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Wide awake to addiction in the city that never sleeps

New York was my first love. It was my first adventure, my first big trip abroad to work on a J1 visa and the first of my many transitions into adulthood.

It was, in 1980, and me a medical student, like stepping onto the set of all the TV shows and movies I had ever seen. So when I returned to the Big Apple this year, I was afraid that it might be like revisiting an old girlfriend after 35 years. It could go either way. It might seem very plain now or it might still feel exotic. I had to presume that New York had changed in those years, but that I had changed too. Would 10 days in NY be too much or too little?

On our return home to the auld sod, I asked my partner what was the greatest memory she had of the trip. I was a little surprised that it was not her shopping ‘addiction’ that she remembered most, but two things: Our visit to a methadone clinic in Harlem, not part of her normal NY itinerary, and how expensive New York had become.

I have always said that a good holiday is where you come home refreshed and more appreciative of your life at home. If you think Ireland is cold, then travel to Iceland and feel real cold. If you feel you are poor and pinned to your collar, then visit India for your vacation.

Relativity is what travel is all about. You think you know the world and yourself until travel knocks you into new contexts and new perspectives.

The methadone clinic in Harlem had different clientele from that of the shopping addiction centres on Fifth Avenue, and we were the only white people on the bus to the clinic for a while. HELP is the Harlem East Life Plan. On Second Avenue in North East Manhattan, it is a diagnostic and treatment medical facility that serves the multi-ethnic communities of the area. The pace in Harlem was definitely different; the bus driver was most patient and helpful as two wheelchair adults were assisted onto the bus. Everyone moved out of their way to accommodate the necessary changes in the bus’s internal structure. Later, I noticed people got off their seats for older folk.

“Nice,” I thought. “Does this happen in Dublin or Fifth avenue? Not so much.

Harlem is meant to be rough, black and dangerous. It was in fact poor and established, more like Ballyfermot than our Liffey-side boardwalks. It felt safer than O’Connell street in Dublin. No lurking sense of drug danger, although everyone should watch their pocket in any city these days.

The most dangerous thing to happen was over in an instant. The cyclist came crashing down, the bus almost hitting him as he splashed across the busy road. The whole street stopped whatever it was doing, as if frozen. The incident involved two men running across the road in front of a public bus, without looking, and running straight into the cyclist. They could have run into worse. Maybe they thought they were in a Hollywood movie. They were lucky not to have been hit by the reality TV of oncoming traffic and end up in ER or Six Foot Under, the box set.

If you have been to the Horse Show in Ireland, you will understand how I felt after my tour of the methadone clinic. Joanne, my guide, gave me a green carrier bag (it wasn’t even St Patrick’s day) with keyrings, cups and mugs, all with their logo and branding.

I was not unsettled by this generosity of time and goodies from Joanne as much as by the feeling that we were standing on water, or that my coffee had been spiked.

As Joanne explained how the clinic worked, I asked: “Is there a subway near here?”

“No,”she replied. “But they are building one at the moment just underneath us.”

“How undermining,” I said.

Run by a private entity but paid for by government, the clinic had primary care, counselling and pharmacy all working together in the same place. Counselling was both mandatory and available for all clients as it was a compulsory part of the methadone programme, dictated by government funders. The doctors see patients by appointments that are either 25 minutes or 45 minutes long, very different from our five-to-10 patients per hour. I was the only one to notice that there were no windows in any of the doctors’ rooms, no natural light, no fresh air.

For me, the iconic features of New York are the skyscrapers and the addiction to be the biggest and the tallest of them all. These buildings are awesome, miracles of modern engineering. How they stay up is incomprehensible to me.

Maybe some day I will be proven right, because some day a building will be built that is just too high. Will it keel over or just collapse on the spot into dust?

Like the addiction to greed, bureaucracy or the latest fashion, at some point all addictions must come to a point where they threaten us. Like a cancer growing, all addictions can eventually break the whole system.

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