I am most keenly aware of the nearness of death when I’m on an airplane.
I’m safe there; I know that in the logical sense. But the sensation of exposure refuses to leave my animal body, which screams in a register only dogs can hear that we need to get down, gods damn it, we were never meant to be this high up. I’ve tried Xanax and Ativan only to be dumped back on the porch of anxiety after my 45-minute ride has ended. I’ve vanquished Prince Valium with nothing but the slide of my tongue and eaten any number of funny gummy bears that dry out my mouth and eyes whilst supplying me with the most vivid paranoia known to man. The only thing that works with regularity is alcohol, sovereign obliterator of thought, sedative known to all savvy stews, available on nearly every flight for a person with a plastic purse and a living liver.
It’s not that I’m afraid of dying; I’m rather ambivalent about my eventual end. I just don’t want to die terrified and brightly conscious. If I am to crash, I want to be too numb to care.
The place where I bid adieu to the last of my fear of death was at the dentist’s office.
As someone who grew up in grinding poverty, I’ve been maimed and shamed often enough in those all-white offices that a decorative promotional stack of floss gives me the shakes. When they offer numbing, I say yes. When they offer anxiety meds, I say thank you. When they told me they were going to have to pull seven successive molars, I said just kill me.
Dentists are not permitted to offer euthanasia.
What they offered me instead was a bleak vista of the next two years: seven teeth pulled in five visits, with time in between to heal. Bone grafts to replace the loss in my jaw, brought on by years of rot I could do nothing about when I didn’t have insurance. Titanium rods drilled into the strengthened mandible, once healed. Implants anchored to those, to help me to chew again and live a partially defanged life. An x-ray of my lower face projected on the wall in blue-black, my teeth flattened out, side to side, wide as my forearm.
“Where does the graft come from?” I asked the maxillofacial surgeon who gave me all this news.
“What?” He didn’t understand the question.
“The bone graft for my jaw. Do I have to give up a toe or something?”
“Oh no,” he answered. “It’s cadaver bone.”
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I imagined sections of a dead man’s jaw layered into mine, like popsicle sticks glued together in some gruesome osseus craft. When the grave gift came, I saw slivers of bone like grated parmesan scooped up in an elegant little coke spoon and then tapped out against my exposed skeleton, to be adopted and absorbed by my own bones.
That time, I was awake.
The first time, the most painful time, the surgeon insisted on knocking me out. This sounded fine to me; even before this game of skeletal Jenga began, I wanted to simply not be present. I sought oblivion on airplanes and at other times of extreme stress. Only natural that I should like to opt out here.
After outlining the first procedure, the dentist and his assistant left the room. The person who entered next undoubtedly has a title, but I think of them as the “insurance nurse.” This person had an iPad and was verifying and quantifying my coverage. Their brow uncreased and they smiled as they accessed the excellent health plan my partner’s union job afforded me.
“Oh,” they said with obvious relief. “You’re getting the good drugs.”
The good drugs, as it turned out, were a cocktail of fentanyl and ketamine, both novel to me and administered through an IV drip kept inside of a lock box. Someone took my blood pressure, someone else placed the line. I don’t remember being told to count backwards, or to relax or to breathe deep. I didn’t have to do anything. Unconsciousness was a flash flood that swept over me, leaving no trace of my mind aware of itself.
I had been sedated before, but never like this. Each previous incident, I had maintained a sense of the passage of time, and even some vague (the body keeps the score) recollection of what had happened to me while I was elsewhere.
This time I had no sense of anything at all. I awoke without pain and with very little disorientation, assuming nothing had happened and I was yet to undergo the procedure.
“There it is,” said the surgeon, showing me my traitorous tooth. “It was really jammed in there. I had to fight it out.”
He put my tooth in a white gift bag with some coco floss. I had to call a friend to pick me up.
Later, I would have time to reflect on what he said as feeling returned and my jaw ached as if I had fought the dead man for his bone splinters and he’d belted me a good one before I took him down. Despite the soreness, all I could do was marvel at how completely removed from consciousness I had been. I was really and truly not present at the time of this extraction. I was gone.
I have not feared death for a long time, but that day I relinquished the last of my worry that it might be a bad thing to cease to exist. I knew the feeling of true nothingness; I had gone down without any panic or distress, and I was not attached to the idea of returning to conscious life. It was simply time, and here were the two figures who would guide me. Friendly fentanyl and kind ketamine took me by both hands, and I knew no more. That was just fine.
It is the moments of agony and terror that present the specter to me now. It is the turbulence on the flight, the ache in my face that remind that what we are to endure is always going to be worse than endurance’s end. Like most people with flight anxiety, I know too much about the exact series of events before many plane crashes; which black boxes contain the sounds of screams and which do not. The ones that go down in silence are my favorites now; the FAA reports calmly explaining that everyone on board lost consciousness long before the fall, the skull-shattering moment of impact.
After they planted a dead man’s bones in my skull, I discovered that not all the skele-sprinkles stuck. A few dozen worked their way out through the healing flesh of my gums, like dandelions pushing up from the soft summer earth. I spat one out on to a cocktail napkin at a bar, where I had been drinking what I thought of as a medicinal cocktail of vodka, a sanitizing wash for the stitches I could still feel like fishing line tangled in the meat of my mouth.
A friend spotted the bone there on the black paper, its luster unmistakable, even in the yellow bar light.
“What is that?” he asked, aghast.
“Loose bone,” I said absently, taking more of my medicine.
“Where did it come from?”
I smiled carefully, not showing the half-healed wounds inside my smile. “Mercifully, I can’t remember.”