Timeless Wounds of Addiction

Addiction is a strange and strangely powerful thing; in its grip, time does not heal all wounds.  

For me it was booze and coke but not in equal measure: the Bolivian Marching Powder held its sway so much tighter.  I fell head over heels in luv with the dopamine rush, giving me what I imagined was a flavor of the happiness normal folks felt day-to-day.  I was alive for the first time.  I haven't touched the shit since September 1994 and yet just now - February 2014, nearly twenty years later - all it takes to trigger the old gut hollowing anticipation is a news special on street drugs where undercover reporters are shown buying dope in Philly on the very same corners I bought coke.  Those corners, those memories, that feeling.

Those pictures of Aramingo Avenue are ringing the old Pavlovian dinner bell and I catch myself salivating.  I've been dry less than eight years and yet haven't come close to the coke-strength craving for booze.  I was drinking every day all day in the bloom of my active alcoholism circa 2006 whereas my cocaine use was limited to a dozen weekends a year with a couple week long binges thrown in for bad measure during a mere six season run.  Almost twenty years ago.  But there it is, rumbling up smack dab in through my gut.

I write this just a few days since one of my favorite artists, actor Phillip Seymour Hoffman, died of a heroin overdose.   He'd been clean and sober for over twenty-two years before falling back into the briny deep in 2012 and less than two years later is found dead with a needle in his arm surrounded by over fifty bags of dope.

Time does not heal all wounds.  

And certainly doesn't heal chronic diseases like addiction.  You have to be vigilant. Try not to let the "fuck it"s worm their way back into your life as they're the prime breeding ground for a relapse.  Get to therapy, get on antidepressants if needed, exercise even if you don't feel like it (it kicks your endorphins into gear).   Also, don't consider a relapse the end of the world.  This might sound counter intuitive to staying clean but it's very important.  A relapse is serious and something you must make a priority of avoiding; however, if it happens the last thing you want is an "I blew everything so might as well keep using to the point of oblivion" attitude.    It's a statistical fact that when addicts relapse after an extended sobriety they rarely ease back into use but rather immediately plunge in deeper than they ever have.  I think this is usually because the addict wants to destroy the thoughts of having "failed" sobriety.

Relapse is not inevitable and if it happens you can get back on the wagon.   I was sober for 14 months in 1993/1994 but relapsed to my best friend cocaine, and subsequently to alcohol as a necessary come down when the coke ran out.  That binge lasted a week and I haven't touched the white powder since but the boozing continued for another dozen years.  Still, I managed to put a plug in that too.  It hasn't, for the most part, been a struggle for me this time around.  I'm pretty sure I'd have stayed off the booze entirely if I hadn't run into my coke dealer and knocked that domino down.  I can't say for sure what I'd do if I bumped into him today, though I'd like to think things'd be different.  The antidepressants I'm on would have a lot to do with making the right decision.  And let's face it: I didn't just "run into" the dude in '94.  I deliberately put myself in the old neighborhood and practically stalked him before making a "casual" encounter. 

No, time does not heal all wounds.

You have to keep treating them.

Rehab

June 3rd, 2006.  As previously mentioned, I was nearly dead and mad in the throes of delirium when my friend Mike found me at home and drove me to the emergency room; however, by the third day I was mostly lucid and on the fourth I started calling around to treatment centers to inquire as to availability and price (I'd be footing the bill myself since my health insurance wouldn't cover this eventuality).  My sister suggested the Sundown Ranch in Eastern Washington.  She was very familiar with the place since her then-husband Tony had gone through there a few times.  The rehab didn't take for Tony but that was no blight on its effectiveness: no treatment took for him because his "bottom" turned out to be death (and if he could have found a way to drink post-mortem he'd have done that too).   Still, I had no desire to travel across the country and was determined to find one in the local Philly area.   Finally, after a dozen fruitless calls from my hospital bed, I land on what I think is the perfect place: The Keystone Center in Chester, PA.  I liked the irony of its location: smack in the middle of the area where I used to buy cocaine in the late 80s and early 90s.  Plus it was relatively cheap at a couple thousand for a two week stay that I eventually extended into three for an extra grand.

I checked out of the hospital on Friday and into the Keystone Center the following Monday morning, June 12th. My sister had flown in and was staying at my house so she drove me down there in my car.  She'd be heading back to her home in Phoenix in a few days and I'd take a cab back to my place once rehab finished.   The Keystone Center organized its patients into four groups: two male, one female and a co-ed group called Freedom.  The architecture of this rehab was unique with a couple of relatively modern two-story buildings behind an old re-purposed stone and wood mansion.  The first floor of the mansion held the administrative offices that I only saw on check-in and check-out.  The second floor was home to the all-female group and the top floor was where Freedom men and women met for therapy and slept.  The more conventional buildings held the medical ward where prescribed drugs were dispensed and where new arrivals slept when going through detox.  The cafeteria, therapy rooms for the two male groups, a large conference room for all-hands meetings and the staff offices also called these buildings home.  There was another building across the alley which housed a group of juveniles.  These shared our cafeteria but otherwise did not interact with us adults, only really affecting us when they overstayed their lunch period, forcing us to wait longer in line. Well, the young punks were also responsible for the caffeine ban (only decaf sodas and coffee were available because they didn't want the tykes getting hopped up).  I hated them for this.

I ended up in Freedom Group.  It was, as I mentioned, co-ed.  It was also much smaller than the other groups and its members had less restrictions than the others.  For one, guys and gals could talk while in their meetings and in the shared TV room in our "penthouse" at the top of the mansion.   There were five bedrooms with either two or four per (these were obviously unisex and it was strictly forbidden to penetrate these walls if you were the wrong sex).   There was likewise two showers/toilets and a private laundry room. Finally, there were no locks on our doors or floor.  The women-only group on the floor below us had similar digs but the male patients not in Freedom lived in large dorm-style rooms with six to a dozen per room and the floors to these rooms locked after 9pm so if you wanted to grab a last cup of decaf or go for a walk, you'd better not get caught out after hours or there was hell to pay because you had to find somebody to unlock the doors, effectively ratting yourself out.  I know this because though I was assigned to Freedom, I didn't sleep there initially; at first, I was still sleeping in detox and then after I was declared clear was moved to one of the other buildings until a bed opened up in the Freedom "penthouse."   Naturally, the other groups resented Freedom and when we mingled together during meals there was no end to the name calling.  How did one rate such an advantage?  I'm not sure.  The people in Freedom were just as fucked up as the others, at least to my eyes.  I think it came down to money and choice.  The ones in Freedom were there by choice, mostly - at least the choice of parents in the case of the kids in their late teens and early 20s - and I think had the money and/or insurance to pay in advance.  Though that's not right either: we had more than a few who were there by court order and at least a few who were being gently/discreetly "reminded" by the staff to call their parents or spouse to arrange payment.   It certainly didn't seem to be divided along racial lines (Freedom had as healthy a representation of ethnicities as the other groups).   Maybe it was the luck of the draw but there was a pervading sense - at least on my part - that this was most certainly intentional.

So, Monday I arrive and check-in.  I pay up front and then after reviewing the medication I was on was told I'd be spending the next day or two in detox.  This confused me because I'd just spent a week detoxing to horrific effect in the county hospital and was quite sure I was as clean as I could possibly be.  The thing is, my gastroenterologist had several years ago prescribed me Nexium for my acid  reflux and Xanax to help me sleep but this latter drug is classified as an addictive benzodiazepine from which I must be weaned.   So they stuck me in a little private room off the Nurse's Station where I could presumably sweat out the withdrawal in close proximity to medical assistance.  There was to my knowledge only one actual doctor at Keystone, the department head, a psychiatrist, but plenty of RNs.  I only took the occasional Xanax so I experienced no withdrawal symptoms at all but rules were rules so I slept here fitfully, trying to ignore where others in rooms beside me were not so fortunate in their cold turkey dance.  During the day up to 9pm, I'd be allowed to go up to Freedom Group for the usual AA sessions/meetings, discussions/testimonials on addiction, and lectures by the various counselors assigned to us.

The Freedom group fluctuated between 10 - 20 people with about 70% heroin, coke or crack addicts, 29% alcoholics and one college age kid who was there for a gambling addiction.  The dude made a lot of money, so he says, but had been kicked off the college basketball team and eventually out of the school itself after the gambling ring he formed was discovered by administration officials.  Turns out Keystone Center had one of the few Gambling Addiction programs in the Philly area with our main counselor, Nick, himself a recovering GA.

The median age of my fellow Freedom riders was about 25, with several under 20 (the heroin and coke crowd).   Jeanie - 19, mother and white suburban upper middle class coke head who fancied herself an inner city gangsta girl - was the wildest, getting into fights during meetings with almost everyone of us and at lunch with the other groups.  She was bi-polar so of course we nicknamed her Tri-Polar.  I was closest with Charlie (a drunk about my age) and Eric (the college gambler), thanks to similar senses of humor.   We'd bust on people waiting in line to eat (an hour's lunch would generally consist of 45 minutes of waiting in line and 15 minutes actually eating thanks to the large population and limited cafeteria seating) but mostly bust on ourselves for being there.  We had no illusions about what we were and this placed us in the distinct minority in that regard.  Most were just now grappling with the fact that they had a problem of some sort, if only because of the fucked up circumstances which landed them in this particular rehab (for many, this was not their first rodeo).  But an addict?  An alcoholic?  "Well, I'm just not sure about that."

Typical weekday Schedule:

7am, decaf coffee available; 8am breakfast, 9 - 10am, AA meeting, 10 - 11am; sober living education, 11 - 12pm, psychodrama (Tue/Thu) or nutrition/dealing with stress (Mon/Wed/Fri); 12 - 1pm, lunch; 1 - 2pm, AA meeting; 2 - 5pm, exercise/swimming/free time (work on writing up post-rehab goals, amends, etc.); 5 - 6pm, dinner followed by reciting of Serenity Prayer in all hands meeting room; 6 - 7pm, evening with counselor Nick on surviving sober or whatever he happened to pontificate on (he was a Jersey-wise-guy-style hoot and could sermonize on AA 101 with the best); 7 - 8pm, guest testimonial/AA meeting; 8 - 10pm, sometimes free time but occasionally a movie in the Freedom common room with addiction theme.

For Freedom group, psychodrama took place twice a week.  This was very interesting.  We walked across the alley to the Keystone out-patient facilities where there was a large room with chairs arranged in a circle around a central chair.  Once seated, a specifically trained "certified psychodrama facilitator" guided us through the next hour and a half.  The process was focused on one member of the group for the entirety of the session.  This volunteer - we were all strongly encouraged to do this prior to completing our stay - would sit in the center of the circle and act out a tragic/pivotal event in his or her life that involved or triggered addictive behavior.  The central player would ask other group members to improvise with them in the guise of specific people in their lives.  It was part theater, part primal therapy.  I surprised myself by raising my hand my last week there.  I had previously watched guys and girls act out physical and emotional abuse, rape, and other unspeakably horrific tales, including one going through Fentanyl-spiked heroin withdrawal.  (While at rehab, there was talk going 'round about a strain of heroin on the street that had been spiked with lethal amounts of fentanyl and while this frightened some of the addicts, two arrived mid point during my stay who had been deliberately seeking out this poison in order to experience the "ultimate high.")

I chose, for psychodrama, to reenact my recent experience with alcohol withdrawal and the delirium that came along for the ride.  I was quite certain at some point about 6 hours into my hospital stay that I was dying of a terminal disease.  I screamed at the doctors and nurses to save me and accused them of murder after they insisted that I was experiencing alcoholic delirium.  Alcohol withdrawal can be fatal if not treated with medication, they allowed, but my withdrawal was in fact being treated.  Lies!   So I re-enacted this with members of the group playing the role of doctors, nurses, my sister, and some of my friends.  It was cathartic,  if more than a bit creepy.  And it brought me closer to a few members of my group, most of whom I'd kept at a distance (I'm not good socializing).  Turns out I was much better at consequential socializing than I am at the normal small-talk usually required.  At a rehab, most everything is emotional and there isn't as much a need to talk about sports or the weather or day-to-day life.  Of course, as I left I promised to keep in touch with all of my new "friends" and then never did.  I certainly regret that now as I'd like to know how they're making out.  I know the statistics say most drank or used again - and some end up in a recovery/relapse loop for years - but you always hope for the best.

I flipped out on the day before I was to depart.   The Remeron anti-depressant the Keystone medical staff had put me on wasn't available once at the nurse's station after waiting in line during evening med call (twice a day you'd line up to get whatever meds you were prescribed).  I went off on the nurse there and continued my tirade with the Keystone director, Deb.  I apologized to both when I cooled down.  I'd only been on the drug for a few days and yet was still horrified at the thought of missing a dose.  I'm sure now that I hadn't been on it long enough for it to have any discernible effect, so I'm sure it was purely psychological.

I only met with the actual staff shrink once.  He was the "chief medical officer" and only M.D. on staff so appointments were hard to come by.  Most were only granted one audience.  I explained to him that I did not believe in a higher power and though I understood the value of AA and the 12 step program for others, I would not be following it per se.  Not strictly.   I'd take what I need and leave the rest, as they say.  I'd already planned to join Secular Organizations for Sobriety (S.O.S).  I liked their philosophy, the tenet of which is the Sobriety Priority (in short, sobriety is #1 priority in your life and everything else flows from that).  Needless to say, this went over like a lead balloon.

I ended up extending from 14 to 19 days mostly because I was comforted by the structure and insulation from "real life."  But my bank account wouldn't let hide there forever so it came to pass that I "graduated" and was discharged the morning of July 1st after which I took a cab back home and into my newly sober real life.

The Experiment

June, 2006. White coats, bright lights, devilish laughter. Everything is distorted. Clear liquid instruments blend into metal running through IV tubes out of my arm onto the tray. My body rises slightly; reacting, rough callused fingers pat my wrist, then push down on the syringe, the big fade. My head falls to the side hard on the pillow, nylon straps gripping me to the gurney. Whispers blue black, silence blood red. And always: white coats, bright lights, devilish laughter.

I'd been in the ER a few hours at this point, but if you told me I'd been here five minutes or three days, I wouldn't have been surprised.

Mike found me at my house at noon in hallucinatory madness, raving about my walking travels through Mexico the night before as though I'd strolled out of my home in Philadelphia through a wormhole into Tijuana.

I also regaled him with the exploits of a female basketball team living mostly in my attic the past week. The racket was grating on me, what with the bouncing of the basketball echoing through the ceiling and their laughter trailing after it. Except for their center, a very tall Asian player who stands motionless and silent next to my skis in the spare room the whole time. Mike took a peek and of course found nothing, no one but me in the house.

And the dog-size rats! With razor tipped teeth flashing yellowy eyes, shit they were flowing like a river of bubonic gray through my house and out the front door yesterday! The pro-rat crowd was out in force down the street, a spontaneous rally aimed squarely against yours truly, upset that I'd dialed up Pest Control. Man, you should have been here, Mike! They had a big parade with those same rats as Grand Marshall. Then the Pest Control folks arrived and the whole parade/rally exploded into a riot in the church parking lot! I went and hid in the church until the smoke cleared. Wicked!

Just the usual small talk between old friends.

Mike looked around and then at me, quizzically. I had red slits for eyes and jaundiced pallor, pouring sweat. Unshaven in weeks, matted hair uncut in months. Shower? Who needs those? Clearly something was very wrong, and I knew it too on some level, but not in a way I could communicate to myself, certainly not to others. Things were fine!

After an uncomfortable few minutes Mike quietly said, "You need to go to the emergency room, I think something isn't right. You're making no sense." I was agreeable, though I didn't know why. It was like an out of body experience, I was just sitting back in the darkened theater crunching popcorn and watching the show with the rest, wondering what was next for our intrepid anti-hero.

The next thing I 'remember' are the white coats, bright lights, devilish laughter.

You see, I was at the tail end of my own special experiment: let's take a medical leave from work and see what happens when you polish off the better part of two 70cl bottles of Tanqueray each day for the long end of four weeks and then .. just ... stop ... cold. Slow motion suicide. A month long gunshot to the head.

The first four weeks were easy enough - well, the first two and half weeks were anyway.

Gradually the challenge of making it to the state store in the morning without dry heaving on the guy at the register became a massively complicated effort, the hardest I think I've ever worked in my life. Trying to look as normal as I could, trying to walk, then actually drive. Man, I was soaked with sweat like I'd been hiking in an Ecuadorian jungle for a week dressed to scale Mt. Everest. And that's after I managed to make it from the bed all the way to ... the chair by the bed. Puts on pants. Slugs down a gin and orange juice, throws up, another, throws up, another, keeps it down - no, throws up. One more. Puts on shirt. Brush teeth. Slugs down another, back up, down, up, down, down. And so on it went. At least on those happy days when I had a little liquid normal left in the bottle. Some days, I wasn't so lucky.

The drives to the state store were the worst - two miles or so, shaking so uncontrollably I could barely grip the steering wheel, big beach towel in the passenger seat to wipe the pools of chilled sweat pouring down my face and arms. Yellow/clear sickness sticking to black leather upholstery and dripping down the driver's side window when I turned the wrong way.

But I managed to do it - not only the state store but a stop off at the Wawa Deli for a quart or two of orange juice on the way back. Then, finally, home. I made it! I had my supplies and life could go on. Well, not quite. After another round of drink, vomit, drink, vomit, drink, drink, drink ... (Three and a half years later, I still can't stomach the smell of orange juice.)

Finally I was straight enough to turn on the TV, check email, veg out and channel surf. Looking for anything that would divert my attention from the 800 pound gorilla sitting on my chest clawing at my stomach. And drink, TV and drink. Until I passed out. And then the daily cycle repeated itself.

Good times!

My trash cans were filling with empty gin bottles, I was truly the Tanqueray poster child for May 2006, though I imagine I wouldn't be their first choice as spokesperson. Sipping on Gin and Juice, laid back. Not quite, Snoop.

The final week was especially miserable, to the point where I couldn't move, open my eyes, or make a sound without heaving. The slightest smell, however innocuous, would kick off a chain reaction of nausea. Only an ever growing intake of booze would temporarily dull this effect, put the genie back in the bottle for a few hours, but less and less for shorter and shorter periods. Eventually almost all the booze ended up in the toilet as sick.

My stomach, never strong and already prone to severe bouts of acid reflux, finally said "no more." It just wouldn't accept anything. So it was time for phase two: stopping. It was a tough road for a day or so - shaking violent upheavals, icy hot chills. And then it seemingly got better, dreamy. In fact the most vivid waking dreams of phantom visitors, parades down my little street, trips around the globe, rats and razors, and human/rodent riots, all from the 'comfort' of the bathroom floor, eye level with the buttons on the bottom of the shower curtain, night and day gleaned from the indirect light reflected off the mirror above me.

Mike found me on day three of withdrawal and by that point, to paraphrase John Lennon, cold turkey already had me on the run.  And the race seemed over. I was pretty much resigned to death, even giddy about the prospect (no more technicolor yawns). Maybe the joviality was simply an outbreak of the delirium tremens, the DTs. In fact I know now that it almost certainly was, but at the time I thought the DTs meant pink elephants or giant imaginary bugs crawling up the walls and such. The Hollywood interpretation.

But I had gotten myself dressed and called Mike to see if he wanted to grab lunch. I thought I had come out the other side at some level. My masochistic experiment over, I kept telling myself. Fat lot I knew. The slight horror on Mike's face when I opened the door should have been a clue I couldn't gauge my condition properly. Then I opened my mouth and uttered the most nonsensical things. It was clear to him that I was off the deep end and plunging into the icy depths.

My delirium fantasies hit full stride in the ER. The staff there - sometimes doctors, occasionally nurses - hooked me up to a diuretic IV drip for what seemed like hours, force feeding me chocolate and corn. But they wouldn't let me go to the shitter. I tried to speak to them, pleading with them to stop but it seemed they didn't understand a word I said. They looked at me, laughed, and responded always with same two word non sequitur: "Kill Kirk." Never anything but that. "Kill Kirk"

What did it mean?

I wasn't particularly fond of the 60s Star Trek franchise, certainly no Trekkie. But I knew of no other 'Kirk'. I didn't actually hear this, so it came from somewhere within me. Maybe I misheard some critical care/medical jargon/phrase.

So, "Kill Kirk" and then he or she would invariably scribble something on a notepad, chuckle devilishly, and furiously hustle away, bent over doing the Groucho Marx walk with the hand out, fingers gripping the invisible Groucho cigar. Except for the last time.

The last visit I received from the ER staff was when they opened the curtain around my gurney and descended on me en masse. This time there was no "Kill Kirk" or scribbled notes. This time, they stripped me naked, pinned a big clear plastic diaper on me and carried me out into the middle of the street in front of the hospital, depositing me there to quite literally shit myself into oncoming traffic. Fade to black.

I awoke in a hospital room, arms and faces melting like wax around me, pricking and poking, talking loud, screaming. I was dying, I swore I heard that. I glanced out the window and saw palm trees. Quickly to the right, there - a motion camera with crew behind it. I was in Hollywood, on a movie set. Or TV. ER? Grey's Anatomy?

I'm not an actor, though, I'm dying!

Was I taking the Stanislavski Method to it's logical extreme? Or part of a documentary on the terminally ill? Somehow they both made sense. How did I get out of the street? Did I crawl back in? How did I make it to Hollywood? Do the ER staff know? They'll find me and fix my wagon for good. But that was in Philadelphia. If I was in Hollywood on a film set, those ER goons couldn't find me. Unless the film crew ARE the ER goons, making ER. This Philadelphia area 'hospital' I'm in was in Hollywood, always had been. The two worlds were one in my mind.

The faces huddled across from my bed, whispering. What is that they are saying? Liver failure? Renal Failure? Don't lie to me! Motherfucking liars! I wanted to go home to die, tried to break free. I jumped up and kicked at the face blocking the door but missed, slamming my foot into a metal cabinet, breaking two toes and collapsing on the floor. Fade to blur.

Dreams, I'm driving a car with a large sack of potatoes next to me, it goes on and on. I'm still running from death but it's embodied as a car full of doctors now, and they're gaining on me with humongous hypodermics sticking out of the roof.

Finally, lucidity begins to regain its footing in my psyche. Slowly I awaken, but in Philadelphia, in a hospital. Hollywood's gone. And I'm not dying, not immediately, anyway. I am securely strapped down to the hospital bed. For my own safety as well as that of the staff, a nurse tells me.

Confused, disoriented, I'd remain that way for the next several days, perhaps forever. But I knew where I was. Arms immobile in the makeshift straight jacket that binds me to a bed in a hospital with IVs coming out of my arm, sharp pain shooting through my foot and a dull, throbbing hurt all around my eyes. Deep black spots speckle my field of vision, an old man in the bed next to me gags, coughs behind the partition. A TV plays overhead - some soap opera I can make out through the bad reception. A doctor on rounds stands over me. What day is it? Monday. When did I get here? Saturday. Your sister is flying in. What happened? You very nearly drank yourself to death.

Ahh, yes.

I knew where I was. But not a clue as to where I might be going.

The Cook

The blue white glow of the gas burner is central to the Cook's world. A world wholly crafted within the confines of his mother's house, narrower even than that: the back room, the kitchen.

The other denizens of this world - guests - huddle round the kitchen table covered in plastic baggies, lighters, spoons, pipes. A smokey stench permeates down into the foundation of the old row home. The fraying early 70s furnishings have long since given in to the activities of the kitchen, as has the ceiling and walls peeling paper, sweat and smoke. It can't be deodorized, fumigated, but there will be no such attempt: this ambiance is essential to the mood.

The Cook does his work at the burner alone. Bag to spoon over burner, powder bubbling to rock. His otherwise trembling hands steady in this endeavor, nimble fingers gingerly raising, then lowering the utensil over the heat. The others fixate on his mastery from the table, no one questions his craft, intervenes in his preparation. He is Emeril Lagasse, Wolfgang Puck. He is The Cook.

Beyond the burner's glow, the house remains bathed only in midnight's colors. Deep blue black shadows illuminate - quickly, a pulse - with flashes of the lighter, a flare of the pipe - rock softly crackling to smoke, inhaling: wwwoooowwww. Euphoria. Murmurs. One minute, two. Gone. Sad Shadows. Flash/flare, wow. Wonderment. Gone. Again. The Cook gently instructing his young charges: slow, slow down - never chase the flame. Disapproving glance, knowing mumble. The 'meal' is ruined with hasty consumption - savor, taste, let the flame chase you.

From the alley the kitchen window takes on the look of a lighthouse, the burner's steady glow punctuated by the table's periodic sweeping flashes. Wow, euphoria. Leading lost ships to its port for a price, fine dining on the edge of a rough sea. Cash or the raw ingredients gladly accepted. Absolutely no checks, cards or credit.

Sitting on the backyard trash can, a stray cat looks into the window transfixed, confused. Then jumps off and toward the Burger King parking lot down the way, more potential there for an understandable meal.