But Inside I'm Screaming

“So why did you end up doing it? Coming in with Alex?”

Isabel picked at her thumb again and pushed down against the speck of blood. “I was scared not to.”

“What are you scared of?”

Isabel looked up from her hands. “What am I scared of? Alex, of course. What else would I be scared of?”

“You’re scared of Alex?”

“Ah, yeah.” Isabel was bewildered at Pat’s naivete.

“Why?”

“Why am I scared of my husband? Are you serious? You seriously do not know why I’d have a reason to be afraid of Alex?”

The therapist was still.

Pat could not be this good an actress.

“Let me see if I am understanding this. He’s been coming to you every week for seven months. Every single week. And he’s never once talked about how he gets violent with me?”

“Excuse me?” Pat was trying hard not to appear astounded.

“You two have never discussed his violent rages? How he’s made me bleed? How I end up in a different motel each time because I’m embarrassed to go back to the same place twice wearing my sunglasses at night? He’s never told you any of this?”

Nothing.

“Oh, my God. I feel sick.” Isabel grabbed for her purse on the floor and stood up to put her coat on. “I feel physically ill.”

“Isabel, wait.” Pat scrambled to think of what she could say.

“Wait? Wait for what? For you to do your fucking job and figure out why your patient is coming to you in the first place? Wait for my husband to kill me? Jesus! No wonder the fights haven’t gotten any better! He’s been lying all along. He hasn’t dealt with any of it. I think I’m going to throw up.”

Isabel ran out of the office, through the lobby and out into the fresh air. She stopped on the sidewalk and sucked in the air as though she’d been suffocating.

Thirty-Two

Isabel was as lost in her depression as an Australian shepherd dog would be without a herd of sheep. It can be a thing of beauty to watch the dog gracefully circling a confused herd. Speeding up, slowing down, sidestepping and charging forward—the dog’s every movement is intense. Lying deep at the instinct’s center is the simple, involuntary need to please.

“Isabel, you seem a bit subdued today,” her therapist remarks. “Is there any particular reason for that?”

Just tell me what you want from me. Tell me who to be and I’ll be it.

Daily meetings with her therapist, her psycho-pharmacologist, the nurse on the unit and then group therapy with Larry…Isabel is sick of it. It’s draining to appear to absorb all the good intentions of the mental health care professionals surrounding her. Outnumbering her.

It’s brainwashing when you think about it: people telling you you’re a valuable person, you shouldn’t think of dying as an option, you’re worth more than that…It’s like they hope that by osmosis you’ll feel better about yourself. You’ll be infused with the intense desire to live.

Why isn’t it working?

“She had it all…a successful career as a television reporter for a major news network, a marriage and a good circle of friends…find out what went wrong…Sunday at eight only on Lifetime, Television for Women.”

“Isabel, I think we need to revisit the medication issue,” Dr. Seidler is saying. “Have you given any thought to what we discussed earlier? You seemed pretty upset. I’ve tried to talk about ECT with you every day this week and each time you shut down. Isabel?”

Isabel stares at the Native American weaving hanging above the doctor’s desk. She hears every word as if she is underwater.

“I want you to know that I feel our options are becoming limited. With electroshock therapy we would take very few risks and see the most benefits. What do you think?”

Sometimes, if you stare at something long enough you can almost hypnotize yourself. Kind of like sleeping with your eyes open.

“Isabel? Are you okay? Isabel?”

The vibrant colors in the wool decoration blur together.

“Isabel? Do you understand that as your doctor I can act in your best interests if I believe your personal safety is in jeopardy? In other words, I don’t necessarily need your approval to move forward, and I am starting to feel like that is an option I may actively explore….”

She sure uses the word option a lot. How many times has that been? Two? No, three. Maybe it’s two.

“Can you hear me, Isabel?”

That voice is so grating.

“Isabel?”

Thirty-Three

“Who should we start with today?” Larry opens up the session by slowly circling the room. Under normal circumstances that would be annoying enough, but with a group of anxious mental patients it is maddening. Some nervous, others paranoid, all twist uncomfortably in their chairs to keep Larry in sight. In the end, he stops behind Ben’s folding metal chair. The others exhale in relief.

“Ben?”

“Um, what, Larry?” Ben sits bolt upright as if he hadn’t done his homework.

“We haven’t heard from you in a while. Why don’t we talk about where you are these days.”

“Where I am, Larry?” Ben has an unnerving habit of repeating his conversation partner’s name with each reply. “I’m here in the session, Larry.” While Ben is serious in his bewilderment and in his literal interpretation of the question, the rest of the group laughs.

Larry is gentle. “What I mean to ask, Ben, is, how are you feeling these days?”

“Oh! I’m fine, Larry. Just fine.” Larry waits for more. “Um, I’m looking forward to finding out about my next stop, though. They tell me they’re still waiting to hear whether I got a bed at Strawbridge Ranch.”

“Why don’t you tell the rest of the group about Strawbridge.”

“Sure!” Ben is relishing this time in the limelight. “Strawbridge is, like, a halfway-house-type place. It’s cool, though, ’cause we get to work on the ranch—milking the cows, feeding the chickens and stuff. Not wild animals but tame farm-type animals. It’s great! And I hear they have great food there. Unbelievable food, Larry. I talked to one of the nurses and she said they’ve got the best blueberry pancakes. I don’t know how often they have them. Maybe once a week or something…but blueberry pancakes! I can almost taste them now!”

Melanie laughs again. Ben is getting so revved up that spittle is forming in the corners of his smiling mouth.

“That’s good, Ben. Good. Let us know when you hear about the bed.”

“I will, Larry. I will definitely.” Ben is a little disappointed to see that his time is over and Larry is moving on to someone else.

“Melanie? What about you?” Larry has turned to Melanie because she is still laughing about Ben’s pancake reverie.

“Well…” Melanie, it is clear to Isabel, is feeling good today. Her animated elation points up Isabel’s empty