But Inside I'm Screaming

by Elizabeth Flock

  “Excuse me, sir? Is this the four or six northbound?”

  The man looks the other way and pretends not to hear her. Isabel’s panic increases as the doors shut and the train picks up speed.

  “Excuse me, is this the four or the six northbound?” she asks a well-dressed woman.

  “What? No. This is the six express downtown. The next stop is Police Plaza.” The woman sounds indignant.

  She thinks I’m a mental patient. She knows I’m staying at a mental hospital. Oh, God, I’ve got to get off this train. Stop! Stop the train!

  Isabel’s frantic eyes search the map bolted to the door of the subway car.

  Jesus, how do I get out of here?

  The train lurches back and forth as it snakes through the underground canals. Isabel hangs on to the strap above her, but with each jarring motion her arm pulls out of her shoulder socket. Instead she grips the greasy bar in front of her.

  Focus. Focus. Once I get downtown what line am I going to take?

  “Next stop, City Hall. City Hall next stop.” But the announcement is warbled and all Isabel can pick up are the words stop and hall.

  The train slows as it pulls along the dimly lit platform. City Hall signs are emblazoned every few feet along the way.

  When the doors open Isabel gets off the train and feels herself jostled by the other passengers hurrying to get off before the doors close and the train heads across to Brooklyn.

  For a few moments, Isabel stands completely still, clinging to her purse.

  What do I do?

  The platform empty, she follows signs for the exit. Her footsteps echo as she carefully makes her way through the darkened tunnels to the turnstiles. The smell of urine and cigarettes increases her sense of frightened isolation.

  Nearing the end of the tunnel Isabel sees sunlight streaming down a dirty staircase. She breaks into a run.

  The sun makes her bare arms tingle after the dampness of the underground corridor. She hails a cab and gratefully climbs inside.

  “Central Park West and Ninety-sixth, please.”

  “It’s so good to see you, Isabel!” Mona presses her hands together in a prayer position and beams at her patient.

  Isabel takes one step into her therapist’s office and bursts out crying.

  Mona guides Isabel toward the couch. Silently, she strokes Isabel’s back and waits for her to speak.

  “I can’t do it” is all Isabel can squeak in between breaths. “I shouldn’t have come.”

  “Okay, first take a few deep breaths,” Mona says. “Deep breath. Good. That’s good. Now. Can you tell me what happened?”

  The words come tumbling out. “I got so turned around. I got lost. Everything’s so crazy here. I used to love this city. I knew my way around backward and forward. I’ve forgotten everything. I don’t belong here anymore. I shouldn’t have come.”

  “I can imagine how scary this must have been for you. Keep in mind, you’ve been at Three Breezes for about a month. That is quite a different, very controlled environment. New York can be overwhelming to anyone, Isabel.”

  Isabel’s heart slows down with each deep breath. Mona’s voice soothes her.

  I’m okay. I’m okay.

  “The bottom line is, you made it!”

  “So now it’s a triumph simply to arrive at my destination?” she sniffs.

  “Yes. For today, for what you’ve been through these past few weeks—it’s a triumph.” Mona motions to the Kleenex, which Isabel dutifully uses.

  “Do you want to talk about Three Breezes?”

  Isabel vehemently shakes her head as she blows her nose.

  “Well, we have to start somewhere—so I wonder, have you been able to think about the Alex question? Why you’ve stayed with him?”

  They had worked on it nearly every session for months before Three Breezes as if it were a riddle: why—how—does someone stay with someone who hurts her?

  Isabel looks up from the balled-up Kleenex in her hand. She remembers her mother’s words: you have to love yourself, Isabel. Suddenly it is clear.

  “Because I hated myself…” She trails off for a moment and then begins again. “I didn’t hate myself because I stayed with him. I stayed with him because I hated myself. How could I have expected anyone to treat me well when I wasn’t treating myself well?”

  Isabel let the words wrap around her like a fluffy hotel robe. For a brief flash she sees her life as an outsider would see it.

  “That’s it.” Isabel hears a rushing sound in her ears. “I figured it out. It’s so simple.”

  “It’s a beginning, that’s for certain,” Mona smiles. “The big question is do you still hate yourself?”

  She looks Mona straight in the eye. “No. I don’t believe I do.”

  The sound of a breakthrough.

  Forty-Eight

  “Can you tell me where to find the information booth?”

  “Huh?” Isabel turns her head to the voice.

  The tall German college student is standing too close to Isabel and is speaking loudly.

  It’s like two Seinfeld episodes in one: a close talker and a loud talker. Who was the close talker again? Come on, you know this. Close talker. Close talker. Judge Reinhold!

  “The information counter. Can you tell me where to find it?”

  Isabel stares at him.

  “You do not know.” The German answers for her and moves toward a commuter smoking just outside the entrance to Grand Central.

  Isabel snaps awake.

  “In there,” she calls after him. “Down the steps, in the middle of the room. You’ll see a round clock on top of it.”

  “Thank you,” the German replies as he pushes through the heavy doors into the terminal.

  Isabel waits a beat and follows him in, scanning the huge departure board on her way down the steps.

  Once onboard the train she collapses into a vacant seat by the window and closes her eyes until the conductor enters the car collecting fares. Without hesitation Isabel pays with exact change.

  She sleeps the entire ride.

  “Where to?”

  “Three Breezes Hospital, please,” Isabel answers the cabdriver.

  “Going to visit someone?”

  “Yeah,” Isabel replies, embarrassed to admit her connection to the place.

  “You got it,” the driver says, turning onto the road that leads to the hospital. “To the Nut Hut.”

  Forty-Nine

  Isabel pulls the folding chair up to the phone in the unit kitchen.

  “Hi, Isabel. Goodman here. I’m calling to see how you’re doing. Haven’t talked to you in a while. I don’t know if you’re checking your messages, but in case you are I wanted you to know that we handled the, uh, situation so you don’t have to worry. I’m still not sure whether you got the message I left a couple of weeks ago, but in case you didn’t, I wanted to let you know everything’s fine. I spoke with HR to make sure your leave of absence forms got through. They got them so it shouldn’t be a problem. Call me, though, if you can. Bye.”

  “Isabel? Hi, it’s me. I know I’m not at the top of your list to call back but I wanted you to know how sorry I am. I’ve been calling you and I keep getting the machine. Are you out of town? I thought this time I’d leave a message in case you’re picking them up. Um, I want you to know I’m getting help. Just like you said to do. I’m getting help. Don’t write me off, okay? Please?”

  “Damn. The machine cut me off. It’s me again. I know you don’t believe this but I love you, Isabel.”

  “Isabel, this is Ted Sargent. We would like to have a meeting with you at your earliest convenience. Call my assistant, if you would, to set up a time. Her name is Deborah and she’s at extension 5421. Thank you.”

  “Isabel? Hi, it’s Michele from work. Um, I just wanted to give you a heads-up that Sargent was up here looking for you. Not to worry you but he looked pissed. After I told him you were on sick leave he went into John’s office and they shut the door for, like
, ten minutes. Is everything okay?”

  “Yes, Isabel, this is Deborah, Ted Sargent’s assistant. He asked me to call you to set up an appointment to meet with him and someone from Human Resources. Please call me at 5421. Thank you.”

  Isabel hangs up the pay phone and fixates on the square metal numbers on the keypad. The longer she stares the fuzzier the numbers become.

  Fifty

  “It happened again.”

  “What happened again?”

  “I had an episode on my trip to the city,” Isabel says. Please don’t tell me this means I’m back to square one.

  “Was this one like the time at work. When Diana died?”

  “Yeah, kind of. Actually, not as bad.”

  “Not as bad?”

  “No. Well, I don’t know.”

  “Tell me what happened.”

  Isabel is fighting to stay focused on the session.

  “What are you thinking right now? Can you tell me?”

  “I’m really trying [focus]…I’m trying not to blur everything together. It’s so comfortable [focus] to stare at one spot. I just want to think for a second.” Isabel is mesmerized by the floor in front of Dr. Seidler’s feet. She is silent for five minutes.

  “I feel numb again.”

  At least I’m saying this out loud. That’s got to count for something, right?

  “Was that what happened in New York? You felt numb?”

  “Kind of—” still staring “—it was kind of like I was in a coma or a trance or something. I heard everything going on around me but I couldn’t move a muscle.”

  “Before that did you feel panicked? Worried at all? I spoke to Mona this morning and she told me that you were disoriented when you got to her office. You had gotten lost. Can you tell me what happened?”

  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 mâché 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 slow
s 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

  “Have you seen my baby?” A disheveled girl accosts Isabel minutes after she walks back into the unit, shoving a tattered picture at her.

  “Huh?” Isabel steps back.

  “My baby. Look at my baby.” The girl slurs her words as she sways her considerable weight from one leg to the other. She looks like she is fifteen years old.

  Isabel glances at the photo. “Cute. You new here?”

  “Isn’t she an angel?” The young mother ignores Isabel’s question and teeters off toward the main door. “She’s my precious baby.” Before she reaches for the horizontal bar that, when pressed, opens the metal door, the nurse, who has been following behind her, steps in front of it.

  “Cindy, you can’t go outside. Back to your room now.”