Hit Doctors: Care, Harm, and the Art of Survival with Sarah Brothers (U California Press, 2026)

So hit doctors, uh, are people who provide ins- assisted injection.

So they inject other people with illicit drugs for compensation.

Um, now this is not my term.

They're called by themselves and others hit doctors, street doctors, or just plain doctors.

And I started this project a very long time ago, uh, back in 2010 when I was attending community college in San Francisco and volunteering and working as a site supervisor and a naloxone trainer at a syringe exchange.

And a lot of what I was witnessing and hearing about from program participants, I wasn't finding reflected in the academic literature.

And then in the fall of 2012, I started my first research project, uh, related to injection drug use as an undergraduate at UC Berkeley when I transferred there.

So, uh, during my shifts at the syringe exchange, people would come in on Saturday afternoons or Tuesday evenings with hundreds and sometimes thousands of syringes.

There was this one woman, uh, who, she would pull up, and she, with this giant smile in her beat-up station wagon, sometimes with her tiny father in the passenger seat, and the back was filled with these biohazard bins the size of kitchen trash cans, and they were all filled with used syringes that she collected from people in her town, which was over an hour from San Francisco.

And I wanted to understand why people were doing this, why people were exchanging syringes for others, a practice that's referred to as satellite syringe exchange or secondary syringe exchange, why they invested their time and energy in a practice that was so necessary for public health and yet illegal at the time.

So by the spring of 2013, I started interviewing people like her who exchanged syringes for others.

And this study on hit doctors had emerged from one of my first interviewers, interviews with this very kind older man named Matt, who practiced secondary syringe exchange for his friends and neighbors.

And early in our interview, I asked Matt, and I was still getting my bearings as an interviewer.

I had not done very many at this time, and I asked him what else he did for people, and I was so nervous.

And we're sitting there sipping our hot chocolates on this tiny ta- table in this quiet cafe, and, like, the- Kind of fading light of the afternoon, and he replied with more confidence than he'd shown at that point.

He goes, "Well, I'm a doctor, actually." And I'm like, "What? What exactly...

Can you explain further? What do you mean by that possibly?" And so he explained that he injected other people for compensation, and he told me that he was quite good at it, but he often did not enjoy the work because his clients were so annoying.

Uh, and so as my fieldwork progressed, I learned that serving as a hit doctor was quite common, really complex, and that many hit doctors found their clients annoying.

And I decided to study hit doctors in more depth.