Pain Management

I’m no criminal. I’m in pain.

So I can see how my recent downfall might be seen as just another junky’s story, but here’s the thing: I’ve got it under control. I only use it to manage the pain in my back and originally I was prescribed opiates for that exact purpose. Then, about a year ago, doctors seemed to suddenly have a change of heart and I couldn’t find the stuff anywhere and had to go to seedier sources for my pain medication.

Granted, during that period of time, I lost my girlfriend, had to downgrade my apartment to a studio and I got fired, but if I hadn’t been on drugs you’d be hard pressed to find a common thread among those problems. In fact, I’m confident that you’d find yourself shrugging and saying “Well, seems like you’ve just hit a rough patch.” Which is, of course, exactly what it is. Sometimes life is hard and the fact that I’ve got to take heroin to manage my pain is simply a small and almost irrelevant detail to the struggles I face.

What makes me different from just any other junky is that I’ve kept my shit together. Mostly. Some other guy who’s shooting up, because he’s bored or simple or weak… He loses his girl, his house, his job and he just keeps going down until he’s sleeping on broken down cardboard boxes under a bridge next to a pile of needles. Me? I’ve got another job. I’m ascendant. This is what I think really irks them down at the needle exchange, that I’ve got this thing under control. This is pain management, not an addiction.

I go to the needle exchange a lot less frequently nowadays. Mainlining heroin is a little too strong and made it hard to stay awake at my last job. What I’ve found really does the trick is to smoke the stuff off of a little square of tin-foil. 

This new job is a sea of beige and light blue and muted gray. The cubicles are just high enough to obscure the heads of sitting engineers, programmers, accountants, analysts, assistants. The black and white clocks silently tick away the hours spent under fluorescent light. The hands of the clock never seem to move in the dead, sickly light, but every time I look it’s a different time. Sometimes time seems to proceed backwards, sometimes forwards. 

I have a hard time remembering everyone’s name. We all look the same here. Gingham and plaid and tweed mismatched with khakhi, wool, secret denim. Brown leather, black leather, brown leather, black leather… These are our great questions, our forum debates.

The days just blend together into the beige smear punctuated by the occasional waking nightmare, which is an unfortunate side effect of using. Not everyone gets hallucinations. I guess I’m just lucky. 

One morning I smoked just a little too much and I’m staring out of my cubicle, zoning out. Then, a silent and plodding procession of middle management marches past chanting something vaguely latin and slapping a cat-o-nine-tails on their backs to accent the end of a line in the chant. Their blue oxford shirts ripped and bloody, they barely react to the sting of the whip. 

I decide that I need a glass of water. That might clear me up a bit.

I get emails from my boss, A. Ahriman, who I haven’t met yet. He seems to really enjoy disassembling the reports I compile. One day I wrote back to comment that while his notes were very helpful I did not see the benefit in re-writing the entire report to accommodate two additional digits of precision when the unit was dollars and rarely dealt with thousandths of cents, much less hundred-thousandths of cents. His response was simple, “A professional in your line of work might see the benefit.” 

Well, the message was clear. This was a power-play and I would have to jump when he said or suffer. Beggars cannot be choosers, I told myself and resolved that once I’d built up a bit of savings again, I’d start looking for employment elsewhere. 

I chased the boiling black blob in the back stall of the bathroom and fantasized about quitting dramatically. I imagined Ahriman’s face, shocked and embarrassed, coming to realize the error in his ways. The shadowless bathroom walls are cool and I lean over to rest my clammy forehead against the gray tiles and grout.

Too much again. After lunch, I slammed my head on my keyboard after nodding off.

Lunchtime conversations are difficult because I can’t seem to maintain interest long enough to remember people’s names to begin placing their various features into their respective files. The details all seem creepingly similar. Between one and four children, educations at some state university or another, everyone had a job title with analyst somewhere in it, nothing made any clear sense. Conversations shifted between different television shows. Sports shifted with the seasons. Fantasy television programs competed among cubicles. The point of the competition, of course, was to see the most fantasy shows. “Have you seen ————?” “No! but I’ve been meaning to! I really have to watch —————.” “Well don’t watch that until you’ve seen ————.”

I get a sort of general anxiety when I’m subsumed into one of these conversations and it makes former injection sites itch. One day, a programmer with a penchant for A-line skirts asked me what was wrong. I looked down to see I was rubbing the inside of my elbow like some smackhead. “Tennis elbow.” I blurted. “You like to play tennis? We should play sometime.” She said.

Sure, I said, but simultaneously thought that it seemed impossible to meet someone like her outside of this scene, outside of this purgatorial stage set. God help us if they let any of you outside! It’d be Day of the Dead out there! It’s our responsibility to keep you all locked up.

At my lower moments, I’m struck by my image in the mirror. My gaunt cheeks make me look like a ghoul myself. I make a concerted effort to eat more, but sometimes I just forget. I’ll wake up on my couch at six and have to get ready for work. The fact that I’ve forgotten to eat dinner again just a passing thought in a steady parade of ideas I need to address for work.

I’m a constant drinker of coffee even though the chemical grit of the poorly filtered city water chokes me up. The coffee wouldn’t be so bad if it wasn’t so watery and if that water didn’t almost have the taste of sulfur on the back end. Faceless office folks comment on my habit and say that surely it can’t be healthy to drink so much of the stuff. “Don’t you have heartburn?” “High blood pressure? Have you been to a doctor?” I tell them that I’m cutting back on it, but my coffee habit has a convenient side effect that I’m loathe to abandon.

Though I’m desperately constipated from the tar and have to take laxatives to shit, the massive consumption of coffee gives me an excellent opportunity to duck into the bathroom every few hours. Regularly irregular, I take the back stall and wait for the room the clear out. The lingering smell of shit and piss as my only companion, I quickly smoke a little blob of tar. I flush the tin and wash my hands before I stroll back into the office, fresh as a daisy. 

A group in the kitchenette one morning  asked me if I’d like to participate in their challenge: no coffee for a month. Like hell, I thought. I’d never shit again. 

“No thanks, my doctor says my blood pressure’s so low that I should be using butter instead of creamer in my coffee.” A spate of grimacing laughter. A gross image, but funny enough. Planting the seed of medical awareness, no one should go around questioning my coffee consumption again.

Weekends are reserved for true relief. That’s when I can sit on the couch and feel complete relaxation and bliss all day long. There’s nothing that obliterates the pain of crushed bone and reconstructed tendons like a shot of smack up the arm. The fact that this country has criminalized it is abhorrent to me. Just more proof that people all around us just want others to suffer. People will tolerate any kind of pain just as long as they know that someone else is suffering worse than they are.

Me? I’m no sadist, no enjoyer of schadenfreude. I much prefer the relief and absence of pain.

However, this does make Mondays a little hard. At least two times on Monday morning, I’ll have to vomit. I usually try to make myself vomit so that it doesn’t look like I’m rushing off to the bathroom. On one particularly desperate Monday morning, I found myself getting lost in the hallways of the office. I would get distracted and suddenly forget where I needed to turn to get to the bathroom. I looked up on the walls for signs, but couldn’t see any. I couldn’t see anyone. It was like I’d found an abandoned part of the office building. I started trying door handles feeling the sickness rising up in me. 

I pulled one door open, but it was just filing cabinets. The next door had a number of specialty printers. The next one I opened was a hallucination. Hooded figures stood around a sigil marked on the floor. A goat was tied to multiple stakes placed at the points of the sigil so that it couldn’t move. One figure lowered a lit flare to the goat and I saw it ignite as if drenched in gasoline. It screamed and writhed against the chains that held it in place, but futilely. Its strange pupils met mine and I realized I could go searching no more. 

I slammed the door shut and threw up in a lined waste paper basket in a nearby cubicle. Panicking, I straightened myself up and walked away. I hoped that if I remained as casual as possible, no one would think it was I who vomited in the trash can, but I saw no sign of anyone as I made my way back to my desk. 

Later, I went back to that empty part of the building to recover the bag of vomit, but I found that it had been carried away. Maybe by a janitor. Looking around, there were no cameras, so I walked off fairly confident that this mistake would be overlooked. 

Could the janitor tell what was happening? Was there someone else here who knew my secret?

All I’ve been waiting for is the surgery. I need to save up just enough to get this one surgery and then poof! the pain will be gone. So the doctors tell me. Up until then, I’ve got to maintain. It’s tough, but I’ve been through tough problems before. 

“You know it’s the pills,” Claire said one night as I fumbled with my dick in the dark. “You can’t get it up because of the pain meds.”

“I know, I know, but I wouldn’t be able to do anything without them. Maybe I can get a good balance going. Let’s try again tomorrow?” I pleaded.

“Tomorrow. You’re always saying tomorrow. But you’re asleep before I even get into bed, drooling on the pillow like some lobotomy patient. Why don’t you try something else? Something other than the pills?”

“Why don’t I? Well, maybe because I can’t fucking stand up without them!” I exploded with anger. “Maybe if you hadn’t been shitfaced that night I wouldn’t need to take handfulls of pills to go to work in the morning!”

“Sleep downstairs, Daniel. I don’t want to see you,” she wept. 

In the morning she left. My back was not the only thing that was broken in the crash those years ago.

There was something about those few days she spent in lockup that turned her into something of a prude anyway. She quit drinking, quit smoking, and started looking down her nose at my prescription.

My prescription! What happened in there? Did she find Jehovah? Became a Christian scientist? What did she want me to do? Pray the pain away? It said right on the label “Take two three times daily” that’s what I’m supposed to do!

Sometimes I get stressed out thinking about this, but then I think about the surgery. Once I’ve saved up enough, I can get the surgery and get off of this shit. A quick little suboxone shot and I’m back to normal. The hardest thing I’ll touch is beer.

I’ve still got a lot to save though and it’s slow going. I get paid every month and I always have a hard time understanding where it all goes. That’s typical though, isn’t it. We never feel like we get enough compensation for what we’re doing.

My supervisor mentioned that I’ve been going to the bathroom a lot, so I’ve decided that I need a more discreet way to medicate. I’ve switched over to sniffing the stuff out of a bullet, which means that I’ve got to start paying more for the stuff. The usual stuff I get will melt into a sticky tar-ball if I keep it in my pocket for too long. 

Autumn is getting more severe. The cold, the damp. I can’t seem to warm my bones and my back aches with my pulse. I feel like a beat dog, whimpering as I drag my tingling legs through the cubicle maze to one meeting or the other. My eyes tear up when I swing my legs out of my car in the parking lot. I wince when I have to turn around in my chair to look at whatever faceless moron who’s decided to darken my cubicle wall today. 

I find myself forgetting how many snorts I’ve had today, this afternoon, this hour. I keep a tally on my notebook, but then I forget which page I’m on. 

Ten? I think, Already ten? It’s only noon. Or was that yesterday’s tally.

I take anti-emetics to keep the vomiting at a minimum. I think that’s how I’m losing track… Losing track of how much I’ve done. Looking into the mirror, my jaw’s slack and I have to practice working my jaw like a normal person, try to brighten my eyes with prescription eye drops, try to rub some color into my cheeks. I look like I’m dead, like I’m on the mortuary slab, like I need my mouth sewn shut as to not frighten my mother, like I need my father’s tie tied for me because these fingers will never tie a knot again.

With the anti-emetics, it’s like losing track of time. The rhythm of dosing and vomiting, dosing and vomiting is gone and I can no longer track the time. 

Is it three already? Wasn’t it just ten? It’s noon? I swear I was just looking at the clock and it said four, four o'clock. Or… Was that yesterday?

I’m startled by a figure standing in the entrance of my cubicle. He is smartly dressed in a casual suit and argyle vest. His hands are in his pockets and he’s flashing the widest smile I’ve ever seen. He looks vaguely Middle Eastern or Indian, but could easily be just well tanned. His slight and athletic build makes him seem like the sort to be out in the sun a lot.

“Feeling sleepy?”

“Not enough coffee, I guess. Really, is there ever enough coffee?” I chuckle emptily.

When did I last have a snort? Was it ten? It’s what, 11:30 right now? Oh, god, it’s only 10:05 according to the computer. Did I really just do it? Was it one or two. Holy fuck, please not be three. This guy’s not leaving.

I rubbed my face and worked my jaw into a sleepy but friendly sort of grin, “Can I do something for you, um, ah…”

“Ahriman, A. Ahriman is how I sign my emails.”

“Oh! Yes, of course! I’m working on the current financial projections as we speak and I’m thinking that I can have it completed end of business on Thursday.”

“That’s just great, really fantastic,” Ahriman said and his face began to stretch strangely. Oh no, I thought, not a hallucination right in the middle of a conversation with my boss. “I don’t see you socializing much with the other employees here at the office.”

“Uh, well, you should have seen me a few days ago, I, uh, met this one fellow out in the courtyard and had a very interesting conversation with… Are you dissatisfied with my work?”

“No, no, of course not. You’re always prompt and accurate in your reporting.”

Inhibitions dulled by a possibly very large dose of heroin floating through my blood-brain barrier, I said, “Well, I couldn’t tell considering the fact that you’re always sending it back to me like a vegan served a bloody steak.”

Ahriman laughed amiably and leaned against my desk, looking down on me with his surreal cheshire cat grin, “That’s a very clever analogy. Might I offer an analogy of my own?

“A spider spins a web to catch his food, but being a spider, he doesn’t have the presence of mind to understand that the rain gutter is probably the worst place to put his web. Every time it rains, he’s obligated to re-spin his web… Are you alright?”

I’d been nodding off during his little speech and was struggling to keep my head up. “Yeah, go on.”

“He’s obligated to re-spin the web only for it to be washed away during the next rain. This constant expenditure of effort to construct the web coupled with the ever diminishing supply of food collected from the web eventually leads to the spider dying of starvation. Its legs curl up and it falls off the web into the dirt where it is eaten by a passing rodent. It’s then excreted and serves as fertilizer for the grasses beneath the rain gutter.”

By this point, I’m starting to feel sick and I know I’m out of anti-emetics. “I’m sorry, what’s the point of this story?”

“Oh, you’ll have time to think about it, Mr. Krupp,” Ahriman said and slapped my back. This was enough for me. I had to run to the bathroom.

“Excuse me, Mr. Ahriman,” I said and made a break for the bathroom. It was dawning on me that everyone knew that I was hooked. They all knew I was snorting heroin in my cubicle. I was getting fired for being a drug addict. I felt desperate and then, in mid stride, I vomited on the carpet. I slipped in it and fell hard. I struggled to get up, but couldn’t. Instead I slipped around on the vomit and began to cry.

“Somebody, please!” I cried, “Someone call my girlfriend, Claire. I’m sick. I need to be taken to the hospital. Please! I’m sick. Help me!”

The faceless cubicle dwellers who had been my neighbors in these past months came out to gawk, or that’s what I thought. Instead they came over and helped me up.

“Oh thank you, thank you so much. I need water. I’m sick. I need to go to the hospital.”

But instead of carrying me to the kitchenette where there was a first aid kit, they started to drag me back to my desk, to my cubicle, my prison. 

“Where are you taking me? I’m sick! I need help!”

They placed me in my chair and then I saw the woman who wore the A-lines. She looked ill herself, she vomited into her hands and then pulled out a long strand of what looked like phlegm, which she then began to wrap around me. It was heavy and wet and tightened with every additional loop.

“What are you doing? What are you doing to me! I’m sick! I need help!”

“You’re beyond sick, Mr. Krupp,” Ahriman said, I could see his cold, dry eyes from beyond the button-downs holding me to my chair. “And you aren’t leaving here. Not until your bones are dried and broken. Till your flesh is picked clean by the carrion, until the worms have had their fill. You will not know rest until your pollutions have been spread across this earth, a little more chaos, a little more tragedy in the story of mankind.”

“This isn’t real! This is a hallucination! I’m sorry,” I wept. “I’m sorry, Claire! I’m sorry. I thought I could do it! I thought I could handle it, but I can’t! I’m sorry, I’m an addict! I’ll go to detox! I’ll go to rehab, just give me something. Make the hallucinations stop!”

“This is no hallucination, Mr. Krupp,” Ahriman hissed. “And no one but I can hear you in the afterlife.”