Drunk in Public: the DIP

Each new booking at the jail answers a set of questions from a screening done by the officers. Nursing reviews the screening forms to see if the inmate takes meds, if they brought meds, and if they claim to have any health problems. As I sat in the small medial office in Intake reviewing the stack of twenty bookings from the day, a local cop brought in a DIP, a Drunk in Public. He was a short man of interderminate middle age with matted, deadleaf-yellow hair and jaundiced blue eyes. He limped and trembled. The intake officer bagged his property and gave him a black-and-white stripped jumpsuit. The DIP put on the jumpsuit in the changing room, but emerged without snapping up the front. "I need to be taken to medical," he said, looking at me.
"I am medical," I replied. "And I am going to evaluate you in the office over here and we'll make a decision about that." I opened the door to the little medical office behind the officer's station and indicated for him to have a seat as I propped open the door.

"I need to go to medical," he repeated, sitting down and trembling. "I've had two seizures and a stroke today."
"That sounds like a rough day," I replied and began to ask him a series of questions about how much he'd had to drink that day, learning that he estimated about 50 drinks and reported waking up in the ER with a blood alcohol of .205. "My liver doesn't work right, I have Hep C," he added. "I'm supposed to go the the Hope House tomorrow for detox, now that's all screwed up, cause I got arrested, and for what? I wasn't hurting anyone. I'm going to sue the city," he warned me. "I've already got four lawsuits against this city," he said, sitting up straighter in the chair and adopting an expression of dignity, as if rehearsing for his trial. "Yes, if I miss detox at Hope House tomorrow, then there is just going to have to be another one," he continued with exasperation, the way a parent would add punishment to an already grounded child. I could smell the alcohol pouring out of him filling the small room. My eyes started to water as I recorded my findings on a progress sheet. "I need to go to medical," he repeated, "At least in medical I can get a nice blanket,"he said, attempting a pitiful look through his yellowed eyes and arched mangy eyebrows.

His vital signs were fine. We do not start treating withdraw until an inmate is actually in withdraw, meaning they have to be sober or much closer to it. We usually did not start a Librium protocol until 12 to 24 hours after booking, if necessary. But still the DIP made me nervous, if someone reaches the point of DT's, Delirium Tremens, from alcohol withdraw, mortality is 40%. I knew the DIP was a candidate for the DT's, but with a BAC of .205, he wouldn't be at the jail long enough to reach them. "Go back out so the officers can finish booking you," I told him without looking up from my writing. "I need to go to medical, I'll have a seizure if I don't," he said again and he shuffled out of the office, his unsnapped jumpsuit baring his sunken, hairless chest down to the top of his underwear.

Security explained the DIP was just there overnight at most. "He stays here then," I told them. "If he has a seizure, we'll deal with it then, but I think he's got more than enough alcohol in his system to hold him till morning." The 350 pound bald officer missing the bottom three buttons on his uniform shirt nodded in agreement. "We'll give you a holler if something goes wrong."
"He says he's supposed to go to detox tomorrow, when he gets released from here, where does he go?" I asked.
"We just release them right out of the door of intake, they are on their own," he replied without looking up from the computer.
"So, I guess you don't, say, put them back where you found them," I said, envisioning a Night of the Living Dead sort of scene on Saturday mornings when all of the Friday night drunks were released to wander back across the interstate towards town, towards the bars.
"No," he replied. I could see the DIP in the early morning light of the next day, limping down the road, talking about the Hope House, threatening to sue the city.