The Girl: Miracle, Tragedy and the Opioid Crisis

Tom Seufert, MD
4 min readMar 29, 2020


For the girl, and as ever, miracle preceded tragedy. The woman, Katie corrected dully, noting small breasts and the cleft of her pale, shaved vulva. 20ish, just plump enough to bring out her curves. She wore sandals with a bit of heel; her toenails were painted sky blue. Glossy. No, a girl.

The miracle, Katie thought, is that there ever was a girl at all. Decades earlier, beyond sight or suspicion, the girl had come to be: one cell. Formed from one egg out of thousands, one sperm among billions. Months of exponential growth and development; a violent push and a creature alive yet pathetically fragile. She would have quickly perished were her every need not seen to by caretakers with legion flaws: only half-ready at the gun, often overwhelmed, short-tempered, illogical, resentful, desperate or just confused. In other words, parents.

But meet her needs they would, and day by endless day (a mere moment, in retrospect) she grew, and grew strong. Motor pathways and muscle groups mastered tasks of movement, feeding and fighting shared in their essentials by ancestors sporting claws, fur and tails. She became adept at speech, and singing, and shouting, and sex; she learned what each could get her.

In addition to such primal skills, the girl acquired wonders beyond nature. Mathematics, writing, the scientific method. Immunizations, dental care, contraception. Driving, field hockey, a taste for sushi, a tattoo.

So armed, her chances of surviving to reproduce towered far, far above those of most every creature that had ever lived. From such heights, talk of mortality would have seemed perverse, obsessively pessimistic. She’d become formidable.

The universe is almost perfectly inhospitable to life, the Earth only very slightly less so. The powers of time, disease and entropy are such that no earthly creature has learned the trick of stitching years and decades into centuries and millennia without reproducing, a neat trick that offers the opportunity both to try new strategies and reset the clock.

But a patient cosmos can be abruptly brutal. All life needs food — without it, the girl is dead in a month. Run out of water — solvent, ballast and lubricant in one — she’s got 4 days, tops. And finally — Bad News, meet Worse News — comes the whole breathing thing.

By a design that (almost) nobody could call intelligent, the girl uses oxygen about as fast as she can get it and makes carbon dioxide and other toxins almost as fast as she can get rid of them. In particular, the girl’s brain, for all its facility solving Sudoku puzzles and parallel parking, is an absolute fiend for oxygen. Every breath she takes, she’s only a few dozen gasps away from drowning on dry land.

Now, tragedy. Thrilling in her mastery of the human portfolio, the independence of college, her reassuring substructure of devoted, middle class parents, she did everything such a girl should do and only a few she shouldn’t have. Today, one of the latter saturated her brain’s pleasure receptors with opiate alkaloid. Two minutes passed. Her breathing slowed, then stopped. Her ship was sinking, and a careless crew member had yanked the bilge pump’s fuse.

Someone found her, of course, and her world of pranks, trying on futures, and a cat named Mr. Z was suddenly one of shouting and Narcan and bone drills; of paramedics, doctors, nurses, techs, pharmacists, and chaplains; of tubes, wires, shocks, compressions, compressions and more compressions.

Now, the girl lies naked to her sandals in a roomful of strangers. It is quiet.

The code lasted an hour, but the girl’s life had ended earlier, in an unknowable instant of scooping too much powder onto her knuckle, or pressing a plunger too sharply, or chewing a pill she should’ve swallowed whole, or cocking her head so vomit pooled in her airway, or her boyfriend falling asleep while he was off pissing, or a dealer trying a new mix to see if it would sell.

A miracle, twenty years, an instant, and an ending.

After the doc calls the time of death, Katie steps back from the bustle. Her shoulders are burning from doing compressions. She steals a couple of minutes and makes up a story for the dead girl. But she can’t change its ending.

She notices the girl’s face for the first time. The girl is beautiful; her bones delicate, her skin unlined. A tulip cut just as it bloomed. Now, a nurse spreads a sheet and the face is gone. No family has come. No friends, no lover. No dealer or fellow addicts. The doc has long since left the room. It’s time to get back to work.

Walking back, Katie realizes two things. First, a tear is sprouting in the corner of her left eye. Sitting down, she wipes it on her collar. More follow, but she’s already catching up on her other patients, and pays no mind.

Second, they still don’t know the girl’s name. The computer calls her Unknown Female. Others, aloud or to themselves, call her every sort of name. Junkie. Overdose. Misguided. Villain or Victim, Warning or Waste.

Katie decides to call her Miracle.

Originally published at



Tom Seufert, MD

Emergency physician, clinical informaticist, software engineer, author, dad.