Storytime: seeing the dirty doc

I jump down from the examination table in one of the back examination rooms of Dr. Ved’s medical practice yet again, unable to sit still. Though I am still in a walking boot and know I shouldn’t, I can’t stop myself from pacing, shocked that I haven’t seen the doctor yet even though I came here first thing in the morning and have been waiting for three hours.

I would say it is unbelievable that this place exists, but it is more unbelievable to me that places like this seem to be relatively rare. From the second I walked into the office with Chris, I observed indications that I was in the presence of drug dealers. The looks on the faces of the 12 people who were waiting in the main office: some vacant and slack, others fully present with desire and irritation. The drug-dealing demeanor of the front-office secretary: equal parts disagreeable firmness against manipulation and flexible malleability towards earning the sale.

And the waiting, oh, the waiting! People waiting over by the smelly and neglected fish tank in the main office, people waiting by the Jurassic-era TV that barely works, people waiting by the ancient People magazines that also seem to be waiting for somebody to finally update them. We wait in line just to wait in a chair just to wait on the examination table in the back office, staring daggers at the clock.

I pace back and forth in the tiny back office, worried about the urine sample that I gave them – won’t it come back positive for heroin, methamphetamine, cocaine, oxy, weed, and xanax? Won’t they kick me out after that, since doing street drugs makes me automatically undeserving of pharmaceutical drugs that are essentially chemical equivalents, despite the fact that pharmaceutical drugs will reduce the harms associated with the drugs that I am going to use regardless?

The doctor can prescribe me cleaner, safer pharmaceutical drugs, or I can go sell street drugs to somebody’s son to get the money I need to buy more street drugs in a ghetto, which I will inject with puddle water if I have to – doesn’t matter to me. It should matter to everyone else, though, because the social safety net will have to front the bill when I go to the hospital to get the infection cut out of my arm, which drives up healthcare costs for all of us. If there’s one thing that God knows, it’s that an IV street drug addict isn’t going to pay his co-pays on his way out of the hospital.

I’m already manic with drug cravings; I’m losing my mind. I should’ve done a shot before I came here. I don’t know what I was thinking, ‘show up to the appointment sober.’ I’m not sober, I am intoxicated with the poison of misery. This doctor is going to take one look at me, peg me for the dangerous junkie that I am, and send me on my way, empty-handed and broken-hearted.

I feel a strange urge to curl up in a ball on the floor – an urge which immediately passes, though not before escaping through my lips in the form of a curse word.

“Fuckin’ fuck,” I whisper-whine, to myself, shocked that it is only 11 AM and I am already this far into withdrawal. I find myself staring at the door, absolutely torn between taking action right this second – wandering into the hallway and finding somebody who can give me drugs, right now – and forcing myself to sit back down and wait, since that is really the only reasonable way to get what I need.

“Lonnie?” a nurse asks, through a thick Hispanic dialect, as the door opens.

“Yes,” I say, turning towards her more suddenly than I mean to, mid-pace.

“Are you ok?” she asks, recoiling from me slightly, her face equal parts confusion and disgust.

“Yeah, my ankle hurts, and I can’t sit still,” I say.

“Ok. Come with me, Dr. Ved is ready for you,” the nurse says, glancing down at her clipboard before leading me out of the back examination room and down a short hall into a room that is directly adjacent to the exit back into the waiting room.

The entire office consists of a large waiting room full of smelly, broken, outdated, and neglected things and people, a glass booth where we can talk to the secretary without the ability to strangle her in craving-laced, withdrawal-induced frustration, and a single entrance/exit that has only one short hallway with three rooms: two back rooms for more waiting, and one room in which we actually see the only doctor in the medical practice. After we exchange money for drugs, we take three steps and are spit back out into the waiting room of the world.

“Here is Lonnie,” the nurse says, opening the door to the messiest doctor’s office I’ve ever seen. My eyes lock onto the eyes of a disheveled, overweight man who looks as fucked up on drugs as I could ever hope to be.

“Come in,” the doctor says, blinking slowly at me from behind a small, flat, black glass desk that is overflowing with papers. There is a small medical laptop parked in front of the man that must be Dr. Ved. I walk into his office and take a seat in the wooden chair that is a few feet away from his disorderly desk.

“Thanks for seeing me on such short notice. Chris said you were a good doctor, but I didn’t think I’d get to see you so quickly,” I say, both name-dropping and complimenting him, which should help me get what I need.

“Yeah. Sorry for the wait,” he says absently, staring at his computer.

“It’s no problem at all,” I say, which makes him look up at me. He looks from my face down to the large walking boot on my right leg.

“What happened?” he asks, zoning out on my walking boot.

“I had my peroneal tendon reconstructed. It hurts,” I say. He looks back at his computer and blinks slowly again, before typing and clicking slowly for a solid minute. I now understand why we are all waiting for hours every time we come here. This man moves in slow motion.

“I believe that it hurts. Looks like you got vicodin a little while ago,” he says, not looking up from his laptop, which gives me a hot flash of anxiety.

“Yeah,” is all I say, because denial followed by talking too much would imply deceit and guilt, yet elaborating in short form is often done by using the truth, which would require an open admission of guilt.

The door to his office opens, and a different nurse pokes her head inside.

“Dr. Ved, Jason is calling again and again, saying he is coming to the office to see you,” the nurse says.

“What? I told him he has to go back to our detox,” Dr. Ved says, irritation mixing into the sedated confusion that is on his face.

“I told him that you said that, but he said he’s coming here, and he’s demanding to talk to you. He said he’s not-”

“He has to go back to our detox, that’s it. I’ll see him again when he’s done in 5 days. Tell him that,” Dr. Ved says.

“I’ll try, but he might still come here,” she warns.

“Come and get me if he starts to make a scene,” he says, glancing back at me, effectively dismissing the nurse. She withdraws her head from the doorway, not even bothering to look at me once.

“Sorry about that,” he says.

“It’s ok. I’m sure you’re a busy guy,” I say, instead of saying something like ‘wow, you really are the ultimate hustler, playing both sides of the drug game. Giving us massive quantities of potent drugs that have as high a potential for addiction as any street drug, and then putting us into your detox once we’re hooked and you decide to pull the plug’.

“Where were we?” Dr. Ved asks.

“My ankle hurts,” I say, eager to drop the pretensions now that I know this dude has exactly the kind of character I would expect based on his actions.

“Right, you had surgery, I can see that here. We usually prescribe painkillers when people are in pain,” he says, again blinking slowly.

“That makes sense,” I say, blinking back at him.

“Right. What do you want?” he asks, moving his computer aside slowly and pulling a prescription pad closer to him.

“I think oxy works better for me than vicodin,” I say, before internally reprimanding myself for using the slang term of ‘oxy’ even if this dude is a straight-up dirty doctor.

“Oxy, 20 milligrams. 90 of them. How’s that?” Dr. Ved asks, without looking up at me, his pen hovering over the prescription pad.

“I think that would help a lot,” I say, as he writes the prescription. I glance around the room, and notice for the first time his old, filthy black dress shoes and the sticky floor underneath him – like he spilled some coca-cola a few days ago but doesn’t care to clean it up. He must be taking klonopin or xanax; only benzos could make somebody so careless.

“Come get this,” he says, holding his arm out weakly. I stand up eagerly and move to secure two pieces of paper – two separate prescriptions, which are dated a day apart, exactly like Chris said. One of them has yesterday’s date on it, which means I can fill them both today. Chris's instructions come back to the forefront of my mind:

"Pay attention. You’re going to get two prescriptions for 20mg oxy pills. Two separate prescriptions. They’re going to be dated a day apart. You go downstairs to Skyscraper Pharmacy (fake name), which is the pharmacy that he owns, and you pay for one of the prescriptions in straight cash – do NOT use your insurance to fill that prescription, do you hear me?” Chris asks, his eyes as wide as his cheeks are sunken in.

"Fill it at Skyscraper Pharmacy right downstairs, nowhere else. Dr. Ved owns that pharmacy. It’s a little mom and pop type place, they have old computers and technology on purpose because they keep minimal records. If you use your insurance, that prescription is automatically going to be entered into the drug monitoring database for controlled substances like oxy.

“That doesn’t mean you can pay cash anywhere else and you’ll be fine. If you pay cash at a pharmacy like Walgreens, they’re going to enter it into the database, too, because they’re a big corporation and they have policies like that,"

“Pay your co-pay at the front desk. Make sure you go to Skyscraper pharmacy first – and don’t go to Costco or CVS, they don’t fill my prescriptions,” he drones, as if automatically reciting an internal script that serves to move the cogs in the machine that keep his hustle moving – a hustle that is beyond the schemes of even my wildest dreams.

‘How did you get here?’ I want to ask. ‘Did you start doing drugs when you were younger and decide to become the ultimate drug dealer, or did you start experimenting when you were older and find out exactly why billions of doses of painkillers and benzodiazepines are prescribed and sold every year?’

“I almost forgot to tell you. The pain gets so bad that I can’t sleep sometimes,” I lie compulsively, even as my thoughts are elsewhere.

“What do you want?” the doctor asks, moving slowly towards the prescription pad.

“Xanax works for me,” I say.

“How many?” he asks.

“Can we go for 60?” I respond.

“Fill it at Skyscraper downstairs,” Dr. Ved repeats, as he fills out the prescription and hands it to me.