Pain Management (19 page)

Still nothing from the woman. Maybe she was showing off her patience, the way she’d shown off other assets the first time we’d met. I wasn’t going to sit there and trade thousand-yard stares with her all night. I moved the white waxed paper my sandwich had come in to the side, folded the cardboard tray that had housed the coleslaw into an ashtray, and lit a cigarette.

“When this is gone, so am I,” I told her, taking a deep drag.

She took a breath. “Never mind the dramatics,” she said. “Come over to my car with me and I’ll tell you the deal.”

A different Filipino brought her Subaru around. She slipped him something; both of us got in. The dashboard and console for the floor shift were both covered in carbon fiber. I couldn’t see any surface that would reflect light . . . and wondered about that shadow I’d seen shifting in her car when I’d last dropped her off.

She drove a few hundred yards toward the river, found a big patch of gravel, parked. It was prairie-desolate out there; nothing but a few of the deserted-looking warehouses within a couple of hundred yards. No way for anyone to come up on us without being spotted. Another demonstration?

The woman hit a switch and both our side windows slid down. She turned off the ignition.

“This way, you can smoke.”

I didn’t say anything.

“What do you know about pain?” she asked softly.

“More than I want to,” I said, voice flat, deliberately distancing myself from where I thought she was headed.

“
Other
people’s pain.”

“That, too.”

“I hate it,” she said. Quietly, the way a nun talks when she tells you about getting the call.

“Pain?”

“Yes,” she said sharply, as if I had been sarcastic. “Pain. That’s what I am. A painkiller.”

“I’m not following you.”

“Listen, and you will. I’m not talking about headaches. Or arthritis, or . . .” She took a deep breath, let it out. Made sure she had my eyes. “I mean bone-deep, searing,
unbearable
pain. Like when cancer really gets a grip. When you’re near the end from AIDS. When . . . when you’d rather be dead than suffer every single minute. And you know what a lot of those people get? Speeches. ‘You make your own pain. It’s in your mind. Just take yourself to a peaceful place. . . .’ Or they get what someone
else
thinks is the right dose of drugs, as if pain were something you could measure in milligrams.”

“Or that they can’t have more dope, because they’ll turn into addicts,” I said.

“Yes! That’s the worst of all. Somebody’s
dying,
what possible difference could it make if they
were
a damn drug addict? That’s the legacy of Nancy-fucking-Reagan, a country where we’re so psycho about ‘drug addicts’ that we sentence millions to be tortured to death. Doctors are so freaked about the DEA, they won’t write the scrips. People are in absolute
agony,
and what they get is sanctimonious babbling about the ‘war on drugs.’ “

“Unless they’ve got money.”

“Sure. If you have enough money, you can get what you need. But how many people have enough money?”

“I don’t know. Can’t be many.”

“That’s right,” she said, her voice vibrating with barely suppressed rage. “Not many. Listen to this,” she said, pulling a long, thin white strip of paper from behind the sun visor. I could see it was covered with tiny words. She cleared her throat and switched to a schoolgirl’s recital voice:

“ ‘In treating the terminally ill patient the benefit of pain relief
may
outweigh the possibility of drug dependence. The chance of drug dependence is substantially reduced when the patient is placed on scheduled narcotic programs instead of ‘pain to relief of pain’ cycle typical of a PRN regimen.’ Do you understand that?” she challenged.

“Yeah, I think so. What they’re saying is, instead of giving you a shot when the pain gets too much to bear, they should be giving you regular doses all along, to keep it at bay.”

“Of
course
! Pain is the enemy. You have to get on top of it and
stay
on top of it. You don’t wait until it’s got its hands around your throat before you start to fight back. And if they dispense drugs the way it says here, the
right
way, there’s even less of a chance of making a goddamned ‘addict’ out of somebody who’s dying.”

“Where did you get that?”

“How about
this
?” she said, ignoring my question, and read aloud again: “ ‘During the first two to three days of
effective
pain relief, the patient may sleep for many hours. This can be misinterpreted as the effect of excessive analgesic dosing rather than the first sign of relief in a pain-exhausted patient.’ “

“What about it?”

“Oh? You understand that, too?” she challenged.

“Sure,” I said, “it’s not rocket science. You’re wasted from the pain. It eats you inside, so you can’t even sleep. You
finally
get a hit of something that knocks the pain back a few feet, you
can
sleep. So you do. Deep. And a lot. They don’t want some chump thinking you’re sleeping so long because what they gave you was an ‘overdose’ and cutting back on the painkillers, right?”

“Right,” she said, sounding tired. “You asked me where I got this. It’s right on the physician’s instructions for Sweet Roxanne.”

“Sweet . . . ?”

“Roxanol. Morphine sulfate. It’s about the best painkiller out there. Except for maybe methadone.”

“Methadone? I thought that was for—”

“Dope fiends? Sure. But, like
all
opiates, synthetic or not, its true purpose is to kill pain. That’s why it was developed—by the Third Reich, after their route to the poppy fields was cut off, and they couldn’t manufacture morphine.”

“So why don’t they just give methadone to the people with the worst pain?”

“Why?” she snarled, her voice so loaded with fury I thought it would shatter from the strain. “Because, see, it’s very difficult to
detox
from methadone. And we don’t want anyone to become a terrible ‘drug addict,’ now, do we?”

“What difference would it make if they were—?”

“Dying? None, obviously. Or even if they
would
die from the pain if they
didn’t
get regular relief from it. Stupid, mean-spirited, nasty little . . . The moralists don’t
get
it. The only way a painkiller can really get you high is if there’s no pain left to kill.”

“No physical pain,” I said, letting the words sit between us.

She gave me a long, searching look. “No physical pain,” she finally agreed.

She was quiet for a long time after that. Me, too. I knew there was more, and I needed to show her I could wait for whatever it was. I lit a cigarette, held it out the window, watched the smoke drift off into the night, went with it.

“Have you ever watched someone die?” she asked suddenly, snapping me back from where I’d drifted off to.

“Yeah,” I told her.

“Someone close to you?”

“Yes.”

“Take them long?”

“Not . . . not like you mean.”

“Is that so? How do I ‘mean,’ then?”

“You mean like from an illness.”

“Yes.”

“No.”

“I don’t under—”

“I had friends go down slow, but not in front of me. I didn’t watch it. I didn’t even know about it until after it was over. I saw . . . In battle, I saw death.”

“But people close to you, you watched them go?”

“I said I did.”

“Can you imagine if it took—?”

“That’s enough,” I cut her off. “I can imagine anything. I don’t want to. It’s a cheap trick. You don’t need it. I’m already sold.”

“I’m sorry. I didn’t mean to—”

“Just tell your story,” I said. I wasn’t going anywhere near watching Belle die. Or Pansy. Both from bullets they took for me. I still had their love. And wherever they were, they had proof of my love for them. In my vengeance.

“It’s not my story,” she said.

“Yeah, it is. No way you’re this . . . intense over some abstract principle. Besides, you dispense the stuff, right?”

“Yes,” she said, proudly. “That’s what I do. It’s no secret. But I’ve never been caught with the goods. Not enough to make it stick, anyway.”

“Maybe nobody’s all that interested.”

“Maybe nobody local. But the feds—that’s all they live for. Drugs. Sacred, holy drugs. Drug
czars.
Drug
budgets.
Drug
squads.
Drug
forfeitures.
Drug money—they all live on it.”

“Sure. We lost the bullshit ‘war on drugs’ a long time ago, and now we’re all POWs to it. But what’s any of this have to do with—?”

“They need it all,” she went on, as if I hadn’t spoken. “Oxy-C, OxyContin; the Fentanyl patch; Vicodin . . . you name it.”

“Who’s ‘they’?”

“People in pain.
Everybody
knows
someone
who’s been there. A friend, a relative, a . . . loved one. It happens
all
over. But everybody it’s happening to, they think they’re the only ones.”

Like the Children of the Secret,
I thought.
Alone in their pain, they never know that it’s not anything in
them
that made it happen. Freaks made it happen. There’s freaks all over. And when you get down to the bone, where the truth is, one person’s pain is always about another person’s power.

“There’s no immunity from terminal pain,” Ann said. “And when people are going to cross over,” she said, “they deserve to go softly. That ghoul with his horrible suicide machine, he wouldn’t have any takers if people could get true pain relief.”

“And if Nancy had bone cancer, she wouldn’t worry about turning into an addict.”

“But you, you don’t care?”

“You know what I think about ‘care’? I think there’s only so much of it to go around inside everyone. The more different things you ‘care’ about, the less you can ‘care’ about any one of them, you see what I’m saying?”

“No.”

“The people who want to
stop
women from having abortions, that’s the
only
thing they ‘care’ about. But the people who want women to be
able
to have abortions, they ‘care’ about a whole lot of stuff—clean air, pure water, logging, cigarette smoking, racism, gun control, animal rights, affirmative action, freedom of speech—”

“I get it.”

“I don’t think you do. Fanatics always have more impact than dabblers. When it comes to getting something done, whether it’s breaking a brick with your hand or overthrowing a government,
focus
is the best weapon of all. People on a jihad are willing to do things most people aren’t, see?”

“Yes, I see. I don’t apologize for what I am. So what’s your point?”

“My point is that I’m sorry about people dying in pain. But it isn’t the thing I care most about in the world.”

“And that would be . . . ?”

“My family.”

“And if one of your family was dying in pain?”

“I’d get them the drugs,” I told her. “No matter what I had to do. Or who I had to do it to.”

She went quiet again. I waited, again. Time passed.

“So, if someone in your family needed them, how would you get the drugs?” she finally asked.

“Buy them. Everything’s for sale, if you know where to look.”

“And you do?”

“For heroin? Who
doesn’t
?”

“Not heroin. The stuff I told you about.”

“They keep it in hospitals. People work in hospitals.”

“You have no idea how strict the—”

“It just means it would cost more, that’s all. If you can get drugs in prison—and, believe me, you can—you can get them anywhere.”

“And if, just let’s say, nobody would sell you any . . .”

“It wouldn’t stop me.”

“You’d steal them, then?”

“For my family? If any of them needed a
heart,
I’d get them one, never mind some damn pills.”

“That
sounds
good.”

“I’m not trying to convince you of anything. You asked me a question; I answered you.”

“Yeah. You did. Some people say you were a mercenary.”

“Some people say Elvis lost weight recently.”

She went quiet again. I went back to where I’d been.

“How bad do you want that girl?” She broke the silence. “The one you’ve been looking for.”

“Bad enough to finance a suitcase of the stuff
you
want so bad.”

“Not enough.”

“There’s a budget,” I said. “And it’s got a ceiling.”

“Not cash,” she said softly. “A trade.”

“I don’t have any drugs. And you don’t have the girl.”

“You can help me
get
drugs. And I can help you get the girl.”

“You said that before.”

“I know I did. I was telling you the truth. Some of it, anyway.”

“Sure. Okay, turn her up and we’ll talk.”

“I don’t think so. But I
will
show you enough to make you believe me.”

“Look, I already told you about ‘caring.’ Don’t knock yourself out trying to make a believer out of me.”

“You don’t have to believe anything. Just tell me what you have so far—whatever you’re willing to, that is. I can work from nothing . . . or nearly nothing . . . but it would go a lot faster if you’d . . .”

“Here’s what I know,” I said. And gave her an edited version of the truth.

She listened carefully, nodding her head at various points, but not taking any notes. When I was done, she said, “I’m going to take you back now. Tomorrow, be around. It doesn’t matter where. Three o’clock. Call me. I’ll pick you up. And take you a lot closer to the girl than you’ve been since you started, see if I don’t.”

When I let myself back into the loft, Gem was there.

“Were you successful?” she greeted me, as if I’d been out trying to sell encyclopedias door-to-door.

“I might have gotten closer. Or I might be getting hustled. I can’t be sure yet.”

“How have you eaten?”

“Fine.”

“Yes? Very well, then.”

She approached me. Tentatively, as if not sure of her reception. As I stepped to meet her, I could see her eyes were closed. I kissed her lips, lightly. Her arms went around my neck.

“I was afraid,” she whispered.