The End of My Addiction

want to wake him. She gave me Tylenol, which had zero effect, and I waited. The hiccups hammered my broken ribs for a long time before eventually subsiding on their own, but I continued to have intense pain.
    Four hours later, after this nurse had gone off duty and been replaced by a new nurse, an attending physician came on rounds with a group of interns. I recognized his name as someone who knew my sister, and we spoke briefly about Eva. I told him the Tylenol was not moderating the pain.
    The attending physician said, “Of course, it’s insufficient. We’ll give you Tylenol with codeine—” He stopped himself. “Well, in your case, we’d better not.”
    “Why not?”
    “Because you could become dependent on it.”
    “I realize that alcoholics have an increased risk of becoming dependent on painkillers. Even alcoholics do not become addicted to painkillers when they take them for actual pain, however, but when they take them in anticipation of pain.” I did not add that this was basic pain medicine and something all doctors should know, not just pain medicine specialists. Patients who are on a self-controlled morphine pump do not become addicted to morphine.
    The attending physician said, “I’d rather be on the safe side. You’ll just have to suffer a bit on Tylenol, and wait for the pain to go.”
    “Suffer a bit? With three broken ribs and hemopneumothorax?”
    The attending physician would not be persuaded, and he left the room with the interns. The nurse who had come on duty that morning followed him out. When she returned ten minutes later, she had six tablets of Tylenol with codeine. She gave them to me and said, “Take two at a time every eight hours.”
    I took two because the pain was then very bad, and within fifteen minutes they produced complete pain relief. Eight hours later the pain had once again become severe. This time, afraid that I would not be given more the next day, I took only one pill, and it worked. In the middle of the night, I again took one pill to help me sleep. Although the pain was still bad, it lessened to the point where I could just barely tolerate it. The next day I was given more Tylenol with codeine, but I continued to take the absolute minimum I needed to rest.
    The nurse told me that she had forced the attending physician to prescribe the six tablets by saying she would report him for cruelty. That was a brave and compassionate act. She said her father had died of alcoholism, and that he had sometimes been treated callously by physicians who knew that an alcoholic’s complaint would likely be dismissed as delusional. She also said the attending physician had expressed anger at me for being an alcoholic doctor and said that my asking for pain medication was a sign of weakness.
    As for the hemopneumothorax, two attempts were made to evacuate the blood from my chest cavity with a needle. It is a slightly risky procedure, because the needle can introduce more air and increase the pneumothorax. The first time, they got nothing; twenty-four hours later, after more X-rays to check that the pneumothorax had not been increased, they drew off a small amount. As the pneumothorax did not impair my breathing, it was decided not to do anything more and to let the lesions in my pleura heal on their own.
    This hospital had an excellent alcoholism treatment center. While I was there, I talked to one of the physicians in that department, Dr. S., and she agreed to see me as a patient. She also arranged for me to have a body computed tomography (CT) scan to check for any further internal injuries and, at my request, a sonogram to check for liver cirrhosis, which would be a death sentence. I was terrified of having contracted cirrhosis, but I had never asked for a sonogram before because I didn’t want to know.
    In the United States sonograms are usually performed by medical technicians, whereas in France they are performed by physicians. During the sonogram, I asked the physician doing it if she saw any signs of cirrhosis. Although she was naturally supposed to report only to the physician who ordered the test and not the patient, she told me, doctor to doctor, that she saw fatty liver tissue, but no cirrhosis. It was a huge relief to hear this.
    Being accepted as a patient by a new alcoholism specialist and having another medical lifeline eased my mind a little. But within fifteen months I had broken my wrist, shoulder, nose, and three ribs, the last with potentially