How to Get Enough Pain Medication to Allow You to Die

The doctors will visit you
at your hospital bed because
that is what they do.

When they ask you if it hurts here,
say Yes it hurts here.

When they ask you if it hurts there,
say Yes it hurts there.

When they ask you where it hurts,
put your hands against the sides
of your head like the Edvard Munch
painting The Scream and say Here.

Move your hands down the side
of your body doing your best
imitation of Mae West primping.

Move them slowly as if you still
had a body worth seducing
and then point to your toes
sitting upright like good students
trying to impress their teacher
and say All the way down there.

Remember those pain numbers
that always confused you when
your cancer first appeared?
Now is the time to call it a ten.

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Jimmy Pappas, a finalist in the 2017 Rattle Poetry Contest, won the 2018 Readers Choice Award. His book Scream Wounds contains poems based on veterans’ stories. He won the 2019 Rattle chapbook contest for Falling off the Empire State Building. His video interview with Tim Green is on Rattlecast #34. His poem “The Gray Man” has been nominated for a Pushcart Prize by Rattle.

About the Poem

“I was inspired to write this poem as I watched the courage my sister showed as she accepted reality and prepared to die. We are a family that believes when the time comes, show courage and face up to the end. She did that.”


7 thoughts on “How to Get Enough Pain Medication to Allow You to Die”

    1. Thank you, Jen. In my family, death was part of life. We were never kept from funerals or even deathbeds. We were expected to say Goodbye and to celebrate a life. So we were all prepared for when the end comes. Our funerals were filled with laughter and crying. It was almost a joyous experience. All of my relatives and family members who died always seemed to do it with courage and dignity.

  1. Fabulous poem. As a PA and EMT, the pain scale takes on a broader context. A 10 when lying in a ditch with an open fracture versus appendicitis in the UC. How to objectify a totally subjective feeling has always been interesting.
    Thanks for your insights. Ellen

  2. I hope by the time it’s my turn that it’s official. In Holland and Switerzland it is. My cousin had a little party on ‘the day’. She went with a smile, surrounded by love, and much dignity.

    By the way, good poerm.

  3. Henry Schneiderman

    This wrenching poem is terribly poignant, reflecting among other issues the second current opioid epidemic, of underuse when indispensable (along with and in part due to the other, of deaths from illegal recreational use).
    I interpret the title as endorsing support for a gentler natural death, not as stockpiling for suicide.
    Another means toward good symptom control is consulting Palliative Care. This is feasible long before an individual is ready to consider Hospice, and does not carry the restrictions and financial implications of Hospice. Implementation of the palliative consultant’s recommendations often requires approval by the primary clinician; too often this person “feels uncomfortable “ and ratchets down the dosing.

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