When you walk into your neighborhood public library, you expect the librarian to help you find your next favorite book or some accurate information on a topic at interest. You don't probably expect the librarian to come running out from behind the reference desk with Narcan, ready to revive someone overdosing on heroin or fentanyl. But this is happening at some libraries.
當你走進你附近的公共圖書館時, 會期待圖書館員幫你找到 下一本你喜歡的書, 或關於某個主題的準確信息。 你大概不指望圖書館員 拿著納洛酮(Narcan) 從參考諮詢服務臺後面跑出來, 準備救醒過量使用 海洛因或吩坦尼的人。 但這正發生在一些圖書館裡。
Public libraries have always been about community support with all kinds of services and programs from assisting with job seeking efforts to locating resources for voter rights to providing free meals to kids and teens even. But what we think of as community support takes on new urgency when you're in the middle of an opioid and overdose crisis.
一直以來,公共圖書館 以支持社區為目標, 提供各種服務和方案: 幫助找工作、 找選民權利的資源, 甚至提供兒童和青少年免費的餐點。 但處於類鴉片和過量危機之間, 帶來了新的社區支持急迫感。
I work at the McPherson Square Library of the Free Library of Philadelphia. It's located in Kensington, one of the lowest income communities in Philadelphia, with a long history of being isolated from resources and opportunity. And because of that, it has been the center to the city's drug trade and drug use for decades. And so inside the neighborhood, our library is nestled inside of a park, which has unfortunately garnered a reputation for being a place to find and use drugs, especially heroin, out in the open, putting us and the community in direct contact with the drug trade and use on a daily basis.
我任職於費城免費的 麥克弗森廣場圖書館, 位於費城最低收入社區之一的肯辛頓, 與資源和機會隔絕的歷史悠久。 因此,數十年來, 它一直是該市毒品貿易 和毒品使用的中心。 位置在社區裡, 我們的圖書館坐落在一個公園內, 不幸的是公園已廣為人知 是尋找和使用毒品, 特別是海洛因的公開場合, 使我們和社區 天天直接接觸到毒品的交易和使用。
And so inside the library, it is routine to see people visibly intoxicated on opioids: eyes closing, body swaying slowly. It is routine for me to ask them if they are OK, but at the same time remind them if they can't keep their eyes open, they have to go. It is routine for our volunteer, Teddy, to pick up dozens of discarded needles on our property and throughout the park. And it is normal for kids to come into the library to tell me or our guard, Sterling, that someone is outside using, which typically means finding someone injecting on our front steps, benches or near the building, then asking them to move along because kids see them. And it is normal for the community to see people in various states of intoxication and withdrawal, to see people buying and selling, and to see people act and react violently.
所以在圖書館裡 常看到明顯恍神的類鴉片藥物吸毒者, 他們眼睛閉著,身體緩慢搖擺。 問他們是否還好成了我的例行公事; 同時還得提醒他們, 如果他們睜不開眼睛 就必須離開。 我們的志願者泰迪 在我們圖書館範圍和整個公園裡, 收集數十個丟棄的針頭也是例行公事。 常有孩子們進入圖書館 告訴我或我們的守衛斯特林, 有人在外面使用,通常意思是: 看到有人在我們前面的台階上、 長凳上 或圖書館附近注射毒品。 我們得要求他們離開, 因為孩子看到他們用毒品了。 社區常看得到處於各式 恍神和退縮狀態的人們, 看到人們購買和出售毒品, 和看到人們的暴力行為和反應。
I'm not sharing this to sensationalize Kensington. I'm sharing this because this is the reality of a community that is constantly striving to move forward, but due to factors like structural racism, urban segregation, the cyclical nature of poverty, of trauma -- the community has inequitable access to education, health care, employment and more. And this is also what it's like when the drug trade and use affects every aspect of life in the neighborhood. And the opioid epidemic has only amplified that stress.
我說這事不是要讓肯辛頓 聽起來危言聳聽。 而是因為這是 不斷努力前進的社區的現實; 但是由於諸如結構性種族主義、 城市隔離、 周期性的貧困和創傷等因素, 導致社區的機會不平等, 諸如受教育、 醫療保健、就業和其他的不平等。 當毒品的交易和使用 影響到鄰里生活的 每個方面時就會是這樣; 而鴉片類疫情只會放大這種壓力。
When I was hired by the Free Library in 2013, I specifically chose to work at McPherson because I understand what it's like to grow up in an environment where substance use disorder shapes the everyday, and I wanted to use those personal experiences as a guide for my work. But before I get to that, I want to share what it was like to witness this epidemic grow in Kensington.
在 2013 年免費圖書館雇用我時, 我特別選擇在麥克弗森任職, 因為我了解在這樣的環境裡長大, 日常使用毒品所造成的紊亂感覺。 我想以個人的經歷 作為工作的指導。 但在談那之前, 我想分享在肯辛頓 見證這種流行病的增長是什麼樣子。
Like many other communities, we were just not prepared. We began to take notice of IDs we were seeing: addresses from nearby and upstate counties and then slowly out-of-state ones. People from Arkansas, Ohio, South Carolina, Alabama coming to Philadelphia for cheap heroin. People began to linger longer and longer in our public restroom, causing us to pay more attention to the restroom than to our daily responsibilities because it was an accessible place to use drugs just purchased. One day our toilet clogged so badly in the restroom, we were forced to close our library for two days because the culprit of the clog was discarded needles. For a while prior to that incident, we had been asking for a sharps container for the restroom, and after that, the library administration quickly approved installing one along with hiring bathroom monitors. And as the weather warmed, we struggled to respond. People began camping out in the park for days, weeks. You could walk outside on a sunny, warm day to find multiple groups of people in various states of intoxication and children playing in between them. The amount of needles collected by Teddy on a monthly basis skyrocketed from 100 to 300 to 500 to 800, to over 1,000, with many found on our front steps and the playground.
像許多其他社區一樣 我們就是還沒準備好。 我們開始注意到這樣的景況: 先是州北部的附近幾個郡, 然後慢慢地有外州的, 來自阿肯色州、俄亥俄州、 南卡羅來納州、阿拉巴馬州的人 來費城購買便宜的海洛因。 人們開始在我們的公廁裡 逗留的時間越來越長, 導致我們得更關注洗手間, 而不是我們的日常工作責任, 因為廁所是使用 剛買的毒品的便利場所。 有一天我們的廁所馬桶被嚴重堵塞, 使得圖書館被迫關閉了兩天, 因為堵塞的罪魁禍首是廢棄的針頭。 在事件發生前一段時間, 我們一直在尋求在廁所裡 裝個放尖物的容器; 在那之後, 圖書館的管理部門 迅速批准裝了一個, 也裝了廁所的監視器。 隨著天氣變暖, 我們努力因應。 人們開始在公園裡露宿幾天、幾週。 在陽光明媚、溫暖的一天外出散步, 會看到各式各樣恍神的人們, 以及在他們之間穿梭玩耍的孩子。 泰迪每個月收集的針頭數急遽增加, 從 100 增加到 300、 到 500、到 800, 到超過 1,000, 發現許多針頭棄置在 我們前面的台階和操場上。
Then there were the overdoses. So many occurred outside in the park, some inside the library. Sterling, our guard, would spend his time walking in and out of the building and throughout the park, constantly making sure everyone was safe, because at times, our fear of having someone overdose and die came close. One overdose in particular occurred after school, so the library was full of kids, noise and commotion. And in all of that, we heard the thud from inside the public restroom. When we opened the door, we found a man on the floor, unresponsive. He was pulled out in plain sight of everyone -- kids, teens, adults, families. Someone on staff called 911, someone else escorted the kids and teens downstairs, somebody went to flag down the ambulance in the park. And the rest of us -- we just waited. This had become our overdose drill because at the time, it was all we could do. So we waited and we watched this man lose air -- seize up. He was dying. I don't know how many of you have witnessed an overdose on opioids, but it's horrific because you know the gasping for air, the loss of color in someone's face, is a timer running down on the chances of this person surviving. But luckily for this man, the ambulance arrived and he received a dose of naloxone through injection. And I remember he jolted like he was electrocuted, and he pulled the needle out, and he told the paramedics to back off. And then he stood up, and he walked out. And we -- we went back to work because people were still asking for time on the computers, kids still needed help with their homework and this was our job -- our purpose.
還有吸食過量。 很多發生在圖書館外的公園, 有些發生在圖書館內。 我們的守衛斯特林 會花時間進出大樓和整個公園, 不間斷地確保每個人都安然無恙, 因為有時候我們所害怕的 有人會吸毒過量致死差一點發生了。 有次的過量事件發生在放學後, 當時圖書館裡滿是孩子、 噪音和騷動。 就在這一切聲音當中, 我們聽到了公共洗手間內 有人倒地的聲音。 我們打開門時, 發現地板上有個人昏迷不醒。 每個人都看得到他被拉出來── 孩子、青少年、成人和家庭。 有個圖書館員打電話給 911, 另一個陪著孩子和青少年們下樓, 還有一個去公園指揮救護車。 而我們其他人只是等著。 這已成為我們的過量演習, 因為當時我們只能如此。 我們等著、看著這個人吸不到氣、 痙攣, 他快死了。 我不知道你們之中有多少人 目睹過鴉片類藥物的過量使用。 它真可怕。 因為正如你所知,掙扎著要吸到氣、 臉色變蒼白, 是這個人生命流逝的倒數計時。 但這個人很幸運, 救護車到了, 給他注射一劑納洛酮。 我記得他像被觸電一樣震起, 他拔出針頭, 告訴醫務人員退後, 然後站起來,走了出去。 而我們── 我們繼續工作, 因為人們仍要求使用電腦, 孩子們仍需協助完成作業, 這是我們的工作、我們的用途。
I think that incident stays with me because of the waiting. It made me feel helpless. And it was that feeling of helplessness that reminded me so well of my childhood. Before I was born, both of my parents began using heroin. It made our lives chaotic and unstable: promises being made and constantly broken, their fighting, the weight of their secret -- the weight of our secret kept so much so-called "normal" out of our lives. Every time we'd be dropped off at our grandparent's house, I'd be stuck on the thought that I was never going to see them again. Every time we'd be left in a car, at a house, at a store, I'd cry. And every time I saw those El tracks -- the same ones I take to work now to McPherson -- from the backseat of a car, I'd be angry, because even kids know when their parents are trying to score drugs. There was so little I could do to control what was going on around me, that that feeling of helplessness was overwhelming. I struggled in school, struggled to read, I was prone to anger and depression. When I was 11 years old, I started smoking, which shortly after led to my own experiences with drugs and alcohol. I convinced myself that my parents' past would be my future. But eventually both of my parents entered recovery and maintained recovery from opioid use. And their strength and their commitment provided support and stability for me and my siblings, and it was those personal experiences that brought me to McPherson.
我認為是因為等待 而使我忘不了這件事。 等待讓我感到無助。 那種無助感讓我憶起童年。 我出生前父母開始吸食海洛因, 使得我們的生活變得混亂不穩: 許下的諾言不斷地被打破, 他們的爭執和秘密的重量, 我們秘密的重量 把我們大多的生活 排除在所謂「正常」之外。 每當我們被丟在祖父母家時, 認為我再也見不照他們的 想法揮之不去。 每當我們被留在車裡、 在房子裡、在商店裡, 我都會哭泣。 每當我看到那些高架列車── (註:市區載客通勤的高架列車) 我去麥克弗森工作 日常搭乘的那些列車── 在車的後座 我都會生氣, 因為即使孩子們也看得出 他們的父母正打算要吸毒。 我幾近無法控制周圍發生的事情, 那種無助感壓垮了我。 我掙扎於學業、讀書之中, 我很容易生氣和沮喪。 我 11 歲時開始吸煙, 不久後導致我自己吸毒和酗酒。 那時我相信 父母的過去將會是我的未來。 但最終我的雙親戒毒了, 並且一直維持著不再用鴉片類藥物。 他們的力量和承諾 為我和兄弟姐妹提供了支持和穩定, 正是那些個人的經歷 將我帶到麥克弗森。
Choosing to be a librarian and choosing to be at McPherson was me letting go of that feeling of helplessness and finding ways to be supportive to others. And one way to provide support was learning how to administer Narcan. Public libraries respond to the needs of their communities, and not knowing how to utilize Narcan was a disservice to the needs of our community. We were on the frontlines and desperately needed access to this lifesaving tool. So finally in late February of 2017, after much advocating, we finally received training from Prevention Point Philadelphia and about a month of so later, I utilized Narcan for the first time to save someone's life. It was after school again, and Teddy came into the library and said someone was overdosing on a front bench. Someone on staff called 911 again, and I grabbed the Narcan kit. The woman was barely in her 20s and barely breathing. Her friend was frantically slapping her in the face in hopes of reviving her. I administered the Narcan nasally, and thankfully she came to. But before the ambulance arrived, she and her friend ran off. And when I finally turned around, I saw the kids -- kids that come into the library on a daily basis, some that I have known for years -- standing on the steps of the building. They saw everything. And they didn't seem like they were visibly upset or in shock, and so I walked into the building, right into our workroom, and I cried. I cried partly from the shock of what just happened because I never thought I'd be saving anybody's life ever, but I mostly cried because of the kids. This is their normal. This is the community's normal. This is a catastrophic normal, and in that moment, I was forced to confront once again that this should never be normal, and as with my childhood, when you're in it, you just accept it.
選擇成為圖書館員, 並且選擇在麥克弗森工作, 讓我摒棄了那種無助的感覺, 並且設法幫助別人。 一種提供幫助的方法 是學習如何施用納洛酮。 公共圖書館回應社區的需求, 而不知道如何利用納洛酮 有損我們社區的需求。 我們站在前線, 急需獲得這種救生的工具。 終於在 2017 年 2 月下旬, 經過多次倡導之後, 我們終於接受費城預防點的培訓, 大約一個月後, 我首次用納洛酮拯救別人的性命。 那又是放學後, 泰迪走進圖書館, 說前頭的長椅上有人吸毒過量。 有個館員再次打電話給 911, 我一把拿起納洛酮工具箱。 那女人剛 20 歲出頭, 幾乎沒呼吸。 她的朋友瘋狂地拍打她的臉頰, 希望拍醒她。 我通過她的鼻腔注入納洛酮, 幸好她醒了過來。 但在救護車到達之前, 她和她的朋友跑走了。 當我終於轉身時, 看到了那些孩子── 那些每天進圖書館的孩子, 有些我已經認識多年了── 站在大樓的台階上。 他們看到了一切。 他們看起來並未 明顯的不安或受到驚嚇, 於是我返回大樓, 進入我們的工作室,哭了起來。 我哭的部分原因是剛剛發生的事情, 因我未曾想過會拯救任何人的性命; 但我更為孩子而哭, 這是他們的日常所見, 是社區的常態。 這是個災難性的正常情況, 在那一刻, 我被迫再次面對這種 永遠不該是日常的情況, 就像我的童年一樣, 當你身處其中,就只能接受它。
The opioid epidemic is not just about those living with opioid use disorder because the reach of the epidemic goes well beyond those living with this and their families. It impacts the entire community. Kensington was a community in crisis before this for reasons that are endemic and intertwined, and anyone familiar with the neighborhood can think of why: racial disparities, failure of local and federal government to properly fund schools, lack of economic opportunity. And what we're trying to do at McPherson is find ways to support this community out of crisis. And perhaps now, because of the epidemic, more people are paying attention to Kensington. But regardless of that, at McPherson, we will continue to do what we can with the resources we have and we will continue to provide whatever help we can in hopes of keeping our community safe and healthy because public libraries have always been more than just books. We are physical shelter, a classroom, a safe haven, a lunch room, a resource hub and yes, even a lifeline.
鴉片類物質的流行不僅是因為 有鴉片類藥物使用障礙的患者, 因為這種流行的範圍 遠超出和這些患者 及其家屬一起生活的範圍, 它影響到整個社區。 在這之前肯辛頓 已是個處於危機之中的社區, 因為地方性和交織性的原因。 熟悉鄰里的人可以想到是為什麼: 種族的差異、 地方和聯邦政府沒適當地資助學校、 缺乏經濟機會。 而我們在麥克弗森嘗試 找方法來幫助社區擺脫危機。 也許現在由於疫情的影響, 更多的人關注肯辛頓。 但不管如何, 在麥克弗森, 我們將繼續盡我們所能 利用現有的資源, 我們將繼續提供任何協助, 以期保持我們的社區安全和健康, 因為一直以來 公共圖書館不僅僅是書籍; 我們是實體的庇護所、 教室、 安全的避風港、 午餐室、 資源中心, 是的, 甚至還是生命線。
Thank you.
謝謝。
(Applause)
(掌聲)