How to be in pain

Oxycodone is a good idea. Unless it puts you to sleep.

Once upon a time, I was having back trouble (spinal stenosis), nothing unusual for a man my age. I had already scheduled surgery at Mount Sinai when a semi-famous friend mentioned my condition to a truly famous biographer who happened to be my former colleague. He thereupon insisted that I see his own doctor, a good friend and a semi-famous upper-East Side neurosurgeon—-few patients, many patents—-who took no insurance.

Impressed by this portfolio of cultural capital, I went to see the neurosurgeon. His waiting room looks like the bookstore I’ll open when I inherit some money from unknown relatives. A well-lighted place, real books on wooden shelves, the New York Review of Books and the LRB as well as The New Yorker strewn artfully, art books the size of your body opened on tables, people poring over them as if being a patient isn’t the point of being there.

No paperwork, no bullshit, just human kindness—-“have a seat, he’ll be right with you”—-and then the doctor himself comes out to the waiting room and calls my name. We shake hands, I’m even more impressed, but I keep looking around for a reality check, you know, like, someone with a clipboard. None ever appears.

When we get into his office, first thing he says is, “This won’t cost you any more than two thousand dollars, no matter what we find in there.” I protest, because I know that the anesthesia alone, and I mean just the drugs, not the attending physician, will run into five, maybe six figures, but he waves my words away.

Then he says, “You’re an alcoholic. You’re going to have a vexed relationship to the painkillers I have to prescribe for the post-op. Oxycodone, oxycontin, hydrocodone. These will fuck you up, big time.”

I say, “How do you know I’m an alcoholic?” And then, self-righteousness rising, so my diaphragm now begins to feel like a furnace, I point my finger at him and say, “Are you saying I’m an addict, already?”

“I read your medical records, that’s how I know you’re an alcoholic. It’s not rocket science. Yes, you’re an addict. Already. You have the same ‘genetic defect’ that doomed the Indians. When you take a painkiller, let’s say 5 milligrams of oxycodone or hydrocodone or whatever, you’ll go right to sleep. Your body just doesn’t know how to deal with this kind of depressant.”

“I do OK with pain,” I say, relaxing, reclining, and I feel like I’m apologizing, “so maybe I can just avoid the oxycontin,” and here I’m remembering that relatives of mine were addicted to this shit.

“No, you can’t,” the semi-famous neurosurgeon says, “it’ll hurt too much, and aspirin won’t help. The point is to see your own vulnerability. I guarantee that you’ll get addicted if you take it according to my own prescription. Then what? Do you understand what I’m saying?”

Well, yeah, I do, but it’s four years later, Doc. Meanwhile, you’ve dug into my lumbar vertebrae twice, and your colleagues have rummaged around elsewhere, in both my knees, just to begin with. These painkillers you’re talking about are now just there, not “over there” like something I reach for in desperate need, nah, they’ve become no more important than aspirin.

I understand what you’re saying.

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