But Inside I'm Screaming

Isabel pulls her eyes from the floor to the window, where they settle on the peeling bark of a birch tree just outside the doctor’s office.

“I’m just trying to get to the root of what appear to be extreme panic attacks,” Dr. Seidler explains. “In some cases they might be termed psychotic panic attacks.”

“But I’m not violent or anything.” Psychotic, psychotic. “I’m not psychotic.”

“It’s just another word for ‘acute’ in this case. I didn’t mean to imply you were violent—I certainly don’t believe you are. Again, was this one as bad as the others?”

“Um, no. I don’t think this was as bad. But that’s probably because I didn’t know anyone. When it happened at work I was on the air. I was in a newsroom surrounded by people I know.”

Isabel remembers the messages left on her answering machine.

“It looks like I’ll probably get fired for that last one. I just called in and checked messages. They want to fire me.”

Isabel’s eyes sting with tears.

“I’m so sorry. Are you sure, though? Maybe you misinterpreted the calls?”

“I’m sure.”

Silence.

“It’s trite but true, Isabel. New beginnings come from other beginnings’ ends.”

“I know, I know…when one door closes another opens,” Isabel sighs. “Blah, blah, blah.”

“I want you to know that this is very treatable. We can prescribe something that can help curb the panic. Millions of people suffer panic attacks. There is a very effective medication I would recommend—it’s Xanax, actually—that could greatly diminish your attacks, if not help them disappear altogether. That, along with working on what triggers the panic in the first place, can be a terrific course of treatment. I don’t think this hinders your efforts to leave here.”

Isabel looks alert. “Really?”

Dr. Seidler smiles. “Really. I can prescribe something today and we can see how it works. I want to make sure I get the dose right since you’re already on Serzone and Zyprexa. Many times Xanax can help boost the effectiveness of antidepressants, so that’s what we’ll hope for.”

Isabel brightens for the first time. “So even though I had another attack you still think it’s okay if I leave? This isn’t a setback?”

“Not at all. As I said, acute panic attacks are more common than you would think, and people aren’t institutionalized for them. I’m most concerned with your coping mechanisms mixing in with your depression. That is and will continue to be the struggle you have to concentrate on. The panic attacks—I’m confident we can successfully address them so they won’t pose any more problems for you. I would have been surprised if your trip into New York went smoothly. In a way, this was to be expected.”

Isabel takes her time walking back to the unit. The footpath veers off to the right, and for the first time, she decides to turn toward the art studio, knowing the patients on her unit do not have art class until later in the day.

She crosses the grassy field and stops outside the door to the studio, careful to listen for any signs there is a class underway. Hearing nothing, she tries the door. The smell is elementary school: papier mache and turpentine. She lets the door close quietly behind her and looks around at the watercolors hanging on every wall of the room. Sunlight floods in from a huge window, warming the clay figures left out on counters to dry. She absentmindedly lets her hand alight on many of the pieces: an ashtray, a vase, a bust of an elderly woman.

Just as she is turning to go, Isabel hears something and stops. Muffled grunting sounds seep out from behind a closed door opposite the front of the building. She listens for a moment, straining to make sense of the sounds. The grunting quickens and mingles with a woman’s sighs.

I’ll be damned! Someone’s having sex in here.

Isabel reaches for the doorknob and hesitates.

What if it’s a doctor or something? I don’t want to see that. But, damn! I can’t leave without finding out who’s in there.

Isabel’s curiosity is overwhelming. She is barely breathing.

Isabel turns the knob and gently eases the door open, trying to make as little sound as possible. Standing just out of sight, Isabel peers inside.

There, lying on a table in front of the kiln is Kristen with Nick the orderly, Connie’s son, standing between her legs.

Oh. My. God.

Isabel shuts the door and runs out of the studio, knowing that within seconds Nick will pull up his pants and race after whoever discovered them.

She crouches behind a hedge on the side of the building. She cannot run directly to the unit because, even with a head start, she would not have time to cross the field without being recognized.

“Hel-lo?” Nick calls, trying to sound casual, friendly. “Who’s there?”

The voice is getting louder. He’s getting closer.

Isabel holds her breath.

“Hello?” Nick calls out again.

There is a sound of a door opening and closing, followed by the sound of hurried footsteps on the path. The steps are heading away from the art studio.

Kristen.

Isabel can feel the pulse of her heart beat in her throat. She knows she has to make a move but is not sure where Nick is.

“I know you’re out there,” Nick is saying. “I can explain if you’ll just let me, whoever you are.”

His voice is coming from farther away.

“Come out, come out, wherever you are!”

He’s circling the building.

Isabel makes a run for the back door to the cafeteria. The door opens easily and she slips inside.

Another unit is in the middle of lunch so she grabs a tray and cuts in line in front of the vat of institutional mashed potatoes, careful not to look over her shoulder when she hears the same door open and close. There is so much noise and activity in the lunchroom Isabel fits in undetected.

Nick scans the room, crosses it and goes out the front door.

She shuffles along in the line of patients and then ditches her tray at the salad bar and leaves.

Looking both ways before cutting back across the field and onto the main footpath that leads to her unit, Isabel consciously slows down, to look as if she is just coming from her doctor’s appointment, in case Nick doubles back.

Within seconds she reaches the smoker’s porch and there, calmly taking a drag of her cigarette, is Kristen.

Why do I feel like I’m the one who’s done something wrong?

Kristen has not seen Isabel approaching and jumps in her chair. “Oh, hi. You startled me.” She puts her hand to her chest.

“Sorry,” Isabel says. “Didn’t mean to scare you.”

“That’s okay. Want to join me?”

I don’t want to join you. You’re on the southbound train and I’m heading north…directly out of here.

“I’ve got to go to the dry erase board and let them know I’m back from Seidler’s office.” Isabel heads to the door, grateful for an excuse to escape the wreck that is Kristen’s life.

Just before it closes behind her, Kristen calls out. “Isabel? If you see Nick, um, that orderly? Could you tell him I need to speak to him?”

Without turning around Isabel says “sure” and goes inside.

Fifty-One