Pulse(90)

There is no specific pharmacological antidote to cocaine poisoning but what I needed was a sedative, something to counteract the drug’s stimulating properties.

And fast.

I shook my head as if to clear it.

‘Think,’ I said out loud. ‘Think!’

I went over to the medicine store cupboard and looked in.

In spite of my body going into top gear, my brain seemed to be stuck in neutral. I knew what I was after but I couldn’t find it – a benzodiazepine called diazepam, known almost universally as Valium.

I dug through the basket of drugs. I knew there was some in here; I’d checked it myself earlier today. Diazepam was an injectable sedative and we had it available in case a jockey had a severe case of muscle spasm, or a seizure.

‘Come on,’ I said. ‘Do you want to live or to die?’

Maybe six months ago I wouldn’t have cared either way, but now I did.

I finally found what I was looking for, a small glass ampoule of milky-white liquid containing thirty milligrams of diazepam in solution.

‘I want to live,’ I said excitedly, but getting the drug from the ampoule into my veins was another problem because my hands had started to shake.

I managed to attach a hypodermic needle to a syringe and carefully broke off the glass top of the ampoule. How much? Ten milligrams was the recommended dose for acute muscle spasm.

But this was more of a crisis than that.

I decided on an initial twenty. That would leave another ten if I needed it later. Overdosing on diazepam was not a worry, no one ever successfully committed suicide by swallowing all their Valium pills at once, not unless they mixed them with other drugs or very large amounts of alcohol.

‘Be careful,’ I kept telling myself as I inserted the needle into the ampoule. ‘You cannot afford to drop this on the floor.’

I drew the diazepam up into the syringe.

It could be injected into muscle but, to be effective quickly, it needed to go straight into the bloodstream, into a vein.

Using my right hand and my teeth I applied a rubber tourniquet to my upper left arm and tapped the inside of my elbow. One of my veins stood up nicely and, with ultra-care and by stressing both my arms against the table, I managed to insert the needle and slowly depress the plunger.

Initially I could feel nothing and I panicked that I’d gone straight through the vein and injected the drug uselessly into the joint cavity.

But then I remembered the tourniquet.

I released it, allowing the diazepam to progress up my arm towards my heart and beyond. Within a minute or two I could detect a soothing sensation, not that it seemed to do anything to reduce my rapid pulse.

And I had a worrying pain in my chest.

Not a bloody heart attack now, I thought.

‘Come on, body, give me a break,’ I said out loud.

I laughed. Fancy talking to myself. I must be mad. Or high. Both, in fact.

‘Get a grip,’ I said. ‘This is the cocaine talking. Concentrate!’ I slapped my thigh with my hand. ‘Concentrate and you live. Waver and you die. Think of your boys. Live for them.’

Also in the medicine store we had a glyceryl trinitrate spray in a small red bottle with a white top. Glyceryl trinitrate was simply the medical name for nitroglycerin, the high explosive that Alfred Nobel mixed with crushed sedimentary rock and washing soda to produce dynamite.

Apart from its explosive properties, nitroglycerin reduces blood pressure by causing the blood vessels to dilate. The effect was discovered by accident when those making dynamite found that it gave them headaches and also that their blood pressure dropped alarmingly at work. Nowadays, it was widely used by angina sufferers to alleviate pain and tightness in the chest by spraying it under the tongue.

I picked up the bottle and removed the top, but then I hesitated.

One of the other actions of nitroglycerin was to increase heart rate and mine was quite high enough already. But the pain in my chest implied that my racing heart was getting insufficient oxygen and, if Rahul Kumar was anything to go by, my blood pressure was probably too high as well.

Would it do more harm than good?

To spray or not to spray? That was the question.

The pain in my chest was definitely getting worse.

Maybe I would die whatever I did or didn’t do. But surely action had to be better than inaction? At least I would then die knowing I had tried, and whoever found me would know that I had wanted to survive.

I squirted a single shot of the nitroglycerin under my tongue and instantly felt a reaction. The pain in my chest subsided but I became very dizzy and I sat down quickly on a chair.

Now what?

My heartbeat was still up in the stratosphere but, even if I’d had any adenosine, I knew from past experience that it wouldn’t work.

How about more diazepam? Or perhaps some oxygen?

We had an oxygen cylinder and I attached a mask to it, turned it on and breathed deeply. Next I drew half of the remaining diazepam into a fresh syringe and injected that into the same vein as before.

I sat on a chair, took more deep breaths of the oxygen and measured my pulse using the second hand of the clock on the wall. It was still very high at 180 beats per minute but I sensed that it was down a little from its maximum.

Was I over the worst?

Was there anything else I could do?

Just sit still and let nature take its course.

I knew from a study I’d read at medical school that ingesting cocaine orally didn’t produce its maximum result for an hour or more after consumption, but I rather hoped that the reactions I had experienced were more due to the relatively small amount of the drug I’d absorbed through my mouth lining, and that I had expelled most of what had actually made it down to my stomach.