contact. It's not like you not to respond. I'm growing concerned." She added a heart emoji, pressed send, and hoped for the best.

Act Four: Kimber

Mary Harris

Act 4, "Kimber." While Jessie was checking in with Kimber by text and Facebook, Stephen, the paramedic, he was trying to help out IRL. After all, he and Kimber lived in the same town. Stephen got Kimber back into rehab. Then he offered to get her into job training. A few weeks after her overdose, he posted a picture of the two of them on Twitter. Kimber had shown up at Stephen's July 4th barbecue.

A few months after that, though, is when Kimber went silent for Stephen and Jessie. Weeks went by, then months. And then Jessie got a text from a number she didn't recognize. It read, "hey, Jessie, it's Kimber. I just wanted to give you my new number." Jessie replies, "oh, hey, hi," four exclamation marks. Kimber was alive.

[KNOCKING]

Mary Harris

Is this going to bug you?

Kimber

No, you're good. [LAUGHS]

Mary Harris

This, of course, finally, is Kimber. Kimber lives in Vermont now. She's been sober for one year. The place she calls home is a tidy duplex where she lives with her little gray dog, Luna, and not a lot else. She didn't bring anything with her when she left Massachusetts, where she OD'd two years back. There aren't any family pictures on the wall, not many mementos. Kimber is growing plants, though. Nature has always been her thing. As a kid, she was the one who was always bringing creatures home.

Kimber

Do you remember Elmyra from Looney Tunes?

Mary Harris

Yeah.

Kimber

So my family called me Elmyra because her thing on the show was like, she would kiss and hug and squeeze animals until they died. And so that's what they called me because I always had some kind of critter or stuff like that.

Mary Harris

In her new apartment, there's a little sunroom off the kitchen. Kimber wanted to make it into a greenhouse, but the radiator started leaking there, and the floor got soft. Still, this is a fresh start.

Mary Harris

Do you keep Narcan around still?

Kimber

I do. I do. I carry it with me. You just never know when you're going to need Narcan.

Mary Harris

Yeah.

Kimber

I just had to revive somebody the other day here at an AA meeting.

Mary Harris

It was different, being on that side of things.

Kimber

You don't even think about the fact that you almost died. That's the crazy part. Like, I forgot about a couple of my overdoses because you kind of just fall asleep and don't even know that you fell asleep. I'd always get mad. You get mad at the person. You're like, what are you stressing out about? I'm here. I'm fine. What is the problem?

And then I watched people overdose, and it's like three minutes between when you Narcan them, and they'll come back. It feels like an eternity, and all those things run through your head. This person's dead. I don't know if this person's coming back. And then you realize, oh. You're like, oh. OK, this was pretty scary.

Mary Harris

On that first day she called the line, the day Jessie answered and Stephen revived her, Kimber remembers waking up to a cold shiver rolling down her spine. She was looking down the hallway to the bathroom where she last remembered being, a bathroom now filled with cops. There was the suitcase she'd just lugged home from rehab. And then she got really, really sick.

After Stephen forced her to go to the hospital, she checked herself out within an hour and walked home, puking along the side of the road. She picked up more drugs pretty much right away. The whole idea of Never Use Alone's approach is that, as Jessie puts it, you give the callers time, one more day to fight their demons. And Kimber had a lot of demons. She says her parents both used drugs. When she was 17, her brother was killed by a drug dealer. The whole family kind of crumbled after that, Kimber included.

Kimber went to rehab on and off for years. She'd use a ton of drugs, realize things were getting a little out of control, and check in for a couple of weeks to "spin dry," as she put it. She'd get clean enough to go back to work and pay her rent, and then the cycle would start back up again. So the call with Jessie was not the moment things changed. That moment came over a year later. Things had gotten bad.

She says the sheriff had kicked her out of her apartment, the one where Stephen had revived her. Her car had been stolen and totaled. She was carrying around a backpack with her passport and birth certificate in it. But then it disappeared. Her cell phone was gone too. She had a friend who would let her crash, but the friend had a condition. Kimber had to call detox every day and try to get a bed, which eventually she did.

The hotline is called Never Use Alone, but walking into rehab, Kimber was utterly and completely alone. And maybe for this part, you have to be. When she arrived, the nurse asked if she wanted medication. Methadone? To make getting straight a little easier? For the first time, she said no.

Kimber

So I went up to detox and detoxed with no medication.

Mary Harris

What did that feel like?

Kimber

It was awful. I just remember going in, and I couldn't lay in the bed. It was so cold. They had the AC blasting. It was summertime. Of course, the AC is on. But you're going through withdrawal, so you're so cold. And I couldn't lay in the bed because they gave you like these thin blankets. So I went in the bathroom, where there's a heater thing in there, and laid on the floor. And they dragged me out. They wouldn't let me stay in the bathroom. They're like, you can't lay in here.

And so then I waited for them to leave, and I went into the bathroom. The only thing that felt good was I stripped down naked. It was a really small bathroom with like tile floors, so I had to throw my clothes out of the door back into my room and just lay on the tile. And I had the blanket over the heating vent, and I just like had the heat on there.

But the coolness on my back and then the heat-- oh, my God. It was the only thing that kept me being able to sit through it. And I mean, I was throwing up the whole time. And I don't know how long I was there. It was a while. It just felt like days and days went on. And I didn't think it was ever going to stop. And I just kept telling myself that I could do it, that I really had the strength to do it.

Mary Harris

Kimber remembers all the details because she's really proud of what she did. Four days after she checked in, she sent Jessie that text from a new phone. "I feel like I'm in a stable enough place right now to reach out and let you know I'm back," Kimber wrote tentatively.

Jessie said, "everything that you've been through has prepared you for today. You haven't been wasting time. You've been getting ready. I'll support you however you need me to, every step of the way." For Kimber, it's been a year of big changes. She's in a new town, but she still doesn't really trust herself around her old crowd.

It's interesting how this one call brought these three people together. Stephen told me when he first met Jessie, they didn't really like each other-- too similar maybe. But the call bonded them somehow. And Kimber, right after that call, she avoided Stephen, even though he kept reaching out. She was embarrassed. He lived in her town, knew all the police. She said she got to this point where she knew other people were sick of her bullshit because she was sick of her bullshit.

That passed eventually. Kimber took a trip with Stephen's family to the beach this summer. There are these photos of them, hanging out in the sand. Jessie, to this day, hasn't met Kimber in person, but they text all the time. On Mother's Day, Kimber sent Jessie a card. There was a picture inside of it, an ultrasound. Kimber is pregnant.

Kimber

I always said my body was too poisonous for anything to live inside. I had done so much to myself and just berated my body. And there was no way anything was going to be able to live in this toxic environment.

Mary Harris

Kimber's got a partner, Mikey. She met him in AA. They moved in together. This pregnancy was a surprise, but a happy one.

Kimber

And I think there was definitely a part of me that thought I didn't know how to be a mother. So when I found out I was pregnant, like even if I had to do it by myself, like I was going to do it. I'm 31 years old. I was sober. I moved to a brand new place, started with nothing. And I knew I could do this. If I could do everything I was doing, I could do this too. So I never for a second thought that I was going to not keep the baby.

Mary Harris

Kimber still dreams about using drugs. These are absurd dreams, vivid dreams, dreams about smoking dope that turns into vanilla frosting. And most of the people she went to rehab with, they've gone back to using. These days, Jessie's still taking calls, sometimes 10 calls a day. She doesn't hear from her daughter Kaylen very much, but I did reach Kaylen. She told me she's trying to use less. Mostly, she said, she's sticking with weed.

As for Stephen, he says reviving Kimber changed his life. He'd been having nightmares about all the people he failed to save. After Kimber survived, he realized he didn't have to be the one pumping oxygen into someone's lungs to keep them alive. He could work more on the hotline instead. So he's doing that. He's even started taking calls.

Stephen and Jessie wanted Kimber to come work on the hotline too. So she went through the training and just took her very first call. Now she's one of the voices on the other side of the phone, saying, put me on speakerphone, lay out your Narcan, unlock your door.

Ira Glass

Mary Harris, she's the host and managing editor of Slate's daily news podcast, What Next. They were our collaborators in making this story. If you liked what you just heard, Mary is such an amazing interviewer. And her daily show gets into the news in ways other people don't. You might check it out.

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Credits

Ira Glass

Mary Harris's story was produced and edited by David Kestenbaum. Our show was produced today by Alix Spiegel. The people who put together today's program include Bim Adewunmi, James Bennett II, Zoe Chase, Michael Comite, Sean Cole, Aviva DeKornfeld, Cassie Howley, Valerie Kipnis, Seth Lind, Katherine Rae Mondo, Stowe Nelson, Nadia Reiman, Alissa Shipp, Christopher Swetala, Matt Tierney, and Diane Wu.

Our managing editor is Sarah Abdurrahman. Our executive editor is Emanuele Berry. Special thanks today to Alicia Montgomery, Paige Osburn, Susan Matthews, Elena Schwartz, Aymann Ismail, Jeffrey Bloomer, Dan Kois, and the entire Slate and What Next team, whose work you can find at slate.com. Our website, thisamericanlife.org, where you can stream our archive of over 800 episodes for absolutely free. Also, you'll find merch. We have the incredible Torey Mala-t-shirt. Check it out. Again, thisamericanlife.org.

This American Life is delivered to public radio stations by PRX, the Public Radio Exchange. Thanks, as always, to our program's confounder, Mr. Torey Malatia. He got fired from his job as an ambulance dispatcher because he was just way too chatty for the gig.

Jessie

If it wasn't for people like you calling, people like me wouldn't have nothing to do. I'd be bored as hell. I am so glad you called me.

Ira Glass

I'm Ira Glass. Back next week with more stories of This American Life.

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