The knife inside

Two nights ago, I fell asleep without getting ready for bed. By the time I woke up, a few hours had past, and I was at least eight hours past my last dose of pain medicine.

Agony: my back was raging, my pelvis was on fire, and my mind and body were at war. I strained to stay as still as possible, as any movement would set off a cascade of sharp spikes of pain that might last a few seconds, or might continue, stuttering and intermittent, for a minute or more, long enough to steal all agency and optimism. The flaw in the stillness strategy: Getting to the pain medicine required movement. Freeing my left arm to prop up my torso, then rolling over to where the bottle was, opening it, and taking the pills, seemed impossible. I hovered there for a few seconds in an uncomfortable limbo, with neither stillness nor motion providing relief, when I finally moved the arm, rolled over and took the medicine.

Then, stillness. I tried not to move or even think, just listen and feel. Narcotics don’t take effect instantly; 20 minutes to full activity seems a reasonable benchmark to me, though they certainly seem to be doing something after about 10 minutes. But for the first few minutes, the dilaudids were working about as well as jellybeans. Every shift made me cringe. Every ebb and flow of my breathing, every gravitational shift and surge of the body’s fluids: I felt them all as they pressed toward the maw of pain at the core of my body, the pelvis. Sometimes pinpricks, sometimes sharp stabs, sometimes an ache surging into echoing pain. I pressed a hand against my thigh as if to remind myself that another form of sensation was possible.

I imagined that I was carrying a dagger suspended by filaments in my lower belly. The weapon was unadorned; nothing but a thin, sharp blade. Any movement could bring tissues and sinew in contact with it, creating sudden jolts of pain reminiscent of electric shocks. In this hyper-aware state, time crawled and I focused on the body’s unceasing activity: respiration and excretion, the twitch of a calf muscle, a sudden spike in sensitivity in a patch of skin asking for a scratch. All of these seemed to cause chain-reactions that led to something somewhere rubbing up against the dagger. I gritted my teeth without relief. Some red lever in my brain is set to “pain” now. There is nothing but the dagger. I imagine the pocket next to my left hip leaking acid on the nerves that run down my legs and up my back. I worry about the old internal radiation burns, healed we hope, but caked with scaly scar tissue that could begin cracking and weeping strange fluids at any time. Even my ankle, with which absolutely nothing is wrong, cries for attention; I slept on it oddly early in the day.

I wait, I wait, marveling at all the complexity and interdependence, and suddenly the cloud lifts, the pain drops, the dagger shrinks. After twenty minutes or so, the knife is gone. I turn over again, slowly and painfully, gather my pillows, and close my eyes.