Luke Kuzmish

Medicaid Rehab

waiting to find out what price / you have to pay to get out of going through all these things twice

Bob Dylan

it was a Sunday in March
we were in the mountains
I was back 
third time in a year
it had rained
I stepped in mud
I didn’t have any cigarettes
nobody seemed to have any cigarettes 
my unit had 40 patients in June
in March there are now 60
we don’t fit in the day room
but when you’re an addict
your complaints always receive the reply
“that's just your disease talking,
trying to find an excuse to leave"
or, the more colorful,
“you didn’t care about elbow room
when you was in the trap house”
the way the overpaid administrators
and underpaid counselor assistants talk
you’d think Pontius Pilate
was in hot pursuit
Sunday was always an empty day
get 60 men out of prison
and off dope for a few weeks,
then give them 4 hours of free time
to sit around and watch the same
10 movies
purgatory is a rehab on Sunday afternoon 
the unit was short a counselor
or two
or three
but that was more of an inconvenience
if you needed to make a call home
for an extra dose of pain and hurt
—the counselors weren’t for talking to
for uncovering existing pain
nor for gaining insight,
they were there to run groups
where they had us color with dried up markers
or perform a skit or
those godawful ice breaker activities
—apparently this is the best chance
you have for getting clean 
if you have the good fortune
of being on Medicaid
when they’ve unlocked our rooms 
for 50 minutes in the middle of the day
I would always imagine taking a nap
but my room was next to the coffee machine
and a boom box
and the stairs
so that was just a dream
and ultimately ended up as
more of that godawful free time
it was on this rainy March Sunday 
that I finally noticed 
the flimsy wood painted soft blue
was also painted with the semen of
whomever had my bed last
I seek out Amy
the head counselor
big saggy tits
and a big Italian nose
she’s a lady
and I’m working on being a better person
so I try to explain the problem
to her in nicer terms than
“I’ve been sleeping next to some other dude’s cum for two weeks,
isn’t this an outrage,
how do I get
this jizz removed?”
she acknowledges the problem
but directs me to the male counselor
as if Amy herself is too delicate 
to orchestrate a cleaning of some loads
the male counselor, Casey,
has had my contempt since last summer
this dude does not give a fuck about me
the other patients
or this job
he does everything he can to show it
stopping short of getting a face tattoo
that says “I support Narcan
because the revolving doors of addiction
pay my bills”
Casey has what the youth today call
a “punchable face”
it’s a large pink oval
with all of his features
close together
making his nose seem like a target
he listens to my problem
even follows me the 100 yards
up the hill to my room
and observes the yellowing trails of semen 
his solution is to find the cleaning lady
and have her give me a warm wash cloth
so I can clean it myself
I do it
that’s what you do when
you recognize a problem
and no one else will fix it for you
Medicaid rehab
is half of what keeps me
from using heroin again
at worst
I die or go to prison
at best
I end up
in the same shitty rehab
hearing the same speeches
3 percent of their patients
report being clean
one year after discharge
the numbers are depressing
just like
rainy days in March
on a mountain
with no cigarettes

Luke Kuzmish is a new father, recovering addict, software developer, and writer from Erie, Pennsylvania. His work has been selected for publication by Nixes Mate,GravelCall Me [Brackets]Anti-Heroin ChicMojave River ReviewFearless, and a number of others. His first full-length poetry collection, Little Hollywood, was published by Alien Buddha Press in 2018.