I want to write about being tired, and about being on call for months now without a day of not being on call. I want to focus on that, because I am simply tired. I am in a self abusive state over it all and I am coming to the end of that too.
But the story today is about Adam (name changed). Adam sat in his wheelchair in front of me yesterday, tears rolling down his face. “If I stop drinking I start eating again.” “It has always been something, even before the chair.” I can‘t stop. I know that feeling, intimately. Adam is really tired of the merry go round (his word). When he said that I was reminded of a thing called the addiction cycle, which I am also familiar with.
The addict uses and feels good for diminishing lengths of time and immediately feels shame, sometimes while using, usually while using, once the new wears off, which happens at an alarming pace when one is using. It is always such a surprise, that. Like, “really, already the dark side of this lovely high has shown up” and the pipe/spoon/glass/dice are still in my hand. The shame is the killer. The shame follows the use in the cycle. The belief that I am simply made wrong, bad. You know, the Original Badness. To get out of that the addict engages in fantasy about something pleasant, like drugs/sex/rock and roll/sugar/dice. The fantasy makes the illusion of the original high, the one where everything truly was great, truly, come back like dawn after a cold night. This fantasy part is very powerful and works like a charm and in a very charming way. Feels like velvet. The brain is already using at this point. Dopamine is being dumped in to fill in the cracks between the unhappy places in my/your/our brain. Dopamine is the brain candy. It is why we take the cocaine. The dopamine is released and washes over our unhappiness like 8 wave sets on Oahu‘s north shore. That is the fantasy part.
Next comes the ritual. Gather the toys, get in the car, make the call, get the works lined up, see the man, pay the money, cut the line, crush the pill, buy the paper go to McDonald‘s, visit the wood shed, debate with yourself at the strip club (knowing the conversation is over), get in line, line it up, clean the pipe. Once the ritual starts it won‘t matter if the man knocks on the door. The néedle is going to plunge. It is an overwhelming promise that must be kept, pretty much no matter what. Brain is racing and no risk is unreasonable during the ritual phase.
Then the use itself. At first it is everything and nothing, a church not made with hands, the realization of comfort and love and hope and the darkness comes as quickly as this sentence changes course. Like that. The words “oh no” come to mind. The merry go round spins faster and faster until you die or someone helps you off. Without help it is nearly impossible to get off. I am sure it happens but “rare” is a generous descriptor of its frequency.
So there is Adam telling me about it. He wants off. He is asking, simply, for help. And in all this story, the part that finally makes the tears stream is when he asks me what he and his therapist have been working up to him asking me…“Doc are you ashamed of me as as patient because of all these struggles.”
No. Adam, no. I am your brother in this. This is the journey of our human lives. This is your day of healing. I am witnessing your birth and your death. The cycle, the merry go round has the chance to stop when you/I/we get help from some one other person, something outside of our closed loop of lies. It is our poor, pitiful, incredibly powerful brains that our looped up in the itchy hunger. The way to stop the cycle is a brief reprieve in which we allow a little of someone else‘s power/love to creep in and help. A brief and honest reprieve allows a little self esteem to root. That can actually grow as the reprieve is maintained. My brain still wants dopamine, but I am now not in the cycle alone. Someone/thing has intervened. That brings hope in to a dismal reality and balances the mind. It allows an alternate ending. For the addict the inevitable ending is the relief of death. For the recovering addict, death is no less inevitable, but between now and that moment is one priceless gift: choice.
Adam is my Monday at 11am hero. He is followed by another and another and I am in that line too. My own hero, helpless, ultimately alone in the world except for the thin thread of love between you and me that is so frail and yet strong enough to hoist me from wells of despair. And still we are alone, even with the love, but the love makes it ok, bearable, possible to come off the merry go round.