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Much of the novel focuses on Paul's struggle with his fame as a writer versus his desire for independent creativity. At the novel's start, Paul hopes Fast Cars will earn him respect as a serious author. He laments that readers of the Misery series only want a good story and have little regard for his literary technique. However, Annie does have an understanding of writing as a process. For example, she conceives of writers as "God to the people in the story" (39) in the same way a writer might. Thus, Annie holds Paul accountable for anything that happens to Misery. Annie even puts on "an editor's hat" (113) giving Paul suggestions for storylines and holding him accountable to continuity. Because she reflects both his fame and his desire for a discerning audience, Annie attracts Paul despite his compromised situation.
Annie's obsession is a result of Paul's fame. She represents the monolithic obstacle he must overcome in order to write Misery's Return; at the same time, she represents the impetus for the undertaking. As Paul's captor, Annie provides Paul with the physical equipment and environment necessary to write. Much of the novel's second half follows Paul's thought process as he writes the book. Sometimes the words come easily, but he also faces writer's block, "trying to have an idea." Paul reflects on how easily "the muse came to him" with Fast Cars, which Annie does not like (127).
While Paul begins to write Misery's Return to appease his captor, by the novel's end Paul admits to himself that it was "never for you, Annie" (315). Rather, Paul writes, as he suspects most writers do, out of a desire to please himself. Even after Annie hobbles Paul, Paul begins to feel "a queer electric peacefulness" (165) around his situation. He spends his days writing with no distractions, save for excruciating pain, which Annie alleviates with Novril. Paul's captivity has ironically put him back in touch with the reason he writes in the first place: a love of creativity. Even after subduing Annie and locking her in his bedroom, Paul can't carry out his plan to burn down her house because he's left his manuscript under his bed. He no longer cares about what any fans or critics think of his work.
Just as Paul becomes addicted to painkillers, he is addicted to fame and finds it difficult to write when he no longer has a devoted audience. After his release from captivity and weaning off Novril, Paul finds himself unable to write. He finds himself wanting "good dope, his Annie-dope" (345) to numb the distracting pain in his legs. However, once Paul begins to apply his vivid imagination to someone he encounters on the street, he finds himself able to write again as he eschews fame as a primary motivating factor.
By Stephen King's own admission, his novel Misery is an extended metaphor for the harrowing relationship between a writer, in this case King's stand-in, Paul Sheldon, and his substance addictions.
Before meeting Annie, Paul has issues with alcohol. He crashes his car after drinking a bottle of champagne at his hotel and drinking another bottle while driving. Paul becomes dependent on the fictional drug Novril, a codeine-based painkiller, which Annie gives to him for his post-crash injuries. When Annie, realizing she can manipulate and control Paul with the pills, withholds them, Paul cries and begs for them. Within a few weeks of being at Annie's, Paul realizes he's healing and probably could use aspirin for pain relief. He tells himself he's going to stop taking the Novril, "only not today" (121) and starts to refer to taking his pills as "the old morning fix" (296).
Though Annie is the cause for and administrator of Paul's addiction to Novril, she holds him above the "cockadoodie drunken bums" like William Faulkner and Ernest Hemmingway (222). This emphasizes the kinds of value judgments that may accompany different kinds of substance abuse. Annie is well aware that she is making Paul develop a dependency on painkillers. Because the character symbolizing addiction in the novel is a nurse, the painkillers are coded as medicine rather than a recreational--and therefore morally questionable--drug, like alcohol. Casting judgement on other writers who had alcohol addictions is a way for Annie, and therefore Paul, to differentiate them from Paul and rationalize his use of pills. Even when Paul knows he no longer needs the painkillers, he tries to regain control of his situation by sneaking out of his room and stashing some Novril of his own under his mattress. Paul cannot get the painkillers without interacting with Annie, which symbolizes the guilt that accompanies the pleasurable feelings of addiction.
After being rescued from Annie's place, Paul feels unable to work, too distracted by his physical pain. Without the Novril, Paul transitions back to relying on alcohol to get through the day, but he still wishes for Novril to ease his pain. He experiences post-traumatic stress, and this makes it even more difficult to withstand his desire for painkillers. In the end, Paul breaks through and resumes writing, but his experiences with Annie still haunt him.
King and his character Paul felt figuratively chained to the things they became famous for: horror novels and Misery novels, respectively. In Misery, King uses many kinds of literal and figurative entrapment as metaphors for this emotional state. Paul's confinement has many levels. His accident leaves him immobilized and dependent on painkillers, which only his captor, Annie, can provide. Annie confines Paul to a bedroom for months. Paul comes to identify himself with "a rare bird which came from Africa" (62) that he saw at a zoo as a young boy. The bird's captivity so far from its home upset young Paul, and he never forgot the image. Paul repeatedly refers to himself as this African bird, emphasizes the incongruity and helplessness of his situation.
On a professional level, Paul is tethered to the 19th-century romance novels that made him famous. Because of this, Paul feels unable to break free from his reputation as a bestselling writer. Like Paul, his character Misery, is also confined. Physically, she's buried alive, scratching at her casket, "tryin' to work her way back up to the land o' the livin'," (134) as one character in Misery's Return says. Figuratively, Misery is a one-dimensional female character that anchors Paul to his trite romance novels. When Paul tries to write "serious work," he's met with "a flood of protesting letters" (30) from the women who read his Misery novels. Fast Cars sounds like the antithesis of Paul's Misery novels; it's never explained what exactly the novel is about, but it has masculine overtones perhaps designed to alienate his core readership.
The cycle of addiction is one of the main forms of confinement present in the novel. Even if Paul could physically leave Annie's house, he is chained to his addiction to Novril, which she controls. She has created a failsafe: In the event Paul tried to run, his addiction to the painkillers would compel him to stay.
Escape from entrapment as a narrative device is another aspect of this theme. As a child, Annie was obsessed with "chapter-plays": serial installments of the Masked Avenger, Flash Gordon, Rocket Man, and others in which the hero was left in some seemingly inescapable situation. The situation, however, would be resolved in the next week's episode. This reminds Paul of a game he used to play at summer camp called "Can You?" (124) in which the students suggest resolutions for impossible cliffhangers. As Misery goes on, Paul uses the Can You? mindset to not only get his character, Misery, out of the ultimate entrapment—death—but to get himself out of Annie's clutches, too. This escape from entrapment is both a literal and figurative self-actualization for Paul. Not only does he escape Annie's and his addiction's clutches, but he also reconfigures his relationship to art, allowing him to more meaningfully express himself beyond the Misery novels.
By Stephen King