A door to recovery

Last month, I drove under the distinctively tall evergreens of Mission, B.C., and arrived at Last Door Keystone Retreat. Nick Ringma was waiting in the driveway to introduce me to a dark-haired rescue llama with overbite and a zealous protective streak. “He thinks you’re a bear,” Ringma explained, a little apologetically.

As the llama decided I wasn’t a threat, Ringma led me to the garden behind the retreat house. His wife, Margaret, and three other volunteers sat around an overturned crate sharing a thermos of coffee and Margaret’s homemade gefulde koek. “This is all we do!” they joked.

A few weeks earlier, I had interviewed Quentin Genuis, physician at St. Paul’s Hospital in East Vancouver and ethicist, about his recent book on addiction recovery. Genuis defines addiction as a disordering of good things. He believes churches can be the type of “thick communities” that offer the things “that all of us want and need – meaning, belonging, joy, peace, purpose, vocation . . . these are the real things, in my view, that produce healing from addiction and sustained recovery over time.”

I had heard that Last Door Keystone Retreat was one of these kinds of communities, and made the 2-hour trek out from Vancouver to learn more.

A lifelong process

Keystone’s gardens and orchard in Mission grow organic produce that goes directly to Last Door Recovery Addiction Treatment Centre in New Westminster, B.C., which the volunteers affectionately referred to as “the Door.” It’s a different group of volunteers every Wednesday, but they’re all connected in some way to the Door.

The Door is a non-profit charity licensed by the Provincial Healthy Authority and accredited by Health Canada. It is a facility for men and boys (14 years old and up) and provides family programs as well. It’s been open for over forty years. Bits of history popped up naturally in the conversation around the coffee pot: Gail has been clean for 35 years and was a client when the Door had a home for women (women now have a separate, but partner, recovery home in New Westminster). Ringma has been clean for 30 years, since 1996, and met Gail when he was a client at Last Door. One of the volunteers shook his head in amazement, expressing a wish to do the same.

“Some people don’t believe it’s possible to be clean this long,” Ringma told me.

Margaret, Ringma’s wife, is an avid supporter of Naranon, a partner support group for persons struggling with addictions. She joined Naranon before Ringma entered recovery, and never stopped going.

Ringma knows how serious addictions are: he refers to his own substance abuse of cocaine and heroin, as well as stories he heard in his work as a clinician. But recovery is serious, too: it’s a lifelong process.

“Have fun,” he tells people starting recovery. “Find what you enjoy.” It’s those things that will sustain them.

Recovery involves service

When I visited in mid-April, the garden was still in Spring mode: thick garlic from last Fall, tiny radish and leek sprouts, lettuce and pumpkin and nasturtium seedlings ready to be moved out despite the brief storm of hail. (“Someone decided the guys need pumpkins for carving this year,” Ringma explained as an aside.) Everything is organic. There’s purple broccoli and several varieties of sweet corn in trays in the greenhouse, as well as three generations of potted tomatoes. In the ground, pak choi is off to a good start. Ringma says the Door has a Thai chef who can tell a sweet pak choi from a sour one just by looking at it. As Ringma talked me through the seedlings, Margaret and Gail rummaged for the right tools to prune the raspberry bushes.

Ringma, who used to work at the Door as a counsellor and program manager, is technically retired but still heavily involved. He has built a life with Margaret in the Door’s neighbourhood in New Westminster. “I can’t walk anywhere in New West without meeting someone I know,” he laughed. Keystone, in Mission, is set up for the Door’s clients to have family retreats. He gave me a brief tour of the beautiful house, including (to my astonishment) a basketball court in an underground bunker.

Ringma quotes Narcotics Anonymous, which says that self-centredness is the “core of our disease” and says that recovery is other-centredness – “For an addict to stay clean he needs to work with newcomers, needs to serve others!” This reminded me of Genuis’ talk about the reordering of goods.

The good life in Vancouver’s Eastside

Since 2016, Vancouver has declared a public health emergency due to opioid-related overdoses. St. Paul’s Hospital is at the epicentre of the city’s crisis, and opened an overdose prevention site in 2021. Dr. Jessica Moe, Canada Research Chair in emergency response to the opioid overdose crisis, told the Vancouver Sun that health-care providers “experience moral distress daily as we witness the devastating societal impact of the toxic-drug crisis firsthand.”

Genuis, who works in St. Paul’s emergency room, tried to explain how these statistics obscure the joy of working in Vancouver’s eastside: “Yesterday, I was sitting with someone in the middle of the night – she’d had, you know, a severe addiction most of her life, she’d been a victim of a lot of abuse, and the person she described as the only man who she knew who hadn’t abused her had just died of an overdose.” There hadn’t been a memorial.

“He was one of those persons who most people just read about as statistics,” said Genuis. “But for her, that was the only man in her life that she trusted.” Genuis knew him from hospital visits and the patient sitting next to this woman knew him from the neighbourhood: “and the three of us just sat there for 10 minutes and we talked about him, and it spontaneously morphed into this little wake for this man.”

Genuis looked for the right words: “It’s sad, at times, unbearably sad. The grief that she bears of his absence.” But he describes it as a privilege to have built enough trust to share such a moment. “The good life, for me, is sitting with that patient, weeping at 3 am under the fluorescent lights. There’s nothing else I would rather do.”

In addition to his medical degree, Genuis did a master’s degree in theology at the University of St. Andrews with an emphasis on bioethics. He was hired at St. Paul’s as a physician ethicist.
He’s quick to state that being an ethicist is not about having authority over what people should do. It’s about helping medical staff “give names to their own moral intuitions.” He compares it to how medical language is used to distinguish whether you’re feeling something “from your brain or your heart or your lungs.”

“All of us look out at the world, we have strong feelings. We feel hopeful or despairing or joyful or angry or confused. And especially for people who work in difficult, morally distressing environments, we struggle to find precise language for where and why we feel strongly,” Genuis said.

Disordered good

“The reason why addictions are destructive is because they don’t work,” explained Genuis. They begin as disordered searches for a good life but “they ultimately don’t deliver the good things people seek through them. And moreover, they erode their ability to seek those things in more fruitful places.”

What leads to a person choosing recovery is unique to each story, Ringma told me: for women it can often be the impact on a family member or child; for men it’s often serving time in jail. “The truth is that no two addicts end up in detox or seek help for the same reasons,” wrote Ringma in 2012, “however when clarity emerges it is usually that the active addiction was no longer delivering on the promise of relief.”

The support that a person receives in that moment can make all the difference. When churches mock the “incoming wounded” – active addicts – and see them as “rebellious and anti-institutional,” they harm their chances for recovery, wrote Ringma. He’s seen clients from “solidly Reformed community” who did all the things: a good career, a family, served on committees – and then found cocaine. When they’re honest with their church community they receive “a Heidelberg catechism God.” What such a person needs is to “get emotionally well, process history, see the immigrant drives (fears and anger and the workaholic madness) as part of his addiction,” get healthy and then “get spiritually well.”

“The role of the faith community is what it is for every believer – a place to worship God,” wrote Ringma. It’s not trying to be a hospital or a treatment centre or a dialysis machine, but a place to seek grace together.

“We can be humbly hopeful that the practices of mature Christian communities are the kinds of practices that produce healing from addiction, in cooperation with good partners, including good medicine,” said Genuis. “You don’t have to pick one: churches, para-church organizations, cultural organizations, good medical care, recovery homes, mentorship groups, chaplains – yes, to all of it.”

Part two of this article and a review of Quentin Genuis’ book, recovering people, will be in the July issue.