Angels on Call

Vancouver, BC

In Vancouver, two street nurses forego retirement to help battle the Downtown Eastside's opioid crisis.

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Length30:00

GenreDocumentary

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Synopsis

In 2016, nurses Evanna Brennan and Susan Giles came out of retirement in response to the opioid crisis in Vancouver’s Downtown Eastside (DTES). Today, at age 73 and 67 respectively, they provide full time care to a myriad of desperately sick, addicted and mentally ill people living in decrepit hotels or on the street. The need for care in the DTES has soared during the Covid-19 pandemic; social isolation protocols have led to more than 100 overdoses a month. Angels on Call not only highlights the worsening opioid crisis, told through the eyes of Brennan and Giles, but the love and emotional support they give their patients, many of whom have no one but the nurses to care for them.

Interview Roster

Evanna Brennan (left).

One of the two “Angels on Call,” Evanna Brennan, 73, has a formidable strength of purpose that was nurtured by a devout religious upbringing in Ireland under the tutelage of Dominican nuns. She met Susan Giles, her current work partner, when she immigrated to Canada. Despite battling cancer Brennan today gathers strength from her remarkable friendship with Giles, as well as the hundreds of patients they care for in the Downtown Eastside.

Jean-Marc-last name withheld for confidentiality reasons, at the request of Lookout Housing Society

Jean-Marc, a resident of First Place in Vancouver, has developed venous sclerosis from injection drug use and is under the care of street nurses Evanna Brennan and Susan Giles. He has also saved dozens of lives in his building as well as the back alley behind it with the Narcan kits (opioid antidote) that he keeps on stock. But he is succumbing to burnout. “All the grief and anger you carry around builds up.”

Susan Giles

The second of the two “Angels,” Susan Giles, 67, is driven by the belief that heath care is everybody’s right. She started her street nursing career in 1979, retired about 25 years later, then reinvented herself as a street nurse working alongside Evanna Brennan. Her early nursing career was spent caring for dying AIDS victims in Vancouver. Today’s situation in the Downtown Eastside reminds Giles of those desperate days. “I feel very hopeless right now. The overdose rate – it’s crazy.”

Dr. Sue Burgess

Dr. Sue Burgess is a palliative care physician who ministers to her patients by walking the streets of the Downtown Eastside. She works closely with nurses Evanna Brennan and Susan Giles, who act as her eyes and ears, connecting her immediately when a patient needs a physician's care. Dr. Burgess, who is also in her 70s, upholds the same humanitarian ethos that drives Brennan and Giles, and understands and respects the nurses' love and devotion to their vulnerable patients.

Rick-last name being withheld for confidentiality reasons at the request of Lookout Housing Society.

Rick is an opioid addict, originally from Ontario, who was prescribed the opioid Percocet after injuring his back in a work accident. He immediately became addicted, and when his prescription ran out, Rick began injecting heroin. He moved to the Downtown Eastside and, since then, developed a myriad of ailments related to his intravenous drug use, including venous sclerosis, a loss of vein function that leads to huge abscesses. He has been a patient of Brennan and Giles for five years. Rick says he likely wouldn’t be alive today if not for their care.

Production Design

Without nursing support from Evanna Brennan and Susan Giles, their patients would suffer greatly, possibly even die, from a malady called venous sclerosis. Common to injection drug users and caused by dirty needles, this condition is characterized by festering ulcers. Brennan and Giles clean and rebandage these wounds on a regular basis, ensuring the patient doesn’t develop further infections in other parts of the body that travel from these suppurative injuries.

Covid-19 has exacerbated the overdose crisis in the Downtown Eastside and throughout British Columbia, with overdose deaths soaring to nearly 1,000 by fall. Heroin and cocaine drug supplies, already laced with deadly fentanyl and carfentanyl before the pandemic struck, have become increasingly contaminated. The necessity of social isolation during Covid has been another key factor in the high OD rate. For nurses Evanna Brennan and Susan Giles, the death toll is emotionally and spiritually crushing.

Evanna Brennan and Susan Giles provide care to people living in transitional housing like the Hazelton Residence on Alexander Street in Vancouver. Residents of facilities like the Hazelton are usually transitioning out of homelessness, working towards stable housing where they can be independent. During the Covid-19 crisis, Brennan and Giles helped isolate potential Covid cases, providing care to desperately ill patients while assisting staff undertake quarantine measures.

The back alleys of the Downtown Eastside can be ominous, even dangerous, places, filled with dirty needles, people selling and buying drugs, shooting up, or smoking meth and crack. Evanna Brennan and Susan Giles are unafraid; they will search the back alleys looking for patients who are in urgent need of care, such as those who are HIV-positive and need their daily dose of antiretroviral drugs.

Evanna Brennan and Susan Giles often meet their patients on the street there they live. Conversations range from how they are feeling to whether they’re getting enough to eat, are they buying contaminated street drugs, are they using at a safe injection site, do they need winter clothes, do they need medical care, and what else can Brennan and Giles do to help them?

More than 2,100 people in Vancouver are homeless. Some are homeless because of addiction or mental illness. Others are homeless because of poverty and sky-high Vancouver rents. A common sight in the Downtown Eastside is people pushing their worldly possessions in shopping carts.
Breaking the cycle of addiction is difficult, especially for those struggling with trauma and mental health problems and homelessness exacerbates this cycle, making it much challenging for medical professionals like Evanna Brennan and Susan Giles to give patients the help they need.