By Beth Macy, Illustration: Celia Jacobs, The New York Times, August 15, 2022
On a chilly spring evening in 2021, Tim Nolan set up a portable addiction clinic next to a McDonald’s dumpster, and he waited. His desk was the dashboard of his gray Prius, his office this parking lot, which smelled like frying oil and trash. The hatchback of the nurse practitioner’s car was full of hepatitis C testing kits, clean needles, fentanyl test strips — and pizzas.
Mr. Nolan’s first appointment of the night was with a middle-aged factory worker named Sammy, who showed up late in a dented old Ford and high on heroin, a broken face mask dangling from one ear. “I’m ready to get off that damn needle,” Sammy told him.
“Why do you want to?” Mr. Nolan asked, gently.
Sammy’s eyes welled. “Sorry, man,” he said. He’d been imprisoned twice, he explained, most recently on drug-related charges. While incarcerated, Sammy faced an additional charge for assaulting a jail guard during what appeared to be a full-blown psychotic episode that Sammy blamed on abrupt withdrawal. A year earlier, his fiancée’s 18-year-old son was killed. He’d just been fired from his job driving a forklift following a fight.