What Took You So Long: My Sister, Addiction, and the Freedom That Failed Her

My sister had every advantage, and addiction took her anyway. The people dying on our streets have the same disease — and we abandon them in the name of freedom.

My sister was a grunge-era débutante. It was the phrase the Bush School used when she died, and it was a perfect description. Her name was Elizabeth. Everyone called her Liffy.

She was the funniest and most stylish person in any room she entered, she knew it, and you loved her more for knowing it. She had an instinct for cool, and her cool was a particular type of Seattle sensibility — thrift-store glamour, leopard-print irreverence, a Parker Posey ease that never looked like effort. She was a little more than a year younger than me, and we were, as she liked to say, almost twins. For most of our lives, I could not have imagined her any other way.

But trouble started early. At sixteen she had learned she carried a rare genetic condition, one that would never let her bear children, and the anxiety it left behind ran deep. Doctors prescribed benzodiazepines, the way they so often do — legal, routine, and brutally hard to leave. The pills opened the door, and over the next two decades alcohol and cocaine came through it too. She was barely a hundred pounds, and it took her by degrees — a functioning life, then a fragile one, then a life she no longer governed.

By her late thirties, after years of this, came the lowest place I ever found her. She had been taken to an emergency room, brought back from a bad night, and discharged the way the system discharges everyone — stabilized, and turned back out the door. At the curb, a taxi driver picked her up. He did not take her home. He kidnapped her — took her to his own house, kept her there, kept her supplied — and for the better part of two weeks we did not know whether she was alive.

I hired a private investigator, a former police officer who worked the desert east of Los Angeles. He found her at last in a small house in the poorest part of Desert Hot Springs. We did not go in. We stood on either side of the door — he was armed, because we did not know what waited on the other side of it — and I called to her through the window: Liffy. It’s your brother. It’s Michael. She came to the door and opened it herself. She could barely stand. She was covered in bruises. And the first thing she said to me, after everything, was: What took you so long? I carried her to the car and drove her straight to the hospital. That is what saved her, that time.

Nothing about that doorway resembled the Liffy I grew up with. But it was her. To understand how she got there, you have to go back. She left Bellingham halfway through her freshman year — it wasn’t for her — came home to Capitol Hill, then went to New York and NYU, where she took a loft in Williamsburg years before anyone called it cool and worked at Vanity Fair and The Charlie Rose Show. After graduation she went to Los Angeles — Silver Lake, then Venice — and earned a doctorate in clinical psychology. Her dissertation was on addiction and recovery. By the time she finished it, the disease she had chosen to study was already taking her, and she spent those years counseling other people through the thing that would kill her.

Whether the addiction had summoned the mental illness or the illness had driven the addiction, no one could ever untangle; they had braided into a single disease, and that disease did the one thing we refuse to absorb. It ate her will.

Ate her will is not a figure of speech. It is, increasingly, a description of tissue. The National Institute on Drug Abuse and its longtime director, the neuroscientist Nora Volkow, have spent two decades establishing what is now the mainstream medical understanding: addiction is a chronic disease of the brain.

Sustained use floods and then exhausts the reward system, hijacking the circuitry that evolved to make food and family and safety feel good and rerouting all of it toward the drug, while the same disease erodes the prefrontal machinery that is supposed to weigh consequences and apply the brakes. The craving is widened into a superhighway; the off-ramp of judgment is paved over. By the time the disease is advanced, the organ that does the choosing has been physically remodeled to choose the one thing that is killing it. This is why willpower is the wrong word, and why my sister’s doctorate could not save her. You cannot reason your way out of a rewired brain any more than you can will a tumor to shrink.

And so we arrive at the fiction on which we have built our entire response — that the person on the sidewalk is a free adult exercising a choice. We know better in every other corner of our law. We do not grant a sixteen-year-old the autonomy we grant a twenty-one-year-old, because we understand that capacity is not all-or-nothing — that there are conditions under which a human being cannot be left to author his own ruin, and that protecting him then is not tyranny but love.

Advanced addiction is exactly such a condition, and, as the neuroscience now confirms, a physical one — written into the brain’s circuitry, not the patient’s character. The person it has captured will choose the drug over food, over shelter, over his own children, over his own life. Offer him a bed with rules and he will choose the street and the needle, and we point to that choice as proof that he is free. It is proof of the opposite. A will that reliably selects its own death is not a will we honor by deferring to it. It is a will the disease has already taken, and we have agreed to call the theft a right.

What followed for Liffy was over a decade of trying — hers and ours. Twelve rehabs. Detoxes and relapses and the brief, unbearable hope of the good months. Nights on benches. Things done to her body in those years that I will not set down here. We pulled her back again and again, and the disease pulled harder, because by the end there was less and less of a chooser left inside her to pull.

I did not used to see it. For years Liffy’s illness was a private grief, something that happened to my family in hospitals and desert towns far from here. But when I walk through downtown Seattle now, I no longer see a policy debate, or a population, or a line item in a budget. I see her. I see the same vacancy in the eyes, the same body a disease has taken the wheel of, the same person somebody once knew when she was whole. Every figure on every sidewalk is somebody’s sister. They did not begin where they ended, any more than she did. The only difference between them and Liffy is that she had a brother with the means to go and find her — and they do not.

What we are looking at on the sidewalks is not, at its core, a housing problem. The people dying out there are, overwhelmingly, sick — with addiction, with mental illness, usually with both. Housing is the symptom we can see; the disease is the cause we will not treat. And we have poured a fortune into the symptom while the symptom has only spread.

Take Seattle, though the same indictment fits Portland and San Francisco and Los Angeles — the whole West Coast corridor that embraced the same philosophy and now lives in the same wreckage. On the most recent count, nearly seventeen thousand people were homeless in King County — a figure the authorities themselves call an undercount. Across the region we spend at least a billion dollars a year on the crisis — a Puget Sound Business Journal analysis put it past that mark years ago — and some experts believe the true figure today, counting every agency and nonprofit, is closer to twice that.

Divide even the conservative figure by the people counted and we are spending something north of sixty thousand dollars a year for every human being on the street — by harder estimates more than a hundred thousand, enough to send each of them to a private college, or to house them in an apartment most of the taxpayers footing the bill could not afford. We buy hotels and convert them into housing at roughly a quarter of a million dollars a unit, by the county’s own accounting. And the number on the street climbs anyway.

It climbs because we are funding the management of suffering and almost nothing to resolve its cause. The pattern holds from San Francisco’s Tenderloin to Portland’s old town to Seattle’s Third Avenue: historic sums spent, conditions worsening, and a public quietly concluding that nothing can be done — when the truth is that we have spent almost all of it on the wrong thing.

What actually heals a person is not in dispute. The research calls it recovery capital: connection, stable housing, meaningful work, and above all relationships. Close family ties, the literature finds, are a kind of cure. What heals an addict is the precise thing the disease strips away first — a web of people who hold you when you cannot hold yourself.

No one built that web more masterfully than Liffy. When she was well, she connected and held and showed up for people like almost no one I have known; it is why she was so loved. But the disease takes more than the addict’s will. It turns her against the very people trying to save her. We gave her everything the research says works — structure, community, the constant presence of family — and one by one she rejected all of it, because the substances had become the only thing she could choose. She did not stop loving us. By the end she was a slave to the thing her body craved more than shelter, more than boundaries, more than us — and so she pushed us away.

So we know what works. And still we spend the money elsewhere, and still we ignore what addiction does to the brain. When Sara Nelson joined the Seattle City Council, the city budgeted $208.4 million to house the homeless and not a dollar for drug rehabilitation. Nelson fought two years for the thing that actually works — root-cause treatment — and pried loose $300,000, a rounding error against the $208 million. It is the morally right thing to do, she said, and she was right. We have built agencies and contracts and careers atop the symptom — an apparatus with little incentive to shrink itself.

For all the money, there was one thing no budget could buy, and it failed Liffy exactly as it fails the people on the street: there was no legal mechanism to hold a person who could no longer hold herself. Even when we found her, even when we got her to a hospital, they would place her on a seventy-two-hour psychiatric hold, keep her safe for three days, and return her on the fourth to whoever was waiting at the curb.

There are good reasons those holds are short. This country has locked away the inconvenient and called it care, and that history is real, and ugly, and has to be carried honestly. But the answer to a mechanism that was once abused cannot be no mechanism at all — which is what we have now, and what killed her.

Slowly, too late for Liffy, that is beginning to change. California has rewritten its conservatorship law for the first time in half a century to reach people too disabled by addiction to save themselves; British Columbia and Oregon are moving the same way. It is contested, and it should be. But the people pushing hardest for it are not ideologues. They are families who could not get someone they loved into care before it was too late, and the doctors who treat addiction and know what it does. We were one of those families.

Liffy died in Sun Valley, Idaho, in December of 2020, at forty-three. For six months she had been living with our mother, sober and going to AA — and then she relapsed, and ran, back to one more man who kept the supply coming. It was benzodiazepines and alcohol in the end, the same prescription that began in a doctor’s office twenty years before. Her heart stopped, and they worked for hours to bring it back. The death certificate said cirrhosis of the liver. Even the record could not name the thing that killed her.

But I have come to believe the silence is part of the problem. We soften these deaths because they are unbearable, and because the person at the end is not the person we knew. The disease changes the brain so profoundly that in her final months Liffy was almost a stranger. We want to remember the bright light she was and not the thing that took her. I feel that pull as strongly as anyone. But as long as we look away from how she died, our country never has to reckon with what it does to people like her. So I will say it plainly, once, for her. My sister did not pass away suddenly. She was failed slowly, by a nation that ignored her disease, left her to die, and called it her freedom.

Her close friend Ben Ryan wrote that she was one of the few people in my life who held in her heart the very core of who I am. That was her gift — she could always see the real person, the one underneath. And we could see her, too, the real Liffy, still there beneath everything the disease had changed. Seeing her was never the problem; saving her was. We never lacked love, and we gave her everything we had — but by the time the disease was this far advanced, love could no longer reach her, and nothing we did could protect her from herself. We could only do so much. And so she died.

A few years before the end, writing about the life she had made in Malibu against everything, she typed three words. im here forever. She meant it. She should have been.

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Michael R. Hatch is an investment manager based in Seattle. A Seattle native, he attended Lakeside School and has served on the boards of the U.S. Olympic and Paralympic Committee Foundation, the Seattle Symphony, the Henry Art Gallery, Intiman Theatre, Seattle Children’s Theatre, PONCHO, and other civic and cultural institutions. Elizabeth Hatch was his sister.