The last time I thought about taking heroin was yesterday. I had received “an inconvenient truth” from a beautiful woman. It wasn’t about climate change – I’m not that ecologically switched on – she told me she was pregnant and it wasn’t mine.

I had to take immediate action. I put Morrissey on in my car as an external conduit for the surging melancholy, and as I wound my way through the neurotic Hollywood hills, the narrow lanes and tight bends were a material echo of the synaptic tangle where my thoughts stalled and jammed.

Morrissey, as ever, conducted a symphony, within and without and the tidal misery burgeoned. I am becoming possessed. The part of me that experienced the negative data, the self, is becoming overwhelmed, I can no longer see where I end and the pain begins. So now I have a choice.

I cannot accurately convey to you the efficiency of heroin in neutralising pain. It transforms a tight, white fist into a gentle, brown wave. From my first inhalation 15 years ago, it fumigated my private hell and lay me down in its hazy pastures and a bathroom floor in Hackney embraced me like a womb.

This shadow is darkly cast on the retina of my soul and whenever I am dislodged from comfort my focus falls there.

It is 10 years since I used drugs or drank alcohol and my life has improved immeasurably. I have a job, a house, a cat, good friendships and generally a bright outlook.

The price of this is constant vigilance because the disease of addiction is not rational. Recently for the purposes of a documentary on this subject I reviewed some footage of myself smoking heroin that my friend had shot as part of a typically exhibitionist attempt of mine to get clean.

I sit wasted and slumped with an unacceptable haircut against a wall in another Hackney flat (Hackney is starting to seem like part of the problem) inhaling fizzy, black snakes of smack off a scrap of crumpled foil. When I saw the tape a month or so ago, what is surprising is that my reaction is not one of gratitude for the positive changes I’ve experienced but envy at witnessing an earlier version of myself unencumbered by the burden of abstinence. I sat in a suite at the Savoy hotel, in privilege, resenting the woeful ratbag I once was, who, for all his problems, had drugs. That is obviously irrational.

The mentality and behaviour of drug addicts and alcoholics is wholly irrational until you understand that they are completely powerless over their addiction and unless they have structured help they have no hope.

This is the reason I have started a fund within Comic Relief, Give It Up. I want to raise awareness of, and money for, abstinence-based recovery. It was Kevin Cahill’s idea, he is the bloke who runs Comic Relief. He called me when he read an article I wrote after Amy Winehouse died. Her death had a powerful impact on me I suppose because it was such an obvious shock, like watching someone for hours through a telescope, seeing them advance towards you, fist extended with the intention of punching you in the face. Even though I saw it coming, it still hurt when it eventually hit me.

What was so painful about Amy’s death is that I know that there is something I could have done. I could have passed on to her the solution that was freely given to me. Don’t pick up a drink or drug, one day at a time. It sounds so simple. It actually is simple but it isn’t easy: it requires incredible support and fastidious structuring. Not to mention that the whole infrastructure of abstinence based recovery is shrouded in necessary secrecy. There are support fellowships that are easy to find and open to anyone who needs them but they eschew promotion of any kind in order to preserve the purity of their purpose, which is for people with alcoholism and addiction to help one another stay clean and sober.

Without these fellowships I would take drugs. Because, even now, the condition persists. Drugs and alcohol are not my problem, reality is my problem, drugs and alcohol are my solution.

If this seems odd to you it is because you are not an alcoholic or a drug addict. You are likely one of the 90% of people who can drink and use drugs safely. I have friends who can smoke weed, swill gin, even do crack and then merrily get on with their lives. For me, this is not an option. I will relinquish all else to ride that buzz to oblivion. Even if it began as a timid glass of chardonnay on a ponce’s yacht, it would end with me necking the bottle, swimming to shore and sprinting to Bethnal Green in search of a crack house. I look to drugs and booze to fill up a hole in me; unchecked, the call of the wild is too strong. I still survey streets for signs of the subterranean escapes that used to provide my sanctuary. I still eye the shuffling subclass of junkies and dealers, invisibly gliding between doorways through the gutters. I see that dereliction can survive in opulence; the abundantly wealthy with destitution in their stare.

Spurred by Amy’s death, I’ve tried to salvage unwilling victims from the mayhem of the internal storm and I am always, always, just pulled inside myself. I have a friend so beautiful, so haunted by talent that you can barely look away from her, whose smile is such a treasure that I have often squandered my sanity for a moment in its glow. Her story is so galling that no one would condemn her for her dependency on illegal anesthesia, but now, even though her life is trying to turn around despite her, even though she has genuine opportunities for a new start, the gutter will not release its prey. The gutter is within. It is frustrating to watch. It is frustrating to love someone with this disease.

A friend of mine’s brother cannot stop drinking. He gets a few months of sobriety and his inner beauty, with the obstacles of his horrible drunken behaviour pushed aside by the presence of a programme, begins to radiate. His family bask relieved, in the joy of their returned loved one, his life gathers momentum but then he somehow forgets the price of this freedom, returns to his old way of thinking, picks up a drink and Mr Hyde is back in the saddle. Once more his brother’s face is gaunt and hopeless. His family blame themselves and wonder what they could have done differently, racking their minds for a perfect sentiment; wrapped up in the perfect sentence, a magic bullet to sear right through the toxic fortress that has incarcerated the person they love and restore them to sanity. The fact is, though, that they can’t, the sufferer must, of course, be a willing participant in their own recovery. They must not pick up a drink or drug, one day at a time. Just don’t pick up, that’s all.

It is difficult to feel sympathy for these people. It is difficult to regard some bawdy drunk and see them as sick and powerless. It is difficult to suffer the selfishness of a drug addict who will lie to you and steal from you and forgive them and offer them help. Can there be any other disease that renders its victims so unappealing? Would Great Ormond Street be so attractive a cause if its beds were riddled with obnoxious little criminals that had “brought it on themselves”?

Peter Hitchens is a vocal adversary of mine on this matter. He sees this condition as a matter of choice and the culprits as criminals who should go to prison. I know how he feels. I bet I have to deal with a lot more drug addicts than he does, let’s face it. I share my brain with one, and I can tell you firsthand, they are total fucking wankers. Where I differ from Peter is in my belief that if you regard alcoholics and drug addicts not as bad people but as sick people then we can help them to get better. By we, I mean other people who have the same problem but have found a way to live drug-and-alcohol-free lives. Guided by principles and traditions a programme has been founded that has worked miracles in millions of lives. Not just the alcoholics and addicts themselves but their families, their friends and of course society as a whole.

What we want to do with Give It Up is popularise a compassionate perception of drunks and addicts, and provide funding for places at treatment centres where they can get clean using these principles. Then, once they are drug-and-alcohol-free, to make sure they retain contact with the support that is available to keep them clean. I know that as you read this you either identify with it yourself or are reminded of someone who you love who cannot exercise control over substances. I want you to know that the help that was available to me, the help upon which my recovery still depends is available.

I wound down the hill in an alien land, Morrissey chanted lonely mantras, the pain quickly accumulated incalculably, and I began to weave the familiar tapestry that tells an old, old story. I think of places I could score. Off Santa Monica there’s a homeless man who I know uses gear. I could find him, buy him a bag if he takes me to score.

I leave him on the corner, a couple of rocks, a couple of $20 bags pressed into my sweaty palm. I get home, I pull out the foil, neatly torn. I break the bottom off a Martell miniature. I have cigarettes, using makes me need fags. I make a pipe for the rocks with the bottle. I lay a strip of foil on the counter to chase the brown. I pause to reflect and regret that I don’t know how to fix, only smoke, feeling inferior even in the manner of my using. I see the foil scorch. I hear the crackle from which crack gets it’s name. I feel the plastic fog hit the back of my yawning throat. Eyes up. Back relaxing, the bottle drops and the greedy bliss eats my pain. There is no girl, there is no tomorrow, there is nothing but the bilious kiss of the greedy bliss.

Even as I spin this beautifully dreaded web, I am reaching for my phone. I call someone: not a doctor or a sage, not a mystic or a physician, just a bloke like me, another alcoholic, who I know knows how I feel. The phone rings and I half hope he’ll just let it ring out. It’s 4am in London. He’s asleep, he can’t hear the phone, he won’t pick up. I indicate left, heading to Santa Monica. The ringing stops, then the dry mouthed nocturnal mumble: “Hello. You all right mate?”

He picks up.

And for another day, thank God, I don’t have to.

what if one happens to be possessed of a heart that can’t be trusted? what if the heart, for its own unfathomable reasons, leads one willfully and in a cloud of unspeakable radiance away from health, domesticity, civic responsibility and strong social connections and all the blandly-held common virtues and instead towards a beautiful flare of ruin, self immolation, disaster. if your deepest self is singing and coaxing you straight toward the bonfire, is it better to turn away? stop your ears with wax? ignore all the perverse glory your heart is screaming at you? set yourself on the coarse that will lead you dutifully toward the norm, reasonable hours and regular medical check ups, stable relationships and steady career advancement, the New York Times and brunch on sunday , all with the promise of being somehow a better person? or is it better to throw yourself head first and laughing into the holy rage calling your name.

its not about outward appearance but inward significance. a grandeur in the world, but not of the world, a grandeur that the world does not understand. that first glimpse of pure otherness, in whose presence you bloom out and out and out. a self one does not want, a heart one cannot help.

by Joni Mitchell

If you can keep your head
While all about you
People are losing theirs and blaming you
If you can trust yourself
When everybody doubts you
And make allowance for their doubting too.

If you can wait
And not get tired of waiting
And when lied about
Stand tall
Don’t deal in lies
And when hated
Don’t give in to hating back
Don’t need to look so good
Don’t need to talk too wise.

If you can dream
And not make dreams your master
If you can think
And not make intellect your game
If you can meet
With triumph and disaster
And treat those two imposters just the same

If you can force your heart
And nerve and sinew
To serve you
After all of them are gone
And so hold on
When there is nothing in you
Nothing but the will
That’s telling you to hold on!
Hold on!

If you can bear to hear
The truth you’ve spoken
Twisted and misconstrued
By some smug fool
Or watch your life”s work
Torn apart and broken down
And still stoop to build again
With worn out tools.

If you can draw a crowd
And keep your virtue
Or walk with Kings
And keep the common touch
If neither enemies nor loving friends
Can hurt you
If everybody counts with you
But none too much.

If you can fill the journey
Of a minute
With sixty seconds worth of wonder and delight
Then
The Earth is yours
And Everything that’s in it
But more than that
I know
You’ll be alright
You’ll be alright.

Cause you’ve got the fight
You’ve got the insight
You’ve got the fight
You’ve got the insight

Everything comes and goes
Marked by lovers and styles of clothes
Things that you held high
And told yourself were true
Lost or changing as the days come down to you
Down to you
Constant stranger
You’re a kind person
You’re a cold person too
It’s down to you
It all comes down to you.
You go down to the pick up station
Craving warmth and beauty
You settle for less than fascination
A few drinks later you’re not so choosy
When the closing lights strip off the shadows
On this strange new flesh you’ve found
Clutching the night to you like a fig leaf
You hurry
To the blackness
And the blankets
To lay down an impression
And your loneliness

In the morning there are lovers in the street
They look so high
You brush against a stranger
And you both apologize
Old friends seem indifferent
You must have brought that on
Old bonds have broken down
Love is gone
Ooh, love is gone
Written on your spirit this sad song
Love is gone

Everything comes and goes
Pleasure moves on too early
And trouble leaves too slow
Just when you’re thinking
You’ve finally got it made
Bad news comes knocking
At your garden gate
Knocking for you
Constant stranger
You’re a brute-you’re an angel
You can crawl-you can fly too
It’s down to you
It all comes down to you

THIS IS THE MOST RIVETING HONEST BRILLIANT BOOK I HAVE EVER READ
EVE ENSLER IS WHO I HOPE TO BECOME
BUY IT
READ IT

Divided
A mother’s body against a child’s body makes a place. It says you are here. Without this body against your body there is no place. I envy people who miss their mother. Or miss a place or know something called home. The absence of a body against my body created a gap, a hole, a hunger. This hunger determined my life.
I have been exiled from my body. I was ejected at a very young age and I got lost. I did not have a baby. I have been afraid of trees. I have felt the Earth as my enemy. I did not live in the forests. I lived in the concrete city where I could not see the sky or sunset or stars. I moved at the pace of engines and it was faster than my own breath. I became a stranger to myself and to the rhythms of the Earth. I aggrandized my alien identity and wore black and felt superior. My body was a burden. I saw it as something that unfortunately had to be maintained. I had little patience for its needs.

The absence of a body against my body made attachment abstract. Made my own body dislocated and unable to rest or settle. A body pressed against your body is the beginning of nest. I grew up not in a home but in a kind of free fall of anger and violence that led to a life of constant movement, of leaving and falling. It is why at one point I couldn’t stop drinking and fucking. Why I needed people to touch me all the time. It had less to do with sex than location. When you press against me, or put yourself inside me. When you hold me down or lift me up, when you lie on top of me and I can feel your weight, I exist. I am here.

For years I have been trying to find my way back to my body, and to the Earth. I guess you could say it has been a preoccupation. Although I have felt pleasure in both the Earth and my body, it has been more as a visitor than as an inhabitant. I have tried various routes to get back. Promiscuity, anorexia, performance art. I have spent time by the Adriatic and in the green Vermont mountains, but always I have felt estranged, just as I was estranged from my own mother. I was in awe of her beauty but could not find my way in. Her breasts were not the breasts that fed me. Everyone admired my mother in her tight tops and leggings, with her hair in a French twist, as she drove through our small rich town in her yellow convertible. One gawked at my mother. One desired my mother. And so I gawked and desired the Earth and my mother, and I despised my own body, which was not her body. My body that I had been forced to evacuate when my father invaded and then violated me. And so I lived as a breathless, rapacious machine programmed for striving and accomplishment. Because I did not, could not, inhabit my body or the Earth, I could not feel or know their pain. I could not intuit their unwillingness or refusals, and I most certainly never knew the boundaries of enough. I was driven. I called it working hard, being busy, on top of it, making things happen. But in fact, I could not stop. Stopping would mean experiencing separation, loss, tumbling into a suicidal dislocation.
As I had no reference point for my body, I began to ask other women about their bodies, in particular their vaginas (as I sensed vaginas were important). This led me to writing The Vagina Monologues, which then led me to talking incessantly and obsessively about vaginas. I did this in front of many strangers. As a result of me talking so much about vaginas, women started telling me stories about their bodies. I crisscrossed the Earth in planes, trains, and jeeps. I was hungry for the stories of other women who had experienced violence and suffering. These women and girls had also become exiled from their bodies and they, too, were desperate for a way home. I went to over sixty countries. I heard about women being molested in their beds, flogged in their burqas, acid-burned in their kitchens, left for dead in parking lots. I went to Jalalabad, Sarajevo, Alabama, Port-au-Prince, Peshawar, Pristina. I spent time in refugee camps, in burned-out buildings and backyards, in dark rooms where women whispered their stories by flashlight. Women showed me their ankle lashes and melted faces, the scars on their bodies from knives and burning cigarettes. Some could no longer walk or have sex. Some became quiet and disappeared. Others became driven machines like me.

Then I went somewhere else. I went outside what I thought I knew. I went to the Congo and I heard stories that shattered all the other stories. In 2007 I landed in Bukavu, Democratic Republic of Congo. I heard stories that got inside my body. I heard about a little girl who couldn’t stop peeing on herself because huge men had shoved themselves inside her. I heard about an eighty-year-old woman whose legs were broken and torn out of their sockets when the soldiers pulled them over her head and raped her. There were thousands of these stories. The stories saturated my cells and nerves. I stopped sleeping. All the stories began to bleed together. The raping of the Earth. The pillaging of minerals. The destruction of vaginas. They were not separate from each other or from me.
In the Congo there has been a war raging for almost thirteen years. Nearly eight million people have died and hundreds of thousands of women have been raped and tortured. It is an economic war fought over minerals that belong to the Congolese but are pillaged by the world. There are local and foreign militias from Rwanda, Burundi, and Uganda. They enter villages and they murder. They rape wives in front of their husbands. They force the husbands and sons to rape their daughters and sisters. They shame and destroy families and take over the villages and the mines. The minerals are abundant in the Congo—tin, copper, gold, and coltain, which are used in our iPhones and PlayStations and computers.
Of course by the time I got to the Congo, I had witnessed the epidemic of violence toward women that scoured the planet, but the Congo was where I witnessed the end of the body, the end of humanity, the end of the world. Femicide, the systematic rape, torture, and destruction of women and girls, was being employed as a military/corporate tactic to secure minerals. Thousands and thousands of women were not only exiled from their bodies, but their bodies and the functions and futures of their bodies were rendered obsolete: wombs and vaginas permanently destroyed.
The Congo and the individual horror stories of her women consumed me. Here I began to see the future—a monstrous vision of global disassociation and greed that not only allowed but encouraged the eradication of the female species in pursuit of minerals and wealth. But I found something else here as well. Inside these stories of unspeakable violence, inside the women of the Congo, was a determination and a life force I had never witnessed. There was grace and gratitude, fierceness and readiness. Inside this world of atrocities and horror was a red-hot energy on the verge of being born. The women had hunger and dreams, demands and a vision. They conceived of a place, a concept, called City of Joy. It would be their sanctuary. It would be a place of safety, of healing, of gathering strength, of coming together, of releasing their pain and trauma. A place where they would declare their joy and power. A place where they would rise as leaders. I, along with my team and the board at V-Day, were committed to finding the resources and energy to help them build it. We would work with UNICEF to do the construction and then, after V-Day, would find the way to support it. The process of building was arduous and seemingly impossible—delayed by rain and lack of roads and electricity, corrupt building managers, poor oversight by UNICEF, and rising prices. We were scheduled to open in May, but on March 17, 2010, they discovered a huge tumor in my uterus.

Cancer threw me through the window of my disassociation into the center of my body’s crisis. The Congo threw me deep into the crisis of the world, and these two experiences merged as I faced the disease and what I felt was the beginning of the end.

Suddenly the cancer in me was the cancer that is everywhere. The cancer of cruelty, the cancer of greed, the cancer that gets inside people who live downstream from chemical plants, the cancer inside the lungs of coal miners. The cancer from the stress of not achieving enough, the cancer of buried trauma. The cancer that lives in caged chickens and oil-drenched fish. The cancer of carelessness. The cancer in fast-paced must-make-it-have-it-smoke-it-own-it formaldehydeasbestospesticideshairdyecigarettescellphonesnow. My body was no longer an abstraction. There were men cutting into it and tubes coming out of it and bags and catheters draining it and needles bruising it and making it bleed. I was blood and poop and pee and puss. I was burning and nauseous and feverish and weak. I was of the body, in the body. I was body. Body. Body. Body. Cancer, a disease of pathologically dividing cells, burned away the walls of my separateness and landed me in my body, just as the Congo landed me in the body of the world.

Cancer was an alchemist, an agent of change. Don’t get me wrong. I am no apologist for cancer. I am fully aware of the agony of this disease. I appreciate every medical advance that has enabled me to be alive right now. I wake up every day and run my hand over my torso-length scar and am in awe that I had doctors and surgeons who were able to remove the disease from my body. I am humbled that I got to live where there are CAT scan machines and chemotherapy and that I had the money to pay for them through insurance. Absolutely none of these things are givens for most people in the world. I am particularly grateful for the women of the Congo whose strength, beauty, and joy in the midst of horror insisted I rise above my self-pity. I know their ongoing prayers also saved my life. I am in awe that it happens to be 2012, not twenty years ago even. I am gratefully aware that at just about any other point in history I would have been dead at fifty-seven.
In his book, The Emperor of All Maladies, Siddhartha Mukherjee says, “Science is often described as an interactive and cumulative process, a puzzle solved piece by piece with each piece contributing a few hazy pixels to a much larger picture.” Science, then, is not unlike a CAT scan, a three-dimensional magnetic electronic beam that captures images as it rotates around the body. Each image is separate but somehow the machine makes them seem like one.
This book is like a CAT scan—a roving examination—capturing images, experiences, ideas, and memories, all of which began in my body. Scanning is somehow the only way I could tell this story. Being cut open, catheterized, chemofied, drugged, pricked, punctured, probed, and ported made a traditional narrative impossible. Once you are diagnosed with cancer, time changes. It both speeds up insanely and stops altogether. It all happened fast. Seven months. Impressions. Scenes. Light beams. Scans.