Comfort Zone

Chapter 24

"I cleaned up my act, doc."

"Oh that's wonderful, Angel, I knew you could do it."

"When my doctor tells me to do something, I do it." He hit the wall with his fist for emphasis. You're a sociopath, Angel Orjuela. You will never clean up your act but you will try to manipulate me into giving you exactly what you want.

"I'm getting out more, like you said. I've been going to church. I went yesterday." He paused.

"That's wonderful," Miriam said again. Don't let him come to mine or I'm converting.

"Problem is I'm in so much pain I can't even kneel down. My knees you know."

Here it comes! Get ready! What a great way to start the week.

"I really want to go, though. It does something good for me. I just want to feel good enough to go. Tylenol doesn't work. Motrin hurts my stomach. My insurance doesn't cover that other medicine you ordered. I even tried marijuana—sorry, doc, I know I shouldn't tell you this, but I want my doctor to know everything!—but it didn't touch the pain. The only thing that works is that oxycodone you gave me last time."

You mean the oxycodone I replaced after the first batch got flushed down the toilet.

Angel was someone who never showed up for appointments, but came in as a walk-in on especially busy days, or after five P.M., either sneaking in when someone forgot to lock the door, or knocking and begging her for some favor when she went to see who it was. She thought many times about discharging him from her practice but didn't have the heart to do it.

Miriam's thoughts ran on. I should stop prescribing narcotics altogether and refer everyone to a specialist, like a lot of other doctors have. Pain management is a pain in the butt. Besides her DEA nightmare fantasies, there were a slew of Florida regulations. Earlier ones had been successful in closing many of the mills, places that in the past had charged hefty fees to patients for fake spine MRIs that justified prescribing huge amounts of narcotics, securing Florida's reputation as the Oxycontin capital of the country. More recent regulations were crafted in response to the opiate overdose epidemic; it remained to be seen whether these would work.

Miriam was careful to satisfy all the requirements, including having patients sign a contract with her, just like the one Mr. Gill signed, and broke, with his pain specialist. Still, in the back of her mind was always the fear of screwing up and facing a fine, or worse. Plus there was increasing evidence that narcotics didn't even work well for chronic pain. Was she even helping anyone? Would medical marijuana be the panacea some claimed, or just another false cure-all?

"Let's try a smaller dose," she said, bringing her attention back to Angel and church, quashing the thought stay home and pray!, and replacing it with a more professional mantra: he's doing the best he can, we're all doing the best we can, he's doing the best he can...

"Love you, doc," he said when he left.

"Love you, too." My God, I just said I love you. What a hypocrite I am. I'm a liar, maybe a compulsive one by now.

The next patient said his wife was complaining that he blasted the TV volume, but it sounded fine to him.

Must be wax, he said, but when Miriam looked, his ears were clean, and everything else looked normal.

"Can you fix it?" He was tapping his fingers on his thigh to some silent song, and Miriam remembered that he played guitar in a rock band. Although only in his forties, the loud music had likely taken its toll.