Bad Medicine: Holly

I would give my life for hers and suffer anything to protect her. She is my daughter.

The first time I met Holly was with her mother. ‘She’s rattling’, said her mother. Holly was in heroin withdrawal in her mother’s womb and her fetal legs kicked her rhythmically. After birth she was given an opiate detox in the special-care baby unit and immunised against hepatitis B. A beautiful baby and much loved by her family. Thankfully, she was free of other infectious diseases — her mother was a hepatitis C carrier. Uncles, aunts, and grandparents cooed over their new addition to the family. All the best that money could buy — new clothes, pram, and cot. As Holly went home her name was placed on the Child Protection Register. Holly was free. She gazed, mesmerised, from the 20th floor of the tower block at the sparkling city below.

She attended the medical clinic with her mum. Her mother — a brighter and funnier woman you could not wish to meet — was stable on methadone, coping with her newborn. A single parent. She was rarely alone because her mum and dad gave her constant support, for she was part of a community. Holly’s dad and family never saw their baby — responsible in the eyes of the family for the heroin — cards and presents left unopened until they stopped coming at all.

In the rain and wind of midwinter Holly’s mum stopped coming to the Health Centre. We phoned and visited but silence. Holly’s now distraught grandparents phoned all her mother’s pals but silence. Holly turned up safe and sound, having been left with a neighbour for a ‘couple of hours’. The neighbour had a bevvy problem and it wasn’t till other neighbours had heard Holly crying that the police were called.

A Kinship application meant that Holly now had to live with her grandparents. Holly’s mum turned up a few weeks later. She had an abscess in her groin from injecting and some weeks later decided to terminate her new pregnancy. She wept but the brand of guilt and self-loathing roasted her heart and soul. Diazepam and crack cocaine added to her cocktail of self-medication. Holly’s mum died in a stairwell with a needle in her arm the following Christmas. She’d tanned six bags in a one-er — the police returned her possessions but all she had was a picture of Holly as a baby — she was 25 years old. I visited Holly’s grandmum. She showed me pictures of her dead daughter and laughed at images of her as a child. Then she wept but the brand of guilt and self-loathing roasted her heart and soul. Time passed — Holly was happy and well cared for by her grandparents and our society. Her life was all she knew and she accepted it as only a child can. A brighter and funnier girl you could not wish for. Guilt, however, is a poor basis for parenting and her grandparents gave her more than they should have.

Oestrogen hit her like a juggernaut. Her newfound awareness and insight gave her an intensity of pain that only a teenager can feel. Anger and loss became an ever-present companion. Her grandparents were unable to help her — feeling an intensity of pain that only a parent can feel — and gave her more than they should have. She found her dad but bitterness and drugs had poisoned him — she never met her half-brother and sister. Fags, violence, bevvy, and sex did not help her pain. Heroin and crack gave her some false and desperate comfort. Whether Holly’s pregnancy was planned or just a ‘mistake’, she never would say — but she really wanted that baby.

She got clean and stable but that didn’t stop the baby rattling after she was born — the opiate detox helped. Her baby was beautiful and much loved by her family. As Holly went home, her baby’s name was placed on a social work Child Protection Register. A burden of guilt and self-loathing pressed down on Holly.

I would give my life for hers and suffer anything to protect her. She is my daughter.

• © British Journal of General Practice 2019