But Inside I'm Screaming

Kristen laughs nervously, afraid that she has crossed the line and has shared too much too soon.

I’m supposed to jump in here and save Kristen from feeling embarrassed. I know the drill. I can’t do it.

Isabel feels a wave of exhaustion that brings the social interaction to a screeching halt. She musters a smile and walks away, knowing Kristen is offended.

On her way past the living room, Isabel sees Keisha nodding her head to the beat of the music funneling into her ears from headphones the size of fluffy earmuffs.

With those headphones on she looks like a black Princess Leia.

Eight

Isabel and Kristen are sitting next to each other for the evening session. All the patients on the unit are seated in a circle and in the middle is an empty chair.

“What’s the deal with the chair?” Isabel whispers to Kristen, who is still wounded by Isabel’s snub earlier in the day.

“You’ll see,” she answers curtly. “He does this every once in a while.”

Isabel is smart enough to know that someone is going to have to sit in that chair in the middle and, whatever it entails, she does not want it to be her.

“My name is Larry,” a large man says after quietly closing the living room door. If Larry were a state he would be Vermont: earthy, self-sufficient, nonthreatening, easy to overlook. Almost entirely gray, his beard appears to be aging faster than the rest of him. His clothing is eclectic and, Isabel notes, hemp in spirit if not in reality.

“Because I see we have someone new in our evening session I want to start tonight by quickly going around the room. Let’s start to my right, here.”

Isabel’s heart races, knowing she will be second.

Oh, God, I hate these things.

“Um, I’m Kristen. I’m here for a lot of reasons. I’m bipolar and I have obsessive-compulsive disorder. Among other things.”

All eyes settle on the newcomer: “I’m Isabel,” she says, her voice an octave higher than usual.

“Why are you here, Isabel?” Larry prompts.

“I don’t know,” she says, feeling her blush deepen. “I mean, I guess I’m here because the doctors thought I should be here.”

Please move on to the next person.

“Well, welcome, Isabel,” Larry says. “You’ll get the hang of this pretty easily.”

“I’m Ben.” The giant can’t wait until it’s his turn. “I’m here because the judge ordered me to be here.”

“I’m Melanie. I’m manic. I mean manic-depressive. I mean, I’m bipolar.” She directs this to Isabel. “People aren’t quite used to the whole ‘bipolar’ diagnosis yet so I always start by telling people I’m manic-depressive. Which is really the same thing. People say ‘bipolar’ isn’t a proven diagnosis yet but, you know, it really is. Doctors know that but people, like the general public, I mean, don’t realize that yet. And that’s all I have to say about that.”

“Okay, Melanie,” Larry gently interrupts. “Thanks. Next?”

“I’m Lark.”

“Lark? Do you want to tell Isabel why you’re here?”

“No.”

“Okay, then.”

Larry politely waits for Sukanya to introduce herself. When it appears she is not going to speak he moves on. Leaning on the empty chair in the middle of the circle, he surveys the group, noting that Keisha is absent. He checks a small notepad and nods to himself.

How’d that girl Keisha get out of this?

As she realizes that her facial expression is mirroring her dread, Larry points directly at her.

They can always smell fear.

“Isabel,” Larry begins, “you’re new to the group so let me explain what we do here. The purpose of this meeting is to get more intensive work done. We set aside two hours for the session because we’ve found that extra time allows us the freedom to dig deeper.

“The chair here represents someone or something you would like to address. Maybe it’s someone you’re angry with. Maybe it’s something that has caused you pain or suffering. Only you can know what it means, this chair.”

Larry stops talking. He waits patiently for Isabel to begin.

“Um,” Isabel clears her throat. “I don’t know. I don’t have any anger,” she lies.

“You don’t?” Larry asks with mock incredulity. “No anger? That’s a bit unusual. Not to generalize, but most people wouldn’t exactly be here at Three Breezes if they had not experienced some form of anger. Hmm. Let’s see.” He consults a file that until then had been sitting on the table next to him.

“Isabel, why don’t you begin by telling the group why you took all those pills.”

Isabel feels like her cheeks are on fire. Her stomach is in her throat and her throat is rapidly closing up. She hears a rushing sound in her ears.

I can’t believe this man I’ve never met wants me to talk about this personal thing in front of these people. Plus, he looks like Obi-Wan Kenobi.

Isabel stares at Larry’s Birkenstocks.

“I don’t really feel like talking about that right now,” she manages to say, fighting to keep her voice from cracking as she chokes back her tears.

“When do you think would be an easier time to talk about it, do you think?” Isabel knows Larry is asking a rhetorical question.

“I get your point, okay? I get it,” she says. “It’s just that I don’t really feel angry at the moment and I don’t have much to say.”

Why can’t you just move on, you big hippie.

“I know it’s tempting to retreat when you first get here, Isabel.” Larry sounds kinder. “It’s just that in the beginning, when everything is still pretty raw, pretty fresh, it’s usually a good time to talk about emotions in general, anger in particular.”

“I don’t feel like talking,” Isabel repeats herself, adding a tone of warning. “Just go on to someone else.” She clenches her jaw.

“Isabel, what are you so angry about?”

Goddammit.

“Isabel?”

Goddammit.

“Right now I suppose I have anger toward you, Larry.” Isabel tries to mimic the group leader’s controlled tone of voice.

“Why me?” Larry asks, a sardonic look on his face.

“For starters, where do you get off reading something from my personal medical file to this entire group?”

“This is group therapy, Isabel,” Larry soothes. “That’s what we do here. We talk about the tough stuff in front of one another.”

Isabel swallows hard.

A moment later, giving in to her exhaustion she says, in a whisper, “I couldn’t do it anymore.”

“Couldn’t do what?” Larry softly urges her on.

“I was on one of those Habitrail wheels they have in gerbil’s cages, you know?” she starts, looking back up at Larry. “I couldn’t keep running on the wheel. I couldn’t live anymore, disappointing so many people like I was.”

“Who? Who were you disappointing?”

Isabel pauses once more and then slowly begins bailing out the water that is sinking her.

“My marriage is over so I’m sure my husband’s disappointed with me. My parents have been disappointed in me for as long as I can remember, I screwed up majorly at work so I know my boss is disappointed in me…” She trails off, knowing she hasn’t scratched the surface.

“Keep going, Isabel. We’re listening.”

“It’s hard to explain.”

Isabel turns her head from Larry to the empty chair. She stares at it for a long minute.

“For me that chair represents all that I expected of myself,” she says sadly. “I was supposed to be perfect.”

Nine

Isabel had been friends with Casey since the third grade. They were close in the way a rose befriends the stake that is meant to help it stand tall. As time passes stalk and stake become interchangeable: they take turns propping each other up, bending into each other with every gust of wind.

When Casey found a lump in her breast it was Isabel she called first.

“Will you come with me for the biopsy?”

“Of course.” Isabel stifled her tears and nodded into the phone.

“You’re crying, aren’t you?” Casey asked.

“No,” Isabel lied. “I think I have a cold.”

“You can’t cry. You’re not allowed to cry right now. I need you to be the strong one. If you cry I’m gonna start freaking out. And you’ve seen me freaking out. It ain’t pretty.”

“Okay, okay.” Isabel sobered up. “When’s the appointment?”

“Tuesday. I’ve got to be there at eight in the morning. I think they said it’d only be a couple of hours.”

“You’re staying in the hospital, right?”

“No. It’s outpatient. I’m going to need you to drive me home and put me to bed. They said I’d be really groggy.”

“Tuesday. No problem. I’ll be there with bells on. Where are you having it done, by the way? UCSF?”

“Yeah.”

“So, what’re you doing tonight? Want to go to a movie? Your pick, Lumpy.”

Casey laughed. “No, thanks. I think I’m just going to take a nice long hot bath until my fingers get all shriveled.”

“I’m coming over.”

“Okay, bye.”

“Bye.”

* * *

“Isabel? I’m assuming you’re on your way. It’s 7:50. If you’re not on your way, you’re in big trouble. I think I just heard a car door slam. That’s probably you. Bye.”

* * *

“Okay, it’s 8:05. Where are you?”

* * *

“I’ve called a cab. I hope you were in an accident or something. That’s the only thing that’s going to keep me from killing you later.”

“After the crash of TWA Flight 800, the FAA intensified its scrutiny of center fuel tanks, not only in 747s but in other, older, aircraft with similar design. Then, an alarming discovery. On Sunday, Boeing notified the FAA that recent inspections had turned up a high degree of wear and tear on wiring in and around fuel tanks in three 737s. Now, airlines have a seven day deadline to inspect and replace wiring and conduits in certain pieces of equipment. Sixty days for others.”

—Isabel Murphy, KXTY, San Francisco.

“Okay, great job, guys,” Isabel said, rubbing her cold hands together. “I’m heading back to the station for the conference call.”

“Fine,” said Mike, her cameraman. “But you’ll have a lot of time to make it there. The conference call isn’t till tomorrow.”

“What’re you talking about? It’s always on Wednesdays. When did they change that?”

“Since today’s Tuesday they didn’t have to.”

“Today’s Tuesday?”

Oh, my God. Casey.

Ten

Casey was propped up in bed.

Isabel, shamed, buried her head in her hands. “Casey, I’m so sorry. Words can’t express how sorry I am. It’s just…”

“You got called to do a story,” Casey sighed. “I know the drill by now. I never should have asked you to take me.”

Isabel shook her head emphatically before her friend had finished the thought. “Don’t say that! I feel terrible, okay? Nothing you can say would make me feel worse. Tell me how I can make it up to you.”

“How can you make it up to me? Jesus! I went to have a lump removed from my breast and you weren’t there and now you wonder how you can make it up to me? You blew me off for my own biopsy. What else am I going to think but that you don’t give a shit about your friends? You’ve always been Miss Career Woman and I understand that. I’ve been your biggest supporter. You know that. But this was important. This was a goddamn biopsy. And you totally forgot. And it’s not like this is the first time that’s happened. Every week you’re standing one of us up. I talked to Nancy last week and she said she was waiting at the café for forty-five minutes before she finally gave up and left. And Paula went to the movies alone three weeks ago, after buying you a ticket and waiting outside the theater through the first half of the film practically. At the rate you’re going you’re not going to have any friends left! Are you even listening to me? Furthermore, you haven’t even asked me about the surgery.”

“That’s because you laid into me the minute I walked in the door.”

“Can you blame me?”

“No. No, I can’t.”

They looked at each other.

“How was the surgery?” Isabel asked.

“It sucked, if you must know. And now both my boobs are sore. I don’t know why they both are since they only worked on one. But thanks for asking.”

“Casey, I know I screwed up. It kills me that I let you down. You have every right to be pissed off at me. I’m pissed off at me, too. I don’t know why I’m such a terrible friend. I don’t mean to be. I love you like a sister. I would do anything for you—don’t make that face. I would. Something happens when work calls me. I can’t explain it. It’s like work overrides everything else in my brain. Like I don’t have room for anything else but work. I wish it weren’t true but it is.”

Isabel started to cry but continued through tears.

“I am so sorry. I hate that I let you down. I will never forgive myself for this. For all of it. Please forgive me. Please?”

“Aw, Iz. Don’t cry,” Casey said from the bed. “I’d hug you if I could but I’m afraid I’d ooze pus.”

Casey had wanted her to laugh but she couldn’t. On the contrary, Isabel’s sobs became three-dimensional.

“I know you’re sorry,” Casey sighed. “I’m sorry I was so tough on you just now. I understand how important your job is to you. I’ve always known you’re really kick-ass driven. You get that from your father, if you want my opinion. You’ve always tried to work as hard as he did. That’s your model. And your mother. Well, let’s just say that I get where your perfectionism comes from. And I respect that, don’t get me wrong. But somewhere you’ve got to take a break and have a life outside of work. That’s something you didn’t see your dad do so maybe you don’t know how to juggle it all. But try, okay? For me?”

“I promise. I will. I love you, Casey.”

“I love you, too, kid.”

Eleven

“What are you thinking about?” Dr. Seidler was assigned to Isabel when she entered Three Breezes days ago. Though her perfect posture and severe haircut suggest an aloof personality, Dr. Seidler’s hands more than cancel out the implication of cruelty. They are long delicate hands punctuated with ribbons of veins that add to their character and grace. Isabel can do nothing but stare at them.

“Isabel?”

Silence.

“I realize it’s been quite an adjustment to get used to life here at the hospital and I’ve chalked our last two sessions up to being quiet times for you to be contemplative,” Dr. Seidler continues. “But we do need to work together—you and I—if you’d let me help you. I guess what I’m saying is, you have to let me in, Isabel.”

“What do you want from me?” Isabel asks, reluctantly looking up from the hands.

“I don’t want anything from you. I want to help you. Let’s start by looking at why you’re really here.”

Jesus. Why are you here? Why are you here? I’m so sick of that question! I don’t know why I’m here. I don’t belong here. Look at me: do I have bandages on my arm to keep me from scratching? Do I babble incessantly about bullshit? Do I sit all day staring into outer space? I don’t belong here. Just give me my privileges and let me go down the driveway, for God’s sake.

Dr. Seidler’s stare is unwavering.

Okay, I’ll blink first if that’s what you want.

“I’m here because I want to kill myself,” she shrugs.

“Why? Why do you feel you can’t live any longer?”

“Um, I don’t know.” Isabel feels like a third grader.

“This isn’t a quiz, you know. It’s not like there’s a right or wrong answer to the question. I’m just curious.” The therapist looks at Isabel’s file and reads from it.

“You mentioned when you first got here that you felt like you were disappointing everyone in your life. Like you couldn’t stay on the treadmill at work and keep everyone else happy. Is that how you feel? You couldn’t make everyone happy so you might as well kill yourself?”

“When you say it like that it sounds ridiculous,” answers Isabel. “Which, I assume, is your point. But it’s not that simple. I feel like I’m being pulled in every direction.”

“What about today? Do you feel suicidal?”

Grounds privileges. The driveway.

Isabel is torn between telling the truth and risking a doctor’s recommendation that she stay hospitalized, or lying in order to be free of this place. “Um, well, no. Not like before.”

“What does that mean exactly? ‘Not like before’?”

“Well, I don’t think about it like I did a few days ago. When I got here,” she continues the lie. “I mean, I can actually think about next week, whereas before I couldn’t see that far into the future. I figured I’d be dead by then.”

Tell her. Tell her how you only buy single rolls of individually wrapped toilet paper. Buying in bulk would be a waste. Tell her.

“So now you can see living? At least another week, or a few days or what?”

“Yeah, I guess so. A few days…”

Tell her.

“What about Christmas?”

“As in Christmas of this year?” Isabel knows where this is going and is confronted with the truth dilemma again.

“Yep. The Christmas that comes in a few months. Can you picture yourself celebrating Christmas?”

She’s got me.

“No.”

“You can’t picture Christmas?”

“No.”

“It’s okay, Isabel. You don’t have to feel crestfallen about that. You’ve only been here a short time. We don’t expect miracles. Patients aren’t expected to go from suicidal ideation to long-range planning in that short period of time. It’s okay.”

Isabel begins to cry.

“Can you tell me why you’re crying?”

Through her tears Isabel’s voice cracks. “I want to get out of here.”

“I hear this is highly upsetting to you,” Dr. Seidler says, trying to soothe her. “But as I told you yesterday, I am going to recommend to my colleagues that you stay with us a little while longer. That will help you in the long run.”

Isabel can barely hear her. Her depression is floating away, disappearing like an airline tray neatly folding back into its cave underneath the armrest, patiently waiting to again emerge for the next flight. She has stopped crying.

“Isabel? Isabel, what are you thinking right now?”

“I don’t know. I’m just blank.”

“Try. Try, if you can, to tell me what is on your mind right now. You’ve got a strange look on your face. You look scared.”

“Huh? Oh. No, I’m not scared.”

“What’s the first thing that pops into your mouth when I ask you to speak?”

Isabel’s eyes settle directly on Dr. Seidler’s face. “There’s no way I’m living until next Christmas. No way.”

“Why? Isabel? Stay with that thought…why? Can you hear me?”

Isabel is already gone. In her mind she sees the truck speeding toward her. She hears the screech of the brakes, the truck’s tires locking up too late. She closes her eyes imagining the impact, the feel of the pavement beneath her bloody body, the relief.

I refuse to be someone who’s in and out of institutions. I will not be Zelda Fitzgerald.

“Isabel. Listen to me for just a minute.” Her therapist is trying to get her attention. “While you’re here we need to work on your coping skills. I see you get a little overwhelmed with life. We need to teach you how to deal with the stuff that’s thrown at you. That way you won’t need to dissociate yourself from it, like you seem to be doing right now.”

“‘A little overwhelmed’?” Isabel snaps back and is crying again. “‘A little overwhelmed’? I’d say it’s a little more than that.”

“Okay, tell me.”

“Well, first of all, I have absolutely no control over my life and what I do with it. ANN has me on call twenty-four hours a day, seven days a week. They’ll beep me at three in the morning and tell me to get to the airport and sometimes I don’t even know where I’m going until I call from the back of the taxi. I have to have a bag packed at all times so that I can just walk away from whatever I’m doing and go to work. I’m in the middle of getting divorced. I don’t even have time to go to couples counseling—not that that’s any big loss, though….”

“Before you go any further,” the therapist interrupts Isabel, “let’s look at these things one at a time. You bring up some very good points. Let’s start with the divorce. What happened in your marriage?”

Isabel softens and slumps into her chair.

“My marriage?”

“I think that might be a good starting point for us.”

“Alex. That’s his name. Alex.” Isabel is sobbing again.

“Tell me about Alex.”

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