Two pills? Or three?

I'm in the kitchen, leaning back against the counter, waiting for the coffee to brew and looking down at the pills in my palm.

I think over how I felt yesterday and how I'm feeling now, and I try to keep my mind on the decision at hand and not on the steep increase in my daily dose this summer.

My old reliable. I first started taking it after the infarction. I complained the first time the nurse brought it -- I don't need this -- but after a day or two I gave in. I found it hard to admit to myself how much better I felt. I kept taking it while I was in the hospital, and then all through my stay in rehab, and then in the weeks and months afterwards....

And soon it was just part of my new life. Wake up in the morning, grab the cane, make the coffee, take the pills.

But after a while, the usual dose wasn't always enough and I found myself taking an extra pill now and then. "Now and then" happened more and more often until my usual dose had doubled.

And it kept creeping up, but so slowly it was easy to think of it as normal. Wilson raised an eyebrow when he was here -- by then my usual daily dosage had doubled again -- but he didn't say anything.

And now I'm taking more than ever just to get by.

But it's what I need. I buy the biggest bottle the drugstore has but it barely lasts a couple of weeks. I look down at the pills, forcing myself to think only about how many I need and not about why I need them, and why I need so many.

They're not Vicodin.

They're docusate sodium and casanthranol. They look a little like jelly beans.

The more Vicodin I need, the more of this I need. It's almost a perfect correlation. And now, this summer with the morphine... I've had to take more of this as well. Every morning for the last month or so I've asked myself the same question: Two or three? The answer's been three every morning for a couple of weeks now.

Oh well. I shove the implications of this out of my mind, decide that if I have to add a fourth pill I'll start with the bedtime dose, and toss back the three pills. I can swallow them dry, but they work better if I take them with plenty of water. I fill a tall glass from the sink and gulp it down.

The coffee's done, and I pour myself a cup to complete my Breakfast of Champions. I finish it, pour the second, and push myself off from the counter to launch myself back to the bedroom to dress.

I smile as I walk down the hallway. I had clinic yesterday, and I had a case that made it totally worth my while, some guy with an amazing swollen tongue. I don't think I've taken such a thorough H&P since I was in medical school. I picked up the admit and I'm going to present the case to the team this morning.

"Ippp crrrm." This is going to be funny.