One

Doc woke up sick, every cell in his body screaming for morphine - head pounding - eyes, nose, and throat burning. His back and legs ached deep down inside and when he tried to sit up he immediately doubled over, racked with abdominal cramps. He barely managed to make it to the toilet down the hall before his guts turned inside out.

Just like every day. Day in, day out. No pardon, no parole. Until he got a shot of dope in him, it wasn’t going to get any better. Doc knew well that the physical withdrawal symptoms were nothing compared with the deeper demons, the mind-numbing fear and heart-crushing despair that awaited him if he didn’t get his ass moving and out on the street. The worst part was that three quarters of a mile of semi-molten asphalt and humiliation lay between him and his first fix, and every inch would be an insistent reminder of just how far he had fallen in the last ten years.

In the old days, back in Bossier City, all Doc had to do was sit up and swing his needle-ravaged legs over the edge of the bed and his wake-up shot was always right there on the nightstand, loaded up and ready to go.

Well, almost always. Sometimes he would wake in the middle of the night swearing that someone was calling his name. When morning came he was never sure that it wasn’t a dream until he reached for his rig and found it was empty. Even then, he had only to make his way to the medication cabinet in his office downstairs to get what he needed - pure, sterile morphine sulfate measured out in precise doses in row after tidy row of little glass bottles. And he was a physician, after all, and there was always more where that came from.

“But that was then,” sighed Doc. The sad truth was that, these days, he had to hustle like any other hophead on the street, trading his services for milk-sugar and quinine-contaminated heroin that may very well have made its way across the border up somebody’s ass.

San Antonio, Texas, was less than a day’s drive from New Orleans but Doc had come there via the long, hard route, slipping and sliding downhill every inch of the way. Consequences of his own lack of discretion and intemperance had driven him from his rightful place in Crescent City society before his thirtieth birthday. In one desperate attempt after another to escape his not-so-distant past, he had completed a circuit of the Gulf Coast in a little over a decade, taking in the seamier sides of Mobile, Gulfport, and Baton Rouge. But when he landed in Bossier City, Shreveport’s black-sheep sister across the Red River, he reckoned that he had finally hit bottom.

But he was wrong.

The South Presa Strip on the south side of San Antonio was a shadow world, even in broad daylight. Squares drove up and down it every day, never noticing this transaction taking place in that doorway or even wondering what the girls down on the corner were up to. The pimps and the pushers were just as invisible to the solid citizens of San Antonio as the undercover cops who parked in the side streets and alleyways and watched it all come down more or less the same way, day after day, were.

Doc stepped out into the street. The block and a half between the Yellow Rose Guest Home and the nearest shot of dope was an obstacle course, and every step was excruciating; nothing but paper-thin shoe leather separating broken pavement and raw nerve. The sun seemed to focus on the point on the back of his neck that was unprotected by the narrow brim of his Panama hat and burn through his brain to the roof of his mouth. He spat every few feet but could not expel the taste of decay as he ran the gauntlet of junkies and working girls out early or up all night and every bit as sick as he was.

There was a rumor on the street that Doc had a quantity of good pharmaceutical dope secreted away somewhere in the dilapidated boarding house. The other residents had torn the place apart several times, even prying up the floorboards, and found nothing. Of course, that didn’t stop some of the more gullible among the girls from trying to charm the location out of him from time to time.

Excerpted from I'll Never Get Out of This World Alive by Steve Earle. Copyright © 2011 by Steve Earle. Excerpted by permission of Houghton Mifflin Harcourt. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.