The day had started out with me shitting blood. A little later, I was shivering in Doc’s passenger seat under the warm July California sun, asking Doc about the blood while we were on the way to Tustin to see this friend of his who was supposed to help us get some morphine.
Doc and I called each other friends, but we both knew without saying that we were drug buddies. That if I didn’t have the five hundred bucks in my pocket that would pry this hospice care friend of his from her ethics long enough to give us some terminal cancer patient’s painkillers, Doc would be in this car alone, or with some other human ATM. He had the connection, I had the money, and this made us, however temporarily, partners in the world.
I was worried the blood could be an ulcer, maybe something more serious. Lately, I hadn’t been able to get much more than Vicodin for my habit, and it had been corroding away at my stomach, a million tiny pickaxes mining the walls of my guts, so I figured I’d caused an ulcer, caused myself to rip and bleed and leak slowly away from the inside out. But, too, my mind slid easily to thoughts of cancer and that I could have been dying—at least dying faster or in a different way than from addiction. I’d asked my friend, Amber, and she figured it was nothing. So I asked Doc, “Is blood out of your ass always bad news?”
“It’s never good news,” he said.
“I didn’t ask if it was ever good.”
“It’s not ever good,” he said.
I took a deep breath. I had the start of what would be full-blown dopesickness in a few hours. The metallic taste at the back of my mouth, the chills. Soon, there’d be sweats. Then puke and diarrhea and my body making a tortured fist of itself. I needed exactly what we were going to get. While, of course, realizing that it was what we were going to get that caused this in the first place. Every day, the same cycle of desperate need met with desperate opposition and sickness. I couldn’t tell my todays from my tomorrows anymore than you can tell the sea from the horizon in a marine layer fog. It all just blurs together. “But is it always bad?”
“Not always,” he said. “But it’s never good, so disavow yourself of that silliness right now.”
I looked at him.
He said, “This is your ass and your blood, I’m guessing?”
Sometimes things are simple. Doc was called Doc because he used to be a doctor. Maybe he still was—I wasn’t sure, but I knew he wasn’t allowed to practice medicine anymore, at least not in California. He wrote some bad scripts, and he ended up losing his license. Or it may only have been suspended. But if anyone official was checking up on him, he wasn’t living too cleanly. He’d been able to hook me up until recently with a pretty steady flow of Vicodin, but that only kept me going and didn’t really make me high anymore. Without it, I was sick—a shivering, noxious presence to all who had the bad luck or bad sense to enter the debris field I’d made of my life. With it I could function, more or less—get to another day of clawing through the hours, wishing the next day would be better, but not seeing any reason it would be. I looked out the window at the towns under the 22 freeway. We’d left Long Beach maybe twenty minutes before, and now we were passing the suburban sprawl of northern Orange County, flashing by under an army of tall palms, blown by the offshore winds. It was a beautiful place, even from the freeway. Rooftops of homes glided under us to the right—to the left, a series of car dealerships in Garden Grove, and just east of them, out of sight from the freeway, a series of Vietnamese Pho joints and body-piercing parlors in strip malls.
I met Doc when he was still able to get OxyContin, eighty milligrams for a while and then forties. Oxy was a dream for a newly-off-the-wagon user like me—a time-released chemical equivalent of heroin, without the sloppy, desperate need to fix with needles. But, as they always do, the drugs stopped working and then, worse, Doc’s source dried up, and the mirage of beauty and ease that Oxys gave, they took away with them.
Right now, though, Doc had talked about an old friend he used to work with who could hook us up with some morphine and maybe more in Tustin and was I in? I heard morphine and said yes and committed my last five hundred bucks from a poker win a few nights before. Normally I needed a lot more info, but most of Doc’s friends, even the addicts, were very white collar. They were all liars and cheats, but generally not as dangerous as street dope fiends. Plus, we were talking about morphine. The risk–reward was too good and I jumped without a second thought, quick as a seismograph at ground zero.
Doc said, “You and Amber been, you know, doing anything?”
“From what I hear, strippers like to strap one on now and again.”
“She’s a dominatrix.”
“Oh, well,” Doc said. “I stand corrected.”
“Fuck you, dude. Lawyers use strap-ons, too.”
“Do not tell someone who has worked in the ER that ass play is limited to sex workers. Trust me. I fucking know ass play knows no boundaries.”
“Then why even ask?”
“Nevertheless, strippers—” He turned to me. “And dominatrixes have been known to strap one on every now and again.”
Amber did, in fact, like to strap one on now and again. But she hadn’t been my girlfriend in almost eight years. It had caused some blood, but only a little, and, well, a hell of a long time ago. Not for days like it had been happening. “Dude, that’s a stereotype,” I said.
“I’m your doctor.”
“You’re not my doctor.”
“Well, I’m a doctor,” he said.
“Nevertheless,” he said. “I have been an internist. I have a certain amount of experience with insertables. I’ve seen an astounding amount of things up guy’s assholes. And women’s assholes. You can tell me. Plus, I need to know the facts to know if this blood is an issue.”
“OK, fine,” I said. “Amber fucked me with a strap-on ages ago. Happy?”
“Don’t get so defensive, man. I’m your doctor.”
I let it slip that time.
Doc said, “When was the last time?”
“For the blood?”
“No,” he said, smiling. “When you let your pervert girlfriend sodomize you.”
I looked at him and he smiled and laughed. He said, “You need to lighten up.” He was driving and not looking at the road much as he hunted for his smokes in the backseat. I gripped the door handle and had visions of car wrecks and blood. Being a passenger scared the shit out of me—if I had any, I always took a few Valium before getting in any car. He said, “Everybody loves something up their ass during sex.”
“It can sure as hell seem that way when you work the ER.”
“I can’t talk to you at all, man.”
“C’mon,” he said. “I’m trying to help. Are you shitting blood? Or is there blood in your stool?”
“What’s the difference?”
“What?” I said.
“It’s an issue. What color is the blood?”
“Red,” I said. “Blood colored.”
Doc nodded. He put in a CD—Jonathan Richman & the Modern Lovers’ Rockin’ and Romance. He cracked the window and lit an American Spirit. He offered me one. Doc had quit for years and only recently started again since his divorce. I took one.
Doc said. “Red isn’t the only color blood can be. Especially on the inside.”
“So is red good?” I said.
“Nothing is good,” Doc said. “No blood in your shit, that’s good. That’s our goal. Our vision. An America with no blood in their shit. That’s the ticket I’m running on. The no-blood-in-your-ass ticket.”
“Red is less bad?” I said.
“That is true,” he said. “Red is much less bad. If the blood in your stool is a greasy-looking dark red, almost black, that is a major and immediate concern.”
He shrugged. “Probably nothing. How many Vicodin a day are you taking?”
I was, until a week before, taking about thirty—but I was stealing, when I could, from Doc’s stash, when he had a stash, so I went with a low estimate. Our supply had run out five days ago and I’d halved my intake from twenty to ten to five to only three the day before. My eyes felt like sandpaper, and the suffocating heat in my head made every pump of my heart an oil-derrick throb of pain all over my body. Like every nerve ending burned with Fourth of July sparklers. “Ten to twenty if I can. Less, lately.”
“That’s probably it right there,” he said. He ticked an ash. “How is Olivia?”
“We don’t seem to be talking,” I said. “She won’t talk until I’m back in rehab.”
“Ah,” Doc said. “True love.”
Jonathan was singing about his jeans and how they were a-fraying as I looked out the window at the blur of objects racing by.
I knew I couldn’t continue on the way I was going. My short-range plan involved the morphine and, after that, a meeting with this guy, Leroy Marcus, about some pot he wanted me to sell. The morphine was supposed to be my last for a while—the plan was to use it and slowly wean myself off, using Vicodins when I had to, to try to detox as painlessly as possible and start clean. Go back to meetings. Be humble and start over. I’d done it before. I could do it again. And, maybe, if I could ever get clean, try to make Olivia think about taking me back.
But at that point, I’d tried to quit various opiates—whether it was by myself or in rehabs—somewhere between thirty and fifty times in my life. Which meant thirty to fifty intentional detoxes. And that didn’t even count the dopesickness from simply running out. Withdrawals made you sorry for ever being born—which sometimes seemed the point of the whole thing. The self-loathing burning hot enough to make the sorrows you suffered from withdrawal seem something like justice for the liar and cheat you’d allowed yourself to become. The twisted core of wrongness at your center everywhere you went was something that made suffering seem valid and just, in some way.
“I can’t drop all five hundred on the morphine,” I said.
“You have to.”
I said, “I can’t. I need at least a couple hundred for tonight.”
Doc said, “You got a game?”
I shook my head. “You know Leroy Marcus?”
“That ’roid rage guy?”
Leroy had a justifiable reputation as a guy you didn’t want to fuck with. He’d been a boxer and had ended up recently with an ultimate fighting obsession. Leroy liked violence—seemed to like getting hurt as much as he liked hurting people, which made dealing with him an uneasy proposition at best. Someone who’s not afraid of getting hurt, someone who actually welcomes the pain and raw savagery of the fight, is not someone you want to face off with. Like my dad told me when I was a kid, you never throw a punch unless you’re willing to kill the guy—because he might be willing to kill you. Leroy probably got the same lesson somewhere along the line. But he threw punches, and I don’t.
“That’s him,” I said.
“What the fuck have you got going with that beast?” Doc said.
“A pot deal,” I said. “I need at least two hundred to sell some medical quality shit he has.”
“You smoking pot?”
I shook my head. “Pot’s dollar signs to me. I’m trying to make some money.”
“Pot’s legal now, dude.”
“Not legal,” I said.
“More or less. Any fuck off the street can get a script for it. How you going to make money?”
“Getting a couple hundred’s worth off him and selling for double to this nut in Silverlake I know. Quick cash. No risk.”
“You can’t trust Leroy. There’s plenty of risk just walking through his door.”
That was true enough. “I need money,” I said.
Doc smoked the end of his cigarette and rubbed it out on the outside of his door—the side of his car was streaked with the ends of his butts. He’d pinch out the tobacco and let the filters pile up at his feet.
“We’re scoring morphine—a real fucking drug—in Tustin,” he said.
“Are we?” I said.
I felt the sickness overcoming me. “We better be.”
“My point is,” Doc said, “we’ll get enough to make some money off that, if you want.”
I had tried over the years to make money with heroin, with Dilaudid, with OxyContin, and a variety of other opiates. All I ever did was end up doing them all, either fast or slowly. With them, I never could seem to go from intent to deal to ever actually dealing.
Doc said, “What if we spend your whole five hundred bucks on the painkillers?”
“Then I’ll do them.”
He looked hard at me.
I said, “I’ll do half of them.”
“Right,” he said. “But what if you let me tuck a couple hundred aside and deal that.”
“For both of us?”
“Of course for both of us, man,” he said. “Who you going to trust to make a buck? Me, or Leroy Marcus?”
Neither of you, I thought. Leroy’s a brutal beast of a businessman, and you’re a dope fiend. But, given the choice, I answered honestly. “I’d rather be in business with you.”
Doc merged off the 22 onto the 55 southbound, where it splits going to Riverside one way and Orange County the other. We were headed toward Tustin, just a few miles away. We seemed to have reached some tacit agreement about the extra two hundred and the profit on the deal.
“So, tell me about your connection,” I said.
“She’s a hospice worker with a terminal case.”
“She’s a diverter. She’s helping us out.”
Diverter is the medical term, and the narc term, for a medical professional who diverts pain meds from the people who need them. The language of distance and euphemism. They’re thieves, and people like me and Doc pay them to steal from people in pain. I tried not to have any more illusions about what I did. I used to be able to lie about it—to others, to myself. But after years of clean time, it was hard to see yourself as anything but a hideous failure. My next drug possession case would put me at what’s known as the SAP pits, SAP being short for Substance Abuse Program.
“How terminal?” I asked him.
“How terminal a case?”
“There aren’t degrees of terminal,” Doc said. “Trust me, I’m a doctor.”
“I mean, how close to dead is this person?” I don’t know why it mattered to me, but it did. As if the closer to dead they were, the less I’d be ripping them off, somehow.
“Close enough to be designated terminal and to have 24/7 hospice care,” Doc said. “That’s usually pretty late in the game.”
Doc said, “And it usually means a lot of pain meds.”
The drug talk, along with my system being weaned off meds the last few days, started to make me feel cravings that hurt. But they were cravings with hope—that tingle when you’re close to the drugs, in both time and distance. “Any chance for Dilaudid?”
Doc shrugged as we reached the two Santa Ana–Tustin exits for Seventeenth Street. The second exit heads south toward Tustin, and we took that one. “Hard to say,” Doc said, lighting another cigarette. “Pain management theory these days shies away from Dilaudid. But we should get plenty of morphine.”
Back when I still shot up, which I hadn’t done this relapse, Dilaudid was like gold. About five to eight times more powerful than morphine. Less went longer.
“Listen,” Doc said. “There is something difficult we might have to do.”
“It’s a relatively new procedure. I haven’t asked Sandra if he’s on it or not, but this guy may have a permanent morphine vial implanted near the base of his spine.”
“Lucky bastard,” I said, and I sort of meant it.
“It’s the wave of the future,” Doc said. “Going to hurt people like you and me. Pills and shit like that are going the way of the horse and carriage.”
“I don’t follow.”
“All drugs are going to be administered using time-released delivery methods,” Doc said. “Soon, there won’t be any pills to steal.”
“You said there’d be morphine at this place, right?”
“Right,” Doc said. “But, worst case scenario, you’re going to have to cut the vial out of this guy.”
“I thought cancer patients had IV drips and patches and stuff.”
“They do,” Doc said. “But, in addition to that, depending on how far gone he is, he might have this semipermanent vial.”
“Why do I have to cut it out?”
“Well, no one’s saying for sure it’s there.”
“If it’s there, why the fuck am I doing the cutting?”
Doc shrugged. “Because I don’t want to.”
And that was that—his connection, his call. No matter how desperate I was, I didn’t think I could do it. Cut a helpless dying person? Only a monster could do it. And, I told myself over and over, I can’t be that monster. But I’d already crossed so many ethical lines I said I would never cross in my life. I’d become a man I couldn’t recognize more times than I could ever count. “He may not have one of these, right?”
“He may, he may not. But you might want to wish he does—concentrated morphine drip.”
“I’m not cutting open some poor fuck who’s about to die,” I said.
“Well, let’s hope it doesn’t come to that. I was just warning you about some of the potential difficulties.”
I shook my head and looked at the faces of the other people driving out on the freeway. I wondered what they were talking about. What they were thinking they might have to do in the next half hour and how sick they made themselves.
As we got off the freeway, I realized how tense I was, realized I hadn’t been taking regular breaths, realized I’d actually been holding my breath. I tried to take in a few deep breaths while Doc swung across four lanes of Seventeenth Street.
“Be careful,” I said.
“It’s important to blend in,” Doc said. “Cops pull over people like you and me when they’re doing the speed limit. People drive like maniacs here. So should we, if we want to be left alone.” Someone honked and Doc gave them the finger.I turned around and looked at the WELCOME TO TUSTIN sign behind us. This other side was for the people just leaving Tustin and it read:
Work Where You Must But Live and Shop in Tustin!
A Vons supermarket slid by on our right. I took nervous breaths and felt my heart beat like a rabbit’s heart in my chest. A church with an impossibly high peaked roof stood on our left with an announcement out front:
“WHY DO THEY WANT US DEAD?
What the Bible says About Islam.”
Doc said, “Almost there.”
I nodded and took several attempts at a deep breath.
He took a left on Mauve—a sign that read Not a Through Street greeted us as we headed down to the second to last house on the right. There was a Toyota in the driveway and we pulled up next to it, blocking one of the garage sides. I pointed and said, “What if someone needs to get out?”
Doc shook his head. “No one needs to get out. Look. This is a call I only get a couple times a year—the situation has to be perfect. We are going into this house and we are going to score, OK?”
“OK,” I said.
“Like I said, this is rare. The patient is alone, they probably don’t have much family. They may have none. My connection has, more or less, the run of the place. It’s like an opiate candy store in there, and we are here to clean them out, understand?”
It was starting to sound too good to be true, but it had a momentum that I couldn’t pull against. Plus, I needed to get high pretty soon, or I’d be a wreck. I wasn’t in a position to argue.
“Give me the money,” Doc said.
I reached into my front pocket and took out a wad of rolled, moist bills and gave them to him.
Doc said, “Dude, you carry your money like a ten-year-old boy.”
I thought of Olivia. “Sorry,” I said.
“You have to stop apologizing for everything, too.”
“Uhm . . . Sorry?”
Doc counted out the bills and folded and rearranged them.
“Tell you what. After we make a few bucks here—will you wear a fucking proper billfold if I buy you one?”
“Is that like a wallet?”
He shook his head. “The way you carry money, there’s no way anyone’s going to take you seriously.”
“People take money seriously—they don’t seem to care how it’s folded.”
“You’re wrong,” Doc said. He lit a cigarette, took one deep drag and then a second. Then he put the cigarette out. He turned to me. “If anyone asks, you are my assistant.”
“Who’s asking here?”
“Inside. There should only be Sandra, my friend. But if someone else is here . . . family, friend, whatever, I am a medical professional Sandra called for an opinion and you are my assistant. Got it?”
I nodded, looked down at my torn jeans and Chuck Taylors held together with electrical tape on the right toe, and thought, Yeah. Medical assistant.
“Great,” Doc said. “Let’s do this.”
ROB ROBERGE’S fourth book, the novel The Cost of Living, was released in Spring 2013 on Other Voices Books. Previous books include the story collection Working Backwards From the Worst Moment of My Life (2010) and the novels More Than They Could Chew (2005) and Drive (2001). He’s a core faculty member at UCR/Palm Desert’s MFA and has taught at several universities including University of California Riverside’s main campus MFA, Antioch, Los Angeles’ MFA program and the UCLA Extension Writers’ Program, where he received the Outstanding Instructor Award in Creative Writing in 2003. He’s a frequent question writer and lecturer and has judged, among others, the Red Hen Story Prize and the University of Ohio/Athens PhD writing award. Currently, he is serving as the advisor for the PEN Mark program. His stories and essays have appeared in numerous journals and have been widely anthologized. He plays guitar and sings with the LA bands The Danbury Shakes and The Urinals.
Adapted from The Cost of Living by Rob Roberge. Copyright © 2013 by Rob Roberge. With the permission of the publisher, Other Voices Books.