The patient is “a skin popper.” She injects heroin into her skin rather than snorting it or injecting it directly into her veins. Her arms are covered with sores in various stages of ulceration from old scars to open weeping sores.
Endocarditis is epidemic in the United States today. It’s rise mirrors the rise of opioid deaths. While this patient’s demise will not be counted in the overdose death numbers, she is nonetheless a casualty of the opioid epidemic that is destroying people, families and communities across the country. The woman is very sick. Too much damage has been done to her heart and brain. After a discussion with her loved ones, she receives a final opioid — morphine, then she is extubated, and with family at her side, she passes on.