The drug of choice in my community is meth and marijuana. We also see a lot of people pop positive for benzos and opioids. Working in the ICU, we see a lot of meth cases coming in with heart problems. They have vegetation on multiple heart valves, and because of their lifestyle choice, they don’t qualify for surgery. The cardiac abscesses we see them come in with is iffy whether they get help or not. Our cardiothoracic surgeon will usually say no until the person has failed to make an improvement with antibiotics (and more often than not, they DON’T make an improvement). It is frustrating because we have these people in the ICU for up to a month or more, trying to fix them, and the whole time all it takes is a procedure that the Dr. is going to perform anyway. I get where the doctor is coming from, but I think that he has forgotten his oath. And more, I think that he is trying to keep his recovery rate high. He won’t even accept these patients into his CVICU because he refuses to deal with them on any level. It is very frustrating.