The opioid epidemic claimed nearly two thousand lives in Massachusetts last year. One of those victims was Max Baker. Baker’s death highlights the dangers of addiction, even after a successful recovery.
Dr. James Baker said his son Max was the kind of kid who took to classic literature at a young age. He was “reading Nabokov and Homer, and a very studious person,” said the elder Baker.
But his passion was playing the drums.
“He’d be on the kit with his tongue out all the time,” said Max’s best friend and bass player, Ryan Clark. “He’d hit the drums really hard. He looked like a super hero.”
But that started to change. He said Max started smoking pot, and quickly moved on to pain pills. By the time he was 17, Max was regularly using heroin. Clark said it was obvious when he’d go to Max’s place to play music together. Sometimes he couldn’t focus, and would just keep starting a song over and over again. Or they’d start playing, and Max would just fall asleep at the drum kit.
“It was really frustrating," Clark said. "I was like, ‘why would you even invite me over?’ you know?”
After a while, they just stopped playing. Max’s life basically fell apart. He dropped out of high school. His dad, who’s a physician, said he could see in Max’s pupils and skin tone the signs that his son was on opioids, and begged him to stop.
“He would have slurred speech, and be nodding off at the dinner table," he said. "And we’d go to a concert together and he would disappear and come back acting differently.”
Max tried to stop on his own, but he’d start again when he got the withdrawal symptoms. Eventually, his father realized he was enabling Max by letting him live with him. So just before his son’s 21st birthday, he wound up doing something unbelievably hard — he kicked Max out of the house. Incredibly, it worked.
“He got started in a detox program, then to a suboxone treatment program and was on his way to — took about a year to get clean of everything, including the suboxone," he said. "And then he was sober and himself again.”
Max got his G.E.D., and then an associate’s degree.
“He called me just a few days before Christmas in 2014,” Max's father said.
“I just wanted to touch base with you, and also I wanted to let you know that I got a job," Max said in the message. "So if you can call me back, that would be great. Alright, thanks. Love you.”
“It didn’t matter to him if he was washing dishes or delivering pizza," Dr. Baker said. "He was working.”
And it was about this time Max met Emma Hargraves.
“He was the love of my life," Hargraves said. "I was going to marry him.”
On their first date, Max told Emma about some of the crazy and awful things he’d been through.
“He was very upfront about his past," she said. "But this past year, at the end he was really strong and really going places.”
Max enrolled in UMass Lowell, where Emma was a student, and started taking classes. He’d decided he wanted to be a doctor, like his father. And he and Clark started playing music together again. After everything he’d been through, by all accounts, Max was a success story. He managed to get into recovery and get his life back on track. Then, one day as he drove home from a class, one moment derailed everything.
“A young teenage girl didn’t see him and just pulled out in front of him, and they had a major accident,” said Dr. Baker.
Max’s injuries included a broken bone in his hand that required surgery. He talked about his addiction with his surgeon, Dr. James Shenko, and about his fear it might cause a relapse.
“So the conversation was, can we minimize that?" said Shenko. "And it became a big discussion between myself and anesthesia between, they were uncomfortable treating this patient differently than other patients because they felt that wasn’t fair to the patient.”
He said journal articles suggested patients on addiction recovery meds like methadone were usually OK after surgery, unless they were not given drugs for pain. But Max wasn’t on anything like methadone anymore, so the best option wasn’t as clear. They wound up using the normal drug cocktail for the surgery, including opioids. The surgery went well, but afterwards, Max’s father said he confronted Dr. Shenko.
“And said, ‘I need medicine for this pain. I need real medicine,’" Dr. Baker said. "And the doctor took me aside, I can tell you he had mist in his eyes, he put his arm around me, said, ‘I don’t know what to do, Jim.’”
“It was horrible," said Dr. Shenko. "Because you’re a doctor, you don’t want people to be in pain, but my fear is this kid is going to go back to — his life is going to be altered because of what we’re doing, in a bad way.”
But if he didn’t give Max the drugs, “I think he would have said, ‘I’m going to take matters into my own hand. Absolutely.”
In the end, Dr. Shenko prescribed just a small amount of Vicodin, an opioid. Less than a month later, Max’s father got a call saying Max had been found unconscious at his mother’s house. Before he could even get there, he got another call telling him his son was dead. When he got there, the police wouldn’t let him upstairs where Max was.
“And they said, did he have a problem with drugs?," Dr. Baker recalled. "And I said yes, he did, but he was recovering.”
Max died of a heroin overdose. He was 23 years old. Dr. Baker called Emma.
“And I instantly was like ‘what are you talking about? That’s impossible,’" she said. "I always knew that dating Max and falling in love with him that this was a possibility, but he just got exponentially better. And it’s like it doesn’t make sense.”
Dr. Shenko, the hand surgeon, said ever since he found out about what happened, he’s been going over and over the decision to give Max medication.
“It’s still ... I can’t put an answer on it. What could you have done differently, what do you change, how do you do something differently, how do you treat patients like this?” he asked rhetorically.
Max’s father, a physician who also prescribes opioids, has been suffering over it, too.
“That’s — at least for me — yet to be sorted out," he said. "And as I’ve gone through the literature, which I do every day now, I get up 3 or 4 in the morning and I study, study, study, try to learn more about this, about safe prescribing, about the different medications that are available here and in other countries, what can be done?”
He’s learned, he said, that there’s just no clear cut answer. He’s now getting certified to prescribe suboxone, the drug that initially got his son off heroin. And he’s taken a course on safe prescriptions of opioids in the hopes of preventing more tragedies like the one in his family.