David Wallace - Infinite jest

‘So I am here with you again in this room!’ The M.D. sings, kind of, when he talks. The name in gold piping on his white coat has a D and a K and a shitload of vowels. Gately almost had to reach up and swat this M.D. after surgery to keep him from hooking up a Demerol drip. That was between let’s say four and eight days ago. It’s probably But for the Grace that his Crocodilian sponsor Ferocious Francis G.’s sitting here watching blandly when the Pakistani M.D. sweeps in this time.

Plus they all have this flourishy M.D. way of sweeping Gately’s chart up off their hip and holding it up to read it. The Pakistani purses his lips and puffs them out absently and sucks off his pen a little.

‘Grade-two toxemia. Synovial inflammation. The pain of the trauma is very much worse today, yes?’ the M.D. says to the chart. He looks up, the teeth emerge. ‘Synovial inflammation: nasty nasty. The pain of synovial inflammation is compared in the medical literature to renal calculus and ec-topic labor.’ Partly it’s the darkness of the classic face around them that makes the teeth seem so high-watt. The smile widens steadily without seeming to run out of new teeth to expose. ‘And so you are now ready to let us provide the level of analgesia the trauma warrants instead of Toradol, simple headache ibuprofen, which these medications are boys doing a large man’s duty here, yes? There has been reconsidering in light of the level? Yes?’

Gately is inscribing an enormous vowel in the notebook with incredible care.

‘I make you aware of synthetic anipyretic analgesics which are no higher than Category C–III [354]for dependence.’ Gately imagines the M.D. smiling incandescently as he wields a shepherd’s crook. The guy has that odd clipped singsong way of talking of skinny guys in loincloths on mountains in films. Gately superimposes a big skull and crossbones over the glossy face, mentally. He holds up a palsied page-high A and brandishes it at the M.D. and then brings the notebook back down and swiftly up again, spells it out, figuring Ferocious Francis will step in and set this ad-man for the Disease straight once and for all, so Gately’ll never have to face this kind of Pakistani temptation again with maybe nobody supportive here next time. C–III his ass. Fucking Talwin’s C–III, too.

‘Oramorph SR for an instance. Very safe, very much relief. Fast relief.’

This is just morphine sulfate with a fancy corporate name, Gately knows. This raghead doesn’t know who he’s dealing with, or what he’s.

‘Now I must tell tell, I would make the personal first choice of titrated hydromorphone hydrochloride, in this case —’

Christ, this is Dilaudid. Blues. Fackelmann’s Mount Doom. Kite’s steep-angled decline, as well. Death on a Ritz. The Blue Bayou. Gene Fackelmann’s killer, by and large. And also Gately pictures good old Nooch, tall skinny Vinnie Nucci, from the beach at Salem, who favored Dilaudid and spent over a year without ever taking the belt off his wing, dropping through Osco skylights at night on a rope with the belt all tight and ready just over his elbow already, Nucci never eating and getting skinnier and skinnier until he seemed to be just two cheekbones raised to a great silent height, even the whites of his eyes finally turning the blue of the bayou; and Fackelmann’s eliminated map after the insane scam on Sorkin and a disastrous two nights of Dilaudid, when Sorkin’d —

‘— though I say yes, this in truth is a C–II medication, and I wish to respect all wishes and concerns,’ the M.D. half-sings, inclined at the waist now by Gately’s railings, looking closely at the shoulder’s dressing but not seeming at all disposed to even touch it, his hands behind his back. His ass is more or less right in Ferocious Francis’s face, who’s just sitting there. The M.D. doesn’t even seem to be aware 34-year-sober Ferocious Francis is there. And Francis isn’t making a peep.

It also occurs to Gately that esoteric is another ghostword he’s got no rights to throw around, mentally.

‘For I am Moslem, and abstain also, by religious law, from all abusive compounds as well,’ the M.D. says. ‘Yet if I have suffered trauma, or the dentist of my teeth proposes to perform a painful process, I submit as a Moslem to the imperative of my pain and will accept relief, knowing no established religion’s God wills needless suffering for His children.’

Gately has made two shaky smaller A’s together on the next sheet and is stabbing emphatically at the sheet with his Bic. He wishes if the M.D. wouldn’t shut up he’d at least move, so Gately could shoot a desperate Please-Jump-In-Here look at Ferocious Francis. The drug-question has nothing to do with established Gods.

The M.D.’s bobbing a little as he leans, his face coming in and then receding. ‘This is a Grade-II trauma we are looking at in this room. Allow me to explain that the discomfort of right now will only intensify as the synovial nerves begin to reanimate. The laws of trauma dictate that the pain will intensify as healing begins to commence. I am a professional at my job, sir, as well as a Moslem. Hydrocodone bitartrate [355]— C–III. Levorphanol tartrate [356]— C–III. Oxymorphone hydrochloride [357]— admittedly, yes, C–II, but more than indicated in this degree of needless suffering.’

Gately can hear Ferocious Francis blowing his nose again behind the M.D. Gately’s mouth floods with spittle at the memory of the sick-sweet antiseptic taste of hydrochloride that rises to the tongue with an injection of Demerol, the taste Kite and the lesbian burglars and even Equus (‘I’ll Stick Anything in Any Part of My Body’) Reese all gagged at but that poor old Nooch and Gene Fackelmann and Gately himself had loved, came to love like a mother’s warm hand. Gately’s eyes wobble and his tongue protrudes from a shiny mouth-corner as he draws a crude syringe and arm and belt and then tries to draw a skull-and-bones over the whole shaky ensemble, but the skull looks more like a plain old smiley-face. He holds it out to the foreigner anyway. The dextral pain’s so bad he wants to throw up, throat-tube or no.

The M.D. studies the palsied drawing, nodding the exact way Gately used to nod at Alfonso Parias-Carbo the totally ununderstandable Cuban. ‘Oxycodone-nalaxone compound, [358]with a short half-life but only a C–III grading of abuse.’ There’s no way the guy could be like intentionally making his voice this wheedly-sounding; it’s got to be Gately’s own Disease. The Spider. Gately envisions his brain struggling in a silk cocoon. He keeps summoning to mind the little detox-story Ferocious Francis tells from the Commitment podium, how they gave him Librium [359]to help with the discomfort of Withdrawal, and how Francis says he just threw the Librium hard over his left shoulder, for luck, and has had very good luck ever since.

‘Likewise as well the time-tested pentazocine lactate, which I can offer with assurances as a Moslem trauma-professional standing here in this room in person with you at your bed’s side.’

Pentazocine lactate is Talwin, Gately’s #2 trusted standard when he was Out There, which 120 mg. on an empty gut was like floating in oil the exact same temperature as your body, just like Percocet [360]except without the maddening back-of-the-eyeball itch that always wrecked a Percocet high for him.

‘Surrender your courageous fear of dependence and let us do our profession, young sir,’ the Pakistani sums up, standing right up next to the bed, the left side, his professional lab-coat hiding F.F., hands behind his back, the dull glint of the metal corner of Gately’s chart just visible between his legs, immaculate of posture, smiling cheerily down, the whites of his eyes as ungodly white as his teeth. The memory of Talwin makes parts of his body Gately didn’t know could drool drool. He knows what’s coming next, Gately does. And if the Pakistani goes ahead and offers Demerol again Gately won’t resist. And who the fuck’ll be able to blame him, after all. Why should he have to resist? He’d received a bona fide Grade-Whatever dextral synovial trauma. Shot with a professionally modified.44 Item. He’s post-trauma, in terrible pain, and everyone heard the guy say it: it was going to get worse, the pain. This was a trauma-pro in a white coat here making reassurances of legitimate fucking use. Gehaney heard him; what the fuck did the Flaggers want from him? This wasn’t hardly like slipping over to Unit #7 with a syringe and a bottle of Visine. This was a stop-term measure, a short-gap-type measure, the probable intervention of a compassionate unjudging God. A quick Rx-squirt of Demerol — probably at the outside two, three days of a Demerol drip, maybe even one where they’d hook the drip to a rubber bulb he could hold and self-administer the Demerol only As Needed. Maybe it was the Disease itself telling him to be scared a medically necessary squirt would pull all his old triggers again, put him back in the cage. Gately pictures himself trying to shunt through a magnetic-contact burglar alarm with a hand and a hook. But surely if Ferocious Francis thought a medically advised short-term squirt suspect, at all, the old reptilian bastard would say something, do his fucking job as a Crocodile and sponsor, instead of just sitting there playing with his nostril’s little noninvasive tube.

‘Look kid, I’m gonna screw and let you settle this bullshit and come back up later,’ comes Francis’s voice, subdued and neutral, signifying nothing, and then the rasp of the chair’s legs and the system of grunts that always accompanies F.F.’s getting up from a chair. His white crew cut rises like a slow moon over the Pakistani’s shoulder, which the M.D.’s only sign of acknowledgment of Francis is to sort of tuck his chin down into his shoulder like a violinist, addressing Gately’s sponsor for the first time:

‘Then perhaps you would please, Mr. Gately Senior, if you please help us help your concerned and brave boy here but a boy I believe whose cavalier attitude underestimates the level of coming discomfort which is sadly unnecessary altogether if he will let us help him, sir,’ the Pakistani sings over his shoulder to Ferocious Francis, as if they were the room’s only adults. He’s assuming Ferocious Francis is Gately’s organic Dad.

Gately knows a Crocodile never bothers to correct anybody’s misimpres-sion. He’s halfway to the door, moving with maddening slow care like always, as if walking on ice, twisted and seeming to limp off both legs and heartbreakingly assless in the baggy seat-shiny wide-waled old man’s corduroys he always wears, the back of his red neck complexly creased as he moves off away, lifting one hand in a gesture of acknowledgment and dismissal of the M.D.’s request:

‘Not my business to say one way or the other. Kid’s gonna do what he decides he needs to do for himself. He’s the one that’s feeling it. He’s the only one can decide.’ He either pauses or slows down even further at the open door, looking back at Gately but not meeting his wide eyes. ‘You keep your pecker up, kid, and I’ll bring some of the son of a bitches by to look in again later.’ He slips in ‘Might want to Ask For Some Help, deciding.’ The last of this comes from the white hall as the Pakistani’s glossy head comes back in close with now a tight strained-patience smile, and Gately can hear him inhaling to get ready to say that of course in Grade-II traumas of this severe type the treatment of preferred indication is the admittedly C–II and highly abusable but unsurpassed for effectiveness and tightly controlled administration of one 50-mg. tab in a diluting saline drip q. 3–4 hours of mep—