Five hours to go, hopefully.

I was a mess and needed a plan.  Five hours was an eternity.  I decided to break it down into fifteen minute chunks.  Twenty fifteen minute chunks.  I would use my stopwatch.  I didn't want to know what time it really was, I just wanted to count down each little chunk.  Then, I realized that I had twenty-five pieces of cracker on the table.  Again, I did the math, and decided that every twelve minutes, I would eat a piece of cracker, then reset my watch.  When all the cracker bits were gone, five hours would have passed.  It was the best plan that I could come up with.  I looked at my watch.  Three minutes had gone by.  Nine more minutes until I could eat some cracker.  Hopefully I could hold it down.

One hour went by.  Then two.  Things were getting worse.  I was sticking to the plan - fifteen pieces of cracker were left, but it wasn't enough.  I had to move.  I decided to add push-ups back into the equation.  I would do ten push-ups every twelve minutes and eat a piece of cracker.  Three hours passed.  I started to pace; I was out of the bed now.  Then back in, then out.  I couldn't stop moving.  I tried to drink some water.  Ten push-ups and a cracker.  Four hours passed.  Then I remembered, weren't they going to draw more blood? That would take time, too, to get the results. The thought put me over the edge.  I scooped up all the cracker bits, threw them in the sink, and rang the nurse.  'Yes?'  'I need help,' I told her.  It had worked with the police. 'I'll be right there,' she said.  And she was.  'What's the matter?' she asked.  'Look,' I said, 'Can you draw my blood to see if my level is low enough for some medication?  I can't take it.  I'm falling apart.'  I wrapped my arms around myself for emphasis.  'Well, let's see what time the last sample was drawn,' she said.  'It's been nine hours,' I said, 'I'm sure, I timed it with crackers.  Please.'  I was clearly losing it.  'OK, let me see if I can get someone from the lab up here,' said the nurse.  I crawled back onto the cot with a low moan.

Hello, Librium!

I wrapped the blankets around me and curled up, trying to make myself as small as possible.  The smaller I am, the less there is to hurt.  To my surprise, after only five minutes, a technician came in to draw blood.  'Mr. Jackson?'  'Yes.'  'Can I have your date of birth?  Can you verify your social security number'  I provided the information and sat up. The needle went in, the blood went out.  I asked, 'How long before the results come back?'  'Probably about a half hour to forty-five minutes.  We're slow tonight.'  I had no response.  I laid back down, reset my stopwatch, and prepared myself for the wait.  Every five minutes, I decided, I would restart the stopwatch.

If you have ever been addicted to alcohol, you understand how excruciatingly painful this time is.  It's a combination of the physical withdrawal and the anxiety for anticipation of relief.  Unfortunately, these two interact exponentially.  I was out of crackers and drenched in sweat.  I had no way to know how much time had passed.  Suddenly, there was a knock at my door.  I pressed a button and took a quick look at the time.  Eleven.  Salvation was at hand.  Again, 'Mr. Jackson?'  'Hi, come in please,' I begged.  'My name is Nicole, and I'm a social worker.  I would like to ask you a few questions if you don't mind.'  I tried to process this, but the neurons were misfiring.  The synapses wouldn't bridge. I just looked at her dumbly, and she said, 'I was going to talk to you earlier, but I had to wait until your blood alcohol was below a certain level, to make sure you understood what we talk about.  Are you OK to answer a few questions?'  I opened my mouth to respond just as a nurse pushed into the room.  'Before you get started, do you mind if I give him some medication?  Mr. Jackson, I have some comfort meds for you.  I am giving you 50 milligrams of Librium, as well as some sub-lingual Ativan.  It should take the edge off and make you feel better able to talk to Nicole.'  She handed me two little green and white capsules and a small paper cup of water.  I drank those down, then she popped a small pill out of a foil package.  'Here, put this under your tongue to dissolve.  It will take just a couple of minutes, try not to swallow it.'  I put it under my tongue.  'Yank you,'  I said as she walked away, keeping that little pill firmly in place under my tongue.  I closed my eyes and laid my head down.  Yank you, I said to myself.

lines of addiction.

Nicole began to ask me some questions, questions I had been asked dozens of times before in similar circumstances.  'When did you start drinking?'  'When did it become a problem?' (Immediately, I answered). 'How many brothers and sisters do you have?'  'Any substance abuse or mental health issues with any other family members?'  And on it went.  I envisioned this giant family tree, compiled over the years, with some sinister family lines drawn in red, leading down to me.  I tried to remember which of my relatives were alcoholic so I could assist Nicole in her endeavors, so she and all of the other social workers and substance abuse counselors could chart the whole world, drawing these red lines down to people like me.  And for what reason?  Maybe it is make-work.  Maybe big pharma is working on a vaccine, one that will be given to the children that appear on the horizon from all of those people in red at the end of those lines.  I thought about this.  Stopping the red lines.  I wish it would have stopped before me. 

Slowly, the medication began to take effect.  It's never quite enough, but the first dose always feels warm and relaxing.  The anxiety melts away a bit; the racing thoughts slow down.  The attention span increases from seconds to a minute.  You look at your watch to mark the time, because you know that in three or four hours, you will be getting some more.  And, you already worry about tomorrow, because they will probably reduce the dose from 50 to 25 milligrams. All of this went through my head, but there was something else.  If I can make it 72 hours, I thought, I can get through this.  Three days.  That's how long it takes before you can even begin to feel quasi-normal, like you have a fighting chance.  How many times had I made it to one day?  Or two?  If you can make it to three, then you might be able to make it to five, which is the magic number.  Right now, I had to make it to three.  My thoughts were suddenly interrupted, Nicole was speaking to me again.  'We are trying to find a transport to get you to the VA hospital.  It might take a couple of hours, but we will have you there before morning.'  The good old VA, I thought.  Detox.  The smell of bleach.  Burgundy, brown, blue, yellow pajama sets.  Socks with rubber treads.  Board games and puzzles with missing pieces.  I was all for it.

transport and arrival.

A portable gurney was wheeled into the room.  The crew of two was typical:  male and female, slightly overweight, young, and pleasant enough.  The woman smelled of cigarettes.  'Are you able to move yourself onto the cart?' the man asked.  "No problem,' I replied, and began to get off the cart I had been on for the last 12 hours. Immediately, four hands reached out to steady me.  'Whoa, take it easy, go slow,' the woman said.  'I'm fine,' I replied, but slowed down enough to not worry them.  I laid down on the gurney.  'We have to buckle you in, but we won't make it too tight.'  Again, safety first.  They cinched up the straps and out of the room I went, feet first.  The ambulance was right outside.  'You're gonna feel a bump when we put you in, so be ready for it.'  I readied myself, and, as usual, felt no bump.  The man got in the front; the woman stayed in back with me.  She was nice.  'Would you like some warm blankets?  Sorry about the light, I'll turn it down once we get moving.  Are the straps too tight?'  I liked her.  'No, everything is fine,' I said.  Maybe I'll try to nap.  'Good idea', she replied. 'We have about an hour to go'.  The ambulance began to roll, and for the first time in three days, I fell asleep.

The next thing I knew, the back door was open and they were lifting me out.  'We're here,' I was told.  I was cold now, and feeling a little tense.  The meds were wearing off. I figured that the nurse on duty would hook me up right away with some more Librium, because that's what the VA does.  They wheeled me inside and lowered the gurney, and I got out and sat in a red plastic chair.  'Thanks, guys, see you later,' I said.  I hoped not.

My vitals were taken, I held out my hands, I stuck out my tongue.  When asked how I felt, I replied with the standard 'horrible.' Two more green and white capsules were handed to me, along with a glass of water.  I tossed those down quickly and handed the water back.  'Would you like something else to drink?  I have some diet ginger ale,' the nurse asked.  'No thanks,' I replied.  To me, diet ginger ale tastes like homelessness.  They gave me a set of burgundy pajamas to change into, along with those socks with the rubber soles.  I was glad to get burgundy - brown were for very thin people, then burgundy, then blue, then yellow, if you were large.  It was good to know that I was wearing the same color as last time, keeping the weight off.  It made me feel a little better about myself.

Feels like home.

The nurse finished with me and took me to my room.  The sun was starting to come up, and, fortunately, the other bed in the room was empty.  This is very unusual for the VA.  She said, 'Mr. Jackson, if you need anything, let us know,  You should try to get some sleep.  The treatment team will want to speak with you in the morning.  I guess you know where everything is?'  I should.  I had been in this particular facility 16 times over the last four years.

I stood there for a moment, asking myself the same questions I had asked myself the last time, and the time before that.  How could this happen, I thought.  What went wrong?  There has to be something I'm missing, something I just can't put my finger on.  For a moment, I felt completely hopeless.  I looked down at the bed, turned, and walked down the hall to the common area.  The TV was off; there was another patient sitting at a table trying to read.  I left the room and walked down the hall to the kitchen and opened the freezer.  There they were:  a couple of dozen chocolate and vanilla four ounce ice cream cups.  How many of these had I eaten over the years? I thought.  I grabbed one of each, found a plastic spoon, and walked back to the TV room.  I sat down , found the little paper tab, and pulled the top off the vanilla.  No sooner had I stuck my spoon into the ice cream when I heard a voice say, 'Is that you, Russ?'  I looked up; it was the guy reading the book.  'Don?'  It never fails.  I always run into someone I know at the VA.  Like moths to a flame.

settling in.

We sized each other up for a moment.  'You look pretty good,' I said.  'When did you get here?'  'Two days ago,' he said.  'You just came in, huh?  Hurting?'  'Yeah, you know,' I replied.  'I'll be alright.  So, what've you been up to since I last saw you?'  He had gone out west.  Was OK for a while, but met a girl, got back on the needle.  Made his way back east, taking his time, spending his money as he went, staying with friends.  He asked me the same questions, and I told him what I had been doing.  Not much, I realized.  The same old questions.  Where are you going after this?  Have you seen so and so?  We caught up with each other about who had died.  I was running out of energy, but was happy to be there with someone I knew.  It makes it easier; helps to pass the time.  After a while, we sat there in silence.  The dawn was breaking now, and it was time for me to get some sleep.  The second dose of medicine was working, as well as it could, and I knew I had a short window.  'Catch you later, buddy,' I said, and walked down the hallway as those rubber soled socks kept me upright.

There is a smell that you never forget at the Veterans Administration.  I could be on a beach in Spain, blindfolded, and I could pick out the smell of a VA bleached sheet. Over the years, it has become almost comforting.  I looked out the window; the leaves were brown and the trees half bare.  It occurred to me, I didn't even remember the leaves starting to change.  I crawled into bed and pulled those sheets and blankets up to my nose, inhaling deeply.  Well, I thought, here we go again.  I have a couple of rough days ahead, but at least I've started the process.  That, in itself, is always miraculous.  I have had more lives than a litter of kittens.   Something has to change.

Twenty-four hours in...

Later that morning, I was lying in bed in that semi-conscious limbo that alcoholics are usually in.  The myth is that alcoholics drink, then pass out for hours. The truth is that when I was drinking heavily, I rarely slept.  I perfected a way of lying in bed for hours, perfectly still, sweating, but not quite asleep.  It was horrible.  Once, when my ex-wife and I were separated, she came back to the house to retrieve some things. I was in bed, heard her enter, and decided to get up.  She came into the room to find me standing near the closet, shook her head in disgust, and walked over to the bed.  'Oh my god, Russ, can you please wash the sheets?  Better yet, burn them.'  I went over to see what the problem was.  There, on the fitted sheet, was a perfectly shaped green outline of my body formed from mildew or mold of some sort.  It was like the Shroud of Turin.  I hadn't even noticed. But I did notice that the other side of the bed looked clean.  I made a mental note.

There was a knock on the door, and someone entered. 'Mr. Jackson, the treatment team would like to see you.'  I looked at my watch.  11 AM. I hadn't had a drink in twenty-four hours.  I was also due for some more Librium.  'OK, I'm just going to stop by the nurses' station for my meds and I'll be right down.'  'No, the treatment team will see you first.  It will only take a few minutes, seeing that you just got here last night.'  I reluctantly agreed, got out of bed, splashed some water on my face, and headed down the hall, feeling a bit sick and woozy.  The treatment team consisted of a physician, a social worker, and a intern.  I entered the office and sat in the empty chair and looked at each one of them in turn.  The physician, a woman, addressed me first.  'Hello, Mr. Jackson.  Nice to see you again.  You did the right thing by coming back.'  For once, I had to agree with her.

Staying put.

Well, the treatment team had little to say to me.  'On Monday, we will begin work on a discharge plan for you.  Over the weekend, give some thought as to what your plan will be when you leave here.'  'OK', I mumbled.  They all looked at me and smiled.  I got up, looked at the intern, and said, 'Thank you.'  Then I walked down the hall and got my meds.

So, by the time I saw this group again, I would be four days sober, providing I didn't get squirrelly and leave.  Now, there is something called signing out AMA.  Against Medical Advice.  If your blood alcohol is below the legal limit of intoxication, and you don't appear to be a danger to yourself or others, they really can't hold you, especially if you entered the facility voluntarily.  There is a lot of gray area here, though, especially in these litigious days.  Even if you WANT to leave, you might be forced to stay up to an additional 72 hours.  The people here aren't stupid.  They know there is a liquor store a half mile down the road.  They also know that during the first three days of detox, the alcoholic is a canny individual.  The pain can become almost unbearable, so the thought of bouncing out of there is always on your mind.  The last time I tried to sign out AMA after one day, they wouldn't let me.  They put me on hold.  I expected this.  But, after 36 hours, they re-evaluated me, and I convinced them to let me go.  Within thirty minutes, I had a pint of whiskey in me.  I was back in that place four days later.  These things are recorded in your electronic medical file.  So, even if I wanted to, the chance of me getting out of here before Monday was nil.  Plus, this ward was better than the psych ward, which is where I would go if I was 'sectioned'.  I decided to simply stay put.

Friday morning.  The weekend ahead.  Nothing happens here over the weekend at all.  We all just sit around, make small talk, and work through our misery.  I had twenty-four hours sober.  The next two days would be rough, but I had ice cream and Librium to get me through it.

Day 2.

The second day is like the month of March.  It comes in like a lion and goes out like a lamb, relatively speaking.  I had taken three doses of Librium in the last 10 hours, so I was hanging on.  I needed privacy, though.  Down time.  In detox, you have the pros and the newbies.  The newbies, not having been that banged up to begin with, start feeling pretty good in a day or two.  They will come up to the new guy and say, 'Hey man, how are you doing?  My name's Mike.  Just hang in there it'll get better.  If I can do this, anybody can do this.  If you need anything let me know.'  And so on.  I want to strangle these people. The pros just sit by themselves, occasionally look at each other, a wry smile and a slow head shake.  We know the deal. 

I was up, couldn't sleep, so I went to the TV room.  Don was there.  We made eye contact, he gave me a little smile, then went back to his book.  He knew that I was too fresh to engage; that I would initiate conversation when I was ready.  There were four or five other patients in the room but I didn't recognize anyone else.  I found a chair in the corner, grabbed a crossword puzzle book (compliments of the DAV, the sticker said), opened it to the easy section and settled in.  Now the wait began.  For the next two days, it would be a routine of meds, ice cream, sleeplessness, and pain.  At least it was predictable.  I briefly thought about my life with all its failure and wasted opportunity.  They say that you have to get over regret in order to become sober.  I suppose that is true, but in detox, regret is right in your face.  I smiled wryly to myself, shook my head, and tried to think about something positive.  At that moment, the well was dry.

The weekend begins.

Detox is a lonely place.  There is too much time for introspection.  I tried not to evaluate myself too harshly.  I was chemically unbalanced, I told myself.  I needed to just focus on sobriety and nothing else and I could get better.  This is easier said than done.  I tried to let my mind drift; not to focus on any one thing, because if I did, I would get the butterflies. Dinner came but there was nothing I could eat.  I briefly thought about taking a shower, but it simply seemed like too much effort.  The hours went by, the meds and the ice cream went down.  Eventually I found myself alone in the TV room; everyone else had gone to sleep.  It was 2 AM and I was approaching the 48 hour mark.  I thought I felt a little better physically, but the anxiety created by the mess I was in was eating at me.  I went to the nurses' station.  'Hey John, can I get some more Librium?  I'm really struggling here.'  He looked at me.  'Russ, you've been getting 50 milligrams every three hours since you got here. (Really? I thought).  Let's try to stretch this out for another hour.'  I looked at him in silence, then turned and walked back into the TV room.  I put my head in my hands and waited.  Exactly one hour later, I received my meds and crawled into bed.

I was surprised that when I opened my eyes, it was morning.  I had actually slept for a few hours.  Encouraging, I thought.  Heading into day three, I had a short burst of energy.  I took a shower.  I even thought about shaving, but that seemed way to difficult.  I felt...better.  A bit.  But enough to give me some confidence.  I went to the nurses' station to get some medication, but this time there was only one green and white capsule in the cup.  I looked up.  'I think I get fifty,' I said.  The nurse on duty said, 'Your orders have you at twenty-five now.  Let's see how you do with that.'  I made it to three hours before I felt like shit.  I must be getting better, I thought.