Performance Enhancing Drugs

Posted by Ian Ganassi

Sometime in April of 2012 I was diagnosed with severe stenosis of the cervical spine which the doctors said had to be treated right away through surgery or I would end up paralyzed. Of course this was a terrifying diagnosis—if I had the surgery I could end up paralyzed but if I didn’t I would definitely end up paralyzed. I had no choice and consented to the surgery.

Leaving aside the fact that the diagnosis took place in April and I didn’t get a surgery appointment until July, I will say that spine surgery is one of the many areas in which modern medicine is doing miraculous things.  But this blog is not about the medical condition or the surgery per se, it’s about one facet of my experience at the hospital.

Unfortunately, one of the areas in which modern spine surgery (or modern surgery in general I guess) is not so advanced, is that of controlling inflammation. The doctor told me after the fact that toward the end of the procedure it’s standard to administer large doses of steroids to control swelling. There’s a slight drawback to this practice which is that a substantial number of patients react to steroids with psychosis and delusions. Perhaps it’s for the best that the doctor didn’t say anything about the steroids, because it couldn’t be avoided, and would probably only have added to my anxiety. On the other hand I can’t help resenting her silence a bit.

A significant portion of the steroid experience, though not the whole thing, was terrifying, if for no other reason than that I was having it. I spent more than two days in a delusional state before the damn things finally wore off.

But the entire “steroid trip” (or what I remember of it) is interesting in a number of ways and for a number of reasons. It has some of the fascination of Through the Looking Glass or of a Carlos Castenada type hallucinogen experience, and also has some interesting personal and extra-personal implications.

The steroid trip, at least in my “sober” mind, divides itself into four “scenarios.” These are “The floor with the 20-something-year-old roommates,” “Restrained for pulling out my feeding tube,” “Restrained with a small person,” and “restrained while the real nature of human existence is revealed.”

I should add at this point that I am still unsure which parts of the experience were real and which were delusions or what characterized the continuum between those two states. I’m not even sure of the sequence of the scenarios. Parts of the “trip” have the quality of dream, but I’m not sure whether I was actually sleeping through some of it (which seems unlikely since the steroids affected me as a stimulant), or wide awake. Also, I don’t remember most of the transitions between the scenarios.

Several times after the steroids wore off I crossed paths with some of the real people who were also in the trip. It was a very strange sensation, as though someone from a dream walked up to you on the street when you were wide awake and introduced him or herself.

In the first scenario I have a roommate who is middle-eastern and who has various friends and relatives coming and going. I know that that much of the trip was based in reality. However in the trip instead of being in hospital beds etc. we are sleeping on the floor in a tent (probably a trite association on my part with the middle east and the desert). However this doesn’t last long; I become annoyed with the roommate because he leaves the TV on all night and I ask him to turn it off, which results somehow in the breakup of the roommate relationship (I believe this really happened).

I don’t know what happend to him, but I end up in a large room that I believe to be in the basement of the hospital. I also believe it is in Albany, New York. (In reality I never left New Haven or the fourth floor of the hospital where I was being treated.) This room is a very large dormitory for women that are either aspiring pharmacists or aspiring nurses (this is an ambiguity of the trip). Every nurse/pharmacist on the floor has a share in the job of helping to restrain those of us who are there for that purpose. The method of restraint is very peculiar—it consists of rows of hedge-like bundles of something like holly, shot through with silvery wires. It is like some sort of weird Christmas display but also has the quality of a line of foxholes. The “foliage” and the “wires” are alarmed, have magnetic properties (they emit an unseen force that holds you on the ground) and can also administer electric shocks. Some of these “hedgerows” are beds for the residents, while some are being used as restraints for people like me. The beds do not restrain the “normal” residents, although there is no external difference between the two kinds of “hedge-beds.”

And once again, at a later point when the steroids had worn off I encountered the girl who had played the biggest role in this scenario of the trip. It turned out she was in fact a nurse, and that one of her jobs consisted of packaging medication, probably for hospital use, and that she was the daughter of a clergyman (even though she looked Jewish). She recognized me, and greeted me with a “hey bud” that implied she had been aware of the condition I was in when we had first met. It was also interesting in that she was very insecure in my presence, in a sort of charming way, but I have no idea whether this had anything to do with our previous encounter.

The oddest thing, however, about the restraints is that they react to sexual arousal. The slightest hint of arousal causes the various restraining factors kick in. They also react to other things, like trying to get up to use the bathroom or to talk to someone across the room. At one point a debate arises among the pharmacist/nurses as to which portions of the restraints are appropriate. Only two or three advocate for the arousal restraint. The girl I recognized after the trip was over (Zoe) is on the liberal side of the argument and feels that the arousal and bathroom restraints are unfair. It also seems that she was semi-formally the “manager” or person-in-charge. An interesting factor is that every time an interpersonal episode of any kind occurs Zoe uses the P.A. system to announce it to the hospital. This is the same P.A. system over which prayers are read (it was a Catholic hospital, which may have had to do with some of the gender politics in the trip). She would say things like “Disagreements remain unresolved for the near future—“ sort of weather reports of the psychological atmosphere.

The good news in this scenario is that I am able (I believe Zoe was the one in charge of my real restraint and again she was on the liberal side of the situation) to go to the bathroom, move around a bit, etc., though most of the time I am restrained. I only get in trouble when I struggle directly against the restraints, or try to leave the room.

Yet another abrupt transition: I’ve left the basement and am in a smaller room where it seems I’m just loitering. However my nose is very irritated by a tube that the doctors installed which goes down to my stomach in case there’s an urgent need to give me something I can’t take by mouth (that much really happened). I’m also seething with anger or frustration, though it’s not exactly clear why. I keep reaching for my nose because I want to pull out the feeding tube but a male physician’s assistant keeps thwarting me in some way. At one point they force me into a pair of pajamas that also restrains my arms, but I am able to tear it open by exerting all of the muscular force of my arms and shoulders. Next they put a big pair of pillowy boxing gloves over my hands which make it impossible for me to grab anything. However these gloves have a velcro seal and I am able to tear them open with my teeth and get out of them. Finally I succeed in pulling out the feeding tube which is white and is made of some sort of flexible ivory-like substance. For some reason I roll it up and put it on a table. It is also attached to a black thread, and although I can pull out the tube the thread remains behind (I later figured out that my pulling out of the tube with the thread left behind really happened). I try to pull out the thread but it seems more attached to me than the tube did and there’s the feeling that if I pull it out I will also pull out part of myself. I leave the thread in where it stiffens and curls into a loop to form a bizarre mustache-like formation.

My pulling the feeding tube out enrages the attendant. It appears that the tube is made of something valuable (quite a bit like ivory) and that by pulling it out the wrong way I have lowered it’s value. There’s also some squabbling amongst the staff as to who has the rights to the tube-substance. Finally (and in this case there is a recognizable transition) three staff members manage to get me onto a bed and restrain me, and the person I think of as a “small person” is put in a chair beside me (although in the trip there’s some ambiguity whether she is on the bed with me or in a chair at the side of the bed).

This person is very interesting in terms of personal appearance, and in the trip this makes a great impression on me. She’s very small and compact, though she doesn’t literally have a “little people” body type. She has short stiff brown hair, wears earrings, looks Asian in some ways and African in others. Her gender is definitely female but her body has pronounced male characteristics. She is physically very strong. In the beginning of this episode I once more split my restraints and sit up with the intention of leaving the bed, but the small person is able to hold me down and retie the restraints.

At this point I begin to become used to the idea of being restrained. I start to think that the rational reaction to being restrained is to just relax and try to calm down and make the best of the situation. It also occurs to me that the restraints have to be a temporary condition. Perhaps the steroids were wearing off at that point. On the other hand, starting with the small person episode, I once again begin to pay attention to, and be very puzzled by, and also fascinated with, whatever it is that goes on in the room to which I’m confined. There are many desks, some of them manned and some not. It seems that something is being packaged, probably medication (I still don’t know what exactly was happening and it’s possible that this part of the trip was largely hallucination). It could be a pharmacy for the hospital except that I remember that before surgery I asked a nurse how the drugs were adminstered and she told me that each individual floor had its own dispensary. In any case there’s the sound of staplers, people busily walking back and forth, taking things out of cabinets and returning to their desks, etc. I begin to develop a theory that this is a criminal operation, probably part of a distribution system for illegal drugs. An internal argument starts in my head. On the one hand I feel that “drugs are bad,” and the illegal operation should be shut down. On the other hand I think to myself maybe it doesn’t matter, maybe drugs have to be sold like any commodity, and that the real nature of human existence is based on the exchange of goods, services and money. The debate deepens to question whether the latter view is cynicism or just pragrmatism.

At this point there’s another significant shift in the trip and its emphasis. Out of the blue, the small person asks me to explain what a “theme” is in a piece of writing. I explain the concept very well (I’m not sure I could do it that well without steroids). It turns out she’s a senior in high school and wants to be a writer. She is preparing to take a test that is important for college admission (maybe the SATs, although this is not clear in the trip). She asks a couple of further questions about writing and we have a very pleasant conversation about genres in which to write, possible careers in writing, and so on. I tell her about my experience as a technical writer, the editing I’ve done, some of my other experience with business-related writing. It turns out that she writes poetry and wants to pursue that as a career. I tell her how difficult it is, that being a teacher is really the only career for a poet, how incredibly competitive the writing field has become, especially poetry, and so on. At some point I offer to look at her work, which is kind of amusing, since I’m restrained on the bed and she’s watching over me from a chair.

I also try eloquence on her to get her to loosen or untie some of the restraints. I talk about how fascinated I am with what’s going on in the room and that I won’t try to escape; I try to persuade her to be more interested in what’s going on, I elaborate my theory that something is being packaged and sold. The small person is interested in all this but not to the point of loosening my restraints.

I basically give up on getting out of the restraints on my own. However at this point I have the epiphany which is both the high point and the ending point of the trip. Or at any rate I don’t remember anything after the epiphany until I find myself hallucination-free and lying in a hospital bed.

While watching the goings-on in the room I return to my previous conundrum regarding whether the activity is legal or illegal and whether it matters. The epiphany consists of realizing that the activity is in fact illegal. What is being packaged and distributed is a new drug that will make everyone happy with their lot in life (echoes of several dystopias). At the moment it is being marketed as an illegal party drug like Ecstasy. This is the way the makers of the drug are field testing it. (Of course this makes no sense in real world terms but in the vision it seemed normal.) Eventually, when the field test is over, they will try to introduce it to the legal market. Unlike a recreational drug, the pill is a one-time dose that will produce a lifetime of happiness. It is the ultimate anti-depressant. My internal debate, upon understanding the entire plan, is resolved. I conclude that if I were a doctor I would have no qualms about prescribing “a pill to solve all your problems.” I decide that the answer to the conundrum is “whatever works,” and that what works is the free market and “better living through chemistry.”

Bear in mind however that this was my attitude in the vision; my normal waking attitude is much more circumspect and ambiguous. And I don’t use recreational drugs of any kind.

A Freudian critic could probably have a field day with this blog. I considered attempting such an analysis but it would have doubled the length of the piece and I’m not sure how useful it would be. Suffice it to say that if this “story” (for lack of a better word) has a moral it’s to take care of your health and stay away from hospitals and doctors bearing therapeutic drugs. Of course that’s not always possible, but do your best.

For myself, I pray that I never have to do it again.

On the other hand, in this case Nietzche’s famous adage “what doesn’t kill me makes me stronger,” seems to have some limited truth value. In general I feel the statement “It didn’t kill me but it didn’t make me stronger,” is closer to the truth for most traumatic experiences. In this case, however, I do think there’s some added strength from having gone through it and come out on the other side relatively whole. At least so far (a big “at least”) I feel more confidence in my ability to stand up to stress. It’s as though some part of me is saying “if I can get through that with minimal help, I can get through anything.” Here’s hoping that feeling stays with me.

Ian Ganassi is a poet and writer living in Connecticut. His poetry, prose and translations have appeared in Octopus, American Letters & Commentary, The Paris Review, Sawbuck, New England Review and, among others.