If it wasn't for the gradual relationship that developed between my nurse and Mr. Z while she handed him safe equipment, he would have never agreed to a first appointment with me. But slowly over time, our nursing staff earned the trust of this 35 year old man, who had a traumatic brain injury and used alcohol and multiple drugs, and he eventually agreed to see the "doctor upstairs." I quickly learned that Mr. Z's multiple unsuccessful attempts at detoxing were because of his brain injury, which made him unable to control his impulses. After my fifth appointment with him, he is now on track to seeing a neurologist and is taking medication treatment for his heroin addiction. His anti-social behavior has decreased, and he has not had any brushes with the law since his involvement with us.