keller at flash.net
Sat Jul 27 23:06:47 EST 1996
This letter is from an individual to their doctor seeking help for their
condition. If anyone has knowledge of this sort of problem we'd like to hear
from you. Thanks.
The letter is as follows-
This letter is a bit longer than usual (2½ pages) -- but it is very
important that you read it right away, before you even put on your white coat
and start seeing patients.
Since we have reached a point in our relationship where all the stops
have been pulled out, I am going to write the most brutally honest, direct
letter I've ever typed out to you.
It is my nature, as you know, to be polite and reserved. But I think
it may tell you more about me if I just say whatever comes to my mind.
First things first: I want to wean off Clorazepate (I''ve been having
a problem with my abdomen hurting constantly for the past several days, even to
the point of keeping me awake; Phrenilin aggravates this after a certain point,
and I'm not sure but that even Clorazepate does the same). If you would give
me one fill (about 30) of the low-powered kind (3.75 Mg.) of Clorazepate, that
should be enough.
As you know from my letter yesterday, I failed miserably in a job I
tried to take on Friday morning. I have to tell you, frankly, that I wept over
that on and off all day... because it's happened so many times before.
As I start this letter, it is 2:00 A.M. Saturday morning. I have been
trying without success, despite Clorazepate and even a little Phrenilin, to get
to sleep for the past 2 hours. I cannot rest; these thoughts are churning
through my head and I might as well put them down on paper.
I recently wrote a letter to a friend of mine, Craig Smith by name, at
the City Christian Fellowship church. Craig is an extremely gifted Christian
recording artist -- his music is beautiful and touching -- as well as a very
kind-hearted person who deeply loves God. He presently occupies the role of
pastor of that inter-non-denominational church (to which many Catholics come,
because the people are so kind, love God so much, and have such a cheering and
positive outlook. They firmly believe in what the Bible says).
I will include here a modified excerpt from that letter about how
things proceeded for me after a certain date in 1978:
From that point on... well, it's almost impossible to put into words,
but I'll try to get something of it across to you.
Think of the worst, most terrifying nightmare you ever had in your life
-- one in which the entire atmosphere was so deadly that you were literally
scared spitless. Then, imagine waking up in the morning... and instead of the
dream-fabric fading away as it normally does, the fear remains completely with
you; you are just as terrified while awake as you were while having the
And the fear doesn't go away. All day, all night, all the next day...
and on and on and on.
Next, think of the most bummed-out, depressive, miserable day or brief
period of time you've ever experienced; a day or two that is so completely
wretched that you really wish you would be the victim of a drive-by shooting --
and I'm not exaggerating.
This terrible depression, just as the awful fear, does not go away
either. On and on, day after day, week after week, month after month. You can
barely sleep; you totally lose interest in doing anything whatsoever; you can
hardly function at all.
Finally, imagine waking up each day with a powerful feeling of physical
malaise. Your body feels bad, all over, in a way you can't put into words.
You ache; worse, you get attacks of bad abdominal pain alternating with
frequent horrible headaches. You've had the same type of headaches and
abdominal pain earlier in your life -- but they're worse and more frequent now.
In a word, you feel absolutely horrible. Life is just absolutely
wretched for you.
Naturally, you seek the help of Physicians and even Psychiatrists /
Psychologists and Counselors. You even end up going to Treatment Programs.
The Medical Doctors run some usual tests but can't find anything specifically
wrong; the Psychiatrists prescribe Antidepressant medications which not only
don't help, they actually make the problem even worse (Elavil, for a start;
this causes even worse bad dreams). The Counselors talk to you and the
Treatment Programs try to put you through disciplinary regimens.
None of these do any good whatsoever.
Try very hard to imagine all of these things afflicting you at once.
There are no answers; no insights; and absolutely no relief. Period.
In the understatement of the century, this is pretty darned bad. If
you're expected to stay on your feet and function, it can hardly get any worse
Now... not too long after these things have got hold of you, you
suddenly end up unexpectedly, one morning when you're supposed to start a new
job, in hospital for a kidney stone. I don't know if you've ever had one of
these but it is said there are very few things that compare with the pain they
produce. You will be writhing all over the place, groaning, throwing up,
because the pain is so unbearable. You can't possibly drive; someone else has
to take you there.
Then, at the hospital, you are given shots of painkillers -- I.E.,
Demerol, Morphine, etc.
And now, something very like an epiphany occurs.
After the administration of the drugs, the pain recedes into the
background. But that is not the thing that immediately grips your attention.
What does make you literally sit up and take notice is the fact that
not only does the physical pain float away, but all the fear, the depression,
the misery, the anguish, the physical malaise -- all these drift away too, as
if they had never existed. For the very first time in months, you feel just
like you did before all the horrors started.
From here on I will make the story as brief as possible. Ever since
that ordeal in the hospital (August 1978), my life has been a running battle
with opiate-type pain medicine -- because it was the only thing that gave me
relief from the unbelievable wretchedness I suffered. I've seen photos of
myself from that time frame; one can tell by looking at my face that something
was seriously wrong with me -- I had this awful expression on my face, as if I
were suffering from some unbearable internal pain. I looked so bad that it
drove some girl I used to go to school with to start praying for me. I've
probably driven my personal physician (whom I've known for 10 years) close to
stark raving mad with my incessant requests for pain-type medication [NOTE:
This is you, Dr. (XXXXX)]. A lot of times the requests were legitimate enough,
as I do get very bad migraine-type headaches and bad attacks of abdominal pain
-- but more frequently it was just to relieve the awful depression and physical
bad feeling. Whenever you've seen me with the familiar bit-into-a-sour-lemon
countenance, you can just about bet that I haven't had any medication of that
type recently and am really suffering.
There was more to that letter, but that was the part pertinent to this
Dr. (XXXXX), do you begin to get the picture? Can you imagine waking
up just about every blessed day, having an indescribable but very bad feeling
over your entire body and/or aching all over? And it being a literal torment
from hell just to get up and do anything at all? And being so miserable and
depressed that you just do not give a damn about anything?
In all honesty, I would not want you to. I would not want Adolf
Hitler, that unbelievably evil and cruel leader of Nazi Germany, to go through
Everyone wakes up not feeling so good occasionally, but this goes very
far beyond that. This, to me, is a cruelty beyond belief. You may have
already guessed this -- but I will confirm to you that I have had a death wish
for at least the past 13 years.
Now, do not misunderstand me on this: I have never -- repeat
emphatically -- never, entertained the idea of ending my own earthly existence.
The same deep, deep belief in God that keeps me from falling apart completely
makes me know, of a certainty, that a human being does not have the option to
end his or her life. It is God-given, for some reason; however unfathomable
that reason may be.
That does not mean that I have not still desired to die very greatly.
I tell you the truth: I have craved death as a man stranded on a desert craves
water. I have hoped I would die in an accident. I have fantasized about dying
in a short-term but fatal illness. Any way at all, as long as it would let me
out of this horrid existence.
Naturally, nothing even remotely like that has ever happened to me.
Once, years ago, a pretty knowledgeable pharmacist informed me that
some medical studies had shown that certain people had either a deficiency of,
or another problem which caused the interference of the action of, the natural
morphines (endorphins and enkephalins) in the body. He said that these people
suffered exactly the same sort of things that I had been suffering for so long
-- they just felt awful all the time for no apparent reason.
At the time I rejected this idea; for some reason it repelled me. I
suppose it was because it sounded like a death sentence, like something no one
could do anything about and would be ultimately fatal many years down the road.
But now... I'll be damned if I don't think that may be just exactly
what's wrong with me. Look at the facts: Apparently there is a natural
check-and-balance of endorphin flow in the body at most times, which makes
people feel normally good and able to function.
I feel horrible all the time; I ache, feel terrible otherwise, and am
depressed. It's like the endorphins simply aren't there at all, or are somehow
prevented from doing their job.
Many people are on an exercise kick. They push themselves hard; they
can run until they hurt and keep on running, and then they get what's known as
the Runner's High. This is because after a certain point of muscular strain
their bodies release endorphins, which make them feel ever so much better (and
they weren't feeling bad to start with).
Do you know what happens when I exercise to the point of aching,
shaking all over, and of nearly fainting?
Nothing, that is, except the most horrible feeling I've ever had in my
life -- the feeling that I'm going to die and wish that I could.
It does not make any difference how often this cruel regimen is
repeated. It can be prolonged endlessly and it does not help to the slightest
I feel horrible all the time and cannot function at all. Apparently my
body is either not producing the endorphins, or else they are somehow being
prohibited from doing their job.
Doctor -- I am absolutely desperate. What am I going to do? Truly, I
might as well be dead as go on like this -- it is pointless! I cannot
function; I cannot work; I cannot live.
This is exactly why I have sought pain pills, etc. so much. In
addition to relieving the very real and violent headaches and bad abdominal
pain I sometimes get (sometimes together -- now there's a real treat!), these
medications mimic what my body is apparently lacking. With them, I don't
generally feel drunk or high; I just feel like I did before this whole damned
thing started so many, many years ago. I can live. I can work. I can
Of course, pain medication isn't perfect by a longshot; its effect goes
downhill after a time and it can have side effects. And, of course, it can
produce physical dependency over a period of time -- though I've learned to be
pretty careful about that.
But it is absolutely the only thing I have ever found that make me feel
like a normal human being again -- like I felt before that turning point in
The most practical thing I've ever found, surprisingly, has been
Lomotil. Let me explain about Lomotil. It doesn't really behave exactly like
normal pain medicine. Lomotil takes a long time to take effect; it is very
slow and gentle about coming on. I just become gradually aware of feeling
normal again, the only side effect being that it makes my mouth a little dry.
Also, though the effect of Lomotil is much less pronounced than that of pain
pills, the effect is prolonged. 4 to 6 Lomotil can make me feel well enough to
function for a whole day.
Doctor, this is truly the bottom line: If I really can't have even so
much as Lomotil or Darvon any more (which is a pretty poor painkiller, not even
as effective as plain Codeine), isn't there for heaven's sake something that
can be done? The only other alternative I see is for me to be certified
completely and permanently disabled, in which case I am certain that I will
probably end up dying soon from sheer misery.
Is there anything, anything at all, that can stimulate the production
of endorphins in the body? I've heard of certain little externally applied
electronic boxes that produce carefully regulated electrical shocks that
stimulate endorphins. I've even read that acupuncture can cause this.
I know you don't have all the answers. I know that some things are
beyond you. But you are very intelligent and well-informed. If you can think
of anything practical, anything at all, please discuss them with me TODAY.
This has to be addressed NOW; it cannot wait!
Sincerely and Desperately,
&&&& & & &&& & & &&& &&&&
& & & & & & & & & Steve Keller
&&&& &&& &&& & & &&& &&&& keller at flash.net
& & & & & & & & & (214)279-1531 <modem/voice>
&&&&& & & &&& &&& &&& &&& & & http://www.flash.net/~keller
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