August 02, 2008

Explaining Amphetamines With Words

By Sean A. Lovelace © 2008

A difficulty, explaining amphetamines with words. I could say it's like dancing about architecture, but Elvis Costello already turned that clever phrase. At least I think it was him, but either way we're still flailing for explanation of experience, trying to suture this with an impossible that, to sculpt the stomach-flop of taking a hill at 100 in an ambulance, to sketch the hot anxiety of kissing a co-worker in a supply closet, to direct a teleplay about the moment you stand over a waxy blue body and it hits you: "We are definitely, no doubt, for sure, put on this earth to eventually die," and now we've come full circle, the rim of a glass vial, a stethoscope bell, or the mind-swim of sprawling on the break room floor and staring at the ceiling for long minutes, no beginning, no ending, only a place to pull from…

I could say this about amphetamines:

I could say, "Well, it's like driving home at dawn from 3rd shift, the graveyard, awake all night, headlights passing the world of well-slept humanity. Your steering wheel floats warm and knobby, twice its size in your hand. You squint, everything all bug-swept, all smeary."

I could say, "Hollow bones."

I could say, "It's like humans, who have notoriously selective insight, and so have rabbits for pets and us with predator features—inset eyes, canine teeth—and rabbits are born as prey, evolutionary prey for eons, and every time you pick one up or put your human face near its cage you are SCARING THE SHIT out of the rabbit."

I could say, "Cold sweating 16 ounce gas station can of beer."

But why would I say any of this, since amphetamines aren't like driving around with an inflated steering wheel or osteocavernosis or unknowingly preying on rabbits. And they certainly aren't cold beer, not even close, not even on an empty stomach, and here we are-are-are again, Elvis Costelloing.

I used to own a rabbit, I did, a little fuzzy angora the color of wet sand. I used to buy a single can of beer for breakfast, every morning on my drive home, while my stereo crackled out Elvis Costello. I used to do a lot of things. Example: med school, in West Virginia, and really that's where the whole amphetamine thing began: all day classes, all night hospital rounds, 36 hours shifts. In some ways that explains amphetamines. In some ways... I remember my first day of this one rotation, Medical Outreach, which is just bullshit code for the crappy rural health centers no doctor ever wants to work (no prestige, no insurance, no $$$) so they always send a team of students—this was right before I quit, I would eventually quit the whole damn thing—and it was late evening or so and the whole time I'm thinking I hope nothing happens, hope nothing happens, because you know we're just a bunch of students and a resident, all book sense and bravado, and I can say personally I knew NOTHING and the last thing I wanted is to have this resident and all these other med-heads figure out is I knew NOTHING. And so it's fine, fine, you know, a coal miner with chest pain, a woman dropping by for a lithium refill, a little girl who swallowed a birthday balloon (the resident scoped her trachea; plucked it out), a lanky farmer stabbed in the elbow by his drunken wife (Novocain, seven stitches, discharge), basically nothing, nothing we couldn't handle. Nothing our resident couldn't... And then he says to us, "I'm going to run and get a Big Mac" and we say go ahead, Doc, you deserve a break today, and get us some fries, super size, etc., and five minutes later this fat cop ambles in with this old Mexican dude, one of those dark sun-shriveled guys that small towns hire for two dollars an hour to do the shitty jobs, picking berries or mixing concrete or shoveling chicken shit out the chicken factories, and the cop says, "This hombre here was walking the highway," which isn’t apparently allowed if you’re Mexican in small town America, and we say, “What’s your point?” and the cop answers, "He ain't got nowhere to stay," and I'm about to go into this whole the health center is not a hotel/homeless shelter and why doesn't this fucking town have any social services and what exactly is the function of all these churches on every street corner and all this other kind of opinionated crap-trap and then BAM! the Mexican dude locks up, spins a tight loop, flops his arms, starts gurgling and choking and hissing, spittle flying all over, eyes spinning to tilt, and then flat out drops to the floor—nearly dead. Nearly, and I should know: I took his pulse, or lack of.

And all hell breaks loose!

Where the fuck's the resident? And then, Where the fuck's the crash cart!? And this ninety-thousand year old scarecrow of an LPN rolls out this sad-ass crash cart, this broken toy, this sick joke, all wobbly and squeaking and wheels clattering and looking like the defibrillator paddles haven't been charged in two decades and the oxygen tubing wrapped in kinks and crazy snakes and the suction clogged with some gray lint-looking shit and here we are standing around this maybe dead guy and the cop leaning against the wall with an expression like, "This should be fun." And so I say, Somebody get his fucking pulse (this ends up being me) and then I say, Somebody charge the defibrillator (ditto) and Somebody get the Ambu bag (ditto) and Somebody turn the fucking heart monitor on (ditto) and finally I can see—actually see in these little green zigzag lines on this dust-covered TV the size of a deck of playing cards—that the guy does have a pulse, a thready pulse, weak and flickering, but a pulse. The man is of the living.

"Okay," I say. "Okay."

That's all I have, really, as far as leadership, all the yelling and this word, okay, and I can feel in the periphery this kind of panic, this blur of running feet and kneeling legs and ripping open surgical kits and snapping on latex gloves and whispering and muttering and stumbling over each other and then finally, finally somebody other than me remembers we are here as a medical team, as givers of care, as doctors to be; yes, all of us. So somebody else does something—this cute girl, name of Sarah, a great kisser—who grabs this hypodermic syringe and jabs it straight through the guy's mud-smeared jeans, right into his Vastus Lateralis—into his fucking thigh.

"What was that?" I ask her.

"Valium," she says, "for the seizures."

"For the seizures? Who the fuck ordered valium? What seizures? The guy is dying here!"

"Well, sor-ry," she says and gives me this glare like I'm the idiot who can't see the word MALPRACTICE lit up like a neon sign above us.

See the thing is an injection is a lot like a bullet from a gun, or words of anger, or like kisses—you can't get it back. And that Valium was working, working its way through his body, his veins, slowing things down, slowing, his pulse, his already pretty-fucking-slow pulse, and then he was, he was, well, he was dead.

Because we just killed him.

And my entire life zooming above my head, beneath my eyelids, crackling and sparkling and shivering, and I take this shallow breath, this non-breath, and I place the Ambu bag over this dead guy's mouth and pump and pump and the damn thing explodes—Pow!—from dry rot! and then that's it, I'm giving this old Mexican dude rescue breathing, mouth to mouth, lip to lip, and everyone yelling and cursing and screaming, and I join in: "Shock this fucker!" and I get the paddles and it's CLEAR! and BAM! And we got nothing! So, CLEAR! and BAM! And still nothing but a green line, a horizon, a flat green horizon, and I'm shouting, "CLEAR, mother fuckers, CLEAR!" and it's BAM! BAM! and his body flopping like some giant fish and I'm breathing into this dead guy's mouth, his lips blue and scaly, his tomato saltines beer hint of urine (urine?) breath, and Sarah's beating the hell out of his chest and the others join in, beating on him, his arms and legs, scissoring off his flannel shirt, shredding his jeans, sticking him with this and that, epinephrine, atropine, magnesium, whatever's in reach, then beating on him some more, just pissed off beating on this guy, and hitting him with the paddles—CLEAR! and BAM! CLEAR! and BAM!—and Sarah's ramming this needle, trying to draw ABGs, any ABGs, any-fucking-where, brachial or femoral or whatever artery she can remember from her textbook diagrams, and blood now spurting all over, just geysers and spray, and me trying breath after breath after breath, and people shouting and crying and praying and CLEAR! and BAM! CLEAR! and BAM! BAM! BAM! and nobody documenting the code or paging the resident or tracking the meds or following any known procedure we were clearly, clearly, clearly and repeatedly, taught to do in this exact emergency situation.
BAM! And nobody said a damn thing about CLEAR and we're all thrown aside like sparks off a fire. And he coughs! He fucking coughs! He coughs up this white frothy liquid, globs of it bubbling down his chin, and his whole body shakes, his fists clench, unclench, and he bolts upright, sits upright, this with IV lines spiraling off and needles sticking out and blood all over and his skin flushed and all these nasty splotches from getting shocked and beat to hell and him naked, chest heaving, belly sagging, and he takes this long shuddering breath and rolls his head to and fro and gives this dreamy grin and says slowly, so slowly, "Vivo?" Vivo. Alive.... And the cop is like, "Holy shit, you guys just saved his life. I'm actually impressed." And there it is, there it fucking is, the resident strolling in, pausing, head hidden behind this crazy stack of McDonald's bags, this big aroma-wave of French fry, and everyone saying, "I think we just saved this guy's life," no mention of us killing him earlier, obviously, and the resident just nodding, just casually folding a fry into his mouth, taking it all in, medical students, a cop, a Mexican guy, a hell of a mess on the floor, but obviously everyone alive, and so then a loopy wave, turning for the break room, for the TV and the Nintendo and the dusty couch.

For whatever reason, the Mexican guy had swallowed a condom full of cocaine and it ruptured in his stomach. That's why his body went spastic, that's why he almost died, I mean before we killed him. But we didn't find any of this out until later. At the time we all just sat there on the cold floor, all huddled up and rocking back and forth and sweating for breath and giving each other these What the Fuck? looks, sitting there in a sea of IV bags and bloody catheters and open needles and trach tubes and sterile wrappings and ampoules and stethoscopes, all of it spread about like a fucking medical nightmare piñata had exploded, and I remember just leaning back, head on the cold tile wall, just dazed, thoughts, synapses, adrenaline spinning, spiraling and throbbing, and me smiling, no idea why, feeling as low and as high and as low as a goddamn parade of the blues and I was seriously thinking, I am going to quit this shit, I am going to quit this, I am going to quit... which I did.

So, I guess that's one way to explain amphetamines.

I mean with words.

Sean Lovelace is on a river right now. He has a spinning rod and a beer. Other times he teaches at Ball State University. He recently won the CrazyHorse fiction prize, and his works have appeared in Diagram, Puerto del Sol, Willow Springs, and so on.

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