It was in her head. Mostly along the length of her jaw, radiating upwards and outwards and backwards so that it often gripped the whole globe of her skull. A gnawing pain. A sensation unlike anything she’d experienced before. Alive and furious at all hours.
Phoebe didn’t remember when the pain started, only when it became something she couldn’t ignore. A Tuesday, last month, the drizzle outside threatening to swell into drops. Normally, Phoebe liked this kind of day, easily aligned with an afternoon sheltered in the university library. She had been sitting inside, a collection of books next to her opened laptop, when she finally understood her pain as horrific. A greedy thing equipped with fangs. She had been trying to work. Trying to transform her ideas into sentences, paragraphs. Into a mildly impressive midterm paper. Trying but failing. Staring at her screen, Phoebe was only aware of the throbbing that wouldn’t settle and dissolve. An ache impervious to the three aquamarine pills she had just swallowed with orange juice.
And the two five hours earlier with iced coffee.
And the four the previous night with water.
And the handfuls this month.
A monster. That was how Phoebe explained her pain. It started as a joke, a line she repeated to friends. The fucking monster kept me up again last night. A phrase that made her three roommates, all of them horror nerds, understand her pain. They knew the terror monsters caused; they didn’t question her suffering.
But soon the thought, in private, veered farther into sincerity. Phoebe knew rationally, logically, there was no creature crawling around her skull. Still, she didn’t know how else to think about her headache other than as an enemy to fight against. Her pain had its own presence, active and hungry. It feasted on her energy, growing more forceful as she deflated.
A true monster.
In time, Phoebe became a haunted version of herself. A papery husk. Agony changed how she interacted with the world. With people. She receded, unable to be anything but annoyed at the sight of her classmates, her friends all functioning and pleasant. Time whirled on and on and the world soon felt out of reach. Stretches of her day seemed real only when those pretty pills claimed dominance, lulled her pain to sleep. But that was just for hours. Minutes, sometimes.
Twice, Phoebe trekked to the university health center. The first time she went, there weren’t any available appointments. The waiting room, the dim hallway, clogged with peaky students, all sniffling and coughing and wheezing. Listening to the swirling sounds, Phoebe tried to be aware of what and who she touched. She fumbled for hand sanitizer as soon as she was secure in the elevator. She made her way back to the health center a week later, the earliest opening offered to her. The woman examining her didn’t write down a single word Phoebe said. She just stood there with her arms crossed. It seemed like she had to force herself to be alert. She then suggested Phoebe increase her dose of painkillers and stop watching television late into the night.
Phoebe’s life continued to collapse in on itself. Her meals consisted of dry cereal, protein bars, pretzels. Sustenance she only had to unbox or unwrap. She stopped answering emails. Only texted back a certain collection of friends, her parents. She missed class after class after class.
And at that, her mother, an unnerved voice transmitted across state lines, called and repeated a doctor’s name twice. Horizontal in the dark with ice over her eyes, Phoebe misheard the first time. The pain, loud in its persistence, sometimes interfered with her hearing. Matthew Reese, not Matthew Rice, her mother corrected. He was a neurologist her mother had been reading about. Good schooling, a list of awards, all accounted for in his profile on the hospital website. Hearing her mother’s severe insistence, her belief in this one man, Phoebe felt a piece of her hopelessness dislodge. She hung up, booked a series of appointments, trusting her mother’s intelligence. Her instincts.
Two weeks ago, Phoebe took a train into the city for tests. That in and of itself felt like progress. A test would show something physical. Its results would be tangible. Well after the morning rush hour, she found an empty car. As the train woke, moved, she leaned her forehead against the window. From her side of the glass, the world muted. Rolling towards the doctor’s office, towards the potential of peace, gratitude melted within her, warm and thick.
Today she repeated her journey, the same flush of anticipation in her blood, and now she was here at the closed office door. Phoebe reached for the doorknob, relief fizzing in her belly.
Sound was nearly absent in the waiting room. A fan spun hesitantly in the corner. The few people seated were staring at screens or books or the space in front of them. Phoebe made her way to the front desk. There was only one woman there, beside her a vacant chair and a snoozing computer. At the sound of her tiny cough, the receptionist looked up at Phoebe. The woman didn’t seem much older than Phoebe. A recent college graduate, maybe; blonde with an avenue of purple lining the right side of her face. A lollipop fastened between her lips. Cherry, Phoebe smelled.
“Hi, I’m here to see Dr. Reese.”
“Ok, what’s your name hon?” As the receptionist spoke, the white stick bobbed in the corner of her mouth.
“Phoebe Miller.” The receptionist turned back to her computer, clicking rapidly.
“Ok, gotcha, you can take a seat. He’s a little behind schedule today, but he’ll be with you soon.” The receptionist nodded towards the couch, its pleather cushion sunken in memory of previous occupants, and resumed typing. Her nails, also purple and filed into talons, loud on the plastic keys.
Phoebe obeyed, settled into the dented couch.
The waiting room was smaller than she had anticipated. The walls were coated a bizarre yellow, the color of mustard mixed with milk. At first Phoebe didn’t mind the choice of paint. Yellow often a reminder of empty, sunlit days. But soon enough, the paint, by some terrible magic, fueled the fury of her pain.
Phoebe leaned forward, balanced her forehead in cupped palms. She’d barely slept the night before. Pain, yes, but anxiety too. Glinting hope. She pressed on her eyelids until shards of indigo flashed across her blackened vision. She tried to focus on the thought of air traveling deep into her lungs, then back out into the expanse of the world. She breathed.
The room smelled of chemicals and citrus. As if the floors, the counters, had been recently scrubbed by a strong, determined hand. Erasing dozens of smells, footprints, skin cells. Traces of other bodies. Other stories. These kinds of rooms didn’t roil Phoebe’s stomach. In fact, they were familiar, fixtures of her childhood. All her life her father spent his days examining x-rays, pointing out lines of fracture. He repaired bone. Meanwhile her mother, always more impressive to Phoebe, operated on glasslike newborns. Tended to their fighting lungs, their rickety hearts. An only child, Phoebe was often shuttled between her parents’ practices, lugging plastic dolls and colored pencils to rooms like this one. In time she came to admire watching medicine at work. She witnessed the urgency and care with which her parents approached their patients. The responsibility they ascribed to each day. She had respected it all. She still did.
After sitting in the couch almost half an hour, the low muscles in her back twitched, stiffening. Her pain was angered. It knew where they were and why. The monster wanted to play. Phoebe bit her lip, but still, tears rose out of hiding.
Once, weeks ago in a more panicked moment after the health center visit, Phoebe thought about the other times she roared in distress. She even pressed pen to paper, made a list. The skin of her knee almost entirely shredded after crashing her bike. Her ankle bent and lame during a soccer game. Countless jammed toes. A dislocated shoulder, once, at summer camp. All of these moments so visceral, devastating. None of them compared to this pain, indeterminate and invisible.
To keep from howling, she scanned the space around her. Tried to be aware of things. The clock with painted blue figures, a fat black rim. The vase of plastic hydrangeas, the stems a too-perfect green. A color that reminded her of a knit sweater she loved until she lost. The unstable tower of magazines on the table in front of her crossed legs. The one on top dated January despite the spring warmth surging outside. Phoebe leaned closer to reach the tabloid; an object of pictures and words, it was a thing of distraction. She let it balance flat in her lap and was faced with an actress. Her body more fit than slender, a rarity in that business. Her hair peroxided to be fair. Angelic. On screen she morphed into a detective, hunting murderers and rapists and abusive husbands, scrubbing society of its spots of evil. Hers was a television show Phoebe recently had been letting fill the apartment with noise as she iced her forehead and prayed for sleep.
Phoebe turned to the actress’s interview. Questions bolded in pink. Answers clean in black. Her eyes strained to understand the sentences, the logic of text, but it was impossible. The more she tried to focus, the more she instead yielded to her pain. She returned the magazine to its stack.
“Phoebe?” A woman called from the hallway. Her eyes weary behind thick maroon glasses. Tall and sticklike except for the pouch of belly that suggested she possessed not one or two but three genetic miniatures. A house a constant whorl of chaos. Tiny feet and gummed hands everywhere. Crude macaroni art hung high in the kitchen.
“Yes,” Phoebe replied. Her step a little too quick, she nearly bounded forward.
“Right this way, second door on the right.” The nurse pointed as she spoke, the whole of her arm a stiff line.
“Thank you,” Phoebe said as the woman held the door open for her.
The nurse wrapped a cuff around Phoebe’s upper arm, recorded her blood pressure. She steadied a thermometer beneath the soft pink of Phoebe’s tongue, made note of her temperature. Following routine, the nurse was quick with her touch and sparse with her words.
“He’ll be with you shortly,” she said when she was finished.
“Ok, thank you.” The nurse nodded in response and left.
Abandoned and seated in the exam chair, Phoebe was again suspended in near silence. She waited. The room was bare, a clone of its neighbors, she was sure. A single line of cabinets on the wall, hovering above a tiny counter with sealed instruments on display beside a sink. Each time Phoebe shifted, even slightly, the paper beneath her crackled. The sound, evidence of her body alone and patient but anxious. Even though the thought of the doctor’s hands, his voice, didn’t make her want to run, her heart was loud in her ears.
The monster was canny today. It scratched, punched, tore. Relentless.
Dr. Matthew Reese entered the room unhurried. Arms like brass pendulums at his sides. His face clean shaven, black hair gelled with care. There was a certain solidity to him, Phoebe noticed. Stable, angular jaw. Little flesh hiding his bones. His shoulders strained against the rigid fabric of his coat. He seemed aware of himself, which only made Phoebe more observant of his presence.
“Phoebe Miller, how are we doing today?” His voice boomed as if he’d just downed a steaming espresso. She shrugged in response.
“The same, I guess. My head’s bothering me right now.”
He settled on his stool across from Phoebe. His legs wide, hands splayed and idle atop his thighs. With one of his thumbs he began to make small circles into his muscle. A runner, Phoebe guessed, tending to a site of soreness. It was simple, but Phoebe found something odd in the gesture. She knotted her own hands together, squeezed. Waited.
“Well, that’s why we’re here, isn’t it?”
“Anything different about the pain today? Any changes since I’ve seen you?”
“No, not really.”
“You said you’re in school?” As he spoke, he glanced briefly at her chart, but didn’t seem to be reading anything.
“I’m a junior.”
“Must be a lot of work.”
“Sure, sometimes. Around exams mostly.”
“What are you studying?”
“Ah, going to save the coral reefs from extinction?”
“Something like that.” She never knew how to respond to remarks like that, but she tried to be polite, jovial. For his sake.
“And how much sleep do you think you get?”
“I don’t know. A normal amount?”
“For a college student.”
“Yes, I guess so.”
“So that’s, what, six hours?”
“Probably. Except not with the headaches, so maybe a little less.”
“Right. And when you do sleep, do you sleep through the night?”
“Mostly, yes. At least I was before the pain got worse.”
“Of course, okay. What about meals?”
“What about them?”
“You’re going to the dining hall, eating healthy?”
“I cook mostly. We have a kitchen in our apartment.”
“Lucky girl. When I was in school, I just had a hot plate. Used an old frisbee for a bowl, sometimes.” He paused, smiling at some vague memory before turning back to Phoebe. For a moment something in his face betrayed a kind of disappointment. As if he resented being stuck in the present. “Look I’m going to cut to the chase, Phoebe,” he continued. “Your tests didn’t show anything, and from the information you just gave me I can only see one explanation for these little headaches of yours: stress.” For a moment, Phoebe thought she misheard.
“It’s pretty common. Busy schedule, little sleep, and, bam, you get these headaches. Simple as that.”
She wasn’t quite sure how to respond. Stress was not a diagnosis. Not what she wanted. She needed words heavy with meaning. An answer.
“But these aren’t just headaches,” she tried to argue, until he interrupted.
“That’s what you’ve told yourself. I think you’ve worked yourself up thinking about what’s happening to you. The mind is a powerful thing, Phoebe. Almost any physiological symptom you can imagine can become real when we are in distress, even if there is nothing actually wrong with us. Amazing, right?”
This information refused to sink into her. Instead it rebounded outwards, rubber balls flying backwards from a wall of brick.
“Well, I, I don’t think that’s what this is.”
“Trust me, I know what I’m talking about. There’s nothing physiologically wrong with you. This pain is psychosomatic. You haven’t hit your head or anything recently, correct? No car accidents or other physical trauma?”
Psychosomatic. The word punctured her hope.
“Exactly. And, if my notes are accurate, you said the headaches just came on out of nowhere, isn’t that right?”
“Well yes, but, that’s just because I can’t remember the first one.”
“Exactly. I’m sure college’s a little more stressful than you were expecting, you’re feeling a little overwhelmed. Sometime that’s all it takes. Pain’s like the body’s alarm system, but sometimes the danger isn’t always what you think.”
Phoebe was stunned. She didn’t know how to make him understand. He saw her distress and seemed unconcerned. Unconvinced.
“I’m sure this information will take a little time to sink in,” Dr. Reese continued.
“Take a break from work. Get some more rest. In a week or two you’ll be good as new.”
“But,” she paused, trying to keep her voice even, “but what if that doesn’t work?”
“It will. Phoebe, you need to relax. Once you do that, I promise you, your headaches will go away. Life will go back to normal.”
Suddenly she wanted to shriek, to explain the ferocity, the tenacity, the absolute hunger of the monster in her head. Feeding and feeding until there was nothing left of her. It wasn’t just stress. These weren’t just headaches. The monster not some benign poltergeist. She wouldn’t survive with this pain in her head. It would win, in time.
Yet her rage was anchored deep within her, unable to rise to the surface.
At her silence, Dr. Reese clicked his pen closed, tucked the gleaming instrument into the pocket of his coat. Without ceremony, he closed her file. Her information, her symptoms and complaints, all sealed, soon to be stored in a file cabinet. Slipped between other accounts of aching bodies. Forgotten.
The grin on his face, all teeth and confidence. Dr. Reese, Phoebe was certain, considered himself helpful. He would never believe her pain was monstrous, not like her friends did. Uttering her idea might even put Phoebe’s body at greater risk. Confinement. Observation. Other, more intense pills. With that thought, Phoebe realized she didn’t even need him to understand her pain exactly as she did. She just needed him to listen.
“Look,” Dr. Reese said, his body already partially outside of the room, “I can give you some stronger pain meds but honestly I don’t think you need them. And you only want to be on that stuff if you really need it, right?”
Phoebe kept her head bent forward as he spoke. She couldn’t look up to meet his gaze.
“I guess,” she mumbled. She didn’t care if he heard her response or not. It didn’t matter. The conversation, mere minutes, had been hollow. This man was never going to offer her any radical help, and Phoebe couldn’t understand why. She maybe never would.
Phoebe stood, stepped through the doorway behind her doctor.
She had no choice but to return to the receptionist’s desk, hand over her credit card. As she waited for her receipt and the insurance form, Phoebe spotted the white lollipop stick discarded next to the computer keyboard. The red candy was almost entirely gone, sucked until chewed by the looks of what was left of it. The gnawed cherry remains reminded Phoebe of rough crystals. Glittering and jagged, discovered in some ancient, echoing cave. She clung to the sight as she stood there, her head throbbing.