ACHIEVE
by Robert Rickelman
As my drinking continued unabated, and cost me yet another crummy warehouse job, my brother Kurt and his wife Jane understandably insisted that I move out of their house and find some sort of rehab that would take me. Kurt found a place called ACHIEVE, which was a rehab center located in Schaumburg, a northwest suburb of Chicago.
On mild, but windy Wednesday afternoon, January 25, Kurt delivered me to the admitting area at ACHIEVE. It was late afternoon, just before 5:00. I was toting a brown paper bag that contained two pairs of jeans, three sweatshirts, and some socks and underwear.
Kurt introduced himself to a staff member. “Hi, I’m Kurt Rickelman. I talked with Lois about getting my brother Rob a bed in your detox.”
A woman said hello to Kurt. “Yes, she left a note. I’m Grace. And I assume that you’re Robert.” She was talking to me.
In a shaky voice I said, “Yes, I’m Robert.”
“Well,” Grace said, “this is a 28 day detox and rehab. The total price for the entire program is $450.”
“Yes,” Kurt said, “four-fifty. Do you accept personal checks?”
“Yes we do,” she said. “A personal check will be just fine.”
Kurt handed her the check. “Do you need me for anything else?” Kurt asked.
“No, we’ll take it from here. Thank you for bringing Robert. We’ll take good care of him.”
“Thanks.” Kurt turned to me. “So long Rob. They’re going to help you get yourself together.” H hugged me and I stifled the tears that were welling up.
“Thanks for everything, Kurt. I love you.”
“Love you too. Get yourself better.” He turned and walked away. I felt lonely and afraid.
“Well, Robert, could I have your bag please? We need to check to make sure you didn’t pack any prohibited items,” Grace said. I gave her the bag. She emptied everything, found no contraband, and put it all back.
“Russell here is our health aide. He’s going to take your vitals.”
I looked at Russell. He was huge — grossly overweight. I figured he had to weigh close to five hundred pounds. His shirt and jeans were filthy and stained. His hair was greasy, and he looked like he hadn’t showered in days.
“Okay Robert,” Russell said, “take a seat here and I’m going to check your vitals and give you a blood alcohol breath test. I’m sure you’ve been told that we only accept patients who are completely sober. Why don’t we do the breathalyzer first?”
He handed me a black instrument with a nozzle sticking out of one side.
“Just blow into the nozzle until I say stop.”
I held the breathalyzer and blew into for about five seconds until Russell said stop.
He took the device from me and checked the LED readout. “Good news,” he said. “You blew a zero. Looks like you are going to be our guest for the next four weeks.”
I was relieved. I had been drinking so heavily for the last few days that I wasn’t certain that all the alcohol would be out of my system.
“Now we need to get your vitals,” Russell said. “First we’ll get your temperature.” He placed a thermometer in my ear, it beeped, and he read the temperature. “One-hundred point one,” he said, “you have a slight fever, which is typical for the first day of detox.”
Next he wrapped a blood pressure cuff around my bicep and pumped a bulb. When he released the pressure he got his reading. “Wow! One ninety five over one fifteen. We’re going to have to keep an eye on you. And your pulse is 120, which is way too high. We’ll be taking your vitals every two hours until they become much more manageable. Well, I guess that’s it for now.”
“Well,” said Grace, “grab your things, Robert. I’m going to show you your room.”
I hesitated then took a breath and asked, “Is this a medical detox? I mean am I going to get some medicine to calm my nerves? I’m shaking like a leaf.”
“Yes, I noticed the shaking. I hate to tell you Robert, but this is a non-medical detox. We don’t have a license to give out medicine like sedatives or sleep aids. The first few days will be a rough ride. I’m sorry.”
“But what if I have a seizure? I’m pretty worried about having a seizure. I’ve been drinking real heavily for a long time.”
“Well, every once in a while, someone does have a seizure, and we call an ambulance. So we’re ready if you do have a seizure.”
“What if I have a seizure while I’m alone? Like in my room.”
She cut me off. “You’re worrying too much. Let’s go find your room.
She led the way as we walked down a hallway with faded green walls and old brown and tan linoleum tiles. I thought that the building had probably been a school, and old classrooms were now clients’ bedrooms. It was a depressing place.
We stopped at room number 10, and went inside. There were three beds. She pointed to one located against the farther wall. “That will be your be for the next 28 days, Robert. Not luxurious, but better than being homeless. Especially in this weather.”
“Yeah,” I said, “I was pretty close to being homeless. I’d definitely worn out my welcome with my brother and his wife.”
“Well,” she said, “you have lots of time to get yourself together, and we’re going to do everything we can to get you clean and keep you clean. Okay, so why don’t you put your things away. It’s just about dinner time. I’ll show you the way to the cafeteria.”
We walked ways and reached the cafeteria. It had probably once been the school gymnasium. There was a long line of about twenty or so people. I took my place at the end.
“Enjoy your dinner, then get some rest,” Grace said. Then she left.
When I finally got to the head of the line, a middle-aged man wearing a hairnet and whose hand shook furiously, handed me a tray with a plate of corned beef hash and two cornbread biscuits. All the tables were occupied, so I took a seat at a table where three other patients were eating.
“Hey, you’re new, huh? You can get a glass of juice over there,” said a clean-cut guy who looked to be about my age. I got a glass and filled it at a dispenser situated on a long lunch table.
“Welcome to ACHIEVE. I’m Kevin, this is Bill, and this is Lucy.” The sight of Lucy took me aback. Her entire face was terribly burned. She did not have a nose and one ear had been burnt away. She also had no eyelids or eyebrows, and she was missing three fingers on her right hand, and the thumb and index finger of her left. I tried not to stare as I was introduced to her. I shook Kevin’s and Bill’s hands, gingerly grasped what was left of Lucy’s right hand. Then I turned to eat my supper. My hands were shaking like crazy.
“It really sucks that they don’t give you anything for the shakes,” Kevin said. I was in your shoes three days ago.”
“Same here,” said Bill. “They shouldn’t make us go through this without some kind of meds.”
“Yeah,” I said, “I could really use something to help with these shakes.”
“Just try to hang in there,” said Lucy. She sounded sweet. I wondered what horrible thing had happened to her. I tried not to stare at her disfigured face.
“Well,” she said, “I know it’s hard not to wonder what happened to me. The scars and all. So I’m just going to come straight out and tell you.”
She was right, I wanted to learn what terrible thing had happened to her. And she began her story.
“Three years ago, my husband told me that he was leaving me for another woman. I was devastated. The night after he told me, I drove to a bar and got extremely drunk. When I left the bar, I turned onto the expressway and was speeding in my 1979 Volkswagen Beetle, a two-door convertible. Well, I was really pressing the accelerator. As I was approaching a large overpass I knew what I was going to do. With the car reaching its top speed, I aimed for one of the huge concrete pillars.
“That’s all I remember, but a week later, when I came out of my coma, I learned that when I smashed head on into the pillar, my car burst into flames. Somehow, I lived through the whole ordeal, but countless bones were broken or pulverized and I sustained third degree burns over seventy percent of my body. I couldn’t believe I had live through the collision. I had wanted to die. Instead, I would have to live through the agonizing pain of a broken body, and much worse, the disfiguring burns that would turn me into the ghastly creature you can barely keep your eyes on.
“I was in the ICU for a month, and transferred to a physical rehab, where I learned to walk again, and to deal with the pain of the healing burns. They gave me a lot of morphine, and after I left rehab six months after the crash, I was hooked on pain killers. So, almost a year after the accident I ended up here, trying to break my morphine addiction. So far, after a week and a half at ACHIEVE, I haven’t made much progress. I need the goddamned morphine. It’s all I have to help me deal with the torture I suffer every waking moment of my life.
I felt so sorry for her, and more than a bit ashamed of myself. But I was going through some wicked withdrawal symptoms of my own. Surely nowhere as severe as hers, but my nerves were screaming and every inch of my body quaked. I wasn’t sure I’d be able to make it through detox without something to calm my screaming nerves. I remembered my first rehab, some eight years earlier. Back then I was given 100 mgs of Librium every four hours, and the withdrawal symptoms were significantly less severe.
I had no appetite, so I excused myself and went to my room to lie down. My heart was pounding and I felt like I had a 500 pound weight crushing my chest. I stayed in bed until lights out which arrived at 10:30. My two roommates came into the room laughing and having a good old time. I envied them. I didn’t know how long they had been at ACHIEVE, or how severe their withdrawals were.
After my roommates finally quieted down and fell asleep, I relaxed a bit. But I was anxious about having a seizure. I knew that seizures were most common in the first 12 to 72 hours of a person’s last drink. It had been just about 24 hours since my last drink, and I was experiencing all the text book symptoms of alcohol withdrawal. First of all were the constant, pervasive trembling, and the rapid breathing and sweating. I was also experiencing incredible anxiety and insomnia. When I finally managed to fall to sleep, I experienced vivid, terrifying nightmares. I suffered through the agony of my first night of non-medical detox.
When I did fall asleep, staff members were constantly waking me up to take my vitals. From what I understand, there wasn’t any improvement over the numbers they got when I was first admitted. I hoped that my numbers would stay high, and that they’d have to send me to a hospital to get my blood pressure and pulse down. But that did not happen.
I was certain that I was going to suffer a seizure. I could only recall suffering one seizure before. I was living on Southport, and I hadn’t eaten in a couple of days. So I took the L train to a blood donation center where I was paid seven dollars for a pint of blood. To save money, I walked the five or so miles back home. On my way I stopped at the supermarket near my apartment and bought a cheap package of hot dogs for fifty-nine cents, and a six-pack of Blatz, which cost me two bucks.
I returned home and put the beer and hot dogs in the fridge. Suddenly, I felt very dizzy. The next thing I knew, I was lying on my back on the hard kitchen floor. The back of my head hurt like hell, and I felt a good-sized bump there. The only thing I could figure was that I’d seized, and come to a little later. It was a frightening event.
I lay in bed throughout the night. The loud snoring of both my roommates did not help me relax.
I finally made it through the night and awoke at 6:30. I looked out the window. It was still dark. I didn’t wish to hear the constant snoring of my roommates, so I put on a pair of slippers and left my room for a common area. The room was empty. I sat on an old, over-stuffed couch. My entire body was still racked with tremors. I knew it would be at least a few days until my nerves would finally calm.
People began waking and coming into the common area. On top of a long table were two commercial-sized, silver coffee makers. The last thing I needed was a cup of coffee. As it turned out, both coffee makers contained decaffeinated coffee, which was a source of a lot of bitching from people who wanted their caffeine fix. But I was told that ACHIEVE did not allow real coffee. Too many people were experiencing various degrees of withdrawal, so caffeine was verboten. I’d later learn that even the soft drink vending machine contained only caffeine-free sodas.
Another problem concerned tobacco items. There were no cigarettes for sale, but they were allowed if you had your own, or if a visitor brought them for you. A couple of people, desperate for real coffee and cigarettes would sneak out and make a beeline for the convenience store across the street. Most of them got away with it, but those who got caught were discharged from the program. It sure didn’t seem worth the risk to me, but there were several people who didn’t want to be there in the first place. Most of those people were brought there by family, and a handful were court-ordered. For the court-ordered, it was either ACHIEVE or jail.
It was fascinating to watch the people as they came back with their contraband. Every one of these brave, or “I don’t give a shit” patients returned with cigarettes, many of which they sold to patients who weren’t willing to make the mad dash across the street. Others would return with liters of Coke or Mountain Dew, which I learned packed more caffeine than Coke or Pepsi. Others would bring large-size cups of real coffee. A couple, one girl in particular — her name was Penelope, and she was quite the free-spirit — would buy coffee, cigarettes, as well as candy and gum. During the four weeks I was there, five people got caught and kicked out. Penelope got caught once, but for some reason, the staff allowed her to stay. I think they did that because the alternative for her was jail. I was amazed that, even after she was caught, Penelope continued to risk the dangerous journey across the street. She had chutzpah, that was for sure. And she was extremely friendly and kind to everyone, be it a staffer or patient. Maybe it was her charm that allowed her to stay after getting caught.
Breakfast began at 7:30. I took my place in line and was served by the same guy with the shaky hands. We were having waffles, the toaster kind, along with pork sausage links. There was orange juice at the long table against the wall. I very carefully filled my glass and headed to the same group that I sat with the night before, Lucy, Kevin, and Bill.
“Still have the shakes, huh?” Kevin asked. He was the most talkative and outgoing of the three.
“Yeah,” I said, “I know it’s going to take a while to get better,” I said.
“Just hang in there, buddy. Pretty soon you’ll be as good as new,” Kevin said.
“What’s the deal with the server guy? His hands shake almost as bad as mine,” I said.
“Oh, that’s Larry. He never stops shaking,” Kevin said. “I had a pretty good talk with him the other day. He really knows his stuff about how alcoholism can fuck you up for good. He told me that forty years of chronic alcoholism affected his nervous system. Something about a Mylar sheath. Anyway, what he said was that he drank more than a fifth of vodka everyday for, like I said, for forty years. He said he couldn’t count how many cases of beer he drank over that time. But after he quit drinking and was sober for over two years, he still had the shakes, mostly in his hands but also his head kind of bobs up and down, and his voice is always shaky. The doctors told him that alcohol eats away at the Mylar, which really messes up your nerves. Some people recover, but some people, like Larry, will never get over the shakes. The damage is just too bad. So, he’s stuck with them for the rest of his life. But he’s a great guy and he has a great attitude. And he really loves being sober.”
For the most part, Kevin was correct, but what he was calling the Mylar sheath is actually the myelin sheath. Mylar is the foil-like material that’s used for shiny, reflective balloons. But Myelin is different. It’s a crucial component that protects the body’s nervous system. Myelin is made up mostly of fat and cholesterol that wraps around the nerve cell to insulate the neuron and direct the nerve’s impulse to where it’s supposed to go. Alcohol is a solvent and it eats away at the fatty myelin sheath. When myelin wears down, that opens up a variety of potential problems with memory, movement, and coordination. The shakes are just one of the terrible results of damage to the myelin sheath. Sadly, in Larry’s case, this damage is permanent.
“Shit,” I said. “If I was going to have a life of shaking like that I’m not sure I would want to be sober.”
Bill, who didn’t like to talk much said, “My doctor told me that for most hard-core alcoholics, it can take as long as two years for the shakes to completely go away. If you go sober for over two years, and still have the shakes, he told me that you’re pretty well fucked. You’re gonna end up like fucking Larry.”
I didn’t say anything. I had been sober for 17 months from Memorial Day of 1987 to October 1988. Even after all that time my hands never stopped shaking. I hated eating with a fork in front of people, and I hated to have anyone watch me when I wrote, like when I had to sign a check or something. I didn’t know that to this day I would suffer from what the doctors called benign essential tremors. There is nothing benign about them to me. Doctors would wind up putting me on Propanalol, which was a beta-blocker blood pressure medication that helps fight the tremors. Klonopin was also very helpful, but staying on Klonopin caused a long string of battles with psychiatrists and nurse-practitioners who railed about its addictive properties. Fuck them. When you come right down to it everything I take, anti-depressants, anti-anxiety, anti-psychotics, and even my asthma meds are just as addictive. It’s not like I could just stop taking any of that shit, but the fucking doctors are always against the Klonopin.
After breakfast, I went to my room to lie down. The staff allowed patients who needed to rest, to stay in bed for the first day or two. As well they should have, in light of their not giving detoxing patients any medicine to salve their quaking nerves. I would stay in bed the entire day, even skipping lunch so that I wouldn’t have to interact with anyone. I was just too damn nervous and sick to be around people, and sleep was a phantom that I continued to unsuccessfully chase. Still, lying in bed helped somewhat.
Realizing that I needed nourishment, I dragged myself to the cafeteria for dinner. There was no line. I was the last person to show up. Larry placed two sloppy joes and some fries on my plate. I thanked him, got a glass of juice, and went to sit with the only people I knew.
Lucy was the first one to say hello. “We missed you during groups today.”
“Yeah, I said, “I just stayed in my room trying to get some sleep. That didn’t happen, but at least I got some rest. I’ll try to make the groups tomorrow.”
“Did they give you a schedule?” Lucy asked.
“Yeah, I guess the first group meets at 9:00 tomorrow,” I said.
Lucy said, “Some of the groups are pretty good, and at least they fill the time.”
I toyed with my food and managed to eat one sloppy joe and a few fries.
“Does anyone want my other sandwich?” I asked.
Bill said, “Thanks. I’ll take it if you’re not hungy.”
“No. Go ahead, I have no appetite. These damn shakes are killing me.”
“It’ll get better, I promise,” Kevin said.
I got up and said good night. I emptied my tray in the trash and went back to my room to try to sleep. My blood pressure and pulse were still high, and staff was still monitoring me every two hours. I hated that, but I figured it was a good idea.
I tossed and turn between visits from staff. At 6:00 the next morning, Marleen, one of the health techs came to my room to get my vitals. My temperature was back to 99 degrees, but my pulse was 110 and my blood pressure was 185 over 100. This was somewhat better than when I first arrived, but she was still concerned. After she left I got up and walked to the common area and sat on a couch.
A pretty, but very young girl sat next to me. She was drinking what she told me was a cup of instant coffee, with real caffeine, and she was smoking a cigarette. This was before there were any kind of bans on smoking.
“Hi, my name is Darcy,” she said. “You’re new I guess.”
“Hi. I’m Rob. I got here the night before last. I’m still shaking pretty bad.”
“So alcohol is your drug of choice?”
“Yeah. I was in a twenty-eight day rehab in 1981. University of Illinois Hospital, and they gave us Librium until the shaking and danger of seizures were over.”
‘Yeah, this place is pretty low rent.”
“What are you in here for?” I asked.
“Mostly for cocaine, and also uppers.”
“God, I can’t even imagine doing any speed right now. Or any time for that matter. I’m way too nervous for that.”
“So I guess you’re not interested in a cup of coffee.”
“No, thanks. I’m already crawling out of my skin.”
“Is that why you drink? Because you’re so nervous?”
“Yeah, I guess so. When I drink, I’m a lot more outgoing. A lot more.”
“I hardly ever drink,” she said. I can’t stand the taste of beer, and I don’t really like wine much either. Which is good because I’m only nineteen.”
‘Nineteen, wow. What’s the age minimum for this place?” I asked.
“Eighteen. You have to be eighteen to be admitted. I turn twenty next month.”
“Well,” I said, Happy Birthday.” She didn’t ask me how old I was. I was relieved. At thirty-three I felt like a dirty old man.
“Thanks. So. How do you plan on functioning if you stop drinking?”
“I saw a psychiatrist in ’83, and he suggested Valium, but I was afraid of getting addicted, so he put me on Inderal, which did help somewhat.”
“Yeah, that was smart of you to stay away from Valium. I’ve seen so many doctors, and I’ve been in a few psych wards. Oh, I want to warn you of the number one drug to stay away from. It’s the worst. That’s Klonopin. I got so fucking hooked on Klonopin, and the withdrawal is hell. But they’re not going to be prescribing any meds here. They don’t have a license for that.”
Klonopin. Speak of the fucking devil.
“Are you on any meds right now?”
“ No, but the doctors have had me on a bunch of them. Let’s see. I’ve been on Prozac and Paxil, they didn’t help at all. You know, I think that the best medication the doctors ever put me on was Wellbutrin. Yeah, I would even consider going back on Wellbutrin if I could kick my fucking cocaine and speed addictions. I love the rush I get when I do a few lines of coke. I was really doing a lot before I came in here, probably about three grams a day. But I’ve been lucky. There is a woman here, Karen, whose septum is fucking deteriorating. You’ll see her. She usually walks around with Kleenex up her nostrils because of the constant nosebleeds. And one time I saw her sneeze and a bunch of pieces of cartilage flew out of her nose. She’s a fucking mess, but she can’t stop doing it. I wouldn’t be surprised if she was still snorting lines in back of the stage area in the cafeteria.”
“She’s doing coke in here?” I was stunned, and scared, very scared. I wanted this to be a safe place. I needed a safe place.
“Oh you don’t know the half of it. People are doing drugs back there, and some are having sex back there. Don’t say you heard it from me, but I know that Karen has fucked at least one guy. His name is Tony, and he gets her blow. She’s married, and her husband even visits her, but she gets high with Tony and they screw behind the stage.”
“Doesn’t staff catch on?”
“No, it’s like they don’t even want to know about all the rule breaking and shit that goes on around here.”
“Well, as long as no one brings in a kegger, I should be safe.”
She laughed. “You know, I’ve been here for almost two weeks and I haven’t seen anyone drinking. Probably because alcohol smells so strong. Anyway, I’ve gotta go take a shower before breaksfast. Remember when you get out. Stay away from Klonopin. It’s the drug from hell. Talk to you later. Try to relax, Dude.”
Wow, Darcy sure knew her shit. And I have to admit, she was young, but she was a fucking doll.
About the Author:
Robert Rickelman was born in Chicago and moved to Tucson in 1995. He earned his BA in Spanish from the University of Arizona, which is where he was introduced to, and deeply affected by, the Latin-American genre of Magical Realism. Robert had five nonfiction stories published last spring and summer. His work appeared in Inscape Magazine, Twisted Vine Literary and Arts Journal, The Long Island Literary Journal, and Blue River Review. His work will appear this spring in Barely South Review and the Bitchin’ Kitsch.