pain aphantasia
adventures in the morgue-adjacent bowels of the hospital
I was greatly looking forward to the extinction of my consciousness. Put me under! I can’t get enough of it. General anesthesia is a freebie, and you wake up still fucked up, if unpleasantly so. But most of the times I’ve been fucked up I have also felt unpleasant, both agent and victim of unpleasantness, so there is a familiarity to the sensation. Anyway, I wanted it. I wanted that sweet propofol. I elected to undergo this procedure in significant part because I yearned for the two and a half seconds between the initiation of the IV drip and oblivion.
The surgeon called in several prescriptions to my purgatorial local Walgreens. Fourteen cefadroxil; eight Zofran; five tramadol. I had told him, several times, not to send the opioid. “Just pick it up,” he kept saying. “You will want it. For the peace of mind.” He has a soft voice and a Russian accent and celery-colored eyes, my surgeon. I was shy to tell him that I can’t be trusted with opioids. I said fine.
When the automated Walgreens text came in I told them not to fill the tramadol and felt virtuous, but also cowardly. I picked up the antibiotic and the antinausea the next day. The pharmacist on duty was the father of one of my daughter’s playground acquaintances. We said hello, good to see you, and so on. His manner with social ties of this tenuous kind was unnervingly analogous to flirtation—eye contact, talking low, a wink—though so obviously impersonal as to make the nature of the analog clear. All the same, I briefly experienced what an excessively beautiful person must feel when she tries to move through the world: a fleeting sense of having been chosen; a frustration with my lack of agency in the dynamic; annoyance with myself for enjoying it anyway; impatience to get away.
The hospital was on Long Island, part of the same network as the hospital in which I gave birth. This time, because it was theoretically possible to know in advance what the hospital’s employees would wreak upon my body, I was shown a bill for the proceedings several days prior to the procedure. They brought me into a cubicle off the lobby and showed me several printouts. Sign this and this and this. Here is your obligation. The total sum which my insurance carrier had negotiated with this hospital network for the surgery would have paid my mortgage for over a year. And this was just the hospital fee! In-network! A whole separate piece of paper reminded me of all the fees which were not included in this sum: the anesthesiologist’s; my surgeon’s; the cardiologist’s. This last was mysterious, as my surgery had nothing to do with the heart, though I expect to receive a bill from a cardiologist shortly, possibly for even more money; who can say? What does any of it mean? I am in the most fortunate possible position, insurance-wise, in this country, at present. I signed the papers.
This portion of the ritual completed, I was tagged with a paper bracelet and led down to the hospital’s bowels: lower level two, intake and morgue. There I sat in a waiting room in which twinned rows of plastic-upholstered chairs faced one another, as if line dancing, and craned my neck to watch a small flat-screen television that had been mounted in the far corner, looming down upon me alone. It was playing an episode of My Lottery Dream Home. When there is a television playing anything, even silently, within my range of vision, I am powerless not to stare; this is why I cannot permit myself access to things like TikTok.
Because it was October, I was thinking of Daniel Kolitz’s excellent gooners piece every time I found myself experiencing this total vacancy in the presence of a screen. As Jon Baskin points out, the aptest metaphor for “the goonstate” is the fate of those who watch the lethal Entertainment cartridge in Infinite Jest—this kind of slavering and passive yet desire-filled attention. (Obviously David Foster Wallace had the proper reverent fear for the moving image. The man watched six hours of television a day.) That cartridge was supposed to consist of a crib’s-eye view of Joelle, the prettiest girl of all time, wearing a “white floor-length gown” (of course), leaning down over the camera and apologizing, over and over. I’m sorry. I’m so very, very sorry. The crib camera was fitted with some kind of mechanism called an auto-wobble meant to replicate the “infantile visual field.” And this, I think, is the neatest parallel: the medium reduces the viewer to a state of sensory overwhelm that is specifically infantile. There is an acknowledgement of total incapacity or failure unto death on the part of the viewer. Think of the gooner video introduced by a woman’s voice whispering “ominously, or perhaps sexily,” that “You can’t turn back”; the mother-figure’s apology implies that something has gone badly wrong with the baby and, of course, it’s the mother’s fault.
In an effort to tear my eyes away for a moment, I got up to retrieve a child-sized bottle of water from a table bearing a sign which read: WATER FOR PATIENTS AND FAMILY MEMBERS ONLY. Heaven forbid that the hospital might have to spend an extra thirty-nine cents on bottled water for all the tourists popping by on their way to the morgue!
Presurgical testing involved questions about every major organ system, the medical histories of my immediate and distant family members, my history with certain vices (here it is important to lie), and a blood draw. This last was more painful than I had anticipated, though I am a baby in the pain arena—even quite recently I have fainted in a medical professional’s office—so I attributed the sensation to my babyishness and not to any user error on the part of the friendly and gentle medical assistant.
Later that night a bruise had bloomed. It progressed from pinky orange to navy to gray to startlingly bright yellow, and it remains, albeit faintly, two weeks later. There were no even remotely comparable bruises from the major surgery I underwent in the meantime.
I sat in the preop room for a while, separated by a curtain from a man in his seventies who seemed to be there to have a toe amputated, and listened to him list, to various nurses in succession, the medications he took. The list was startlingly long and included many agents that modified the functioning of the heart, the thickness of the blood. He was on a GLP-1, and thus was able to answer the vice question by saying that he no longer had any desire for wine. There was a sense of wonder in his voice as he described this new iatrogenic anhedonia. They spook me, these drugs. Who doesn’t want to desire?
The anesthesiologist showed me a small clear bag of liquid benzos and said she was hooking it up to my IV. To help with nerves, she said, as I was taken to the OR. “It might tingle going in.” It did. But I was feeling no nerves; I was just dying for my propofol.
Finally I was wheeled down the hallway. My infinitesimal moment of pleasure approached! I wondered how they would ease me into unconsciousness. Would they have me count backward? From which number? How far would I get?
Strangely, there was another empty bed in the OR, and mine was wheeled in next to it; I don’t know if they planned to decant me into it, or if it was eventually removed, but it seemed to be the bed of a ghost, and this, finally, made me nervous; I wondered if the benzos weren’t working; this question was idle, it didn’t rise to the kind of panic swell that makes the heart beat in the ears, and in retrospect I know they must have worked; and yet that question is the last thing I remember. There was no counting. There was no rush of extinguishing agent in the bloodstream, no instant of elation. I’d been cheated. I didn’t remember it, and so it had never happened—the opposite of twilight sedation.
The surgery was to last four hours; I had been advised of this fact; I had no idea of its implications, and chose not to google or otherwise learn them. In fact it lasted more than six. When I returned to memory-forming consciousness in the recovery room I had gauze draped over my eyes and intermittent pneumatic compression devices massaging my calves, and my right bicep felt as if it had been slashed, and I was very cold. The soft-voiced surgeon appeared before me at some point and declared his satisfaction. I can’t imagine I said anything sensible in reply.
A wheelchair was brought around to take me from the hospital bed to my mother’s car, and I accepted it gratefully. I even put my feet on the little wheelchair foot rests. I had no remaining pride. In the car I was snappish with my mother and requested certain radio stations, and then silence. We were caught in rush-hour traffic and the car’s lurching aggravated the nausea brought on by my delicious propofol. Like any good drug experience, it came with a hangover so acute and prolonged I wished for more of the substance that had induced it, in order that I might delay the point when pleasure turned to suffering—but I did not regret the experience itself.
The bicep was the most painful part, weirdly. It wasn’t what had been operated upon. It had just been palpated by a blood-pressure cuff for six hours straight.
I did wish, upon returning home, for that Tramadol I’d so pridefully rejected. But I didn’t get it!
Anyway, now I can breathe better. Much like childbirth, I’m aware that the experience was painful, but I can’t call up a sense-memory of that pain. Is pain aphantasia universal?
Unrelatedly, a story of mine came out in Joyland this week. It’s also about oblivion.