Editor's Comments on 'Bridges to the Island: The Abandonment of Addiction'

 , March 19, 2017

In Anant Shukla’s “Bridges to the Island,” we see a snapshot of a life on fire.   We read the story of a young woman who, when starting a flame to prepare her heroin, created an explosion where she suffered severe burns.  It is an encounter with misfortune incarnate, but as the story progresses we see that more tragedy is yet to come.  As she goes to her family and friends for help, she is repeatedly turned away.  Everyone is wary of her self-destructive habits.  Here, the reader comes to see that the burn victim has burned her bridges.  Indeed, this is the central metaphor for Shukla’s piece, and it is brought to its culmination in the gut-wrenching ending.  Shukla, who has hit “pause” on the cacophony of pager alerts, takes time to connect with this patient, to understand her, counsel her, arrange for close follow-up medical care.  It is the kind of approach that should lead to a happier ending—one in which the physician partners with the patient for a better outcome.  It is an approach that many of us strive to provide to our own patients.  Yet when the patient, Sandra, is nowhere to be found and missing from all her follow-up appointments, the reader is left to assume that she has resumed her destructive habits.  The metaphor Shukla shares is especially powerful— she has burned her bridges and her island is still on fire.  In his time with her, he has caught but a moment of the inferno which addiction fuels.  It is this slow inferno to which Shukla refers when he leaves the reader with the uncompromising and honest ending: “And that is addiction.”

Stephen Raithel