This is a novella about narcotics, substances, and their significance to and relationship with chronic pain and chronic illnesses and the people who suffer with them. There is extensive discussion of various substances. This will be the only content warning. If these topics aren’t for you right now, I have other stories on this site that may be more to your taste. Happy reading!
 

the Herbalist

By: Mary Selina

“Take me to a hospital,

I need paracetamol,

Tramadol, Ketamine,

I just need some pain relief,

Take me to a hospital,

Fill me up with Tylenol,

Tramadol, Ketamine,

I just need some pain relief!”

–Painkiller, Beach Bunny

Chapter 1: Breezeblocks

“That’s where the pain comes in,

Like a second skeleton,

Trying to fit beneath the skin

Oh, I can’t fit the feelings in…”

-Every Single Night, Fiona Apple

“You should get out of the house,” Rita’s mom says. Her voice bears the tentative strain of someone making a suggestion that has been made and refused many times. She continues, not expecting a response. “It’s a lovely day out.” Her demeanor is as bright as the streaks of golden sunlight streaming through the gauzy white curtains that adorn every window in the house. Motes of dust swirl slowly, caught in the light, as still and quiet as the rest  of the room.

“Maybe later.” Rita’s standard response comes on autopilot. They’re not really words, more like an insurance policy. A charm against  failed expectations. With an indignant wrench, her pain enters the conversation. If she closes her eyes, it will seem as though an iron hand is grasping  and twisting a heaping handful of her back and right side. Even thinking of moving tightens the grip. All she can do is wait for it to  loosen.

Pain has its own timeline. It forces you to do everything on its terms. Rita casts around for anything else to think about. Her mom has already deposited laundry. When did she leave? Looking around the childhood bedroom that has grown with her, she finds many potential distractions, but none that won’t make her feel worse. This room used to be a place of freedom and adventure when she was little, and a place to share secrets at slumber parties when she got a bit older, but now it feels like the wrapping of a mummy paralyzing her in the past and the person she hasn’t been able to be in years.

Over time, the walls of the bedroom have grown into a massive collage stretching back to Rita’s middle school interests. There is hardly a square foot of bare white wall to be seen. She’s never bothered to take anything down, merely layering overtop and filling every space she could with posters, drawings, cards She liked the art or sentiment of,  and photos of better times, featuring distant, ignorant relatives and friends she’s long since lost contact with. Not because any of them went anywhere.  Except into a fog of pain. She hasn’t spent time with any of them in years. So many gave her awkward looks at graduation a few weeks earlier. She couldn’t help but wonder how many expected her not to be there. Bitches.  She had been perfectly on track to graduate until she developed pain that made sitting through an entire school day virtually impossible.

From the trash can beside the cluttered desk overflowing with unread college brochures, to the posters of concerts that she’s been to, but not for the past 2 years, everything in her room seems to belong to the person she used to be, not the pain wracked husk she fears she’s becoming.

Patting the comforter beside her stiff torso, her hand closes around her phone, carefully lifting it in front of her face. Unlocking it with a fingerprint, she presses play on the playlist that’s still open from the night before. The  music gives her something else  to focus on, but it’s still not enough of a distraction to block the pain that feels like it’s trying to cut its way out of her, and doesn’t even have the decency to do it at the seams.

Switching to YouTube, she quickly navigates to the channel of one of her favorite content creators and finds the playlist where she and her wife have documented their journey to becoming parents. She also has chronic pain, and more than Rita, and watching her videos reignites the sputtering spark of hope deep down in her mind that things might actually get better. Or at least be better managed in the future.

Sweat breaking out all across her back, she tries to forget about the appointment she has coming up with a pain management clinic. Otherwise known as the specialty they chuck you into when they can’t figure out what’s causing your pain. How is it possible to be this impaired and still not have a name for what’s causing the issue? She wonders as her pain starts shooting down her right leg.

There was a time, about 6 months after the accident, when her pain first flared into chronic hell, when they thought the ‘diagnosis’ of SIJ dysfunction was ‘the answer’ they were looking for.  In reality, all that came from that hard to pronounce word were more ineffective treatments and some even more ineffective physical therapy. Rita is more likely to tell someone that her back is screwed up than to try to explain the fancy term for the same meaning. Like the dentist who diagnosed her with TMJ issues. All the term tells you is that the joint isn’t working properly, not why or how.

With each negative test result and failed procedure, Rita grows more and more skeptical that she’ll ever get the help she needs. None of the meds they’d put her on have done more than  take the edge off, and most have side effects that make them not worth taking.  Muscle relaxers are one exception and she grits her teeth at the wash of pain that shoots through her right side, creeping through her shoulder into her right arm as she stretches to reach the prescription bottle on her nightstand. Collapsing back into her pillows, she clutches the orange bottle in her fist triumphantly. She undoes the safety cap on the third try, swallowing one of the flat, round tablets dry. She lets out a sigh of relief minutes later when the cyclobenzaprine takes effect, opening the fist a few millimeters. It’s a little known fact that all you need to be able to remember and pronounce medication names is to be reliant on them for your comfort and or functionality.

Rita tries to relax, letting the sweet, soothing British voice of the youtuber occupy her mind. For once, she welcomes the drowsiness that usually accompanies muscle relaxers. Time passes, and she notices her legs are stiff. Moving them, she finds less pain than she’s expecting and smiles in spite of herself. Careful of her back, she gently pushes herself into a sitting position, her joints creaking but not screaming.  Looking around, she realizes she doesn’t have any plans on how to spend these unexpected spoons. She flops back on her bed, resuming the playlist from earlier. She looks toward the window, remembering the now distant conversation with her mom. What time is it? This time of year the sun won’t set until past nine so the light is no clue. She checks her phone. It’s 5:30. Mamá will be making dinner soon. Tia will be home from work by now, posted up at the kitchen table  with a glass of white wine. Rita doesn’t want to have to interact with them, but she doesn’t want to stay locked up in her room for one more minute either.  

With a resigned sigh, Rita pushes her still aching limbs into a standing position, puts on her favorite hoodie, and grabs her keys from the cluttered desk out of habit.

She walks down the hall and can almost see the shadows of herself as a child running the same path, happy and carefree, the framed photos on the walls beside her freezing the moments in her memory. Now, she has forgotten how she walked before the Accident. She’s become so accustomed to adjusting however she can to take strain off her back and right side, that she can’t stop even when it’s not necessary. With her luck, the first time she tries will be the moment that something gets reinjured.

Sure enough, the kitchen is occupied. She can hear the voices from halfway down the stairs.

“hear about Maria’s boy?” Tia’s voice drifts  through the house with the acrid smell of nail polish that makes Rita slightly sick.

“Augusto? He was such a sweet boy, that pageant he was in with Margarita? Adorable!” Mamá’s voice is a chorus of bells, clear and bright , sweeping over the brass and varnish of her sister’s.

“Well he’s not eight anymore,” Tia  holds the pause, lingering over the gossip, savoring it. “He was arrested!”

“No!”

“Yes!”

“That poor family.”

“Well every family has their black sheep, of course. But I heard he’s claiming it was the father that gave him the dope in the first place.”

“Heroin?”

“No, I heard it was reefer. Mind you, Raul was rumored to be a pretty major stoner in high school.”

“I never heard that.”

“You must not have been listening too hard. He’s denying it, of course, but when there’s so much talk, there must be something behind it.”

“Poor boy,” Mamá tsks as Rita enters the kitchen, stirring a pot on the stove in front of her. The air smells like onions and peppers and home. “I should pay Maria a visit. Make sure she’s coping. Mija! Feeling any better?” Rita shrugs, not knowing how to put it in words.

“maybe a little.”

“Nice to see you up out of bed for a change,” Tia says in a tone she probably thinks is sympathetic.

“Adonde vas?” Mama asks “Dinner will be ready in about half an hour.”

“I’ll be back,” Rita promises. “I just need some air. Thought I’d go for a walk.” She eyes the cane next to the back door, but decides she doesn’t want the interrogation using it is sure to come with.

“You have your phone?”

“Yes, Mamá,”  

Stepping out the kitchen door that has always been used more than the front door, Rita pauses on the small stoop, letting out a sigh at the sight of her boring back yard. Holding the wobbly, splintery railing, Rita walks down the concrete steps, limbs heavy, ignoring the corresponding twinges in her hip and flank. Dry brown grass crunches beneath her feet as she passes under the small patch of shade from the apple tree Mamá planted the year she was born.

Walking aimlessly down too familiar  streets, music carrying her from one street to another, Rita finds herself walking in the direction of the river. In the summer, when the days are hot and the evenings are full of mosquitoes, the river often feels like it has the only truly fresh air in the small College city of Lewiston Idaho. Rita had gone swimming there with friends once. When she was young and carefree. She hasn’t been swimming in years.

There’s a new sign up near the highway. It shows a young man from behind in a clean white space.  He reaches towards a door in the shape of a marijuana leaf  with a red Bic lighter for a handle. Just behind the door is a chaotic mess of used needles, filthy pipes, baggies, and other drug paraphernalia. In the shadowy spaces between the objects, bulging eyes and scarred, distended veins stand out in sharp relief. The single line of text below the image reads: “Don’t open the gateway.” Shaking her head and feeling uncomfortable for reasons she can’t or won’t parse out, Rita turns into a small park with dry fields and squeaky but reliable play structures. Sighing again, she takes a seat on one of the swings, wondering morosely what her younger self would say if she could see her now.

With  a sigh, she gazes out across the snake river, a few loose strands of hair blowing limply against her forehead and getting stuck on her glasses. It’s hard to believe that a person can follow this river all the way to the Pacific Ocean if they are determined enough. If they have the right kind of boat, and if they’re able to pass the innumerable lochs and dams lining both the snake river and the Columbia beyond it, and if they’re okay going against the current half the way. But technically it is possible. Rita wonders who the last person was to make it all the way from Lewiston to Portland and beyond, but doesn’t care enough to look it up.

As a new song starts to play, Rita closes her eyes, swaying gently on the swing and trying to lose herself in the music.

She may contain

The urge to run away

But hold her down

With soggy clothes and breezeblocks…

What are breezeblocks? She wonders. She has heard this song dozens of times, never knowing what the title means. She pulls out her phone and searches for the definition. She learns that breezeblocks are an architectural feature, often made of stone or concrete with small holes built into them, often in an artistic designs.

Rita closes her eyes and, as the dreamy music plays, she imagines she is trapped in a cell made of the thick concrete structures. Too small for her to stand with no way to escape and only small holes to let in light and air from the world outside. Is it a gift or a curse, these small glimpses of normalcy? Would solid stone be kinder?  Is it better not to know what you’re missing out on?

When the next song plays, Rita is back in the park, on the playground. She sighs and, with a grimace, gets up to leave. Scuffing the dusty pavement with sneakers stained the same color, Rita freezes momentarily when she spots someone she knows. The two of them were in the same high school class, but Rita has barely ever spoken to her. Pulling her hoodie further forward, she turns her face away and hurries around the corner, breathing a sigh of relief when she’s out of the former classmate’s eyeline.

The smell of Mama’s cooking drifts out on a summer breeze, drawing Rita back to the house, getting hungrier with every step.

“How was your walk?” Rita shrugs at mama’s question.

“It was okay, I guess,” she says, hiding a wince as she eases herself into one of the hard, uncomfortable chairs that have always been around the kitchen table.  “Dinner smells delicious, gracias, Mamá.”

“De nada, mi amor,She smiles warmly as she serves Rita and Tia.

“I had hope Cameron would join us, but we’d better eat while it’s hot. I’ll make him a plate for later.” No doubt Rita’s older brother is out with one of his innumerable friends. Each one is more irritating than the last, but still Rita can’t help but be jealous of him. She starts in on her food, a half frown creasing the space between her eyebrows.

“So, have you given any thought to what you might want to… do this summer?” Mamá asks. Rita’s frown becomes a full-on scowl. I would, she thinks, if every plan I had for my future hadn’t been stripped away one by one by this broken fucking body.

“Not really,” she responds quietly.

“Well, I was talking to a friend the other day. You remember Angela, right honey?”

“Sure I do,” Rita lies.

“Well, she was asking about you and just happened to mention that she’s looking for someone to help her in the shop part -time.” Rita’s face is unreadable, but inside her emotions are storming. She feels the beginning of a migraine brewing in the back of her head.

“Uh-huh.”

“And we thought you’d be perfect for it,” Mamá says, and the expression on her face is so sincere and full of hope that Rita can’t bring herself to disappoint her. Again.

“That tiny hole in the wall near the orchards?” Tia puts in, granting Rita a precious few seconds.

“That’s the one.”

“Isn’t the old lady who runs it a Santera?”

“Maybe, but that doesn’t make her a bad person.”

“Just a witch.”

“So what do you think?” Mama asks, ignoring Tia. “ It’s just part time.” Rita shifts stiffly in her chair, feeling like  she’s just been jumbotron-proposed to. What do I think? She asks herself. Too many things to sort out in the next few seconds. They’re waiting for my answer. I’m so tired…

“I’ll try it,” Rita says at last, her voice barely a whisper, a trickle of sweat running down the sore side of her neck.

“Wonderful! She said you can start on Monday, and I can drop you off on my way to the hospital.” Mamá wrings her hands, eyes darting excitedly around a mental calendar only she can see as Tia coughs something into her wine that sounds suspiciously like ‘About time’.

“Great.” Rita finishes her dinner, sets her dishes in the sink, and drags her aching limbs back upstairs to rest up for her new job in a couple days, and process the events of the past few hours.

Flopping down heavily on her bed fully clothed, she lays still, feeling like a dead battery shoved to the back of a junk drawer with keys to nothing and old rubber bands, drained of everything. She shifts one hand a few inches enough to press play on the playlist still queued up on her phone. The soft, dreamy music is a siren song to the sweet relief of sleep. Her eyes flutter shut, sinking into the pile of pillows on the bed and, briefly, feeling completely  relaxed in a warm cocoon of exhaustion.

Halfway through the third song, a sharp ache shoots through her hip and low back, causing a spasm in her right leg and tensing every other muscle in her torso. I miss the days when I could just fall down and sleep, she thinks. Her tired mind quickly fills with every task she needs to do before she can sleep. Change or at least strip her clothes, take meds for the migraine she can feel building, plug in her phone, get her pillows arranged properly, but also turn on the window fan so she won’t wake up completely drenched in sweat. But all of those things require moving, which no part of Rita is in the mood to do. I’m too tired to go to bed, she thinks for the hundredth time.

The one time she told a friend that, she insisted it was contradictory and derailed the conversation to the point that Rita never brought it up, or  anything like it to her again.  She manages to muster the energy to reach her right hand behind her and pull the pillow poking her back so it’s flat across the back of her waist.

Rita used to enjoy getting tired. She can still remember the days when sleepiness felt like the natural conclusion to a full day’s effort. Like a gentle wave waiting to carry her to sweet dreams. Now she’s tired all the time. She cannot remember the last time she woke up feeling energized. When you’re constantly fatigued, you don’t have the luxury to wait for a moment of energy. You either do the things you need to do in spite of the fatigue, or they don’t get done. And Rita has plenty of experience waking up with the consequences of the  second option, and she doesn’t want to tomorrow, but she’s so tired, and sleep is so tempting.

If you don’t get up now, you’re going to wake up in all the pain, An annoying voice in Rita’s head reminds her. You’ll spend all day in bed, at least,. And what if it’s like that time in sophomore year? You’ll fail your new job before it even starts. A flash of memory starts Rita awake from dosing. The smell of rubbing alcohol, the sound of voices she doesn’t recognize, the way it felt to retreat inside herself, the sight of her body flailing as it’s held down, and someone who won’t stop screaming. She feels a chill and realizes she’s holding stock still. Shaking her head as if the memories will fall out of her ears, Rita shoves to her feet, swaying unsteadily like someone who’s drunk.  On autopilot, Rita makes her way out of her room and into the bathroom next to it.  She goes through the motions, concentrating on the music and willing the  intricate blue and white pattern of the tiles in front of her to overwrite the images that feel burned into her brain.

Back in her room, she just manages to switch the fan on before she collapses back on the bed, this time with her back to the headboard. It’s another 20 minutes before she has the energy to move her pillows to where they need to her to keep her spine stable while she sleeps, but by the time she has the one between her knees, the other between her arms, and the contoured one under her head, her brain has decided it’s not sleepy anymore. She’s still tired. Dead tired. But her brain won’t shut off. Sighing, she pulls up the YouTube playlist she was watching earlier and resumes it.

Sometime around midnight, Rita hears Cameron come home. She feels jealous of everything her older brother does; staying out late having fun with his friends, having friends, still having the energy after  to run up the stairs two at a time, the under 10 minutes it takes him to shower, the sheer number of things he never has to worry about. Rita will feel guilty, eventually, for her resentment, but in this moment she’s too tired to feel any of it,  more like an observer of her own broken body than a controller of it.

Eventually, finally, Rita feels the heavy fog of sleep start to engulf her. Closing her eyes, she silently hopes that she’ll get through at least part of a full night’s sleep before pain inevitably wakes her.

Chapter 2: Angela’s herbs and Remedies

“Black cats hiding in the hedges,

Superstitious

I was first To galvanize the magic,

Dipped my eyes In the glitter of a curse

There you were, In a world of enchantment,

Unimagined…”

-Zella Day, Only a Dream

Sitting in the passenger seat of her mother’s car, Rita pulls at her seatbelt. It’s in its usual position, but somehow this morning it feels like it’s trying to slowly strangle her. She rubs at her temple, willing away the migraine she spent the entire previous day dealing with. She’d forgotten to take her sumatriptan the night before and it’s less and less effective the farther from the onset it’s taken. And, of course, the July sun only makes things worse, even through sunglasses. It’s hot, too. Rita’s shirt is already sticking to her sides. It’s a light blue blouse that buttons down the front with a short collar and small cutouts on top of the shoulders. Despite the lightweight fabric, Rita can feel her temperature rising.

“Are you excited?” Mamá asks, flashing a bright, hopeful smile over at her daughter. Excited isn’t the word, Rita thinks. Nervous, anxious, pessimistic, and nihilistic are all closer to the mark.

“Uh, pretty excited, I guess.”

“I really think this is gonna be great for you, Mija.” She turns briefly to scan Rita’s face before looking back at the road.

“There’s a stop sign,” Rita blurts involuntarily.

“I see it,” Mamá reassures. “Angela’s different. I really think you’ll get along.”

“What’s she like??”

“The herbalist is… very wise. And much more compassionate than some.” Rita nods, sinking into her thoughts for the rest of the drive. It only takes about 15 minutes. “You ready?” Not at all.

“As ready as I’ll ever be.” At least that part’s true.

“You want me to walk you in?”

“Mamá, I’m an adult. I don’t need you to walk me in.”

“Lo siento,” She responds, her hands placating. “I’ll pick you up when I get off.”

“Text me when you’re on your way.”

“Of course. Good luck, Mijja.”

Taking a deep breath, Rita watches her mom’s Subaru round the corner, smoothing down her shirt. She’s taken every med she has that helps at all, but she can still feel the pain, lingering under the surface, waiting to rear its ugly head. Taking one last steadying breath, Rita pushes open the glass door, bells tinkling as she enters the small shop.

It’s smaller than Rita remembers from when she was a kid, but brightly lit by the sun coming through the front windows, and seems clean. The smell is immediate and unidentifiable. A complex, almost overwhelming blend of dozens, if not hundreds of herbs and tinctures. It’s the kind of place you can scan in 30 seconds, or spend an entire week examining in detail. Every wall is covered in small parcels and bottles, most of the labels printed in dark green ink on brown paper.  

Walking up to the counter across from the door, Rita smooths down her shirt one more time, trying to hold it shut where it gaps across her chest. She undoes the bottom button, leaving it untucked to hide her muffin top. Already the nice, non-stretchy pants she never wears feel like they’re trying to cut her in half. The probably IBS cramps are already starting, high up, almost under the ribs. How many pounds has she gained at this point since her pain flared? She stopped weighing herself months ago because it always makes her feel like shit. Even more than usual.

“Margarita!” Angela the Herbalist appears through the doorway behind the counter, hobbling with a carved wooden cane, a bright smile set into deep wrinkles under snow white hair. “So nice to see you again! You’ve gotten so tall!” At nearly 5’4” Rita doesn’t hear that often, but she’s easily a head taller than the old woman, who is certainly under 5 feet.

“Thank you for hiring me,” Rita responds, hands clutched in front of her for want of something else to do.

“Please, I’m just glad it worked out,” The old woman says, reaching across the counter to take Rita’s hand in both of hers. Her skin is soft and brown as old, worn leather, and her knuckles are stiff with arthritis, but her grip is strong.  “Come, come, I’ll show you around.” Beckoning with one hand, she uses the cane in the other to raise the flapped section of the counter to Rita’s right. “You look lovely dear, but please don’t feel the need to stand on ceremony here. We like to keep it casual.” That’s a relief, Rita thinks. The Herbalist herself is wearing a red-brown smock dress with a blue knitted shawl draped over her shoulders.

“We?” She asks, coming around the counter and peering tentatively towards the doorway behind it. It doesn’t seem like a single back room. More likely there’s an apartment connected to the shop.

“Myself and my nephew, Paolo. He’s doing a few chores around the house, I’m sure he’s around here somewhere.”  Rita vaguely remembers someone tall but not in any detail. “Do you still get the bronchitis, dear?” Rita hasn’t really thought about it in years. When she was a kid she’d come down with a horrible cough for 2 weeks every January that made her miss school, but through high school it’s been not much more than a slight tickle in her throat.

“Not really, I think I grew out of it.” If only I could grow out of everything else.

“That’s good, dear. If it ever comes back, I still stock the tea I used to sell your mother. The teas are all over there, next to the cold and flu remedies.” She gestures at the wall to the right.

“Teas over there, got it.” She proceeds to show Rita where each section is and how to operate the card reader and cash register. Unlike every other cashier job Rita’s applied to, this one actually has a chair behind the counter. It looks a little like the high chair Rita had used as a toddler at the kitchen table. Or maybe it was closer to the bar style stools the bougie coffee shops put along their front walls so their patrons can people-watch. Presumably it has to be tall to provide the diminutive proprietor a good view of her wares, but either way Rita is grateful for it.

“I can move it if you prefer to stand.” The herbalist offers.

“No, no this is perfectly fine,” Rita says quickly, trying not to let the true extent of her relief show on her face. Trying to be professional. Maybe I’ll be able to do this after all, she thinks for the first time.

Rita’s first 4 hour shift passes smoothly, though by the time she relaxes into a bit of a groove, her flank pain is flaring, making it  hard to  concentrate. About a dozen customers come in, mostly students from the college who are looking for summer cold remedies. There must be something going around on campus. Thankfully Rita doesn’t know any of them, but they still make her feel self-conscious. Despite the pain in her head and sides, Rita  is absurdly proud when she looks up to see it’s half an hour to the end of her shift, and she hasn’t cried, or fallen, or called her brother to pick her up early.

A customer walks in, dressed in a suit jacket and sweater vest and polishing wire-rimmed glasses on the hem of the shirt underneath, Rita quickly guesses he’s a professor from the college and points him to the display to her right she’s been pointing at all afternoon.

“Actually, I’m here for, you know, something else.”

“What are you looking for?” Rita says in a voice she hopes sounds chipper. “I’ll try to help you find anything you need.”

“I just need, you know, the stuff you keep in the back.” Rita looks around behind the counter, trying to understand what the professor is hinting at, but the only things Angela keeps behind the counter are the large jars of herbs she sells in bulk on request. “If you want something specific, just let me know what and I’ll try to find it.” . Just then Paolo appears in the doorway behind her.

“Prof!” he says, confirming Rita’s assumption. “I’ve got your herb, I’ll be right back. Not for the first time, Rita wonders what they do ‘in the back’ when they disappear. Angela’s been working on something back there since she handed off the counter earlier in the afternoon. The Professor clears his throat, polishing his glasses again in what must be a nervous habit, and avoiding eye contact. “Here we are,” the Herbalist’s massive nephew carefully holds out a small, unmarked parcel about the size of a packet of tea, and the Professor takes it gratefully, handing over several larger bills. If it is tea, it must be made with edible gold leaf to cost that much.     

As the door swings shut, bells tinkling, the shift in air pressure sends the smell clinging to Paolo right to Rita’s nose. It takes a second, but eventually she places it. It’s the smell of the wooded area in the park, the dirt patch under the bleachers where the burnouts go to smoke. It’s the smell of her brother’s friends that wafts out from under his door when they’re hanging out in his room. Rita rears back as Angela shuffles out from the doorway, rubbing her hands on an apron around her waist and reeking the same as her nephew. What the hell has Rita gotten herself into?

Chapter 3: The Herb

“I wait, not sure what for,

The worst or something else,

My aches, all of my pain,

I worry all about myself,

I’ve never been that good at saying when I’m lonely,

But I’m lonely now,

I’ve never been that good at saying when I’m needy, ,

but I’m needy now,…”

-Tegan and Sara, Pretty Shitty Time

“But isn’t that illegal?” The words sound lame and wrong as they leave Rita’s mouth but they feel like they’ll choke her if they’re not released.

“Technically, sure, but there’s always going to be someone doing what we do. Better us than sketchy assholes who sell shit cut with who knows what.” Angela puts a hand on Paolo’s shoulder, silencing his stream of words.

“Yes. It is illegal.” There’s no apology in her expression, just a world of experience  that seems   incomprehensibly deep and dense to Rita. “Come, We’ll show you,” Angela says, turning back into the doorway to the back and gesturing softly to Rita to follow.

“Are you sure, Abuela?” Paolo asks. Angela’s deep brown eyes contain an incomprehensible array of emotions and sentiments as they hold Rita’s. She feels in this moment as though the herbalist looks straight through her eyes and into her soul. To the very core of her being. Rita wonders, bizarrely,  what that looks like.

“I’m sure.” Ther’s no uncertainty in her voice or face as she turns and leads the way into the back of the shop. Rita’s curiosity wins out over her pain, and she stands and follows her new employer.

They keep it in the basement. Rita’s initial assumption is proven correct as they pass through a small, cozy kitchen to reach a narrow flight of stairs going up and down. Thankfully there’s a railing, and Rita manages to avoid losing her balance as she follows Angela the Herbalist down into the dark.

Rita smells the plants before she sees them. Paolo, descending behind her, flicks on purplish overhead lights, revealing about a dozen rows of bushy Marijuana plants in various stages of growth.

“They just started their blackout phase, so a few more minutes of light won’t hurt.” The Herbalist gestures again over her shoulder, taking slow, careful steps with her cane towards one of the far rows. Rita follows,, feeling like Alice in wonderland if she was on Vice. “These are the indicas,” Angela gestures with one gnarled hand  at a series of plants that looked indistinguishable to Rita  “Sativas here, and these are the hybrids. Don’t worry about remembering for now. And this plant,” she gestures to a smaller shrub to her left. “-is the one CBD plant I keep on hand for Sarah’s boy. You’ll meet them all, eventually.”

“Your… customers?”

“Yes, the regulars, at least.”

“Why don’t they just go to one of the dispensaries in Washington?” it isn’t more than about a half hour’s drive across the state line where Recreational weed has been legal for years.

“Apart from crossing back into Idaho with herb also being illegal?”

“Uh, I guess, yeah.”

“There are many reasons. Most of my customers don’t have the time or money to take that route. Substances being legalized doesn’t mean patients’ insurance will cover the cost, especially if they’re having to get it in a different state. Medical users need more and have different priorities in terms of effect than recreational users, and most Washington dispensaries only give a 10 % discount to medical users, if they have  one at all.” Rita nods uncertainly, trying to process the flood of information,.

“Others are more concerned with their reputations,” Paolo adds. “I deal more with them.”

“With who?”

“The recreational users who, for whatever reason, choose not to cross the state line to get their  product.”

“You know I hate that word,” Angela puts in.

“Sorry, Abuela. Anyways, they’re how we can afford to cut prices for the medical users.”

“But isn’t that unfair, charging some people more for the same thing?”

“Think about it this way,” the Herbalist starts. “For the people who rely on a substance, it’s medicine, and no one should have to go broke paying for medicine. For recreational users, substances are a choice, a garnish, something they don’t need, but do enjoy. Nothing harmful will happen if they don’t get the substance. The same is not true for medical users. I’ve watched friends waste away to nothing, crippled by nausea that doesn’t respond to the basic meds. Selling smaller amounts for recreational use allows us to provide affordable rates to our medical clients. And we’re still charging less than most dispensaries.”

“I guess that makes sense,”

“Don’t worry,” Paolo adds. “We handle all the back room business. We really did just hire you to be a cashier.” Rita can’t hold in a small sigh of relief.  “Though, of course, we still appreciate your discretion when discussing your job with anyone else.”  Like I have anyone to tell, Rita thinks.

“Of course,” she says. All three start at a sudden chime from Rita’s pocket. Her brother is here to pick her up. Making her excuses and promising to be back tomorrow for her second shift, Rita pulls herself up the narrow staircase, pain howling, and makes her way back through the kitchen to the shop and out the front door, bells ringing her sendoff.

Cameron’s car immediately catches the eye. With its peeling pain and patches of rust, it’s definitely the jankiest car on the street. Seeing her approach, he leans across the console of the aging Camry and opens the passenger door for her.

“How was it?” Rita doesn’t know how to answer.

“It was… interesting.”

“I’ll bet,” Cameron flashes a smirk from the driver’s seat. “Does she pay you in cash?”

“Um.. I don’t know.” Rita tries to focus on her brother’s words, but her own seem to be lodged in her throat. It feels like her body has been saving up its symptoms all Day until it knows she’s on her way home, then hitting her with all of them at once. “I haven’t been paid yet.”

“For sure, for sure. Do they tip you in joints? ’cuz if so, I might be coming after your job, little sister.” Like any job would hire me over him. Her brother’s words have the cadence of a joke, but Rita’s in no mood to laugh. The sentences sink slowly into the lukewarm soup that is Rita’s mind in this moment.

“Uh, no. Wait, you  know?”

“Yeah of course I do, I have like 3 friends who get their flower there.” Rita can imagine.

“Do you think mom knows?”

“Definitely,”

“Really?”

“I’d bet you 20 bucks.”

“Okay then.”

“You okay?”

“Mmhm.” Rita thinks the words but somehow they don’t make it to her mouth.”

“Is it your side?” Amongst other things. Rita nods.

Cameron turns up the radio as Rita’s eyes fall shut, and they pass the rest of the ride without talking much, listening to his rap music. It isn’t Rita’s favorite, but trying to parse the meaning of the lyrics gives her something other than her pain to pay attention to.

The pictures on the wall watch Rita as she makes her sore way up the stairs, step by  creaking step. A collage of family memories, hung in no particular order. Rita feels detached from the girl depicted in them.  The memories attached feel like they’re from another life.

Cameron runs up the stairs ahead of her. Unlike Rita, he seems to get almost all his features from their mom. Whatever traits he’s inherited from his father, whoever he was, are nothing compared to his resemblance to Mamá.  Rita is taller, paler, thicker. More awkward. Rita fixates on a photo of her and her father when she was 7 or 8. His hand rests on her shoulder as she grins ear to ear. She used to visit him every summer. She can’t remember the last time she smiled like that. Mamá keeps the photo up because she says it’s one of her favorites of Rita. It used to be one of Rita’s favorites, too. Now the eyes follow her slow ascent, mocking.

Later that night, Rita lays awake in bed, teeth gritted in pain, paralyzed by indecision. She watches the hours slip away, each one marking one less hour of sleep she might get before waking up to go to work tomorrow. She thinks about the not one, but two times she was unenrolled from high school due to nonattendance. Her mother called every morning and brought doctor’s notes, but it didn’t make a difference.  She cringes, remembering the walk of shame to the registrar’s office both times, her back seizing with a sharp, bone-deep ache. She can’t miss her second day of work. But her pain has other plans.

She rubs at the perpetual knot in the side of her neck, not hearing a word of the YouTube video playing on the phone propped up on a pillow beside her. Rita grabs her phone, tired of prolonging the inevitable. She types Angela’s Herbs and Remedies into a search engine and finds the business’s phone number annoyingly quickly. Taking a deep breath, she taps on the number and hits the call button. She gets the voicemail, the message recorded in English and Spanish. Of course, they won’t be open for a few hours yet. The words don’t come easily, but they sound like they do.

“Hi, Ms.Perez, hits Rita. I don’t think I’ll be able to come into work today. My pain is flaring really badly and I think I just need to stay here and rest. But I’ll definitely try to be there on Wednesday. Thanks for understanding, I’ll see you then.” The words are gone the second they leave her lips. No way to take them back.

Rita flops back on the pillows, the phone in her hand thumping on the mattress beside her. Sighing, she restarts the video and adjusts her system of pillows. She wants nothing more than to sleep, but every time she feels she’s getting close to it, either her pain or thoughts flareup, pulling her roughly back to consciousness. She tosses and turns, but no position feels comfortable for more than about 15 minutes.

It’s 9:05 when the call comes in. Even though she’s been expecting it, the sudden sound of her ringtone makes her jump. She scrambles to get her phone untangled from the blanket, hurriedly pressing the answer button, heart racing, eyes wide.

“Rita? It’s Angela. I got your message…” Here it comes, Rita thinks, bracing for the worst. “Of course it’s alright that you miss work today.” Rita holds her breath. “It’s a part time position anyways, you just take care of yourself and we’ll see you when you’re feeling better.”

“I will, thank you so much.”

“Of course, take care dear.”

“You, too.” Rita hangs up, letting out a deep sigh of relief. Relaxing back, she lets it sink in. She now has the whole day to rest. Somehow that knowledge finally allows her to relax enough that she feels  herself drifting off. Maybe this will work out after all, she thinks, dozing.

Chapter 4: Pain Management

“I go to the doctor  to get dismissed,

‘Try losing weight, you’re just anxious’,

That’s fine, that’s cool, I’m not pissed,

Just wait ten years for a diagnosis.

‘Psychosomatic, you’re so dramatic,

Hysterical, emotional, hormonal, erratic,’

Heart disease, chronic fatigue, depression and anxiety,

‘Do you have pain? No you don’t.’

‘Cause we never really studied the female body.”

-Farideh, Female Body

Over the next couple weeks, Rita grows accustomed to the way the shop functions, including the ‘back room’. Those customers are easy to distinguish from the others. they walk straight up to the counter without looking around, and they’re slightly more taken aback by Rita’s presence, especially when she’s seemingly alone. She quickly masters the certain smile that somehow says ‘I know why you’re here and I’m cool with it.’ Usually there’s already a parcel in the small bin under the counter with the person’s first name marked on the small chalk label on the front of what Rita thinks of as the outbox.

The backroom customers always pay in cash that gets tucked away in its own slot in the cash register. They’re different than Rita expected, coming from every walk of life. They’re so… normal. Just people, like any others. People who just happen to have chronic conditions that respond well to marijuana.

The recreational customers are more what she’s expecting. Most are under 35 and give stereotypical burnout vibes, but not in a chill way. Rita is glad that Paolo deals with them. She would have a hard time maintain aa pleasant retail attitude if she had to talk to them one on one for more than five minutes. They make her feel uncomfortable for reasons she can’t quite put names to.  The herbalist and her nephew are the opposite. Her first week, Angela makes a point of telling her that she can try some herb whenever she wants, but there’s no pressure either way.

They’re so much more neutral about the drug than most of the opinions she’s experienced. She’s heard so many things, both positive and negative about marijuana. The positives usually sound unbelievable, and the negatives have so much misinformation running through them that it’s hard to know what to believe.

It isn’t the first time Rita has been offered marijuana, but it is the first time she considers accepting. In the past, anyone who was for it usually made her feel guilty for not trying it sooner, given her chronic pain. It always makes her uncomfortable and, while not the only reason, is a large part of  why she hasn’t tried it yet.

This particular Thursday morning, Rita sweeps a little too fast, her nerves not allowing her to sit still. She has her first pain management appointment today, and she somehow simultaneously has no idea what to expect,  and can’t stop thinking of worst case scenarios. What if they drop her as a patient? What if they don’t believe her and she gets permanently red-flagged as hysterical in her medical records? What if they say there’s nothing they can do?

Rita’s anxiety thoughts are not helped by the conversation between the herbalist and a close friend of hers who comes in all the time. Not for the stuff behind the counter, just to talk to her friend. The woman is younger than Angela, Middle aged, probably. A heavyset white woman with long greying brown hair twisted into a knot,  she uses a cobalt blue mobility scooter thanks to crippling joint pain. She’s usually dressed neatly in office wear, always seeming to have come from work. Rita mentally dubs her ‘The Engineer’ when she first meets her, after the job she talks a lot about. She has heard the woman’s real name but never remembers it.

“I tell them my pain has increased and they halve my prescription!” The Engineer rants.  “What kind of pain management is that?”

“The same kind given by those who see criminals before patients and treat with suspicion before compassion,” the Herbalist responds.  “Opioid overdoses must be up again.”

“Exactly! Every time this happens it’s some war on drugs bullshit. As if criminalizing  chronic pain patients and our doctors is helping anyone. It’s bullshit, is what it is. Bat rastards.”

“Not all of them.”

“But enough,” the Engineer finishes Angela’s thought.

“You’re always welcome to try what I’ve got to offer.”

“Nah, you know how I feel about it. Can’t afford to lose any of those little grey cells.”

“And yet, you drink alcohol. Which actually kills nerve cells.”

“I know, I know.” The Engineer waves a hand.

“Suit yourself.” Rita gets the sense that this is a well-worn argument. The herbalist turns her lined brown face towards Rita, wise dark eyes fixing on her face. “Rita has her first pain management appointment today, isn’t that right, dear?”  Rita nods jerkily, putting a hand on her aching back.

“My mom will be here in a few minutes to pick me up.”

“Not at cascade, hopefully,” the Engineer says.

“I think it’s called ortho-something,” Rita can’t remember the full name of the clinic.

“That’s good. I’ll have to come back next week and hear how it goes. I might want to get a referral there. Don’t give them any reason to think you might be drug-seeking.  Or that you don’t take drugs seriously.”

“Well, I do take drugs seriously,” Rita says truthfully. “So that should be easy.”

“You would think so,” the Engineer says.

“You would think so,” The herbalist echoes, shaking her head.

“Good luck, kid.”

Feeling not at all comforted about her impending appointment, Rita’s stomach sinks as her mom’s car pulls up in front of the shop. Opening the front door, Rita sweeps the small pile of dust she’s collected out onto the sidewalk, then crosses to the cabinet behind the counter where she returns her broom and apron to their proper places. She stops short on the way out at the sight of Mamá and Angela standing it the doorway, chatting as the bells tinkle above their heads.

“Angela was just telling me how great you’re doing,” she says as Rita approaches stiffly, worlds colliding.

“It’s  truly a blessing to have her here.” The herbalist smiles warmly up at her. Rita blushes, glancing around uneasily.

“I had a feeling she would be.” Mamá’s brown eyes sparkle as she holds the door open.

“Buena Suerte, amiga,” the Herbalist says, laying a warm, slightly tremoring hand on Rita’s forearm. Is luck more potent when it’s given in 2 languages? Rita wonders. Hopefully so.

“How are you feeling, Mija?” Rita stares out the car window, no idea how to respond.

“Alright enough, I guess,” she gives an equally vague answer.

“A little nervous?”

“Yeah,” she shrugs one shoulder.

“It’ll be fine,” Mamá reassures. But Rita, sadly, is beyond the age when she blindly believed her words. When she was small, her mother’s words  were magic. Now they’re just words.

Sitting in the waiting room of the pain management clinic, Rita’s foot taps nervously against the floor. Jostling faint tinkles from the clipboard in her lap. Her hips and back quickly yell in protest to the motion, and she makes herself stop, starting again a few moments later when her attention shifts to the forms in front of her. The waiting room is nicely appointed and the receptionist is friendly and inviting, but the questions on the forms make her suppress a shudder.

In the past 30 days, how often have you run out of your pain medication?

Seems innocent enough, but they soon escalate.

In the past 30 days, how often have you stockpiled medication?

How often have you shared your medications with others,?

How often have you taken prescription medications for pain that were not prescribed to you?

It feels like navigating a minefield, any one of which might blow up her chances at getting any help. The Herbalist’s earlier conversation with the Engineer floats back to the front of her mind as she carefully answers the form’s questions. Two  neighboring questions ask:

In the past 30 days, how often have you used alcohol to manage your pain or other symptoms?

And

How many units of alcohol do you consume per week?

Followed quickly by:

In the past 30 days, how often have you used street drugs to manage your pain?

And

Have you tried marijuana for the treatment of your pain?

Is that legal to ask in a state where it isn’t? Rita wonders.

On the back of the questionnaire , Rita has to suppress a groan at the all-toofamiliar sight of twin front and back anatomy figures with text above and below asking her to circle every region where she has pain and annotate the quality and intensity of the pain using an alphanumeric code detailed in a small key in the corner that Rita has to squint to read.  By the time she’s done, most of the figure’s body parts are circled and annotated. It takes over fifteen minutes to answer all the form’s questions, including L and I questions that don’t apply to Rita, and functionality questions that are just depressing.

After she finishes the ‘Are you a drug-seeking criminal’ and ‘tell me every single detail of your pain’ forms, she moves on to the more standard privacy policy, medical history, and insurance forms. The forms have an optional spot for a preferred name and pronouns, which Rita considers a good sign. It definitely gets old hearing medical personnel call her Margarita when no one else does apart from her mother. She’s halfway through the forms when she’s called back by the medical assistant, flustered as she tries to balance the clipboard and pen and maintain her own balance on the way. Mamá grabs her purse and makes to follow but Rita gestures to her to stay.

The medical assistant  takes her back to the room, wearing clean scrubs and a stethoscope. He introduces himself as Calvin and takes Rita’s vitals and pharmacy information. Rita is glad the scale is set to kilograms. She knows she’s gained weight in the past two years, but she’s not sure how much. In the past, weighing herself at home sent her into far too many anxiety spirals, so she gave up on it entirely. Bad enough to have to feel her stomach drop when she checks ‘yes’ to weight gain on the intake forms, she doesn’t need a number to obsess over. The medical assistant records her vitals  then leaves her alone in the exam room. He says the doctor will be in soon, which could mean 20 minutes or 2, so she rushes through the forms in case it’s the latter. Of course, because she does, it turns out to be the former, and she’s left to try to untangle the spiraling mess of her thoughts and feelings in painful silence. She tries to answer the anxiety and depression screenings as honestly as she can, though they always make her uncomfortable. She’s grateful, in that moment, that  Mamá hasn’t come back with her.

She gives up on trying to keep her leg from bouncing, biting her nails as she silently reviews everything she is and is not  supposed to say. The appointment hasn’t even properly started yet and she’s already mentally exhausted.

Eventually, there’s a knock on the door and Rita hastily straightens her shirt, sitting up straighter in a way that immediately pains her back as the door opens and the doctor enters, crossing to the computer terminal opposite the door and sitting on the rolling stool in front of it. He’s probably in his forties or fifties and looks like a dictionary example of a doctor from the 1970s or ‘80s.

“Hello. How are we doing today?” The doctor wears a white lab coat and glasses. His graying brown hair and beard are neatly trimmed and his voice is gentle and soft. Still, Rita has enough experience with the medical system by now to keep her guard up.

“Not too bad, I guess.” Rita immediately  chastises herself for reflexively minimizing her symptoms.  She’ll never get the help she needs that way. But she can’t overexaggerate either, or she might be accused of faking.

 “That’s good. So…” Rita can see the screen’s reflection in his glasses as he spends several painful minutes reading over her file and intake forms. She wonders if it’s reflected in her own glasses too, and wishes she could see well enough to read along. You never know what a provider night be writing about you in their notes until you read them after the fact. Rita has wondered before if part of the reason they use such dry, boring med speak in them is to deter patients from spending the time and energy to read them. “We’re looking at some pretty significant flank pain, looks like.” He looks at her, eyebrows raised.

“Yes,” Rita nods a little too vigorously and puts a hand to the growing knot of tension on the left side of her neck.

“And it looks like you’ve been worked up pretty thoroughly. I’m seeing a number of diagnoses in your file.”

“But none that can really explain my pain.” Rita nods again.

PCOS, Ulcerative Colitis, or something else that could cause kidney stranding, Crohn’s,  Gallstones, Endometriosis, IBS… If it can possibly cause torso pain and isn’t easy to rule out, she’s probably been diagnosed with or investigated for it at some point. But none can really account for the severity and specific presentation of her symptoms. Much as she longs for one definitive answer, it gets more and more clear that she won’t find one.

“Uh-huh. And where’s your pain at present?” Rita takes the worst kind of inventory, focusing inward on all the pain in her body, which she usually avoids at all costs.

“There’s the usual pain in my side, or flank, I guess.” Rita motions over the area as she speaks. “And then there’s  the pains in my legs and arms. And my neck hurts.”

“And on a scale from 1 to 10, how would you rate the severity of your pain right now.” It’s at least the third time she’s answered this question in the past half hour, and probably the thousandth in general. It doesn’t get much less irritating with the repetition. Alone, it hardly even gives any useful information. 10 is usually set as the worst pain the person answering has ever experienced. But that’s bound to vary wildly patient to patient. And how is one supposed to adequately scale pain when it is actively becoming the worst they’ve ever experienced?

“I would say, 8, I guess?” It comes out more as a question than an answer. “It gets worse, but it’s pretty bad right now.” Her hand comes up to rub at the knot of tension on the left side of her neck.  Thankfully, the doctor asks follow-up questions. Unfortunately, he decides to poke and prod at her side as he does.

“That 8, that’s the flank pain?” he asks as his fingers find the sorest spot.

“Uh, yeah, I think so,” Rita gasps, wincing satisfactorily as the fingers poke deeper at a spot on her back an inch over.

“And what’s the arm and leg pain at?”

“Right now?”

“Yes.”

“Uh, maybe a 6?” The doctor nods, finally letting up. Rita lets out the breath she’s been holding and tries to maintain focus through the throbbing pain in her side.

“Would you describe the pain as shooting? Stabbing? Burning?” Rita takes a shaky breath, blinking through the lights flashing in her peripheral vision.

“Stabbing? I guess?” her voice sounds short of breath and her thoughts are slow and sluggish, as if her head is full of thick mud. “But deeper. Sometimes it’s less sharp and more like a really bad, really deep ache.” She can only hope her words are sufficient to convey her pain. They don’t feel sufficient. It’s difficult with so many missing. She isn’t fluent, but she understands enough Spanish to know it’s no different in her mother’s language. She supposes it makes sense. Most people are deeply uncomfortable talking about pain. Some even seemed to  hold a superstitious fear of the subject, as if talking about it would let it come for them next. No wonder the vocabulary on the subject is stunted. “The pain in my arms is different. It moves around more. Sometimes it’s burning or searing, other times it’s like  anything touching my skin hurts. Like, small itches or, say, a tag on my clothes becomes painful pretty quickly if I don’t do anything about it.”

“What makes it worse?”

“Moving. Sleeping on it wrong, bad weather.”

“Weather?”

“It hurt worse during the winter storms. And when it was really cold in January.”

“Is that the pain in your flank? Or elsewhere?”

“Both,” Rita shrugs a hand as she answers. “It hurt worse in my flank and in my arms and legs.” The doctor nods thoughtfully as a trickle of sweat runs down Rita’s side.

“You’ve been through quite a few specialties. It says here you did get physical therapy. How did that go?” Rita chooses her words carefully.

“Okay, at first, but after a few weeks it started to actively make my pain worse, so my PT said I should stop. That’s around when I got the injections.”

“And the ablation. I see that here.” He turns the screen a little farther away from her.  Rita’s eyes dart nervously around the small room and she pulls her phone out of her pocket for something to look at while the doctor reads. She  scrolls through the 3 notifications in the dropdown menu, then quickly shuts it off again and returns it to her pocket as the doctor clears  his throat. “What were the results of the ablation?”

“It worked on a small section of my back, about 2 inches square, but did nothing for the surrounding pain.  And the nerve pain when it came back was awful.”

“How long did the relief last?”

“About a month, I think.” The doctor makes a low, noncommittal noise in his throat.

“And you were on oxy for a little while?”

“Before it was chronic, yeah.”

“Tell me about that.”

“It helped a little, but only really took the edge off. My primary care doctor wasn’t comfortable prescribing it to me long-term with so little benefit.” The doctor nods again and Rita wishes she could see what he’s thinking.

“And this was how long after the accident?” Rita’s breath hitches in her throat but she forces it through enough to respond.

“About 6 months.”

“I see.” The doctor nods again. “Has anyone ever talked to you about Fibromyalgia?”

“Someone brought it up at some point, I think, but I don’t really know anything about it.”

“It used to be called Centralized Pain Syndrome, and it often develops following a trauma.”

“So it’s, a real thing, then?” Most of the references Rita’s heard to the condition are making jokes about it being fake.

“Most definitely.  I see patients with it all the time. Pain often proliferates. When one part of your nervous system is sending constant pain signals, the rest of your nerves can become primed to send their own signals at any provocation.”

“So, you’re saying it’s my fault?”

“I’m saying it’s not unexpected, given what you’ve been dealing with for the past 2 years.”

“Is there a test for it?”

“No, it’s just diagnosed based on symptoms. And you have quite a few of them.”

“I do?”

“Yes.”

“Is there a cure for it?” She holds her breath awaiting the answer. It’s as cruel as it is short, when it comes.

“No. But it is treatable.” Rita looks down at the smooth tiled floor, trying to hide the disappointment that crushes her. The doctor continues. “I think there are a few things we can do to try to get you some relief. I’m going to put you back on Gabapentin, at a higher dose than you were on before. I’ll refill the muscle relaxers you’ve been taking. Any side effects with those?” It takes several moments for Rita to respond.

“Not really, no.” The doctor nods, typing. “A little drowsiness, but it doesn’t bother me much. If anything, it helps me sleep.”

“That’s good.” The doctor nods again, then turns to face Rita, their eyes locking through their lenses. “I also have a few more types of nerve blocks you haven’t had yet that I’d like to try, if you’re amenable.” Rita doesn’t know how to answer. The doctor goes on. “We can provide IV or oral sedation, if the actual procedure itself is the concern.” Rita nods, thinking. Sedated nerve blocks definitely sound better than unsedated nerve blocks, but they still don’t sound great. One of the ones she had before backfired so badly it put her in the ER with an acute flare. Probably the worst one yet. That was probably her 10, not that anyone ever asks.   The doctor is waiting for her answer. She suppresses a shudder. She can’t afford to seem uncooperative.

“Okay,” she says reluctantly.

“I also think you may benefit from seeing our in-house pain psychologist.”

“A psychologist?”

“You show several symptoms of depression and anxiety. That stress could hypothetically be  adding to your pain level. Talking to someone might help in the long run. And a pain psychologist only treats patients with severe pain, so they understand your circumstances better than a regular therapist will.”

“I’m not sure if my insurance covers it.”

“It should, but I’ll have my practice manager make sure.”

“Okay,” she agrees, a little less reluctantly. At least this one doesn’t involve needles in her spine.

“Excellent,” the doctor finishes whatever he’s typing on the computer, logging out to the same screensaver it was showing when Rita was brought back. “I’ll want to see you back for a follow-up  in about 4 weeks. See how things are doing.” Rita nods. “You can schedule everything at the front desk on your way out. Any questions I haven’t addressed?” Rita can’t think of any in the moment, so she shakes her head, the motion catching on the knot in her neck. “Excellent. I’ll see you soon, then.” Rita nods as he sweeps out of the room, leaving her alone in the near silence.

“I have a   2:30 or a 4:45…” The receptionist pauses her typing, awaiting a response.

“2:30, I guess.” Rita thinks that the earlier appointment will give her less time to worry leading up to it.

“And for the Nerve block, I have a 2:00 next Tuesday.” That’s so soon. Rita feels like she shouldn’t be allowed to  schedule a procedure she knows so little about. She forgot to even ask the doctor what the block he wants to try is called.

“I guess that works,” she answers, head aching and back spasming.

“And we’re doing the IV sedation for that, is that right?”

“Yes, please. Definitely.”

Alright, I’ve got you all booked up. Would you like a reminder card?”

“Sure.”

“And the doctor wants you to try filling out a pain log for the next few weeks.”

“Why?”

“it can help to identify triggers.”

“Okay.” It’ll just add to the pile of things on Rita’s  desk, but maybe she’ll get some motivation to start using a calendar app again  instead of vaguely holding her upcoming appointments in her head and relying on Mamá to remind her of the exact times.

“How did it go?” Mamá wants to know as the car pulls out of the clinic parking lot. Rita suppresses a sigh. She’s so fucking tired and drained and just plain ow.

“Not too bad. He has a couple things he wants to try,” Rita says in a tired, breathless voice.

“Oh yeah?” Mamá glances sideways, smiling. “Like what?”

“Nerve blocks, gabra something.” Rita yawns and shifts in her seat, unable to really get comfortable. “A couple other things. I’ll remember later.”

“You tired?” Stating the obvious.

“I don’t remember the last time I wasn’t.” Rita yawns through the last words.

“Wait until you have kids.” Rita makes a noncommittal noise. Who knows if she’ll ever be able to have kids. Like this, probably not. And she forgot to even ask what the doc thinks is causing her pain,. They went over her various diagnoses but it feels like the conversation isn’t finished. Like she didn’t say or ask the right things. Taking a deep breath, Rita reminds herself that this won’t be her last appointment with this provider and she can make a list of questions to ask him next time.  Still, she blinks back tears at the thought that she might have failed herself.

For now, though, her day is done and she’s on her way home. In the end, as she returns from  the pain management clinic for the first time, it’s with an air of Exhausted and Extremely-cautious Non-pessimism. 

 Chapter5: Nadiya

“So take my pain and

Tell me something’s wrong, yeah,

I need to know

I need to know!

You can tell me I’m a lost cause,

I’ve had enough,

‘Cause if my body is a temple,

Why does it hurt like hell?”

–Tonight Alive, Temple

I’m so freaking tired, Rita thinks as she wipes down the counter with a damp rag. This late in July the air hangs, hot and dusty over the city everywhere but the riverbanks.  She can remember it making her tired and sluggish before she was chronically injured. Now it’s all she can do to keep her eyes open. She leans back in the high-backed office chair Paolo found to replace the unsupportive stool that  was behind the counter when she started out.  She gathers her hair into a ponytail, her side spasming painfully at the reach. She’s grateful for the mesh back, it being the only reason her shirt isn’t completely soaked in sweat.

This afternoon, Paolo is out running errands and Angela is working in the basement, so Rita mans the register.

She’s still waiting on the Nerve blocks. The gabapentin helps a bit with the fibro pain, but does little to nothing for her flank pain. And the heat is not helping   things.

The bell on the door jingles and Rita looks up, sitting up straighter to greet the customer. It turns out to be a young woman not much older than Rita, with pale brown skin, long, lanky limbs and a plain metal cane covered in anime stickers. She comes in about once a week, but Rita hasn’t had the opportunity to talk to her one-on-one until now. She struggles to remember  her name.

“Hello, how can I help you?” Rita could cut to the chase with the regular back room customers, but she doesn’t like to assume that’s the only reason they’re here. The other woman browses.

“Just looking around.” Her cane taps against the floor as she peruses the shelves full of teas and herbs. She wears a t-shirt with characters Rita’s not familiar with over comfy-looking lightweight billowy pants in shades of purple and blue tie-dye. Her chin-length dark hair is done in neat, even cornrows and her eyes are expressive, narrowing as they take in her surroundings. “What’s your name again?” Her voice is sharp and to the point.

“Rita.”

“I’m Nadiya.” She waves a hand. Her knuckles are swollen and slightly pink.

“Thanks,” Rita chuckles, waving back. “That’s the problem with not using our special customers’ names in any records. Makes it really difficult to remember them when  you’re here in person.” Nadiya laughs and approaches the counter.

“It’s nice to finally meet you properly.”

“Likewise.” Rita retrieves her brown paper-wrapped parcel from behind the counter and sets it between them.  Purple. A hybrid bred for pain relief and other things Rita can’t remember offhand. Probably the kind Rita would go for.  It’s a smaller package than a lot of the backrooms because Nadiya comes in once a week instead of once a month like most. Rita wonders why. Clearly she has some mobility issues, but Rita doesn’t want to pry or make her uncomfortable. She so rarely meets people like her who are her age, she doesn’t want to make a bad first impression.

“Do you like working for Angela?” Her shrewd dark eyes fix on Rita’s face.

“It’s pretty great,” Rita says, shrugging a hand. “I’m pretty sure I wouldn’t be able to work for anyone else. She’s super… understanding isn’t quite the word…”

“Accommodating?” Nadiya suggests.

“Yeah, I guess so.” Nadiya nods understandingly.

“That’s why I work for myself,” she explains. “It’s so hard to find bosses who understand that we sometimes need to miss work or go home early or have a chair when everyone else doesn’t.”

“Tell me about it. I  applied for a few other cashier jobs but they all require their clerks to stand. They claimed the customers prefer it.” They roll their eyes in unison, chuckling when they notice.

“How old are you?”

“Eighteen.”

“Cool, I’m twenty. Would you want to come over to my house on Friday and hang out?” Rita almost can’t believe her ears.

“I’d love to,” Rita replies hastily, inwardly cringing at how overeager she sounds.

“Cool, can I put my number in your phone? Then I can text you the address. It’s just down the street.” She gestures vaguely to her left, Rita’s right.

“yeah, definitely.” Rita hands over her phone and tries to compose herself as her potential new friend enters her contact information.

“Cool.” She hands over cash and takes her parcel off the counter. “I’ll see you Friday, then.”

“Not if I see you first,” Rita says, cringing inwardly. Why does she sometimes seem to turn into a sitcom dad when she’s nervous? It’s all she can do to stop herself from shooting finger guns at Nadiya as she exits the shop, bells jingling above her head.

Alone once more, Rita lets out the breath she hasn’t realized she’s been holding and looks around. Did that just happen? This job has lots of perks, it seems. Rita can’t wait until Friday. It seems months away, not days.

On Friday, Rita stands on the sidewalk in front of Nadiya’s house, her cane tapping nervously beside her foot. She checks the address for the tenth time.  Every house on this street looks exactly the same. All two stories painted some shade of off-white, with picket fences and neatly manicured,  green lawns.  The kind Tía calls ‘ticky tacky’.

“This place looks familiar,” Cam says from the driver’s window of his car parked at the curb behind Rita.  “Way spenser  than our neighborhood.”

“Probably built by the same developers as the block near us.”

“Maybe…” Her brother sounds unsure.  Nadiya spoke the truth. The development she lives in is just up the road from Angela’s. Still, Rita is glad she got a ride to conserve her energy.

“You can go now,” Rita says, gesturing him off.

“Not til I see you get inside safely. Mom’d kill me otherwise.” Rita grins, shrugging.

“You’re not wrong.” Taking a deep breath, Rita   teeters up the stone walkway, climbs the two steps up to the door, and knocks.  It’s all she can do to keep her cool as she waits. Nadiya is the first potential new friend Rita’s made in years. Definitely the first since the accident.

Rita’s not sure why she expected Nadiya to open the door herself, but she did, and is taken aback when an unfamiliar face greets her. A taller guy stands in the doorway, looking down at her. His dark hair is cut into a short fade and he wears a t-shirt and basketball shorts. He probably weighs twice as much as Rita, most of it muscle, and she finds herself taking an involuntary step backwards.

“What’s up?”

“I’m here to see Nadiya,” Rita squeaks out. The older guy’s face softens in recognition.

“Right… the chick from Angela’s, right? My sister mentioned you’d be coming over.” Rita nods gratefully, sighing in relief that she’s gotten the right house after all.  “Come in.” She steps into the house past Nadiya’s brother, looking around at the tidy foyer.

“Yo! Clay! How long has it been?” Rita jumps slightly at Cam’s cry, looking back over her shoulder through the open front door. Her brother turns off the engine and climbs out of his small sedan, loping up the walkway to clasp arms with Nadiya’s brother. “We were in high school together,” Cameron explains when he sees Rita’s questioning look. “How’ve you been, man?”

“Not bad, not bad,” Nadiya’s brother, Clay responds. Leaving them to catch up, Rita tentatively ventures further into the house. The floors are a glowing hardwood, the walls covered in family photos, the knickknacks on shelves dusted and neatly arranged.

“Well,  hello!” A shorter dark-skinned woman with a bright smile glides into the foyer through the far doorway, wiping her hands on the apron she wears around her waist. “You’re Nadiya’s new friend, right? We’ve been expecting you. I’m Darlene, Nadiya’s mother. It’s so nice to meet you!” Her voice is smooth and melodious. Rita inwardly sighs in relief that Nadiya lives with her parents, too.

“You, too, Rita says, flustered as the older woman folds her hand in both of hers. Her hands are soft and warm and she has the same bright, expressive brown eyes as her daughter.

“She’s upstairs, working. She said you can go right up.” Darlene gestures to the broad staircase behind her, the wood banisters glowing in the sunlight coming through the windows around the front door. There’s a thick metal track along the wall on the left hand side. Looking up, Rita notices a stair chair at the top of the stairs. She’s halfway up, cane in one hand and the railing clutched tight in the other, before it occurs to her that she could have asked to use it as well. She finishes the climb and pauses on the landing to catch her breath.

It’s obvious which door leads to Nadiya’s room, even without her voice emanating softly from behind it. The door is decorated with a large yellow ‘yield’ sign, with the words ‘To The Boss’ added beneath in silver sharpie. Rita grins as she knocks.

“Come in!” Nadiya calls through the door, finishing the sentence she’d been in the middle of as Rita walks in.

“-I’m just saying, as gamers in general, we should be trying to move away from the toxic misogyny and general bigotry of speech rampant in parts of our community.” Nadiya sits propped-up in bed, a screen in front of her, a controller in her hands, and an expensive-looking pair of over-ear headphones with a microphone that snakes down over her jaw on her head. She glances up at Rita and gestures to her to come over, quickly returning her focus to the game she is playing. “Not to say I’m against profanity. I’d go fucking crazy living in this body without the outlet of expletives, I’m just saying there’s a significant difference between swearing at the world and life in general  and calling people slurs. That being said, to answer your question, grocerygrover99, I think ‘clam slam’ is the best afab alternative to ‘t-bag’. I like the rhyme.” Rita looks around, taking in the walls covered in art and posters, the nightstands on either side of the queen bed covered in meds, wet wipes, and other chronic illness aids, and the desk in the corner where a much more impressive-looking gaming setup is arrayed. Nadiya’s room is nearly twice the size of Rita’s, yet somehow everything is much more within reach. It’s so surreal to see how set-up her house is for her disability. It gives Rita good ideas and excellent vibes. “my new friend Rita’s just arrived.” Rita jumps slightly when she hears her name. Nadiya pauses her game and covers the mic with a hand. “Are you okay being on camera a little?” She asks in a half-whisper. “It’s cool if not, I just have 45 minutes left on this stream.”

“Um,” Rita stutters. “I guess that’s fine.” She shrugs a hand, slightly flustered.

“Cool, come on over then, make yourself comfortable.” She pats the unoccupied side of the bed closer to the door. As Nadiya resumes her game and her conversation with the people in the twitch live chat, Rita sits down on the edge of the bed and repositions one of the plentiful pillows behind her back, laying her cane down carefully along the side of the bed, settling in to watch. “Thank you for the recommendation,” Nadiya says to someone in chat. “But if you want to have a say in what I play next, feel free to join my Patreon. Even the lowest tier gets to vote on my next Vod.”   She plays in silence for several seconds, then turns to Rita. “Someone in chat wants to know if your glasses are actually purple.” Nadiya glances over. “They look purple to me.”

“Yeah, they are.” Clearing her throat, Rita takes off her glasses to show the camera the purple-enameled wire frames. “And the other side is green.” She turns the frames to show Nadiya’s webcam the inside.

“Nice!  They suit your face well.”

“Thanks.”

“Chat likes them, too.”

“Thanks, Rita chuckles as she replaces her glasses and refocuses on Nadiya’s screen.

“Yes, she also uses a cane,” Nadiya says wearily, eyes darting as she reads the live chat. “Mods can we get this person kicked from chat, please?” A moment passes, and Rita squints at the screen, trying to read the comment Nadiya’s referring to but the chat’s already moved on. “Thank you very much. The stream is once again a troll-free zone.”

The game she plays is interesting, involving firing paint instead of projectiles at other players. Consequently, it’s vibrant and colorful, and visually captivating. Still, Rita finds her gaze wandering around the room more often than not. She marvels at how much Nadiya’s room says about her. She’s clearly a person with layers, hanging retro gaming posters next to an endangered species calendar, beside a picture of Nadiya, using crutches on some school trip surrounded by classmates, smiling and laughing. 45 minutes pass in no time, and Nadiya  signs off and begins stowing her equipment in a rolling cart stacked with drawers pulled up to her side of the bed.

“Sorry about that,” Nadiya says, coiling up the cord of the headphones before stowing them in a drawer. “It’s both a gift and a curse having chosen a career I can still do during a flare. On the one and, I can still work on a bad day, which is great, but it also means I don’t have an excuse not to work on bad days either.”

“You’re a streamer?”

“Mostly, yeah. I make some other shorter-form content from time to time, but mostly I’m a streamer, yeah.”

“That’s awesome.”

“Thanks.” Nadiya smiles, shrugging a hand. “It’s definitely not what I’d be doing if I was healthy, but until someone invents a cure for faulty hemoglobin, it works for me.”

“Hema-what?” Nadiya smiles wearily as she explains.

“I have sickle cell anemia. Basically I inherited faulty genes from my parents so my body produces defective hemoglobin and my red blood cells are too rigid. They collect in the blood vessels and joints and cause pain flares and tons of other potential complications. You’ve probably heard the term crisis, which refers to severe flares that usually land us in the hospital for one reason or another.”

“Damn. That sucks ass.”

“Definitely. I don’t really know anything else. I was diagnosed at 2, before I can even remember. this is the only body I get. So I work with what I have.”

“I get that.”

“What’s wrong with yours?”

“I’m not really sure?” Rita tries to explain. “I got rear-ended a couple years ago. At first the injuries seemed relatively minor, but then 6 months later it… flared up really suddenly and painfully.” Nadiya nods knowingly, listening. “No one seems quite sure what’s wrong with me now. I guess I have fibromyalgia. But, like, several other things as well, if that makes sense.”

“It definitely does. Most people think medical science is all-knowing. But people like us run into its limits all the time.” She packs the bowl of a small glass pipe as she speaks.

“That’s a really good way of putting it.”

“Thanks. I’ve had a lot of practice.  Is the pain constant?” It’s the first time anyone’s asked her that question without pity in their voice.

“It shifts around and fluctuates in intensity, but, basically, yeah. Something’s always hurting, whether it’s my flank, my limbs with the fibro, something else, or a combination of things.”

“That’s rough, buddy.”

“Is that an Avatar reference?”

“Yeah, totally! I love that series.”

“Me too!”

“Sick! If you could be any type of bender, which would you pick?” Rita considers.

“I’d probably go with air bending. With Aang’s reflexes, I might just even out to a normal level of balance.” Nadiya laughs freely and Rita joins in. “what about you?”

“Fire bender, all the way. I like their intensity.”  Nadiya lights the bowl and inhales deeply, then exhales into a small box with a mouthpiece.

“What’s that?” Rita asks as Nadiya switches on a small air purifier on her nightstand.

“It’s a smoke trap.” She explains, taking another long hit off the pipe before snuffing it and setting it back on the rolling cart. “Cuts down on the air pollution when I don’t feel up to going outside to smoke.”

“Oh, speaking of which.” Rita reaches into her pocket and pulls out the small Ziploc she almost forgot about. “Angela sent me with a gift.” She hands it over. “It’s just a couple pre-rolled joints. But she did say that this strain is supposed to be really good for joint pain.”

“Sweet,” Nadiya says, taking the bag. “Maybe we’ll smoke one later.”

“I don’t know,” Rita says, uneasy. “I’ve actually never tried it.” A trickle of sweat runs down her side as she shifts her weight uncomfortably, not meeting the other woman’s eyes.

“Oh, for real? Okay, no pressure either way.” Rita sighs in relief.

“Thanks for that.”

“Do you mind if I ask why you’ve never tried it?”

“I… don’t know, really. So many people feel like I should have already, but then the other half judge anyone who does. It’s just so… confusing.”

“I totally get that. The number of people who almost seemed to imply that my parents and or doctors were negligent for not giving me any at whatever age they decide is the right one that day. It sometimes feels like there’s one set of rules for us and another for everyone else. Like as soon as you bring chronic illness into the conversation everything instantly becomes several times more loaded.”

“Exactly!” Rita can’t describe the relief she feels at finally finding someone who understands where she’s coming from. It’s  one of the first times she actually wants to continue the conversation.

“So, you mainly use it for pain, then?”

“That, and chronic nausea.”

“Nausea?”

“You’ve heard of the munchies?” Rita nods. “To some people they may be a joke, but to me and people like me, they’re a lifesaver.” Rita looks at the thin woman next to her, with not a pound to spare, and realizes the full truth of her words.   Nadiya continues. “Most of the prescription antiemetics are only really useful if given through an IV, and none of them also stimulate my appetite the way weed does. And when you’re in as much pain as us, your stomach gets upset at the drop of a pin.”

“Tell me about it. I didn’t realize that’s why my stomach hurts when my pain flares, but now that you lay it out that way, it makes perfect sense.”

“Right? If only all providers had the patience to explain stuff like this.”

“tell me about it. Can you imagine?”

“Only in my wildest dreams.”

“Do you mind if I ask you a couple more questions about it?” Rita has never had an opportunity like this before to pick the brain of someone in so similar a situation to hers. Especially since she seems to have so much more of a grasp on the whole situation than Rita. She supposes that’s the product of Nadiya’s condition being genetic and therefore present since birth, where Rita seemed perfectly healthy for the first 15 years of her life.

“Sure, go ahead.” Nadiya takes another hit from the pipe as she listens.

“Well, they say it can cause memory loss if you start using it before age 25, right? I hear it all the time. Are you worried about that at all?”

“Those statistics are almost always misquoted  by people with the privilege of assuming they’ll live past 25. Some of us are struggling just to make it to next week. And it’s not like the legal drugs I  get prescribed have any fewer side effects. Most have many times more. If a little memory loss is the price I have to pay for significant relief during a flare and not losing 15 pounds every 6 months, then I’m happy to pay it. It’s not like I want to remember my crises anyway.”

“But aren’t you worried it’ll interact with the meds you’re prescribed?”

“Not really, seeing as all my doctors know I use medical marijuana and none of the meds they’ve prescribed have interacted with it yet.”

“Your doctors know you smoke? Aren’t you afraid they’ll turn you in? even if it was legal, you’re still underage.”

“Not really. Hippa would only allow them to share my information if I was a danger to myself or others. Me smoking weed to help with my pain and nausea isn’t hurting me or anyone else. Besides, in Washington you can buy weed under 21 if you’re a documented medical user. I’ve yet to have a doctor tell me not to use it. Including my pulmonologist.”

“Really?”

“Really. I was like, ‘yeah, I smoke, but only weed,’ and the medical assistant just nodded said ‘oh, yeah, that’s fine,’ and didn’t write anything down just checked the no smoking box.

“I would think a lung doctor would at least tell you to switch to edibles.”

“I know, right? I mean it’s not like I reach for a joint when I’m having an asthma attack, but it doesn’t seem to trigger them, either.”

“That’s so weird. I’d think any smoke would be a trigger.”

“you would think so. Who knows why it isn’t. But I’m glad of it. I take edibles sometimes, but I prefer inhalables because they’re faster-acting and easier to regulate in the amount of high you get.” Rita nods, thinking.

“That’s interesting. The customers seem to mostly agree with you. That or they’re making their own edibles with flower they buy from us.”

“Yeah, the dosing with edibles is always tricky. Three out of three times I’ve ever gotten too high it was from edibles.”

“And how long have you been… you know.”

“Smoking? Only regularly since 18, but I dabbled before that.”

“And you’ve only gotten too high 3 times?”

“yeah, I mean, It’s bound to happen to most people eventually. I took some CBD and rode it out. I guess my  system just responds well to cannabinoids” She shrugs with a grin. “One of the only things it responds well to.”

“I hear that.” They both chuckle.  “Is it true it stops you from dreaming?” her dreams are one of the only best escapes Rita still has and she doesn’t want to lose them.

“So I’ve actually researched this,” Nadiya starts. “Because I heard that too, from several different people.”

“I’ve tried, but it’s hard to find research on it in conjunction with conventional meds.”

“Tell me about it. The ability to just try substances and see what happens is a privilege of the able-bodied.”

“Hear, hear.”

“So, according to what I’ve read, THC doesn’t actually inhibit your dreams, so much as it affects your sleep cycle and memory. It makes it easier for your brain to get into and stay in the first stage of sleep, before your REM cycle starts up your dreams. That’s why many people use it to treat insomnia. That being said, it can also shorten the period of REM sleep in your sleep cycle and make it harder for you to remember dreams when you wake up. But it doesn’t actually inhibit dreams in the way most people think. I still have vivid dreams pretty much every night as long as I stick to strains that my nerves  react well to.”

“What strains don’t they like?”

“Heavy Sativas and anything with too high a THC concentration.” Rita nods, digesting.

“What happens with them?”

“Usually, I get a short, sharp anxiety flare, then a bit of a headache and some low-level paranoia.”

“So that part is true?”

“For some people, yeah. Everyone’s nervous system is unique. NO two react exactly the same to any stimulus. And there are hundreds of different weed strains; if not thousands.”

“You sound like you’ve read a lot.”

“Yeah, well, I’ve been gaslighted by nedical providers more than a couple times, so I like to arm myself with information. I do read a lot more scientific studies than most. Which isn’t to say I always understand them, but I do try.”

“I thought I was the only one.”

“Not at all! It’s super common in our community.”

“What community?” Rita blinks at the flood of information.

“People with chronic illnesses. Spoonies.”

“Ah, right, sorry.”

“No worries. The brain fog is real.”

“Definitely. Why would anyone smoke Sativas if they make you anxious and paranoid?”

“Well that’s just the reaction I have to them. Others have no issue. And more abled users often prefer the more alert Sativas because the higher energy makes them  more functional while high. Indicas can make some people too sleepy and relaxed to feel motivated to get things done.”

“Some people, but not you?”

“No. Since, for me, it’s medicinal, the relief it gives me from symptoms makes me more functional when I’m high, not less. Plus the sleepiness factor is nothing compared to chronic fatigue.”

“That makes a lot of sense.”

“And since I don’t drive or operate heavy machinery, it really isn’t much of an issue. Not compared to everything else.” Rita nods thoughtfully.  “I never really wanted to learn to drive,” Nadiya muses.  “but every now and then I get the urge. Do you drive?” Rita stiffens abruptly, eyes darting. She forces herself to breathe through the  wash of anxiety that suffuses her torso, making her heart pound erratically and her stomach drop harshly. The pain that comes a few seconds later as a result of the tension is almost enough to make her forget what they’ve been talking about. Almost, but not enough. Nadiya notices her change in behavior and her tone softens in response.

“Sorry. Sore subject?” a small choked laugh bursts from Rita’s lips.

“Literally.”

“You don’t have to talk about it if you don’t want to.”

“No, I think I do want to. It’s just hard.” Nadiya waits, listening patiently. Rita usually avoids talking about the  details of the accident, but it’s different with Nadiya. Rita’s instincts tell her she’ll understand in the way few others have. Rita takes a deep, shaking breath. “I’ve only driven a few times. It happened during my first practice drive for driver’s ed. I was stopped at a light and I got rear-ended. My foot was on the brake and the impact went up from there.” Nadiya nods sympathetically and Rita continues, encouraged. “I haven’t driven a car since. As long as someone else is in the driver’s seat I’m fine. But every time I’ve tried to get back behind the wheel I start to sweat and freeze up and basically have a full-on panic attack. I don’t know if I’ll ever be able to drive again.”

“That’s super understandable.”

“Yeah?”

“Absolutely! You went through a trauma and were permanently injured as a result. It makes total sense that you’d have a strong reaction when recreating those conditions.” Rita breathes a sight of relief that seems to fill her whole body.

“Thanks for understanding.”

“What are friends for?” Nadiya gently bumps Ria’s shoulder with her own. “We spoonies gotta stick together.”

“Yeah,” Rita smiled. “We do.”

They hear a  knock and Nadiya’s older brother pokes his head around the door. Cameron right behind him.

“It smells… familiar in here,” Cam says jokingly. Rita cringes inwardly, but Nadiya glares openly. “I know! It’s weed.”

“You’re not funny,” Nadia says, cutting off his laughter. “When you make that comment, what you’re actually saying is ‘it smells like medicine in here. Like you need medicating.’ Which is something I already dwell on enough, thank you very much.” Cam looks chagrined.

“It’s all good,” Clay consoles him. “I should have warned you my little sister has

a tongue as sharp as her bony ass elbows.” Nadia throws  a light pillow across the room at her brother but she isn’t scowling anymore.  He easily dodges, grinning.

“You should be grateful I’m the one with these bony-ass joints, or you’d be the one laid up in this bed.”

“I know, I know. Thank you again for housing the shit genes.”

“You’re so welcome.” Nadiya smiles through her own sarcasm. Rita gets the impression this is an exchange the siblings have had more than a few times before.

“We’ll be on our way then. Just wanted to say hi,” Clay says, turning to Rita. “Good to meet you… Rina?”

“Rita.” She waves a hand slightly. “Likewise.”  Cam looks like he’s about to loose another quip, but thinks better of it, waving bye to Rita on his way out of the room.

“Sorry,” Rita says when they’ve left. “he’s not usually so tactless.”

“It’s fine,” Nadiya says. “I’m used to it.”

“It must be nice having a family who’re used to you being chronically ill.”

“Yours will get there, too,” Nadiya assures. “And no one’s perfect. I’m sure if you asked clay what type of defective hemoglobin I have he’d just stare blankly or make something up.”

“There are multiple kinds?”

“quite a few, yeah. I’m type S. The type most people are somewhat familiar with. Clay and my parents are all carriers, they’ve been tested. They just don’t have enough abnormal blood cells to be symptomatic in normal conditions.”

“So you pulled the genetic short straw?”

“Basically.”

“That hella sucks.”

“It really does.”  They sit in silence for a couple minutes, just thinking.

“I kinda think I might want to try it.” Rita blurts, nervously tucking her hair behind her ears. “Smoking, I mean. With you.”

“I would be deeply honored.” Nadiya smiles and puts a hand over her heart.

“I mean, not tonight,” Rita adds hastily. “My mom’s coming to pick me up at eleven when she gets off work. But some other time, maybe?”

“Cool, let’s talk it out.” They do and Rita agrees to come over again in a week and gives Nadiya a gentle hug full of endearing winces and crackling joints.

Rita takes the chair down the stairs, holding her cane carefully between her knees so it won’t snag on anything, and thanks Darlene profusely for having her, before stepping out into the cooling night air and walking over to Mamá’s car.

“Did you have a good time, Mija?”

“ I really did. Rita gets in and buckles her seat belt before realizing that Tía’s in the back seat. It’s only then that she remembers her aunt’s weekly poker game.

“Hi, Tia, how was your game?”

“Not too bad,” she replies, smile reflected in the rear-view mirror. “I’m up sixty bucks!”

“Congrats.” NO wonder she’s in a good mood.

“So what does this new friend do?” Tia asks.

“She’s a streamer.”

“You mean she works for Netflix or something?”

“No, I mean she plays videogames on camera for people to watch.”

“Who’d want to watch that?”

“Millions of people. Have you been on YouTube in the past decade?”

“I have. I just keep my viewing to worthwhile content.” Rita knows there’s no point trying to make her aunt understand. She doesn’t need to, anyways. Rita gets it, and that’s enough. In spite of Tia’s cynical attitude, the whole ride home, Rita can’t stop smiling.

Looking for the rest of the story? More chapters will be available soon on my Patreon page.