In "Angels Walking" by Karen Kingsbury, Tyler experiences a sudden and intense wave of pain as the effects of his third dose of pain medication fade. At around one in the morning, he feels the sharp sensations coursing through his shoulder and neck, which overwhelms him, forcing him to stifle a scream.
This moment illustrates the severity of Tyler's physical suffering, highlighting both his struggle and the emotional turmoil that accompanies his condition. The vivid description conveys the depth of his pain, setting the stage for his journey in the story.