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
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
This book is dedicated to my consultant, Social Media Maven, and best Chronic Pain Pal.
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.