Infinite jest - David Wallace

‘Oramorph SR for an instance. Very safe, very much relief. Fast relief.’

This is just morphine sulfate with a fancy corporate name, Gately knows. This raghead doesn’t know who he’s dealing with, or what he’s.

‘Now I must tell tell, I would make the personal first choice of titrated hydromorphone hydrochloride, in this case —’

Christ, this is Dilaudid. Blues. Fackelmann’s Mount Doom. Kite’s steep-angled decline, as well. Death on a Ritz. The Blue Bayou. Gene Fackelmann’s killer, by and large. And also Gately pictures good old Nooch, tall skinny Vinnie Nucci, from the beach at Salem, who favored Dilaudid and spent over a year without ever taking the belt off his wing, dropping through Osco skylights at night on a rope with the belt all tight and ready just over his elbow already, Nucci never eating and getting skinnier and skinnier until he seemed to be just two cheekbones raised to a great silent height, even the whites of his eyes finally turning the blue of the bayou; and Fackelmann’s eliminated map after the insane scam on Sorkin and a disastrous two nights of Dilaudid, when Sorkin’d —

‘— though I say yes, this in truth is a C–II medication, and I wish to respect all wishes and concerns,’ the M.D. half-sings, inclined at the waist now by Gately’s railings, looking closely at the shoulder’s dressing but not seeming at all disposed to even touch it, his hands behind his back. His ass is more or less right in Ferocious Francis’s face, who’s just sitting there. The M.D. doesn’t even seem to be aware 34-year-sober Ferocious Francis is there. And Francis isn’t making a peep.

It also occurs to Gately that esoteric is another ghostword he’s got no rights to throw around, mentally.

‘For I am Moslem, and abstain also, by religious law, from all abusive compounds as well,’ the M.D. says. ‘Yet if I have suffered trauma, or the dentist of my teeth proposes to perform a painful process, I submit as a Moslem to the imperative of my pain and will accept relief, knowing no established religion’s God wills needless suffering for His children.’

Gately has made two shaky smaller A’s together on the next sheet and is stabbing emphatically at the sheet with his Bic. He wishes if the M.D. wouldn’t shut up he’d at least move, so Gately could shoot a desperate Please-Jump-In-Here look at Ferocious Francis. The drug-question has nothing to do with established Gods.

The M.D.’s bobbing a little as he leans, his face coming in and then receding. ‘This is a Grade-II trauma we are looking at in this room. Allow me to explain that the discomfort of right now will only intensify as the synovial nerves begin to reanimate. The laws of trauma dictate that the pain will intensify as healing begins to commence. I am a professional at my job, sir, as well as a Moslem. Hydrocodone bitartrate[355] — C–III. Levorphanol tartrate[356] — C–III. Oxymorphone hydrochloride[357] — admittedly, yes, C–II, but more than indicated in this degree of needless suffering.’

Gately can hear Ferocious Francis blowing his nose again behind the M.D. Gately’s mouth floods with spittle at the memory of the sick-sweet antiseptic taste of hydrochloride that rises to the tongue with an injection of Demerol, the taste Kite and the lesbian burglars and even Equus (‘I’ll Stick Anything in Any Part of My Body’) Reese all gagged at but that poor old Nooch and Gene Fackelmann and Gately himself had loved, came to love like a mother’s warm hand. Gately’s eyes wobble and his tongue protrudes from a shiny mouth-corner as he draws a crude syringe and arm and belt and then tries to draw a skull-and-bones over the whole shaky ensemble, but the skull looks more like a plain old smiley-face. He holds it out to the foreigner anyway. The dextral pain’s so bad he wants to throw up, throat-tube or no.

The M.D. studies the palsied drawing, nodding the exact way Gately used to nod at Alfonso Parias-Carbo the totally ununderstandable Cuban. ‘Oxycodone-nalaxone compound,[358] with a short half-life but only a C–III grading of abuse.’ There’s no way the guy could be like intentionally making his voice this wheedly-sounding; it’s got to be Gately’s own Disease. The Spider. Gately envisions his brain struggling in a silk cocoon. He keeps summoning to mind the little detox-story Ferocious Francis tells from the Commitment podium, how they gave him Librium[359] to help with the discomfort of Withdrawal, and how Francis says he just threw the Librium hard over his left shoulder, for luck, and has had very good luck ever since.

‘Likewise as well the time-tested pentazocine lactate, which I can offer with assurances as a Moslem trauma-professional standing here in this room in person with you at your bed’s side.’

Pentazocine lactate is Talwin, Gately’s #2 trusted standard when he was Out There, which 120 mg. on an empty gut was like floating in oil the exact same temperature as your body, just like Percocet[360] except without the maddening back-of-the-eyeball itch that always wrecked a Percocet high for him.

‘Surrender your courageous fear of dependence and let us do our profession, young sir,’ the Pakistani sums up, standing right up next to the bed, the left side, his professional lab-coat hiding F.F., hands behind his back, the dull glint of the metal corner of Gately’s chart just visible between his legs, immaculate of posture, smiling cheerily down, the whites of his eyes as ungodly white as his teeth. The memory of Talwin makes parts of his body Gately didn’t know could drool drool. He knows what’s coming next, Gately does. And if the Pakistani goes ahead and offers Demerol again Gately won’t resist. And who the fuck’ll be able to blame him, after all. Why should he have to resist? He’d received a bona fide Grade-Whatever dextral synovial trauma. Shot with a professionally modified.44 Item. He’s post-trauma, in terrible pain, and everyone heard the guy say it: it was going to get worse, the pain. This was a trauma-pro in a white coat here making reassurances of legitimate fucking use. Gehaney heard him; what the fuck did the Flaggers want from him? This wasn’t hardly like slipping over to Unit #7 with a syringe and a bottle of Visine. This was a stop-term measure, a short-gap-type measure, the probable intervention of a compassionate unjudging God. A quick Rx-squirt of Demerol — probably at the outside two, three days of a Demerol drip, maybe even one where they’d hook the drip to a rubber bulb he could hold and self-administer the Demerol only As Needed. Maybe it was the Disease itself telling him to be scared a medically necessary squirt would pull all his old triggers again, put him back in the cage. Gately pictures himself trying to shunt through a magnetic-contact burglar alarm with a hand and a hook. But surely if Ferocious Francis thought a medically advised short-term squirt suspect, at all, the old reptilian bastard would say something, do his fucking job as a Crocodile and sponsor, instead of just sitting there playing with his nostril’s little noninvasive tube.

‘Look kid, I’m gonna screw and let you settle this bullshit and come back up later,’ comes Francis’s voice, subdued and neutral, signifying nothing, and then the rasp of the chair’s legs and the system of grunts that always accompanies F.F.’s getting up from a chair. His white crew cut rises like a slow moon over the Pakistani’s shoulder, which the M.D.’s only sign of acknowledgment of Francis is to sort of tuck his chin down into his shoulder like a violinist, addressing Gately’s sponsor for the first time:

‘Then perhaps you would please, Mr. Gately Senior, if you please help us help your concerned and brave boy here but a boy I believe whose cavalier attitude underestimates the level of coming discomfort which is sadly unnecessary altogether if he will let us help him, sir,’ the Pakistani sings over his shoulder to Ferocious Francis, as if they were the room’s only adults. He’s assuming Ferocious Francis is Gately’s organic Dad.

Gately knows a Crocodile never bothers to correct anybody’s misimpres-sion. He’s halfway to the door, moving with maddening slow care like always, as if walking on ice, twisted and seeming to limp off both legs and heartbreakingly assless in the baggy seat-shiny wide-waled old man’s corduroys he always wears, the back of his red neck complexly creased as he moves off away, lifting one hand in a gesture of acknowledgment and dismissal of the M.D.’s request:

‘Not my business to say one way or the other. Kid’s gonna do what he decides he needs to do for himself. He’s the one that’s feeling it. He’s the only one can decide.’ He either pauses or slows down even further at the open door, looking back at Gately but not meeting his wide eyes. ‘You keep your pecker up, kid, and I’ll bring some of the son of a bitches by to look in again later.’ He slips in ‘Might want to Ask For Some Help, deciding.’ The last of this comes from the white hall as the Pakistani’s glossy head comes back in close with now a tight strained-patience smile, and Gately can hear him inhaling to get ready to say that of course in Grade-II traumas of this severe type the treatment of preferred indication is the admittedly C–II and highly abusable but unsurpassed for effectiveness and tightly controlled administration of one 50-mg. tab in a diluting saline drip q. 3–4 hours of mep—

Gately’s good left hand skins a knuckle shooting out between the bars of the bedside crib-railing and plunging under the M.D.’s lab-coat and fastening onto the guy’s balls and bearing down. The Pakistani pharmacologist screams like a woman. It isn’t rage or the will to harm so much as just no other ideas for keeping the bastard from offering something Gately knows that he’s powerless at this moment to refuse. The sudden exertion sends a blue-green sheet of pain over Gately that makes his eyes roll up as he bears down on the balls, but not enough to crush. The Pakistani curtsies deeply and bends forward, crumpling around Gately’s hand, showing all 112 teeth as he screams higher and higher until he hits a jagged high note like a big opera lady in a Viking helmet so shattering it makes the crib-railings and windowglass shiver and woke Don Gately up with a start, his left arm through the railing and twisted with the force of his attempt to sit up so that the pain now made him hit almost the same high note as the dream’s foreign M.D. The sky outside the window was gorgeous, Dilaudid-colored; the room was full of serious A.M. light; no sleet on the window. The ceiling throbbed a little but did not breathe. The one visitor-chair was back over by the wall. He looked down. Either the stenographer’s notebook and pen had got knocked off his bed or the dream had made up that part, too. The next bed was still empty and made up tight. It came to him all of a sudden why they called them hospital corners. But the railing Joelle van D. had folded down to sit on the bunk in the fucking Erdedy kid’s sweats was still folded down, and the other railing was still up. So there was some like evidence of the one part, that she’d been really there, showing him the pictures. Gately brought his skinned hand gingerly back inside the railing and felt to make sure there really was a big invasive tube going into his mouth, and there was. He could roll his eyes way up and see his heart monitor going silently nuts. Sweat was coming off every part of him, and for the first time in the Trauma Wing he felt like he needed to take a shit, and he had no idea what arrangements there were for taking a shit but suspected they weren’t going to be appetizing at all. Second. Second. He tried to Abide. No single second was past enduring. The intercom was giving triple dings. There really were sounds of other rooms’ TPs, and of a meal cart being rolled down the hall, and the metally smell of food for the edible patients. He couldn’t see anything like a hat-shadow in the hall, but it could have been all the sunlight.

The dream’s vividness had been either fever or Disease, but either way it had fucking seriously rattled his cage. He heard the singsong voice promising about increasing discomfort. His shoulder beat like a big heart, and the pain was sickeninger than ever. No single second was past standing. Memories of good old Demerol rose up, clamoring to be Entertained. The thing in Boston AA is they try to teach you to accept occasional cravings, the sudden thoughts of the Substance; they tell you that sudden Substance-cravings will rise unbidden in a true addict’s mind like bubbles in a toddler’s bath. It’s a lifelong Disease: you can’t keep the thoughts from popping in there. The thing they try to teach you is just to Let Them Go, the thoughts. Let them come as they will, but do not Entertain them. No need to invite a Substance-thought or — memory in, offer it a tonic and your favorite chair, and chat with it about old times. The thing about Demerol wasn’t just the womb-warm buzz of a serious narcotic. It was more like the, what, the aesthetics of the buzz. Gately’d always found Demerol with a slight Talwin kicker such a smooth and orderly buzz. A somehow deliciously symmetrical buzz: the mind floats easy in the exact center of a brain that floats cushioned in a warm skull that itself sits perfectly centered on a cushion of soft air some neckless distance above the shoulders, and inside all is a somnolent hum. Chest rises and falls on its own, far away. The easy squeak of your head’s blood is like bedsprings in the friendly distance. The sun itself seems to be smiling. And when you nod off, you sleep like a man of wax, and awaken in the same last position you remember falling asleep in.

And pain of all sorts becomes a theory, a news-item in the distant colder climes way below the warm air you hum on, and what you feel is mostly gratitude at your abstract distance from anything that doesn’t sit inside concentric circles and love what’s happening.

Gately takes advantage of the fact that he’s already facing ceilingward to seriously Ask For Help with the obsession. He thinks hard about anything else at all. Heading out w/ old Gary Carty in the pre-dawn reek of low tide off Beverly to bring up lobster traps. The M.P. and the flies. His mother sleeping slack-mouthed on a chintz divan. Cleaning the very grossest corner of the Shattuck Shelter. The billow of the veiled girl’s veil. The traps’ little cages of cross-hatched bars, the lobsters’ eyes’ stalks always poking through the squares so the eyes looked out at open sea. Or the bumper stickers on the M.P.’s old Ford — SEEEEE YAAAAAAAü and DON’T TAILGATE ME OR I’LL FLICK A BOOGER ON YOUR WINDSHIELD! and MIA:  and I HAVEN’T HAD SEX IN SO LONG I FORGET WHO GETS TIED UP! The fish asking about what’s water. The sharp-nosed round-cheeked dead-eyed nurse with a weird Germanish accent that would sell Gately little sampler bottles of Sanofi-Winthrop Demerol syrup, 80 mg./bottle, vilely banana-flavored, then would lie back slack and dead-eyed while Gately X’d her, barely breathing, in an airless Ipswich apartment whose weird brown windowshades filled the place with light the color of weak tea. Named Egede or Egette, she eventually started telling Gately she couldn’t come close to coming unless he burned her with a cigarette, which marked the first time Gately seriously tried to quit smoking.