Garcia’s The Pastoral Clinic: Addiction and Dispossession along the Rio Grande provides a fascinating look into the lifestyle and challenges faced by people in New Mexico, tracing complicated histories of heroin addiction, detox resources, overdoses, and structural violence. Methodologically, the author describes her own experiences working as a detoxification attendant in a drug detoxification clinic in Española Valley. I found it interesting that she sought out this job to obtain an intimate relationships with her subjects, facing the harsh realities of this occupation for herself. Since other attendants only needed to pass an exam on prescription medications – without official training – there was a low barrier to access this way (2).
Later, when recalling her own experiences in this area, she says how she “would speak of New Mexico’s distinctive beauty, never of the deep suffering that I knew existed there” and eventually realizing how physical landscape and systematic addiction is inextricable – each with “its own processes of sedimentation” (6). This sentiment was particularly powerful to me, as I am currently in an Environmental Humanities class where we explore similar topics with regard to how ecological terrain can propagate narratives of “nature,” human destruction, and generational significance.
Garcia’s book describes a particular instance of “self-discharge” from clinics whereas some detox patients are unable to complete the process to eliminate drug dependence. She gives the example of John, who had apparently “gotten over the hardest stretch of heroin detox” and motivated himself toward progress with the threat of going to prison despite ultimately “self-discharging” and supposedly relapsing (4). The author asks “were there other, perhaps deeper dynamics of loss and longing during our walk that contributed to his relapse? How would I be able to begin to understand the motivations, force, and meaning of his “self-discharge”?” (4). The very presence of syringes in the natural environment poses a threat to getting and remaining sober because of the reminder it serves.
Your connection of the physical environment as it attributes to the systemic addiction in this region reminds me of Garcia’s comments regarding the social environment in the same way. In the introduction, she states that high heroin death rates are proof that “within this close network of rural towns and villages, everybody knows somebody who is addicted to heroin or has died because of it” (p. 2). Heroin addiction, whether through family, friends, or neighbors, is explicitly present in the everyday lives of people living in this region. Thus, even when someone like John seems to be successful in heroin detox, their social relationships can push them back into their addiction, as a relative could be their dealer or a friend could still be addicted. The integration of heroin into everyday social contexts is evident through the simplest of Garcia’s experiences; her neighbors just so happen to be heroin dealers. Thus, Garcia’s experience living in close proximity to the omnipresent mark of heroin reflects the community’s overall expereince.