“Raza?”

The raven-haired woman looked up from her phone toward the door that was held ajar by her psychiatrist, a late 20 something year old woman with loosely braided red hair and green eyes. She was wearing an olive-green mechanic’s jumpsuit, black Converse sneakers, and golden hoop earrings. Her style didn’t match Raza’s, who tended to wear dark colored clothing, and had several earrings in the many piercings in her ears. Today she wore a black pleated miniskirt, white low-top sneakers and a black crop top shirt with a leather jacket, her navel exposed.

She slipped the phone back into her jacket pocket and stood up from the couch in the waiting room that was on the 6th floor of the high-rise, nestled in the far corner facing the streetside.

Raza walked up to the door. “Dr. Marten.”

Dr. Marten opened the door wider for her, and the two walked through, into the cold-fluorescent lit hallways where the interviews and therapy sessions were held.

“How have you been?” Dr. Marten asked, in that overly friendly way that she spoke.

She had a way of being both friendly and almost condescending at the same time. Raza figured it had something to do with her upbringing, because she spoke like a transplant from middle America. Even when they spoke about serious issues, she wondered just how much was okay to tell this sheltered doctor in training. Of course, this question was not meant for serious discussion while walking through the hallways, it was meant for small talk, a panacea for the uncomfortable awkwardness of walking in silence to the cube of a room where one was expected to immediately lay their soul bare. In many ways, it was more deeply intimate than exposing yourself completely nude. Raza preferred to just remain silent and be spared the inane exchange altogether.

“I’m okay.”

At best it was a half-lie. But who answers that question negatively? She wondered how the conversation would go if she did. Wouldn’t it be easier to just say what you thought? She had a habit of rehearsing conversations, and Dr. Marten assured her that it was common to do when you suffer from anxiety. Raza wondered if Dr. Marten really knew the extent that she did it, though. She began whispering to herself, re-enacting their conversation playing both parts, except this time answering negatively. What would Dr. Marten say? What would Raza say in return? It was entirely involuntary, and she continued the whole way through the hallways, until they reached the interview room.

The room was more like a cell. It was an 8×8 ft square room, painted in a muted clinical blue, lit with a cool-fluorescent light with a meager amount of natural light coming from the rear window, the mid-afternoon sun mostly obscured by a commercial sized air conditioning unit. In front of the window was the patient’s couch, where Raza was to let down her walls and succumb to psychoanalysis. As if.

Raza sat on the couch, cross legged, and pushed her skirt down in front, to at least protect some modesty. She looked around the room at the same spider plant that had been growing there for the past year, the generic framed picture of a boat on calm seas that was probably selected by a committee and a cheap bookshelf, which for as long as Raza has been coming here has been oddly devoid of books.

Dr. Marten always kept some fidget toys on the side table next to the couch, and Raza picked up a new one she hadn’t seen before, a metal interlocking puzzle. “You’ve got something new here!” She tried to solve it.

Dr. Marten sat at the desk adjacent to the couch and logged into her computer, smiling to herself. “You always notice the new toys.”  

July 20, Patient: Tabula, Raza 26 y.o. female, In care for medication management for: Bipolar 2 disorder (major depressive episode), generalized anxiety disorder, panic attacks, r/o complex PTSD. |

Dr. Marten turned in her chair to face Raza, who was quietly playing with the puzzle.

“So, what’s new with you?” She tilted her head slightly to indicate that she was listening.

“Nothing.” Raza stared at her blankly. She thought about telling her that she had stopped taking her medications for two days now but held her tongue.

“So, last time you said that you were feeling depressed again. Has that improved this month?”

For Raza, her depression came and went in cycles. It was uncontrollable. Lithium helped even out her mania, but it didn’t do much for her depression. She had asked directly for medication to manage that, but all she received was an increase in the lithium dose. Her pills were huge now and swallowing them was like swallowing rocks.

“It’s about the same, Dr. Marten. I told you last time the lithium isn’t helping. It’s like…” Raza paused. Something about these walls made her shrink within her own mind.
“…I don’t know. Maybe it has something to do with my circumstances, or you know, my life at home. I spend so much time lost in my own thoughts, and I have no support structure.”

“Didn’t you say you lived with your boyfriend?”

Raza scoffed. “Please, we barely speak. And when we do it’s just him talking shit to me. He hasn’t said a kind or caring thing to me in years. He doesn’t touch me. He doesn’t even love me.”

She could feel tears welling up. When she first came here a year ago, she made a vow to herself that she would defy the stereotype and would not be one of those girls to cry to their therapists. And so far, she’s kept her word. She went silent as she thought of what he would say if he could hear the conversations that she’d had with Dr. Marten. Unconsciously, as if compulsory, she began whispering the conversation to herself, and how it would play out in her head. And of course, these things never went well. Actual conversations never went the way Raza rehearsed.

“Did you have any dreams this time?”

Dreams, Raza thought. Dr. Marten had been trying to pry into the pandora’s box that is Raza’s childhood for the past year, but Raza had been trying in vain to keep that door shut. She had inadvertently given the doctor a lifeline last session, like hidden leverage to get her to speak. It was cliché, Raza knew, but if she purposefully conflated her experiences as dreams, it made them easier to talk about. ‘Dreams’ was coded language, a password to open the doors Raza never wanted opened. And once those doors had been opened, a torrent of words and repressed emotions came flooding out.

Raza took a deep sigh and ran her fingers through her long black hair. “Last week…” She cleared her throat. “I had a dream last week. It was in the fourth grade, so I was maybe… nine years old.”

Raza looked at the floor. Recalling these intimate and haunting memories was like opening festering wounds that had never had the chance to scar over. It was painful, shameful and humiliating, and she couldn’t bear to look at Dr. Marten in the eye.

“It was the day of parent-teacher conferences. My teacher called us up one-by-one and told us our grades. I had straight A’s! I was proud of myself.” Raza’s eyes met her doctor’s and she had a beaming smile.

“My stepmother was going to attend; my father never showed any interest in me at all.”

Raza fell silent for a second. The words she had just spoken were truths she had known since she was five or six years old, but it still stung like a dagger in her heart to say them aloud. Even after all this time.

Raza looked up at Dr. Marten. “My dad worked nights, you see. He couldn’t attend things like that. So, he left it up to her…” She looked back down at the floor.

“She came home later that night and told me to get my ass in their bedroom. She woke my father up and told him that my teacher told her that I was failing all of my classes. I told my dad: ‘No! No! I’m not! I just spoke to my teacher earlier and he told me that I had straight A’s.’” She fell silent and wet her lips.  “My dad looked at my stepmother and said: ‘Well, she said she spoke to the teacher earlier.’”

Raza’s expression grew dark, a frown sliding down the corners of her mouth.

“She started yelling at my dad, saying that he believed his lying bitch daughter over his wife. She said that she’s the one who sucks his dick and that he doesn’t love her anymore. It was an obvious threat. I’ve got to give her credit for that.” She said it with such venom that belied the forced smile she flashed at Dr. Marten.

“She sure knew how to manipulate a man. Maybe I should manipulate my boyfriend with sex too. Not that it’d work.”

Raza looked back down at the floor.

“That threat must have annoyed my father because he completely ignored what I was saying. He got up from the bed and I got scared and was telling him I was being good and telling the truth. He punched me right in my stomach and knocked the wind out of me right in the middle of me pleading with him to not hurt me.” She rubbed her chest as if the trauma was still fresh. “That was the first time I ever had that happen to me, and I was really scared because I couldn’t breathe, or speak. It felt like I was suffocating. He picked me up by my shirt and tossed me to the floor in my bedroom and pulled my pants down. He told my stepmother to get his belt, which she did happily. I begged him ‘please don’t hit me’ and insisted I was telling them the truth. I kept saying ‘I’m not lying’, but I guess they didn’t hear me. They still beat me until I was raw and bloody. I cried and sobbed on the floor afterwards, I just didn’t understand why it happened.”

Raza smiled brightly. “I couldn’t sit for a while after that one. I went to my teacher the next day and asked him why he told my stepmother that I was failing, when he told me earlier that day that I was doing so well. I mean, I was so excited for these conferences. I felt betrayed, like he set me up. He told me that he never said that to her, and that he was going to call her to set things straight. I think I must have broken down in class when he said that. I never cried so hard in public before. I begged him not to call, because I knew that I would be beaten even worse. And he never did.”

Dr. Marten seemed to be in contemplation. “Thank you for sharing that. But let me ask you a question. Why is it, do you think that you insisted you weren’t lying, rather than saying whatever you could to get out of the situation? Do you think had you said nothing at all, you would have had a different reaction from your stepmother?”

Raza looked at her doctor, her lips curled in a sneer.

“Oh, fuck you!”

“You’re angry. Why are you angry, Raza?”

“It’s your stupid fucking question. You try it. Being broken and hated and living in constant fear since you were five years old. When you’re being fucking beaten by your parents—who are supposed to love you by the way—for no reason at all, you aren’t thinking: ‘What can I say to get out of this situation?’. You’re thinking: ‘Please don’t hurt me’, and ‘I was being good’. You blame yourself for not being good enough. I insisted on telling the truth and I did it because I desperately wanted to be seen as a good girl in my parents’ eyes.” Raza raised her hand, becoming animated in the explanation. “I thought if only they could hear me, they would understand how good I was.”

Raza looked up at Dr. Marten, hostility raging in her eyes.

“Okay.” Dr. Marten held her hands up in surrender. “You’re right, that was an insensitive question. We’ll leave it there for the day. You’re still taking your meds as prescribed? Any issues, side effects?”

“Everything is fine.”

“Alright…” Dr. Marten nodded, not quite believing that everything was fine. There was only so much she could do. “We’ll see you back same time next month.”

Aug 20, Patient: Tabula, Raza 27 y.o. female, In care for medication management for: Bipolar 2 disorder, generalized anxiety disorder, panic attacks, r/o complex PTSD. |

Raza sat on the couch, and took off her grey rain boots, the kind that slipped on and came to her knee. It had been raining non-stop in the city for the past three days. She put her umbrella against the wall, and a small stream of water began to seep across the floor. She sat cross-legged, and had on loose fitting jeans, a studded leather belt and a cropped-top white shirt. She was oddly chipper, almost excited.

“I see you had a birthday! Happy belated birthday!” Dr. Marten said with a smile.

“Thank you, it was on the 7th. And it was uneventful. Most of my family forgot. My boyfriend didn’t even say anything to me. Oh, but my dentist’s office remembered and sent me a text!”

They both laughed. But it also sort of stung.

“So, what’s new Raza? You seem happy…”

Raza shook her head. “Happy? I don’t know if that’s the right word. But I met a guy. And we had sex. It feels pretty good to be wanted.” Raza had a toothy grin.

Dr. Marten smiled gently. “It does, doesn’t it? So, this is a new boyfriend?”

“Oh no, nothing like that. I just met him the other day.”

Dr. Marten’ brows furrowed in concern. “Raza… Can you tell me more about how you met?”

Raza leaned back on the couch, and crossed her right leg over her left, shaking her dangling foot. “I passed him while walking to the train the other day. I thought he was cute, and I asked him if he wanted to fuck. He said yeah, so we went back to his place.” Raza said it as simply as one would read off a list of groceries.

“Did you get his name, or use protection?” Dr. Marten asked with urgency in her voice.

Raza pursed her lips and shook her head. “Nah, I didn’t do either of those.”

Dr. Marten rubbed her forehead with her fingers. “Raza, why?”

Raza hadn’t considered it. Why? There wasn’t a specific reason. Who cares. “Because I felt like it.” She shrugged.

“Are you taking your medications, Raza?”

“Dr. Marten, I’m just gonna be honest. I haven’t taken any since the last time I was here a month ago. I honestly feel more like me without them. The lithium makes me feel like a zombie. The lorazepam is okay… I guess. Anyway, I’m doing fine. I was just having some fun.”

“I don’t think you’re fine, Raza.” Dr. Marten shifted in her chair. “You’re showing some textbook examples of mania. Are you having insomnia? Restlessness? Any impulsive spending?”

Raza sighed in annoyance. “Shit, I know the symptoms Dr. Marten.  Look, I’ll take the meds, okay?” It was a lie, but she recognized where that line of questioning was going.

Dr Marten took a deep breath and looked at Raza for a minute in silence. “I’ll trust you then. I don’t want to have to hospitalize you again.”

Raza didn’t want that either. It was how she learned she had all these psychological issues, when she was ‘suddenly’ hospitalized after a bad episode. Maybe it wasn’t so sudden. In truth she took half a bottle of over-the-counter acetaminophen pain reliever, which to everyone appeared to be a suicide attempt. Raza maintained it was an accident.

Dr. Marten went into a lecture on the importance of taking medications. Raza tuned it all out, and besides, she had heard all this before. There wasn’t much this white-bread girl could tell her that she hadn’t heard previously.

“Hey Dr. Marten. Why isn’t there any books in your bookshelf?” Raza asked, interrupting, as if subtly taunting her.

Dr. Marten paused and looked over at the shelf. “Most of my books are e-books on my iPad. I know some other doctors have their bookshelves full of books they don’t read, but isn’t that a little pretentious?”

Raza could agree with that. She respected her a little bit more.

“Have you had any dreams lately?”

“I have,” Raza replied quietly. She put her hair up in a ponytail. “I was maybe 9 years old. My little sister and I… never had new clothes. They were all hand-me-downs from our stepcousins, who were older girls. They were old and worn. Even our shoes were the cheapest you could buy.”

Raza looked to the side. “We were with our mother one day during her custodial visit, and she was upset because we were sent to her in rags with sneakers that had holes in them.” Raza chuckled suddenly. “I just remembered, my princess light-up sneakers had a hole from the heel straight through to the ground!”

She sighed, shaking her head. “Anyway, my mother threw away the clothes we had on and bought us brand new ones, right down to our panties… and brand-new shoes, too. Oh, we were so happy. It was the first time I could remember that someone had bought me clothes. But when we came back home, my stepmother saw us happy and was furious. She called us into the den and had us stand in front of her and stripped us naked.”

Raza began to bite her lip nervously. She hated this part. By this time in her life, the abuse had become psychological. You understand physical pain. You feel it, you recoil from it, and you avoid it. It’s natural. All animals understand this. But psychological pain is unique to people. You must have a sense of self, and an understanding of language to be manipulated this way. You can’t feel it, and you can’t see it coming. It’s insidious and malevolent.

“She lied to my dad that our mother threw away the good clothes that she had bought for us. She said the clothes our mother bought made us look trashy and slutty… like we were prostitutes or something.”

Raza shook her head, her jaw clenched in lingering frustration.

“And my father believed this for some reason! Like our mother would do that to her own daughters!? They made us watch as my father took out the charcoal barbecue and put our brand-new clothes on the grill.”

Tears began streaming from Raza’s eyes. “He doused our clothes in lighter fluid and lit them on fire. We were forced to watch until there was nothing left but ashes.” She took a deep breath. “I can still remember the smell.” Raza silently wiped her face.

“Raza? What did you feel at the end?”

“Nothing.” She answered too quickly.

They were both silent for a minute.

“That was a lie,” Raza said with a sigh, “I was reminded of my worth. And what happens to children who dare to dream above their place.”

“Your worth?”

“That I was worthless. Only good as an object of torment. I thought too highly of myself that day. I didn’t deserve that happiness.” Raza shifted in her seat uncomfortably.

“I noticed something else, Raza. You refer to your father as either ‘my father’ or ‘my dad’, as if they were two separate people. When you’re defending him, or saying something nice about him, you say ‘my dad’. When he’s doing things you don’t like, you say ‘my father’. I noticed it last time too. Have you noticed that?”

Raza didn’t say anything. Instead, she silently looked down at the ground and picked at her nails. Two separate people? Maybe it was her way of separating the man from his actions. You could hate the actions, but how could she bring herself to hate the man? He was the only father she had. After all, she was the one who was all too happy to live with the man and followed him straight into the pits of hell. She didn’t have any more energy for this.

Dr. Marten decided not to pry any further. “Again, thank you for sharing. This gives us some background on your condition and possibly trying to work on some of your other diagnoses. Now Raza, you don’t have to answer this if you don’t want to… but do you ever have dreams about sexual assault?”

It was not the first time she had been asked about this. Anyone who ever learns of the extent of the abuse and neglect she has suffered always asks about it. And there was a good chance that it could have happened to her. But she could not remember. There was a lot she could not remember, and it was only through keeping a journal recently that she was able to recall some things that she had forgotten.

“I don’t know. I don’t want to talk about this anymore.”

Dr. Marten nodded and finished the interview.

“Next month, on the 14th. Okay?”

“Yeah.”

Sep 14, Patient: Tabula, Raza 27 y.o. female, In care for medication management for: Bipolar 2 disorder (manic episode likely), generalized anxiety disorder, panic attacks, r/o complex PTSD. |

Dr. Marten led Raza into the interview room and sat down at her desk. Raza appeared to be sullen, and stood by the door for a minute, feeling a sense of apprehension about doing this again today.

With a sigh, she entered the room and sat down on the far end of the couch. She put her right arm on the armrest and rested her face in her hand.

“Hi Raza!”

Raza eyed the doctor out of the corner of her eye. She was wearing purple scrubs today and had a white polka-dot bow on top of her head. Raza wondered what was up with this girl’s fashion sense and considered how the conversation would go. Oddly, she had an intrusive thought about taking this girl out on a date. Raza didn’t discriminate between men or women because love was love, but that was just not a thought that she ever had before.

“Any issues with the medications? Have you been taking them again?”

“Yes, I’m taking them.” Raza’s voice held a monotonous tone. Another lie. It had been three months now since she last took them. The manic heights made her feel like she was superhuman again, like she could accomplish anything she set her mind to.

In the past, she had accomplished so much in so little time. She thought that she was just naturally talented but never considered the countless hours she would sink during the sleepless nights and restless days. However, these occurrences were momentary, fleeting, and impermanent.

And so, when she got cast down again from her pedestal in the sky, tumbling down to the world of mere mortals, she faced the reality that she didn’t accomplish anything. In her wake was a trail of half completed projects, burned bridges, severed ties and crushing debt, so many pieces of her that had been ablated like a shooting star streaking across the sky. And like a shooting star, Raza shone bright not due to her own light, but because her momentum caused friction with the world around them. And eventually shooting stars burn up into nothing.

“Alright.” Dr. Marten turned to face Raza, who was still avoiding her gaze. “Is there anything new since we last spoke?”

“No, nothing.” Raza quickly replied but felt a pull in the pit of her stomach, as if she were going to start sobbing.

“Ugh.” she sighed and looked up to the ceiling. She was fighting back tears.

“Ok. I think things are ending between me and my boyfriend.”

“Ok,” Dr. Marten nodded softly. “Hasn’t that been going on for a while?”

“It has. But this is the first time I’m actually saying it to someone out loud.” Raza laughed an inappropriate, nervous laugh. “We live together in this city of millions of people, and I’ve never felt so lonely in my life.”

“Raza, why not talk to your friends, or coworkers?”

Raza shook her head. “I don’t have anyone. I’ve been so mixed up in my own life that I’ve forgotten basic things. Like how to relate to people. And how do I turn this off?” She poked her head.

“Medications are one piece of the puzzle. But so is therapy. You’ve refused it every time I try to recommend it to you. Maybe you ought to take another look at it?”

“I don’t believe in therapy. It’s stupid, you just talk about your problems, and then what? Someone who thinks they know better than you tells you what you should do. You pay them a hundred dollars for stating the obvious to you and repeat it in another two weeks.  It’s pointless.”

“You sound like you’ve been in therapy before.”

“I have,” Raza said, crossing her arms. A clear signal that she did not want to talk.

“What about group therapy? You can talk things through with people who have been through similar experiences.”

“I don’t want to talk about this anymore.”

“Okay. Have you had any dreams recently?”

“If you want to ask about my childhood, then just do that. We don’t have to do this song and dance around it anymore. But I don’t feel like talking about that either.” Raza snapped at her. She was getting annoyed.

It wasn’t the line of questioning; she understood that it was part of the job. Maybe because it was her that was asking it. Since she met this doctor, she always felt a sort of repulsion mixed with a yearning for validation from her. It was an ambivalent kind of relationship, and she couldn’t understand it. She didn’t want to answer any questions, but that need for validation, and longing to be accepted was her weakness, and she hated herself for it.

“So, should we end it early here today? And make another appointment for next mon- “

“Wait,” Raza said, suddenly getting up and frantically holding her hands up to stop her. “There’s something I’d like to talk about.” There was nobody else in her life that she could talk about these things with, so despite herself she wanted this thing to continue for as long as possible.

“I’m upset that my boyfriend is probably leaving me. When we got together, I told him that I didn’t really care what he did, just as long as he didn’t abandon me. Just stay by my side.” She started tearing up. “I’m the worst kind of person. Last month I fucked a guy for no reason; I just cheated with a random stranger. Why did I do that? How can I ever ask him to love me again?”

“Raza, you can’t beat yourself up about it. Hypersexuality and unfortunately cheating are very, very common with people who have bipolar disorder and don’t manage it.”

“I know, but that doesn’t make what I did right. I deserve everything bad that’s happened to me. I didn’t manage it.”

Dr. Marten rested her chin in her palm. “You mentioned abandonment. Where do you think this fear of abandonment came from?”

“I think… just about everyone in my life has abandoned me at some point. After my parents divorced, I was left to my father when I was 5. He only took me and my sister in for the child support. I went willingly, and happily because I wanted him to love me, even though he never had any love to give me. But he abandoned me again to be raised by my stepmother who completely destroyed me mentally and physically with abuse, neglect and manipulation… My relationship with him was one where we only spoke when I was being beat.”

Raza paused for a second in contemplation. How much should she tell of the rest? She looked up at the doctor who was looking at her with a pained expression. She felt anger welling up in her. This bitch pities me? She didn’t even know why it made her angry, after all, she could agree she was a pitiful person. Or was she more pathetic? It didn’t matter anymore.

“I made a new family. My new stepfamily. And I loved them.” Raza nodded, a tear falling down her cheek.

“I loved them even when my new grandmother constantly told me I was evil and was going to burn in hell for the lying that I never actually did. I loved my new little sister even when she would get her mother to take away anything I cherished. It didn’t matter what it was, if my sister wanted it, she got it. I had to hide things,” Raza pointed to the ground, as if she were back in that house again, “in the heating ducts. I loved them all even when my birthdays came and went and I couldn’t celebrate because I was standing in the corner for weeks on end, wet from my own urine because I wasn’t allowed to move to use the bathroom and couldn’t hold it in anymore.”

Raza glanced at the picture on the wall. “I shouldn’t have ever been excited for my birthdays anyway, it’s not like anyone even remembered them.”

She took a deep breath; her gaze fixed on the floor. “I loved them when I was starving for years and had to sneak out of bed late at night to steal raw pasta and rice to eat because I wasn’t fed enough during the day. Sometimes, if there was nothing else, I would even eat the dog’s food. For seven long years I loved them as my own family until my stepmother finally abandoned me too. I loved them all, even when none of them attempted to contact me afterwards.”

Her eyes narrowed. “Like our time spent as family meant nothing. I guess it never mattered to them. I never even got to tell my friends goodbye. And then my father abandoned me as soon as he could and dumped me on to my grandparents, who promptly kicked me back out when I turned 18.”

“And you know… I was conflicted when my stepmother abandoned me. You’d think after years of abuse I would have been happy. I was, but I was also hurt. Even if they never thought of me as their family, they were the only ones I had for all those years, and they were taken from me overnight.”

“I hope this clears things up for you,” Raza said coldly.

Dr. Marten was wiping away tears. “Children are supposed to be loved. I’m sorry that you weren’t. I think this is a bit past my expertise. We do medication management and treat medical disorders. I do a little talk therapy, but honestly Raza, you need a one-on-one therapist. There is a lot going on with you, and too many threads for us to detangle here. Promise me that you’ll consider it.”

“Sure,” Raza lied.

“Oh, and Raza, next session will be our last. I’m finishing my residency, so you’ll have another doctor.”

Raza’s eyes grew wide, and her mouth was open in shock. “What!? But you can’t go! I have to do this again with another person?”

“Well, yeah. This is a teaching hospital. So, when residents finish their residency, they go off into the world.”

Raza felt tempted to ask her where she was going. Maybe she could follow her. She knew that she was just her doctor, but she hadn’t been this close to anyone in years. She didn’t want to start over with someone else. She didn’t want to lose another bond.

But she remained silent, and the interview ended, and she was led back out into the world.

Oct 20, Patient: Tabula, Raza 27 y.o. female, In care for medication management for: Bipolar 2 disorder (depressive episode), generalized anxiety disorder, panic attacks, complex PTSD. |

“Raza? Raza, hello?” Dr. Marten was waving her hand. Raza stared at her blankly. She had brought herself to the interview today but didn’t really care to be there.

“What’s new? How are you feeling?”

“I’m—” Raza began. She was going to lie and say she was fine, and Dr. Marten was going to pry further and make her tell her how she really felt. That’s how their dynamic was, that’s how their interactions always went. Today she was exhausted, so Raza decided to skip all the usual formalities and just tell the truth.

“I don’t want to do this anymore.”

“What do you mean by that?”

“I’m just tired.” Raza pulled her knees up to her chin and hugged her legs.

“You’re tired, but I don’t think you mean from a lack of sleep. Can you elaborate for me?”

“I’m tired of everything. I’m tired of being lonely, I’m tired of feeling the way I do, I’m tired of constantly overthinking everything.” Raza sighed. Now she wondered if she wasn’t just complaining.

“I’m tired of my life. It hasn’t amounted to much more than pain and suffering.”

“Well Raza, you can always make a change, and keep in mind the positive things about your life. The things that you’re looking forward to, and the things that are worth living for. Start small with something you’d like to see in the near future.”

Raza knew that she had good intentions, but surely this doctor didn’t believe these silly sayings actually help people. She probably read it in a textbook somewhere. Dr. Marten was too pure for this job.

“Those are just empty platitudes.” Raza brushed it off with a dismissive wave of her hand.

“I have you on the waiting list for a therapist, but you actually have to accept it. You can’t keep refusing the help that’s provided to you, or they’ll skip you and go to the next person that’s waiting in line.”

“I’m in my mid-30s, and I feel like I haven’t accomplished anything. I’ve got a ton of things I half finish. When I’m gone, what’s gonna be left to even prove I existed?” Raza was desperate to change the subject. “I feel like my life itself has no intrinsic worth. In fact, if anything, I’m worth more dead than alive. Did you know that?”

Dr. Marten was silent and looked at her with a stoic mask.

“I’m not planning anything, but… yeah, I did the math. Considering the life insurance, the death benefit insurance from my job and the cashing out of my retirement funds, I’m worth way more to my family dead. And you know, I don’t think anyone but my mother would mourn me. I have my boyfriend as the beneficiary, but I’m sure that would probably just piss him off. Too much work to do to collect.”

“If he dislikes you so much, why do you think he hasn’t broken up with you yet?”

Raza thought about it for a minute. She believed that she knew the reason, but it was one thing to believe and another to speak it into existence.

“It’s not for love, if that’s what you’re thinking. It’s probably just for convenience. I’m a simple little puppy who always comes home. I’m well-trained and never bite back.”

She put her legs down and Dr. Marten turned to face her computer. “I’m going to print up some fliers of providers I know, and I hope you give them a call. I don’t know if your insurance will cover it, but they are low-cost.” She reached into her printer tray, and grabbed the copies, handing them to Raza.

“Well, that’s it Raza. Your next doctor will call you to set up a meeting. I’ve also sent refills of your prescriptions, so you should be set for the next month. I’ll still have access to my emails for the next two months, so if you have an issue send an email and I can forward it along.”

Raza quietly stood and walked over to Dr. Marten. A part of her wanted to hug her, and yet another part wanted to just walk out. She instead took her hand and thanked her and did not meet her eyes.

Raza walked out into the lobby. There was a large trash can next to the elevators, and she tossed the fliers in.

---

 Raza slowly opened her eyes, burning from dryness and aching from the bright fluorescent lights above her. Adjusting to the light she tried to get her bearings. She was lying in a hospital bed, in a small room with a single interior window. Still groggy, she tried to rub her eyes but could not move her arms. She tugged and felt the restraints around her wrists.

She couldn’t recall what she did this time to end up back in the psych hospital. She looked down and was only wearing a hospital gown, with grey grippy socks.

Oh shit, I’m really here, she thought. She laid back in resignation and stared at the tiled foam ceiling. She had an IV in her right arm and was oddly itchy across her body and felt like she had the flu. Her mind began racing. What was she going to do about work? Does anyone know I’m here? Will my boyfriend notice that I’m gone?

She then had a glimmer of hope that he would finally notice her and come looking for her, and imagined him walking through that door, impassioned in his concern for her. But deep down, she knew he would never come.

An hour went by, and then two. Maybe more time went by than Raza knew, as she had neither a window to discern the movement of the sun, nor any stimulation at all save for what she brought with her in her mind. And she remembered the events that led her to being hospitalized.

It started with a choice. A kindness, really, she thought. She knew that she was a burden, that she didn’t deserve happiness or love, and began spiraling in thoughts of her own worthlessness, catastrophizing every imagined interaction rehearsed endlessly in her manic and hyperactive mind.

And who could she tell? Who could she go to for help? Who cared enough to try to understand? In desperation, she tried to tell her boyfriend how she felt, but he responded coldly and callously. She felt that he had given her permission to end it all. That everyone would be just fine without her.

She wanted out. A way to do good as her final act, to prove her worth. She was proud that she had not given up on the notion that she was a good girl, after all.

Raza did not want to feel pain. She’d had enough of that in life. And the last time she tried this she was painfully sick to her stomach.

She nervously bought oxycodone pills.

Deciding for it to happen in their apartment, she wrote a note for her boyfriend, first apologizing, then simply saying not to enter their room, and to call emergency services to let them handle her body. She wouldn’t write anything personal; she wouldn’t write ‘goodbye’ or ‘I love you’, or any other tender words of affection that were both unappreciated and that he considered superfluous. Even if she felt them.

She faintly remembered taking a handful of the pills. She made sure that she didn’t eat that day, so she would hopefully die sooner. Everything was foggy, but she did remember one thing. The feeling she felt was unmistakable. It started as drowsiness, which soon changed into an intense euphoria that radiated throughout her body. Before she lost consciousness, she had felt better than she had ever felt in her life, even better than sex. She understood why people became addicts.

Raza gazed at the vitals monitor next to her bed, as her heart rate fluctuated slightly over time. She was definitely still alive.

She started laughing out loud to herself. Raza had spent most of her rent money on those pills. Her boyfriend would leave her for sure now. She’d be out of work for who knows how long and would probably get fired. Everything was set up so perfectly, but she still couldn’t pull off something so simple.  

“Ugh, I’m a fucking failure.” Raza closed her eyes and turned away from the monitor in disgust.