I know it’s coming. I know
the hammer and the pick are readying.
Yet nothing I do stops it. No medication. No
meditation. Slowly the pain swells

like a small wave. The world seems slightly
off-kilter. I sense something over the horizon,
rolling in. I hope for just a wave, but I know . . .
I know the devil has his fun, and I’m next.

I know I can’t avoid my triggers all of the time.
So I see a room of dressed-up people. And
their scents will linger. They will drift up my nose,
bring tiny hammers to chisel the insides

of my turbinates. My head will start to feel heavy;
my stomach, queasy. I’m lucky. I’m not too far
from home. I can get there before the worst
comes, before all the food I ate heaves up.

And all the while the hammers will be pounding
harder and harder. I’ll feel hot, cold, chilled, flushed.
Every sound will hit my eardrums and vibrate through
my head. The footsteps of my partner will hurl

into my brain like an elephant’s. The pedestal fan
that whirs will begin to rev its engines like a plane
about to take off. Every light will meet my eyes
like a flashlight’s. So I’ll block off all the windows,

use that rag to cool my head to cover my eyes.
I won’t read anything now, won’t look
at anything, won’t be touched by anyone,
for every sensation will fire pain in my brain.

If not for the medications I trained myself to take
early on, could I endure the vise? Now I struggle
to keep the antiemetic down while I swallow the pain pill, though I know that even a slight taste could 

bring both meds up. I try to suck on ice chips, can
barely hold a sip of ginger ale. I am rocking
in pain, moaning as the hammer pounds
and the pick sticks. If there is a hell,

I think, this is it. How long will it last?
Hour after hour. Can’t lie down without nausea
rising up. Every movement swirls the stomach,
like being in a boat in rough water.

I begin to pace, as I know what’s coming.
I have to hover over the toilet, grab a towel,
throw two down to kneel on. I know
I’ll get it in my hair, though I’ll try not to,

because it comes so suddenly I have no
time to think of maneuvers. The body
propels forward. Everything comes up.
For a moment, I feel better, but it won’t last.

I grasp the cup of mouthwash to rinse
my mouth. I swish. I try to drink a sip of
ginger ale. I’ll repeat this scenario,
retching, till I gag.