For many people, the word fentanyl brings one thing to mind: the opioid crisis. News reports often connect it with addiction, illegal drug production, overdose, and death. Yet fentanyl also has an important place inside hospitals, where it is used under medical supervision for pain relief and sedation.
That distinction sits at the centre of part of Tim Westall’s experience in The Fentanyl Chronicles: Tales of Delirium from Intensive Care.
After suffering a near fatal heart attack in 2024, Westall spent months receiving intensive treatment at Harefield Hospital. His condition was severe. His heart failed, his lungs and kidneys were affected, and he required multiple forms of life support before doctors began preparing him for the next stage of treatment.
Fentanyl entered the story as part of that medical care.
Westall had heard of the drug before, mainly in connection with the damage caused by illicit fentanyl in the United States. Experiencing it as a hospital patient was very different. In a controlled clinical setting, it was used to manage pain and help keep him sedated while his body endured serious medical treatment.
What he did not expect was what happened inside his mind.
Night after night, he experienced vivid dreams and episodes of delirium. They were strange, detailed, funny, and often completely convincing. Hospital surroundings became other places. Nurses appeared in unexpected roles. Needles, machines, family members, former colleagues, travel memories, music, animals, and fragments of ordinary life found their way into elaborate imagined situations.
For Westall, fentanyl therefore became connected with two very different realities.
One was clinical. It was a powerful medication being used during a period when his body was critically ill and medical teams were working to keep him alive.
The other existed entirely in his head.
That second reality became the foundation of The Fentanyl Chronicles.
The book does not attempt to present fentanyl as harmless. Westall acknowledges its potency, its addictive potential, and the dangers associated with misuse. What makes his story unusual is that he encountered the drug in the setting for which medicines of this kind are also designed: closely monitored medical treatment.
His account gives readers something rarely seen in public discussions about fentanyl. It shows the experience from the hospital bed.
The result is part medical memoir, part survival story, and part collection of wonderfully improbable dreams.
The Fentanyl Chronicles looks beyond the familiar headlines and into the strange private world of a patient whose body was fighting for survival while his mind was travelling somewhere else entirely.
