Elizabeth Flock - But Inside I'm Screaming

The rain has left the air thick with humidity, and inside the unit it feels more like the middle of August than the end of September. The central air is working overtime and Isabel begins counting the seconds between its blasts in order to bring on sleep. She makes it to one hundred and loses interest.

Outside her room, over the hum of white noise artificially produced by her Hammacher Schlemmer, Isabel hears a series of doors opening and closing. She strains to understand the muffled urgency of a distant conversation that gets louder and then stops altogether.

They’re late for the one-thirty check.

Out of boredom and the certainty that sleep is futile, Isabel gets up and turns the noisemaker off. She opens her door and peeks down the empty hallway.

She follows the voices until she can vaguely make out a word or two. Isabel recognizes the raspy intonations of her favorite night nurse. Connie is involved in the dispute, evidently taking place in the soft room.

“No!” she hears a male voice say.

“Wait until the count of three,” Connie orders.

“If we…” Another voice trails off before Isabel can identify it.

Around the corner, light from inside the soft room falls in a triangle across the linoleum floor. Shadows slice into it from time to time as figures pass from one side of the room to another. The ebb and flow of agitated voices continues.

“You aren’t listening to me!”

“Okay, here’s what we’re going to do,” Connie is saying over the din. “On the count of three we’re going to lift the top part off simultaneously. The restraints are in place so this shouldn’t be a problem. Fred, you stand on the right and get ready to grab her if you need to.”

“She looks pretty sedated,” the male voice replies. “Maybe that shot’s finally kicking in.”

Isabel inches forward and looks over her shoulder. The hall is still empty. Whoever is in the soft room is commanding the attention of all of the night staff.

“Okay, ready?” Connie asks. “One!”

Isabel inches forward.

“Two!”

Isabel takes two more steps toward the room.

“Three!”

As she moves to the edge of the doorway she hears the sounds of metal hitting the ground and the muffled sound of a woman groaning.

Isabel takes a deep breath for courage and forces herself to look into the room. Strapped into a stretcher with a square of duct tape angrily slapped across her mouth, is Kristen. Her eyes are wildly darting from side to side and sweat is beading on her forehead. She looks petrified, like a trapped animal moments before it tries to gnaw its own leg off in order to escape.

Connie and several orderlies have peeled another stretcher off the top of her. While the others are busy cleaning up a mess of medical equipment, Connie crouches at Kristen’s forehead and is whispering something to her, trying to calm her down. Isabel feels physically ill and turns away.

It is as if a flash of lightning has illuminated a photo negative of her nightmare and in that one moment, the difference between Isabel and Kristen has crystallized. In that instant Isabel knows they are traveling different roads. She stands there, outside the soft room, and hears Regina’s voice. You’re not like the others…you’re normal. She imagines Ben in camouflage marching down the halls of his school. She pictures Sukanya in the laundry room, reciting a Yiddish prayer. She sees Lark’s bloated body dangling, lifeless above the dryer.

She walks slowly, mechanically back to her room.

When Isabel closes the door to her room she knows, perhaps for the first time in years, that she is going to live. Before this night the prospect of returning to the “real world” had filled her with anxiety. Now she feels a quiet confidence.

“ There’s nothing more for me to do here,” Isabel announces to Dr. Seidler within thirty seconds of the beginning of their appointment. “I’m ready to go home now.”

“Wow,” Dr. Seidler smiles. “Good. Okay, let’s get you home. Tell me about this resolve. What happened?”

“I’m ready to go,” Isabel says, completely sure of herself. “I know I’ve said this before, but this time I mean it. I am truly ready to go.”

“Excellent. I think you’ve done some good work here, Isabel,” Dr. Seidler says. “You’ve made incredible progress. It’s my hope that you’ve also learned some coping skills so when you feel overwhelmed in the future you can better deal with it. There are a lot of options out there.”

“I know. I do feel like I’ve gotten much better about talking things out rather than letting them build up inside. That’s been my problem all along. One of my problems. The rest I can continue with in New York, with Mona. That’s an ongoing project.”

Dr. Seidler has been nodding enthusiastically. “Absolutely,” she says.

“So. When can I blow this Popsicle joint?”

“Let me get your paperwork together and prepare you for your official discharge. You should know that I am required to put in a call to your therapist, Mona, just as a courtesy more than anything else. It’s just to notify her that you are leaving. You will need to call her to set up an appointment. As part of your discharge we need to be sure that you will have outpatient follow-up care. Just a formality since I know you will continue your work with her.”

“I’ll call her right after this,” Isabel says. “And I’ll call my mother to come pick me up. I need to tell her when, though.”

“When would feel right for you? I know you have your meetings in two days.”

“I can do it from there. Maybe it’s best that I get acclimated for a day back home before I go into the office. So…tomorrow? Can I leave tomorrow? That way I’ll have Larry’s group today and a chance to say goodbye to everyone.”

“You’re sure about this, Isabel?”

“Positive.”

“Then let’s make it tomorrow.” Dr. Seidler smiles warmly. “Why don’t you have your parents pick you up right after our morning appointment so we can say goodbye as well.”

“Great.” Isabel had forgotten she would also be saying goodbye to Dr. Seidler.

“Now that that’s settled, let’s talk about what you’re going home to,” Dr. Seidler says. “Let’s try to use every minute we’ve got left talking about what you’ll face when you leave here. That is, unless you have something else you’d like to address before you go?”

“No. That’s a good idea.”

“There are two pressing issues I feel you need to be especially careful about when you leave here, but I know you don’t need me to tell you that. Your meeting at ANN is likely to be stressful, and you’ll be facing Alex for the first time in quite a while. How do you think you can best cope with those situations?”

“See, that’s why it’s best if I go in from the outside, not from here. If I went into the city from here, got overwhelmed again—even if it’s only half as bad as it was on that other trip—then went in to meet with my boss, I’d be a basket case. I’d have absolutely no strength to say anything in my defense, even if it were just to save face. I’d be worried that my medication wouldn’t be powerful enough to prevent another panic attack and I’d freeze up again right there in Sargent’s office. It would be a nightmare.

“Whereas if I leave here tomorrow I can have a night to get used to my apartment and I’ll have a fighting chance of salvaging at least a shred of dignity at ANN.”

“True.” Dr. Seidler is nodding again. “It just occurred to me, what if they don’t fire you?”

“Huh?”

“Well, you’ve been assuming you’re going in to face the firing squad. But what if you come clean and tell them you’ve been getting the help you need in order to deal with the medical problem that had prevented you from doing your job and you feel ready to tackle it again. What if they said, ‘Okay, Isabel. Then come on back.’ What then?”