Listening to Dilaudid


Yes, that’s my right arm, exactly seven days after the crash. You can see the IVs that went in, the ones that failed to go in, the vein that blew afterwards. In the end they actually opened up one of the big veins in my neck and sewed something in, I think it was called a CVC.

I gave up pain medication in the fourth day, to prove to the hospital that I was able to leave on my own and wouldn’t require IV meds to continue. Now I have a vial full of Oxy, which I’ve limited to use between 2am and 8am. I’d like to throw the vial out and as soon as I can sleep without it I’m going to.

But let me tell you about the wonderful things I experienced when they had me plumbed by the jugular and I wasn’t yet stubborn enough to wave them off…

Dilaudid is a kind of remixed version of morphine. One way to get it is to dissolve morphine in alcohol then to heat that solution in the presence of a platinum or palladium catalyst. It was developed about ninety years ago. The effect of that “remixing” is to increase its ability to cross the blood-brain barrier, meaning that in actual use a given amount of Dilaudid is eight or more times as powerful as morphine — three times as powerful as heroin.

While it would be an exaggeration to say that everything hurt when I was first admitted to the hospital (my left hand seemed fine, as did my left knee) it wouldn’t be far from my perception at the time. After some time in a CT scan machine at all kinds of weird angles, it was time for me to sit 24 hours or so until the spleen procedure could take place. At that I was in so much pain that I’d been short-breathing for hours.

“We are going,” the nurse said, “to put a unit of Dilaudid in your neck here.” I woke up four hours later. They saw me wake up and I waved them off when they went to do it again. By the end of the night, however, I was ready for another one. I believe I had a total of five, maybe six injections before announcing that I wouldn’t take any more.

Here is how it works.

The injection is something you can feel in your neck, cold and smooth. And within a minute, or less, all the pain simply disappears, as if it’s been washed away with a clean wet cloth. The absence of pain is one of the most wonderful feelings, and nothing provides it like Dilaudid. If it stopped there, you could take it every day from now until retirement and it would be fine, but it doesn’t stop there.

What comes next is, of course, total bliss. Bliss is to the absence of pain what the absence of pain is to having nine fractured bones rubbing around. Bliss is a sudden arrival of certainty that absolutely everything is wonderful. Your blood-soaked right hand? Wonderful. The dirt on the floor? Wonderful. The fact that you’re in the hospital recovering from a tragic accident? Wonderful. Every decision you’ve ever made has been correct. You love everybody. They probably love you, too. The bliss just keeps ratcheting up and right when you’re thinking that the broken ceiling tile dangling above you is just the most beauitful thing, it hits maximum and you pass out.

All of that, I think, I could handle and not become completely addicted to, though it would be tough. For me, it’s the dreams that made me start planning to stop taking Dilaudid the minute they gave it to me.

I’m a nightmare kid. My whole life. Dusk till dawn. Terrible things are happening. From the commonplace (you mean I don’t have enough credits to graduate?) to the bizarre and specific (my son fell in a machine that will dismember him unless I can rewire the control panel?) and on and on and on. I think it’s how I work things out. But it’s made me a night owl. I don’t sleep until I need to. I don’t mind missing out on sleep.

Dilaudid dreams, on the other hand, are universally blissful. Just random songs that are happy, and the feeling of being held, and the anticipation of opening presents on Christmas morning. The sense that some people report from childhood, of always feeling perfectly safe. You wake up from those dreams and everything is still just fine.

Except, of course, that the pain is starting to seep back through. Another injection? You’re allowed to have it. What do you say? Better say no. Need to get back to rehab, to work, to being productive, to leaving the hospital. But it would be so nice to have one more, and one more afterwards, and to keep going with it.

What did the man say? “If God made anything better, he kept it for himself.”

13 Replies to “Listening to Dilaudid”

  1. Brian E

    I’ve never experienced this, and God willing, I hope I’ll never have to. It sounds like the stuff of which addictions are made. I’m not sure anyone really knows how they’d react to it beforehand. There’s enough history with alcoholism in my family that I sometimes wonder if the migraine that sneaks up on me with my third drink is the only thing keeping me from that fate. I fear anything that could take the edge off the world without the negative effects of alcohol. Maybe I could handle it, but why take the risk? Better not to try if I can avoid it, and hope I never hit the wrong patch of icy pavement.

  2. Tre Deuce

    II figured you to be a Night Owl. Same here and it still goes on at 67′.

    But, I also use my short spurts of sleep to solve problems from personal to technical. The unconscious sees everything, and knows everything that you have ever learned, and sleep is the best way to access that knowledge.

    Howard Hughes kept similar hours and kept a cot in his office, if he needed a little time for rest, he simply laid down on his cot. Some of us have no time for bed and regimented sleep cycles.

    A little rest(1/2 hour) goes a long way for me, and when possible, a couple hour afternoon nap is my best rest and sleep catch-up time.

    This ability to not need much rest or be reinvigorated in a very short time has served me well in long distance sailboat races/deliveries or long cross country drives.

    Back in the late seventies, I delivered a boat to Ensenada, and then I drove from Ensenada, Baja, CA to Lund, BC a distance of some 2,500 miles in less then two days with some sight seeing on the way. Never slept. Picked up the next boat to deliver and sailed it to Sechelt, BC before I slept on the third day.

    Several single handed long passages from Hawaii to West coast ports are part of my sailing resume along with a Panama to Hawaii solo passage. The ability to stay awake or be attentive to your surroundings while resting lightly is very important to safe sailing. You don’t want to get run over by a freighter.

    I liken this to our caveman days. Some men had the ability from nature to keep the night watch, and it still is with some of us so called, modern men.

    Boy, Jack, you sure got F—ked up. But you have the right attitude for recovery. Hope it is as speedy as possible.

  3. Birju

    As a doctor I’ve always wondered why the pain med seekers preferred “vitamin D ” so much more than any other narcotic. Only you could phrase it’s powers so eloquently.

    I love your writing jack here’s to a quick and as pain free as possible recovery.

  4. galactagog

    Ah, very glad to see you didn’t lose any of your wit in that crash….and gladder still that everyone is on the mend!

    I had a similar experience with morphine

    “There is no pain, you are receding….the distant ships smoke on the horizon…”

    Coming back down was very bad for me though…truly waiting for the worms

    At least your fretting hand is in good shape!

  5. Mark in Maine

    My near-death experience was accompanied by seven weeks as the guest of three different hospitals, in turn, and several rounds of surgery. I was given Fentanyl, which cut the pain well enough, but also produced first-rate hallucinations – all damn day. I had them take me off the patch just as soon as it was possible to do so, and still vividly recall some of those strange days in SICU.

  6. Domestic Hearse

    The first time I had a Dilaudid injection, I described it as a big warm blanket being rolled up on my body.

    “Holy mother of God,” I said.

    “What, what? Are you okay? Let me listen to your heart,” said a suddenly concerned nurse.

    “No, no. I’m fine. It’s just a good thing I never discovered this stuff in college.”

    And I immediately fell asleep. Awoke a little bit later, heaving into a one of those tiny little puke tins they provide at the hospital. By now, they have to know better, right? My cat can fill up that thing, how’s it supposed to suffice for a 200 lb man?

    That’s when I discovered that Dilaudid does not play nice with me. Back to regular old morphine, which in comparison, is like an aspirin.

    I’m glad you were able to tolerate it, Jack. It’s a wonder drug for busted up race car drivers, cancer patients, and burn victims.

    I understand your eagerness to chuck the Oxy. Blunts the mind, and only marginally effective in blocking pain. I describe it like this: With Oxy, I’m still in pain, I just don’t care as much.

    When you are taking it, be sure to also take an industrial strength laxative. Oxy does a number on the involuntary muscles of the lower GI tract. Which means, you’re not moving stuff through normally, and you can get backed up in a hurry.

    Other’n that? Fuck being productive right now. Stop should’ing yourself. Your priority now is self-care. That’s hard for those of us who work best on deadlines and stress with multiple projects going on simultaneously. We feel guilty being still. Can’t wait to get back in the mix. Go-go-go. Just don’t, for now. Pull up Still Life Talking on the iPod, and chill.

  7. Athos

    On the up side, your arm doesn’t look like peperoni which is how my dad’s did when he had a heart attack long time ago.

    Glad to see everyone seems to be recovering.

  8. disinterested-observer

    But the morphine eased the pain,
    And the grass grew round his brain,
    And gave him all the confidence he lacked,
    With a Purple Heart and a monkey on his back.


Leave a Reply

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.