I just saved someone’s life. Wish I didn’t have to

Earlier this week, as I was leaving the San Francisco Chronicle building, I saw a woman slumped in an uncomfortable position on steps across the street. I called out, “Hello!” as I walked up to her, but got no response. Something was wrong. Her face was ashen, and when I shook her and asked her to wake up, I realized she wasn’t breathing.

As the gravity of the situation hit me, I tried not to panic. Only one other person had bothered to stop, and he looked nervous.

“Call 911 and tell them we have an overdose on Fifth and Mission,” I told him as I unzipped my backpack and sifted through it for naloxone, the overdose reversal drug. I’ve carried it everywhere I go for five years after three young people overdosed and died near my house in the Haight. The day their bodies were discovered I went to a drop-in clinic and got trained to respond to an overdose.

I swore as I realized I only had one dose of brand-name Narcan with me. Would just one work? Depending on how long she’d been there, more than one dose might be necessary to block the opioid receptors in her brain and start her breathing again.

I broke open the packaging, pressed the plunger into her nose, and then I shouted at the top of my lungs into the street.

“I need Narcan! Does anyone have Narcan?!”

A couple of people stopped, looked at me quizzically and kept walking.

Realizing I had to do this alone, I pulled her into my lap and gave her a firm sternum rub, seeing if pain could bring her around.

“Please wake up,” I begged, starting to cry a little. “You are loved, and we want you here. Please come back to us.”

Slowly, the color came back to her cheeks, and then she took a

deep breath in. But her eyes stayed closed. As the noise of sirens grew closer, I stroked her hair and told her she was going to be OK. First responders poured out of a fire truck.

“I gave her one dose, it’s all I had,” I said, stepping back. “But I got her breathing.”

“Good job, that’s exactly what she needed,” said a paramedic.

Everyone was calm and gentle, and in a matter of minutes, they had her conscious. She was loaded into an ambulance. The paramedic looked around for me, gave me a thumbs up, and drove away.

I stood on the sidewalk, surrounded by Narcan packaging and pieces of an oxygen kit. Traffic sped by and people walked around me, moving through their day. I felt stunned by how fast the scene wrapped up — and shocked to be reminded how quickly and quietly a life can be lost on our streets without passersby knowing the difference.

That was the first time I’ve had to administer naloxone. I’ve stood at the scene of countless overdose reversals, been that bystander on the phone to 911 and held people’s hands as others have brought them around. I know how to load syringes, inject into muscle, do a sternum rub and breathe for somebody when they can’t do it on their own. I walk slowly through San Francisco, checking on people as I go, watching for the rise and fall of their chests as they sleep in doorways. I was as ready as anyone could be.

Despite this, nothing prepared me for what it felt like when someone needed help, and I was the only person around who knew what to do.

Standing on the sidewalk that day, I didn’t feel like a hero. I just felt sad.

I carry naloxone because I want people to live and be happy and experience love, regardless of whether they use drugs. I check on people in the streets because our city fails to care for them.

We have no cohesive, citywide plan to save lives, and it shows: 2023 is on track to be San Francisco’s deadliest year on record for accidental overdoses. At this pace, more than 800 people will die of overdoses. I believe every single one is preventable.

Overdose prevention centers save lives, and yet San Francisco closed its only one nearly a year ago. More people want and need drug treatment than can access it, but as a city, we’re utterly failing to meet demand. Our street drug supply is toxic and unpredictable, but we could learn from Canada’s program that distributes controlled, tested drugs to reduce overdoses.

Without this infrastructure, it’s left to regular people like me to either intervene or let people die in our periphery. Many city workers trained to help are patrolling the streets. But absent centralized infrastructure, San Francisco is too big a danger zone for only those with professional training to be tasked with responding to overdoses.

All the while, our politicians have turned the overdose crisis into their personal battlefield. Grand plans are announced and then fizzle out. There are neverending, circular arguments about whether we should invest in policing or treatment, harm reduction or abstinence. As deaths rise, the conversation has only grown more bitter, with fewer and fewer people willing to reach across the aisle in service of pragmatic solutions.

In the face of such weak leadership, the rest of us are left to step up.

Processing what happened in the days since the overdose, I realize I’m OK because she’s OK. I did everything I could, and this time it worked. Next time, we might not be so lucky. I worry about that. I do not feel equipped to handle the grief of trying to save someone’s life and failing. I feel angry that a city without a plan hands the responsibility of saving lives to its residents, but I also feel that in the wake of its failures, we have a moral obligation to act. We can arm ourselves with naloxone, learn how to do rescue breathing and check on those we pass as we walk down the street. We can choose to care about strangers and act with compassion when people need us.

Because if we don’t take action, who will?

Nuala Bishari/The Chronicle Nuala Bishari holds a spent dose of Narcan that she used it to reverse a woman’s overdose on Fifth and Mission streets in S.F. on Tuesday.