Painkiller (5 page)

Every single day.
 

I wake up…

… Not too bad today.

It’s taken three days but I think I can get out of bed. Maybe even out of the house.

Breakfast. OK. Fine. Dressing myself. A bit of a struggle, but yes I get everything on. Tights. Skirt. The works.

So now I’m up.

What do I do?

I’m tired of thinking about the letter. Thoughts affect my emotions, and emotions affect my pain. I’m sure the mere fact the letter troubled me, and it prowled around my brain like an angry tiger, helped to keep me in bed for three days.

Perhaps I should do something positive. Get out of the house. Perhaps I should keep that appointment with my pain specialist. His secretary has been leaving me messages for weeks, reminding me that I’d been booked in for a consultation today.

I ease the car into the hospital car park, and soon I am in the tiny pine-themed reception area, barely big enough for four people. I am greeted with a smile from the overly tanned pine-themed receptionist. It’s not long before she tells me, in words so soft that I can barely hear what she’s saying, that Dr Kumar is ready to see me now.

He welcomes me warmly, gestures to a seat, but does not shake my hand. Inadvertently causing his patients to scream by touching them is an occupational hazard.

His office is pristine; a smooth desk, devoid of clutter, an anaemic watercolour of some forget-me-knots on the far wall. On one of my better days we got to chatting, and he happily took me through the decor in his office.

‘When I started,’ he explained, his voice swooping and rising like a flock of swallows, ‘my office was very cluttered. I had a big clock on that wall over there, and family pictures covering the back wall, and a bird who took drinks from a glass on the desk, a present from my daughter when she went to Mallorca. Then I realised after some weeks many of my patients had little tolerance for such things. The ticking of the clock, the reminders of a carefree family life, the repetitive movement of the ornament… Because of their condition they fixated on these things and it made them quite agitated. Now, as you can see, I keep things very clean, very tidy, no distractions…’

I listened and I sympathised and I pitied those people, because it was one of my good days.

On another day I knew I would be imagining myself (
tearing the clock off the wall and stuffing his bloody drinking bird down his throat
)

Now, when I’m on a bad day, I fixate on the forget-me-knots, wondering if the painting is designed to provoke me. Forget-me-knot.
As if I could.
Sometimes I even look at the places where the clicking clock and the dipping bird used to be, imagining the bobbing movements and hearing the tock-tock-tock.

I wish he hadn’t told me.

Today, like every day I see him, he is in good humour. On my better days I admire him for that; his job – dealing with poor wretches like me, day in, day out – must be very difficult, and he has cultivated a crusty shell of bonhomie to keep him sane.

On my bad days I would like to (
take him by the throat and crush his bonhomie out of him
)

‘So, five years. Is it really five years now?’

‘Yes, five years.’ I don’t know what else to say, so I just say ‘yes’ again.

‘Goodness.’

‘Five years.’ I don’t know why, but I repeat myself.

He knows better than to supply the automatic response: ‘Doesn’t time fly?’ Because he knows it doesn’t. Instead he grins his big sunny smile and says, ‘Well perhaps this will be an auspicious day, a new chapter of your life. How are the combinations working these days?’

‘Fine…’

‘Good.’

‘Well… OK. Well, I say fine, I mean, not fine, exactly.’

‘I see. You still have the usual symptoms.’

‘Oh yes. My spatial awareness is still wonky, and I still have incredibly weird dreams…’

‘Yes, yes… yes… right…’ He is making notes.

‘My sense of time is shot to hell – I lost three days this week.’

‘Oh dear oh dear…’

‘Like that old Tommy Cooper joke…’

‘Hmmm?’ Smiling bemusement.

‘You know. “I’ve been on the whisky diet”.’

More mystified beaming.

‘“I’ve lost three days”.’

‘Ah,’ he says. ‘Ah! Very good! Ahahah! I will remember that one. Whisky diet. Yes. Well. Oh dear. A lot of this to be expected, I am regretful to say.’

‘Oh, of course. I know it’s because of all the drugs, but the pain levels… I need to take bigger doses. I take more so I can get to sleep…’

‘I see…’

‘… but even before that, I knew I was taking enough to put a bull elephant into a coma.’

He knits his fingers together and gives a dazzling smile. ‘Well yes, we have discussed this…’

But even though we
have
discussed this, he continues anyway. Same words. Same everything.

‘Most drugs – and I am including nicotine, alcohol, heroin in that category – are alien substances that we put into the body. In most cases our bodies build up an immunity to these alien invaders, and we have to take greater doses to create the same effects.’

‘Only I can’t, can I?’ I finished his lecture for him. ‘I’m probably harming my kidneys by taking this amount as it is…’

He pulls a sad, helpless face. I continue.

‘… You did tell me I’m ruining my health by keeping some of the pain at bay.’

‘In some ways.’

‘But even at those health-ruining doses they won’t work for me soon.’

‘That is only a possibility.’

‘Irony of ironies.’

‘… But there are always options.’

‘Not from where I’m sitting.’

‘Have you considered moving onto morphine? I know we have talked about this before.’

My eyes grow cold. ‘I did. I tried morphine at the start. Look at your notes. According to my husband I was incomprehensible; practically a vegetable. I kept asking him to change the channels so I could watch a different ceiling.’

‘Oh dear, yes. Ah, but there are combinations. The prescribing of morphine is a much more sophisticated process now. It is not what it was.’

‘And you said there was a possibility I could get addicted.’

‘Well, yes, that is the case, but…’

‘But?’

He spreads his hands again, and I realise what the gesture means.

‘Ah.’ I nod. ‘I see. I get you. I see what you’re saying. What’s wrong with me getting addicted to something I could never be able to stop using anyway?’

‘Actually, it is more controllable these days…’

‘No thanks,’ I say firmly. ‘I haven’t come to that yet. The drugs work. Most of the time. And not totally. But they sort of work. They get me out of the house. Sometimes.’

‘Well, maybe drugs will no longer be needed. At least for some periods of time… Because I may have some auspicious news for you!’

This has been on the tip of his tongue since I entered the room. He has been waiting for this; he has been waiting for me to turn down the offer of morphine again, so he can tell me something. I’ve told you the drugs make me so very sensitive to everything; smells, noises, moods. I sensed his excitement the moment I came in, a hum of anticipation coming from his body.

‘There has been some new research. They are conducting trials, and they are asking for suitable subjects. They are very interested in you, Monica. They think you might be an excellent subject.’

‘Gosh.’

‘Indeed, and furthermore, they would like to include you in the trials as soon as possible.’

I sit up straighter, trying to make myself comfortable. ‘So what is it? Don’t tell me. Amputation?’

‘No, it is not amputation.’ I can hear a grin in his voice but his medical precision compels him to take my question seriously. ‘This is quite a different principle. Amputation is designed to trick the nerves into forgetting about the pain. The process of applying capsaicin patches to the body is to block the signal of the nerves that transmit pain to the brain.’

‘Capsaicin what?’

‘Patches. Yes.’

‘Which is…?’

‘Oh. Please excuse me. Capsaicin is a compound extracted from very powerful chilli peppers. Very hot. It is commonly used in pepper sprays and to repel rodents and insects.’

‘You’re not really selling this to me, doctor.’

‘It has been proving very successful with arthritic pain and post-cancer care, and they are expanding trials to look at how it can deal with chronic pain management. To use an analogy…’

I smile.

‘… it is like a farmer burning the stubble from his field, so that nothing may grow back.’

‘So you’re going to burn me so I don’t care about the pain any more.’

There goes his funny little laugh again. ‘You are making light of this, Monica, and I think you are right to make light of it. I do not wish to get your hopes up. It is an experimental trial, yes,’ he continues, ‘and there may be unpleasantness. I am not telling you to do this, but if you do agree, I would do all I can to ensure you make an informed choice before you say yes.’

‘I’ll do it,’ I say.

Of course I said yes. I was hooked the moment he said ‘new treatment’.

I go home and celebrate. I celebrate by going to the toilet.

One of the side effects of the pain is constipation. The muscles contract with the pain; shoulders, neck and… down below. Things don’t work as well as they should, and I do get backed up, and I have to deal with it.

My body leads me upstairs, into the bathroom, and the unwelcome form of a pale blue ring of porcelain. I squirm on the seat, staring at the puddle of knickers around my ankles, staring at my forehead reflected in the bottom of the mirror. I count the agonising bullets as they splash into the water. Sometimes I lunge forward and I see my whole face, stretching and wincing, grinning savagely (
like a mad woman
).

I stand, wobbling uncertainly, clutching at the towel rail, and I scuttle crab-like around in a circle and look down at the result.

Two tiny little pellets are bobbing in the pan. Little rabbit pellets.

I remember my rabbit Jumpy, and crying when I couldn’t remember his name, crying when he died, watching my father going up the path to the back of the garden, the soft flap-flap of the tops of his wellingtons.

I can remember Mum shouting at Dad for emerging with the red-tipped spade.
How could you be so stupid, Adrian?

Not now. Don’t think of that. Back on the pan.

The front door bangs, and I can hear movement downstairs. Sure enough…

‘Monica?’

I can’t answer back. Not now. I can hear him moving about, the
thud
of his briefcase on the kitchen top, and the slow, laborious twenty-two
thuds
on the stairs.

‘Monica?’

‘In here! In the bathroom.’

His footsteps come into the hallway. I can see a dark form take shape in the pebbled glass. A huge fuzzy, dark mound.

‘Hello?’

‘Won’t be a minute. On the toilet.’

‘Take as long as you want.’

‘Don’t worry I will.’

‘I’ll be down in the kitchen.’

‘Wait… I’ve got something to tell you.’

‘Oh. Right.’

‘Guess what? Dr Kumar has found something that might help me!’

The fuzzy mound in the glass takes a different shape, bigger, as he comes closer to the bathroom door.

‘Oh really? Great. You mean an operation?’

‘Not quite. They put patches on your body and burn you with this super-jalapeno. It’s meant to stun, or kill off the nerves under the skin.’

‘Which is it? Stun or kill off?’

‘I’m not sure. Why?’

‘Well, killing all the nerves? Won’t that mean you won’t be able to feel anything?’

‘Fine by me.’

‘You know what I mean.’

‘I don’t think it’s like that. I think they kill off some. The burning process just knocks out some. It reduces the pain more than anything.’

He frowns. ‘Doesn’t sound very pleasant. Do you want to try it?’

I’m surprised by the question. ‘What have I got to lose?’

‘Your skin, by the sound of it.’

‘It won’t scar. It’ll just
feel
like I’m being boiled in oil.’

‘Right.’

‘I’ve got info. I’ll show you what it’s all about.’

He backs away, dutifully; he knows I hate him listening to my bathroom sound effects.

He’s sitting waiting in the kitchen, tapping idly on the table. I show him the information Dr Kumar has given me – the photocopied sheets, and the doctor’s own handwritten notes which he has thoughtfully scanned for me – and I tell Dominic I have a website he can look at.

We go to the study. He’s on his side of the computer, and the little square box for his password is sitting in the middle of the screen; there’s a picture of a tiger next to it.

I sit down and he leans over the desk, masking the screen with his back, and pointing his bottom in my direction. He’s changed into casual clothes, and I can see his boxers through the worn patches of his jeans.

Yes, he’s put on weight a bit
, I think.
But he’s over forty now. He’s allowed.

He puts in his password –
peck, peck, peck, peck –
and sits back heavily on the chair. ‘OK…’

I give him the URL and he finds the site, studying slowly. I peer over his shoulder, not reading, just staring at the pictures and wondering what he’s thinking.

‘Very interesting.’

‘It looks promising, doesn’t it?’

He nods, but says nothing.

‘The whole process lasts less than a day. I don’t even have to stay in overnight.’

He’s still reading, eyes darting up and down the screen. ‘It says here that the results are partially successful…’

‘Yes.’

‘And even if the results are successful, most – if not all – of the pain returns eventually.’

‘Well, you know Dr Kumar. He’s always keen for me to try things, even when they’re at a very experimental stage. They’re still investigating what happens when they repeat the treatment. If they do it enough… the results could be permanent.’