Chapter Ten

DR. CERISE FISCHER SURVEYS THElegal pad balancing on her lap. On top a single line is written. ELIZABETH BLACK. 05.24.2022. She glances up. Elizabeth sits so still on the sage-colored couch that someone could be painting her portrait. Rain splatters against the thin-paned windows. Outside, the ocean is a violent clash of waves.

Cerise's office is on the top floor of a converted Victorian mansion. The doors are heavy and swell shut in the summer. She liked the idea of patients entering a place resembling a home. Of traveling the spiral staircase to her office in the turret. There was something whimsical about it that called to Cerise as well when she rented it. A fanciful notion of princesses in castles.

"Elizabeth?" Cerise says. Her voice is smooth and low. Inviting. She's been told the tone is reminiscent of her great-grandmother's, who'd immigrated from Jamaica and been a nanny. She loved singing to her charges. Her favorite lullaby was "Swing Low, Sweet Chariot."

Ellie blinks. "Everyone calls me Ellie."

"Okay, Ellie." Cerise smiles. She is a middle child. A people pleaser. A helper. Some clichés are true. "Since this is our first session, I thought we could get to know each other. Chat a bit. How does that sound?"

Ellie doesn't answer. Her eyes land on something over Cerise's shoulder. Cerise shifts to see what has captured Ellie's attention. "Have you seen one of those before?"

Ellie shakes her head.

"It's a Newton's cradle—it demonstrates the conservation of energy." Cerise reaches and pulls back one of the spheres and lets it drop. It collides with the others and sends the sphere on the opposite end swinging out. The pattern continues, keeping a steady beat like a metronome. Delicate clinking noise fills the office. Cerise settles back to peer at Ellie again. "And that's about all I know about physics."

Ellie's lips twitch with the beginnings of a smile, but it's quickly wiped away. "I like it. It's kind of comforting." Her gaze stays trained on it.

Cerise inhales and regards Ellie with a tilt of her head. "How are you doing right now, in this moment?"

Ellie's hands flex, and she bites her lip.

"Are you nervous?"

"No." Her denial is quick, and her eyes flick everywhere, all over the office.

The brain is always vigilant, always assessing for danger, searching for threats. But when something happens to someone, something traumatic, the brain becomes hyper-vigilant. Thinking isn't possible. Cerise wonders if this is happening to Ellie. If she's reverted to some primal state.

"Yes, actually. Kind of nervous," Ellie admits.

"Okay. Let's go with that. What is making you nervous? Are you nervous to be here?" Cerise perches at the edge of her chair, ready to receive, to listen without judgment.

Ellie shrugs. "Here. Anywhere. Alive." She laughs, but it is dry. No humor in it.

"Are you not supposed to be alive?"

Ellie's mouth forms a firm line. Cerise senses she's lost Ellie again, to some hollow space.

"You've been home for a few days now. The hospital report stated that you were having acute anxiety triggered by lights and noises. How has that been?" Cerise pretends to leaf through the file underneath her notepad. She's memorized most of the details of Ellie's case. But she wants to give Ellie a moment.

"Fine. The headaches are better. I don't feel…" Ellie trails off.

"You don't feel…?"

"Anything," she says, her voice raspy all of a sudden. "I don't feel anything. It's like I'm wrapped in cellophane."

Cerise's heartbeat slows. "That's understandable."

"It is?"

"Yes." Cerise nods. "I don't know what happened to you." She waves a hand at Ellie's open mouth. "And you don't have to tell me right now. This is all conjecture on my part, but when someone becomes… overwhelmed, a person may disassociate. It's a survival response. And it can manifest in many ways—amnesia, identity confusion or alteration, depersonalization…"

"What's that?"

Cerise grips her notes, thinking. "Let's see. How to explain? Depersonalization is a kind of detachment. When you say you feel as if you are wrapped in cellophane, that would be depersonalization. The world is more dreamlike or unreal in that state."

Tears pool in Ellie's eyes. Cerise has struck a target.

"Identity confusion is a loss of who you are. A struggle of sorts. And identity alteration is a change. Like something in your behavior is fundamentally different." Such as refusing to shower or sleeping in a crawlspace or turning the lock on your bedroom door over and over again, or not eating but hoarding food. Over the last few days, Cerise has had long conversations with Kat. She reacted strangely when I wanted to cut her hair. Said she was not allowed. Cerise knows what Ellie is like now, or at least, she has a good idea. But she would like to know the Ellie before, too. That is how healing starts, bandaging those past wounds. When you study what you've been through, what happened to you, it loses its power, and then you have a choice: stay or move on.

Ellie cups her knees. "That makes sense."

Red and blue lights flash against the window, slicing up the neutral room. An email circulated last week about increased traffic in the area. Ellie tenses. "The governor is in town," she explains, hoping to calm Ellie. Sweat has formed on Ellie's brow and she compulsively rocks. Cerise shoots up from her chair and closes the curtains with a swish. They are flimsy and near see-through but help filter the brightness. She sits back down. "Sorry about that. Better?"

Ellie inhales long, exhales long. Repeats, flexing her fingers. When she opens her eyes, they are bloodshot, ravaged with terror. "Bright lights are still bothering me." Her voice is rough as sandpaper.

"Do you want me to dim the lights? Or would you like to sit where I'm sitting, with your back to the window?" She aches for Ellie. What happened to this girl?

"No. Sorry, I'm so jumpy." Ellie musters a smile, won't look at Cerise. The clock behind Ellie is near the top of the hour. They have fifteen minutes left in the session. "It's fine."

It's quiet for a moment. Rain patters against the window. "What are you thinking about, Ellie?"

Ellie picks at her fingernails. "How does the doctor-patient confidentiality thing work?"

"Oh." Cerise purses her lips. It's not an unusual question. People are always afraid of telling a stranger their secrets. "As your physician, I am legally and ethically prohibited from disclosing our conversations."

"So, whatever I say, you can't tell anyone?'

"With some minor exceptions, of course."

"Exceptions like what?"

"Well, if you posed a threat to yourself or others, I would have to disclose that. Or, if you were being harmed by someone—your parents, boyfriend, etcetera—I would be legally obligated to tell the authorities."

"Huh."

"This is a safe space, Ellie," Cerise reassures her. "Now, do you want to share what you're thinking?"

"I was thinking about forgiveness," she half-whispers.

Cerise sinks back. She is not religious anymore, but she grew up attending church. "What about forgiveness?"

"How sometimes people do things that make it impossible for the world to forgive them."

Curiosity strikes, and Cerise feels a little chill. Did Ellie do something bad? She immediately rejects the idea. Victims often blame themselves. "That's interesting." The clock clicks forward. It's one minute to the hour. Cerise wishes she could go on with Ellie. She makes a note that their next session should be longer. Ninety minutes. But she's got another patient in the lobby. A yellow light, placed discreetly in the corner, lets her know when someone is in the waiting room. "Let's pause here and pick this up again next session?"

Ellie leaves. And Cerise makes quick notes about their session. The patient seems to be suffering from disassociation. She is visibly frightened and hyper-vigilant. Cerise inhales and exhales deeply, takes a few seconds to compose herself, to think of Ellie Black, maybe even say a little prayer, not necessarily to God, but to the world, that Ellie will find only kindness from now on.

Then she rises. Gets ready for her next patient. She opens the curtains. The governor's security detail is pulling away—black sedans and police cars with red and blue flashing lights. The color catches in the water on the window, the droplets sticking to the glass like blood spatter.