As Needed for Pain

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As Needed for Pain Page 17

by Dan Peres


  One lie to solve two problems—the nodding out and my constant absences from the office. I was particularly proud of this one.

  But I knew it needed to stop. That I needed to stop. I’d seen Dr. Ron, the addiction specialist, three times in as many months, but every time—after a few days of injecting buprenorpine into my thighs and swearing off painkillers—I was right back at it.

  “These shots aren’t the answer,” Dr. Ron told me. “They don’t cure addiction. They’re just here to help you manage the symptoms of withdrawal. You need to go to meetings. You need more help than I alone can give you.”

  I didn’t realize how true that was until the summer of 2003, when I was in Milan for fashion week. I never liked Milan. I referred to it as the Trenton of Italy—industrial and bleak. There were some beautiful areas, of course, like the historic Brera district in the heart of the city, home to the Duomo and La Scala and the Four Seasons Hotel. Most of the city, though, was gray and depressing and reminded me of Soviet Bloc housing. I dreaded going. There were, however, two upsides—pasta and pills. Doctors in Milan, unlike those in Paris, could prescribe the same powerful opiates I was getting in America.

  I’d been going to Milan at least four times a year since taking over as editor of Details. In addition to the men’s fashion shows that I attended for a week every January and June, I went several times a year for meetings—one-on-ones with designers and fashion executives. Most of the revenue that the magazine made came from luxury fashion advertising—brands like Giorgio Armani, Versace, and Dolce & Gabbana—making Milan a frequent destination.

  Nothing eases the burden of being in a city you hate like staying in the Four Seasons Hotel. A converted fifteenth-century convent, the Four Seasons in Milan is one of the chicest hotels in the world. Tucked away on the relatively quiet Via Gesù and just a few doors down from the sprawling, art-filled home where Gianni Versace used to live, the Four Seasons was the best part of every trip to Milan.

  “Ciao, Signore Peres,” the doorman would say as I stepped out of the car. I loved this in any language.

  They always gave me the same room, 262, which was the size of a large New York City studio apartment and had a huge marble bathroom, stocked with fragrant Bvlgari soaps and shampoos that I used to stuff into my Dopp kit and take with me. It didn’t matter where I was, I smelled like I’d showered at the Four Seasons in Milan.

  I once stayed in room 262 for most of fashion week, because I didn’t have enough Vicodin to get me through the week and I got sick. I spent four days in a plush terry cloth robe sipping broth from room service and having housekeeping clean the room around me.

  This was before I knew I could get opiates there, which I did on two occasions. The first time, I asked the front desk to send an English-speaking doctor to the room. Within thirty minutes, a friendly bearded man with round tortoiseshell glasses showed up. I performed my standard back pain routine and he wrote me a large prescription. Piece of cake.

  The second time, about a year and a half later, was more challenging. I was taking sixty pills a day by this point—fifteen every four hours—but had run out the previous night. Early the following morning, I called down to the front desk to ask if they could arrange for a doctor to see me. Thirty minutes later, the same bearded man with round tortoiseshell glasses was at my door. I hadn’t considered that this might be a possibility. I pretended that we’d never met.

  “I remember you,” he said after I put on quite a show of hobbling across the room to illustrate how bad my back was. “I’ve seen you before, yes?”

  “I think you may be right,” I said. “What are the odds? This has happened only one other time since I had my back surgeries. Maybe I should stop coming to Milan?”

  He wasn’t amused, but wrote me a prescription anyway, though for far fewer pills than he had the last time.

  “The farmacia will give you thirty tablets,” he said, handing me the prescription. “Next time be sure to travel with your medication. I won’t be giving you any more drugs.”

  I filled the prescription at the pharmacy around the corner from the hotel and raced back to my room to take the pills and get ready for another day of back-to-back fashion shows. I could feel the drugs kicking in while I was in the shower—the warm tingling sensation that I’d come to need to function.

  With a few minutes to spare, I sat on the edge of the king-size bed wearing the white robe that was hanging in the bathroom, lit a cigarette, and tuned the television to CNN. The next thing I knew, I felt like I was slipping. Startled, I jolted upright. I had nodded out. The cigarette I’d been holding was next to me on the bed; a hole the size of a half-dollar was still smoldering at the edges in the top sheet. I quickly patted it out with the palm of my right hand before dousing it with what was left in the green glass bottle of San Pellegrino on the nightstand.

  I put on a navy blue suit and left for the Dolce & Gabbana show.

  Donna

  What’s wrong with you?

  By 2004, the doctors were asking. Their receptionists were asking. The pharmacists at the small mom-and-pop pharmacies were asking.

  Even if they weren’t saying the words, I could see it in their eyes when I came to the office for a prescription refill weeks before I was scheduled to.

  I could feel it in the way they crossed their arms when I explained that I’d lost the pill bottle on a recent trip here or there. And I could tell they were talking about me when they left the exam room to get my file.

  What had begun in 2000 as a well-rehearsed and polished performance for every doctor I saw was becoming harder to consistently pull off. After a few years, I’d started phoning it in and the cracks were definitely beginning to show.

  But this wasn’t always the case. In the beginning, the con was flawless.

  The act would start well before I got to the door of the doctor’s office, sometimes even when I was still a block or two away. What if the receptionist or nurse was out getting a coffee and saw me walking normally? I wasn’t about to take the risk. No, I got into character the moment I stepped out of the taxi or climbed the stairs from the subway. Like a method actor, I would limp down the street, sometimes dragging my right foot behind me like a ball and chain. I moved slowly and deliberately, stopping often to rest my leg and rub the small of my back, my face scrunched in pain. It was the most committed I’d ever been to anything.

  By the time I limped into the doctor’s office, I was out of breath, awkwardly lowering myself into the waiting-room chair like an expectant mother.

  I had been seeing three different pain management specialists a month, supplemented by new doctors—often neurologists—when necessary. These were the one-offs—the quick fixes for when I was in a jam—who wrote small prescriptions that I’d use to tide me over. The pain doctors were my bread and butter. They were more comfortable prescribing large amounts in higher doses. Their practices were made up of people in chronic pain—cancer patients and accident victims. I’d often have to step around their canes and walkers as I made my way back to see the doctor. They were in agony, misery seared on their faces. I used them as inspiration to hone my performance.

  Once every six months or so, one of the doctors would ask me to get an MRI so they could see what was going on with my spine. I happily obliged. Thanks to that disastrous cartwheel attempt years earlier, not to mention the scar tissue from my two surgeries, these MRIs always showed a messed-up spine and bulging discs—an unfakable prop that made the act all the more believable. And they all bought it. I always showed up clean-shaven and often wearing a suit, even on the days—and there were a lot of them—when I was going through withdrawal, my skin crawling, my heart racing, and my body aching for a fix. Those were the Oscar-worthy performances. I had to dig deep on those days, but in the end, it worked. I didn’t look like an addict. This was before opiate addiction was a national crisis. Before the CNN specials and the presidential commissions. This was before nice Jewish boys from towns like Pikesville who went to summe
r camp and did magic tricks looked like addicts.

  It always worked. I got all the pills I needed. Until I started to need more. I was feeding an addiction that had become insatiable. My tolerance had grown so high that the monthly prescriptions I was getting from the three different doctors combined—over eight hundred pills—barely lasted two weeks.

  The con got more elaborate.

  “I’m going on a two-week tour of Italian luxury goods factories for work,” I told Donna. “And then I’m taking a well-deserved vacation for a couple of weeks with my new girlfriend. We’re going to visit her family in Australia. It’s getting serious.”

  Donna was Dr. Stanley Fine’s sister and office manager. She ran the show. Nothing happened in that office without Donna knowing about it. She was in her early sixties and wore a white lab coat over her clothes. She was the widowed mother of two sons. One was a dermatologist with a new practice in Edison, New Jersey, and the other was a freelance journalist who’d written an unproduced play about John Wilkes Booth.

  “Maybe my son should be writing for your magazine,” she’d say.

  “Of course,” I always replied. “Please put him in touch. We’re always looking for dermatologists who can write.”

  “Oy. If you were my son, I’d smack your face,” she’d say.

  This was our shtick. I saw Donna at least once a month for three years and it was the same thing every time. I knew how to con a Jewish mom. I’d been conning my own for years.

  Just to play it safe, I had my assistant call the Condé Nast travel agency and have them put together an itinerary showing flights from New York to Milan and then, two weeks later, from Milan to Sydney. A trip I would never take. I didn’t even stop to consider what my assistant might be thinking; I didn’t care. I had been conning her, too, of course, but with far less dedication. Plus, I was starting to nod out in the office. Odds were that she knew I was a mess. That I could deal with, but for Donna, I needed to put on a good show.

  “I know I’m a week early for my prescription,” I said, handing her the itinerary, “but this trip is happening, and I don’t want to be without my medication while I’m away.”

  Medication. I never really considered it medication. Maybe when it was first prescribed to me around the time of my surgery, but it hadn’t been medicine in years. They were simply my pills. My fuel. I could count the hours of the day by how many pills I had left in my pocket, like beads on an abacus. They were so many things to me, those pills—fuel, an escape, and eventually a necessity—but medication was not one of them.

  “Let me see if I can grab Stanley,” Donna said. “Wait here.”

  Donna had Dr. Fine write me a prescription and asked to keep the itinerary for my file. I hobbled back out onto the sidewalk and limped my way to the subway.

  A few months later, I called Donna on her direct line and asked if I could come in to see the doctor in between my normal monthly appointments.

  “Didn’t we just see you a few weeks ago?” she asked.

  “Yeah, I know. I have another big trip planned. We’re launching an English version of the magazine and I’m going to be in London for three weeks hiring a staff,” I said, lying. “I’m dreading it.”

  As if somehow dread made the lie more convincing. The rate at which I was running out of pills impacted the con as much as it did my ability to function. Taking massive amounts of opiates has its share of powerful side effects, and lying should be at the top of the list.

  “Sure, Dan,” Donna said after a long pause. “Come on in.”

  That afternoon I got my pain face on and shuffled into Dr. Fine’s office. Donna was perched behind the counter, where she always was, talking on the phone. She didn’t smile at me the way she normally did. She just waved me over and held up her finger, signaling she’d just be a minute.

  She eventually brought me into the doctor’s office—a small, cluttered room with a large wooden desk barely visible under a blanket of papers and files. Stacks of drug samples in colorful boxes sat on top of a black metal filing cabinet. Nothing worth stealing—I always checked. I also scanned the desk for a prescription pad, but no luck. I’d never stolen one, but I’d fantasized about it, to the point that it was totally normal for me to quickly go through drawers when I was left alone in an exam room—cautiously listening for footsteps on the other side of the closed door.

  While I’d never written a prescription before, I did pretend to be a doctor once and called in a prescription to a pharmacy, back when Vicodin could be called in over the phone. I kept an unfilled prescription that a neurologist, Dr. Kornbluth, once wrote for me for a muscle relaxer. This would happen in the early days. Doctors would try to give me drugs I had no use for until I eventually just started asking for exactly what I wanted. One night shortly after 9/11, when I was a sweaty, dope-sick mess and contemplating yet another trip to the emergency room, I fished out the unused script. I had no idea what I was doing or if it would work, but I’d been in the room once when a doctor called in a prescription for me. The key, I learned, was to have a DEA number—a unique series of nine letters and numbers assigned to doctors by the Drug Enforcement Administration allowing them to prescribe controlled substances. It was ten p.m. and I called the twenty-four-hour pharmacy at 14th Street and Fourth Avenue and impersonated Dr. Kornbluth.

  “Patient’s name?” the pharmacist asked.

  Oh, right. I need to give a name. I hadn’t thought this through.

  “Joseph Silver,” I said, giving my grandfather’s name after a moment of panic.

  I read Kornbluth’s DEA number off the prescription and asked for thirty Vicodin—one to two every four to six hours as needed for pain—and held my breath.

  “Patient’s birthdate?” the pharmacist asked. I told him my grandfather’s birthday.

  “Okay. All set,” the pharmacist said. “Have a good night, Doctor.”

  Terrified I might get arrested, I nervously walked into the pharmacy thirty minutes later, wearing a blue Nike baseball cap pulled down low, the brim nearly covering my eyes, like I was casing the joint, and picked up my dead grandfather’s prescription.

  Donna didn’t mention anything about her son’s writing for the magazine this time. Instead, she sat down behind Dr. Fine’s desk and asked if I was okay, a look of genuine concern on her face.

  “We can’t give you the prescription, Dan,” she said. “You’ve been coming in too often. Dr. Fine and I are worried about you.”

  This was serious. Donna had always referred to him as Stanley when she spoke to me. It was only a matter of time until this happened. I’d become desperate and it was showing.

  “Why?” I asked.

  “Dan, you know we adore you,” she said, “but we think that maybe you have a problem. Are you taking the medication as prescribed?”

  “Of course I am,” I said with a touch of indignation. “Why would you ask that? I can’t control how much traveling I have to do for my job, Donna. I wish I could.”

  “This just doesn’t seem normal,” she said.

  There was that word again—normal—stuck to me like some junkie scarlet letter. She knew. The blood drained from my face. I wanted so badly to stop the charade. It was exhausting—all of the scheming and lying. I’d been trying since my first visit to Dr. Ron, and here was my chance to come clean with Donna. I genuinely liked her. I could cry with her, tell her everything. She was a Jewish mom. She’d hug me and tell me everything would be okay. I believed it when she said that she and Stanley adored me. Maybe they could help? Maybe this was the answer? But the fear of not having the pills, of going through the withdrawal, of living life without, overpowered any instinct I had to tell the truth. I needed drugs, not truth.

  Cornered, I clung to my lie and lashed out. “What are you suggesting?” I demanded.

  “I think you’re addicted to the medication and that you’re abusing it, Dan,” she said matter-of-factly. “It happens all the time. It’s okay.”

  “Nothing about this is
okay,” I said. “And I resent the accusation.”

  “Let me get Dr. Fine and the three of us can discuss this,” Donna said. “I’m not trying to upset you, but we feel like you need some help.”

  “Help,” I said. “The only help I need is for my back. Look at me, I can’t even stand up straight.”

  I exhaled deeply, put my hands on my thighs, and slowly rocked back and forth in the chair. The con was over, but I wouldn’t let go. Not yet. Maybe I could turn it around.

  I dug in. “Listen, I know all about addiction,” I said. “The magazine has published a bunch of stories about it over the years. I’m terrified of it. I’m the last guy who would ever abuse medication like this.”

  “Okay,” she said. “But we can no longer have you as a patient here. Dr. Fine will recommend another doctor for you.”

  “Wait. Please don’t do this,” I said, like some poor soul refusing to accept that his girlfriend was dumping him.

  “I’m sorry,” she said. “This is our decision.”

  “Fine,” I said. “You couldn’t be more wrong, but fine.”

  I stood up slowly, using the arms of the office chair to push myself up. My cover may have been blown, but I stayed in character.

  “I’ll leave,” I said as Donna stood from behind the desk. I could tell that this was hard for her.

  I limped down the hall.

  “Please don’t leave,” Donna said. “Let us help you.”

  “First do no harm,” I said, stopping and turning to talk to her. “Isn’t that what doctors say? Isn’t that part of the Hippocratic Oath?”

  I’m not sure where that came from, but I was ad-libbing at this point. This was unfamiliar territory, and I felt like I’d just been punched in the gut. Part of it was that I needed the pills, of course, but I also didn’t want Donna to think poorly of me.

  “Well, guess what?” I said. “You are doing a lot of harm right now.”

  “Come on, Dan. Why won’t you sit down with the doctor and discuss this?” she said as I hobbled out the door. “What’s wrong with you?”

 

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