AMERICAN PAIN (22 page)

Stacy said: No, no, I’m fine.

Shelby said: Stacy, you need to get some sleep. You don’t look good.

Stacy said he didn’t need sleep, he was fine. He got back in the car, and his friend drove away.

Kevin was alone at the farm about 3:00 p.m. that afternoon, sprawled on the couch watching the Georgia Bulldogs bowl game, when Stacy came in carrying a garbage bag. The brothers didn’t say much to each other. Maybe they nodded. Maybe they exchanged a word or two. Kevin certainly didn’t start questioning Stacy about where he’d been all this time, while everyone worried. Mom would do that later.

Stacy dropped his bag in the back bedroom and headed back outside.

At halftime, Kevin got up and looked outside but didn’t see Stacy or the friend who’d brought him home. A few minutes later, his parents came home. Kevin told them Stacy had returned, but he might have taken off again. Alice and Eugene left the house to check the trailer. Kevin kept watching the game.

A few minutes later, Kevin heard his mother hollering, and he looked outside and saw her running down the hill toward the house, screaming for him to call the ambulance, and suddenly everything clicked in his mind and he knew exactly what had happened even as he refused to believe it.

Alice returned to where they’d found Stacy hunkered over a barrel behind the barn, on his knees like he was praying. She held his body on the cold ground. Eugene lay beside her. Kevin came up to the barn after calling 911, and he just sank to the ground too, leaning his back against the barn, bewildered.

Rocking and crying and holding Stacy as tight as she could, Alice felt something hard against her ribs, something inside Stacy’s jacket. She slipped her hand into Stacy’s jacket pocket and pulled out two pill bottles. She gave them to Eugene and went on grieving.

The ambulance took forever to find the farm at the end of Hummingbird Lane, maybe thirty-five or forty minutes. When the paramedics finally got there, they called the coroner’s office.

In town, Shelby got a call from Stacy’s cousin. They’d spoken earlier in the day during her hunt for Stacy.

He said: Something’s wrong. I called some neighbors down there and they said there’s a bunch of ambulances and stuff on Hummingbird Lane. Police cars and stuff.

Shelby hung up and starting looking for a ride from someone who knew where the Mason farm was. Before she could find a driver, Stacy’s cousin called back.

He said: Stacy’s dead.

Shelby went to Lisa’s house and told her. Lisa lost it. Screaming, waving her hands, running in circles. She said it was her fault. She said she shouldn’t have argued with Stacy.

Shelby took her to the emergency room at Rockcastle Regional. Shelby’s son-in-law had to carry Lisa inside.

Billy Dowell knew the Mason family the way he knew most Rockcastle County families: He’d embalmed and buried their ancestors. Dowell was a funeral home director and also the elected coroner of Rockcastle County since 1966. Now in his seventies and well over six feet tall, he towered over everyone else at death scenes. Local cops called him “The High Coroner.”

He loaded Stacy’s body into the dark blue van that bore the letters R
OCKCASTLE
C
OUNTY
C
ORONER
on the side and carried it to Dowell & Martin Funeral Home. The body spent the night in the funeral home cooler, and the next day, Billy Dowell loaded it again and drove eighty miles to the state medical examiner’s office in Frankfort. He rode with the body up to the third floor, weighed it, and then, as was his custom during the postmortem, went to the break room to have a cup of coffee and yak with whoever was around. He’d watched autopsies before and believed if you’d seen one, you’d seen them all.

The autopsy technicians disrobed Stacy and recorded his height, weight, hair color, skin color, tattoos, and scars. No obvious needle puncture marks, no track marks or drug residue on nostrils. No evidence of natural disease. They removed blood from the femoral vein near the groin, urine from the bladder, and vitreous humor from the eyeball. Those fluids were packaged, labeled, and sent to a toxicology laboratory in Indiana to be screened for drugs.

The techs made a Y-shaped incision from the upper chest to just above the groin, and the organs were removed, weighed, examined. The most significant finding was that his right lung weighed 920 grams, and his left weighed 720 grams. A normal pair of lungs typically weigh approximately 1,000 grams together. There was no infection or lesions in Stacy’s lungs—they were just sodden with fluid buildup.

And even without the tox screen, that finding pretty much nailed down the cause of death. Heavy, congested lungs are the hallmark of respiratory depression caused by opioid overdose. High doses of opioids mute pain, and they also mute the psychological discomfort caused by carbon dioxide buildup, the useful rush of panic you feel after too long underwater. Carbon dioxide is produced by the body’s metabolic processes, and it’s flushed out of the blood with each pump of the lungs. When the lungs slow, receptors in the brainstem detect higher levels of the chemical and trigger a breathing reflex. That’s why you can’t kill yourself by holding your breath. Even if you managed to hold it long enough to pass out, the breathing reflex would kick in.

So Stacy had felt fine even as the carbon dioxide thickened in his bloodstream. His breathing reflex drowsed, and so did he, kneeling over the barrel behind the barn. His inhalations and exhalations slowed to four a minute . . . then two . . . then one. His heart continued to push blood throughout the body, but his lungs didn’t do their part. Millions of air sacs in the lungs began to flood, drowning him in his own blood serum. The few slack breaths he did take forced bloody foam up into his mouth and nose. His brain swelled with fluid. His heart, starved for oxygen, pittered into wild arrhythmia.

The postmortem over, Billy Dowell zipped the corpse into a body bag, loaded it into the coroner’s van, and headed back toward Rockcastle County.

Alice, Lisa, and Shelby. The three women who loved Stacy. They had questions. Of course, what had killed him? But also, where had he been the last couple of days? Why was he so weak and exhausted? Why hadn’t he gotten Lisa’s voicemail messages?

Shelby talked to Stacy’s friend, the one who’d dropped him off at the farm. Stacy’s friend said he’d picked up Stacy at Peg’s, the little grocery off the interstate. Then Stacy’s friend said something crazy. He said when he picked him up, Stacy said he’d just got back from Florida.

Florida? This made no sense to Shelby. Stacy had never been on an airplane. Never seen the ocean. He’d barely been out of Kentucky. No way he’d been to Florida.

Stacy’s friend said Stacy had started the argument with Lisa so he could leave and go to a pain clinic in Florida. To get pills. Stacy had gone with a group of people he didn’t know well, the friend said.They’d driven all night and just gotten back on New Year’s morning.

It was outlandish, but Lisa now believed the story. After she calmed down some, Lisa told her mother how the argument had started. Stacy had said he might go to a pain clinic to try to get some pills. His doctor in Mount Vernon had cut him off, he told Lisa. Cold turkey. He needed the painkillers if he was ever going to get back to work. They argued, and he said he was leaving, going to the farm.

Alice was all torn up and people spoke carefully around her, but Lisa told her about the Florida rumor.

Alice couldn’t imagine it, Stacy going all the way to Florida, where he didn’t know a soul. But then, a couple days after Stacy died, Alice remembered the pill bottles she’d taken out of his jacket pocket.

Alice told her husband to get the bottles so she could look at them. And sure enough, the name of Stacy’s doctor in Mount Vernon wasn’t the name printed on the labels. Instead, there was a name she’d never seen before, a name she didn’t know how to pronounce: Dr. Cynthia Cadet.

There were three bottles. One contained alprazolam, and two contained oxycodone, two different dosages, 15 milligrams and 30 milligrams.

Oxycodone. Alice had heard of oxycodone. She believed it was some kind of cancer drug.

The alprazolam and the 15-milligram oxycodone had been filled at a place called America’s Pharmacy. The 30-milligram oxycodone was from a place called Speedy Scripts II. The addresses were Fort Lauderdale. Florida.

They went through the garbage bag Stacy had brought home. Mostly clothes, but also some papers. A photocopied sheet with drawings of people doing stretching exercises. A pharmacy receipt with the Speedy Scripts II logo at the top, the words tilted slightly to call attention to the speediness, like they were about to zip off the page. Stacy’s name and the farm’s address. The doctor again: Dr. Cynthia Cadet. Oxycodone HCL 30-milligram tablet. Quantity: 240. Stacy had paid $247.30, cash.

The receipt contained a long set of printed-out instructions.

“. . . used to treat moderate to severe pain . . .”

“. . . acts on certain centers of the brain . . .”

“. . . Follow your doctor’s instructions exactly as prescribed . . .”

“. . . take this medication only ‘as needed’ for acute pain (e.g., pain after surgery) or on a regular schedule for chronic pain (e.g., cancer pain) . . .”