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“It’s out there. Waiting for me,” I say. The doctor only nods, lines of indifference carved across his forehead. “It waits with an eternal patience that outlasts the formation of mountains. The formation of the continents. The formation of the stars.”

“And what is it?” he asks, staring down through a pair of thick glasses at a clipboard, a pen incessantly scratching out words on white paper. Words about me that I’ll never read.

“I can’t describe it in words,” I say, shaking my head violently. The chirping of the florescent lights hurts my ears. “No one can. Words are a social construct.”

“Of course,” replies the doctor. “Can you tell me where out there really is? Where it is waiting?”

“Words are cultivated by the cultures that create them. A reflection of how we think and perceive.” I scratch at my hands, digging splintered fingernails into my palms. Flakes of skin drift silently onto the white, linoleum floor next to my naked feet. “The very act of thinking, in order to understand, veils the true reality scurrying just beneath the surface of our limited senses.”

“Fascinating,” The doctor says. The scraping of the pen gets louder. I shake my head again.

“That’s where it waits, doc.” The scratching stops. The doctor looks up for a brief moment, one of his brown eyes hovering just above the wire frame of his glasses. He doesn’t blink before checking his watch.

“Then how do you know what it is if you can’t describe it with words?” The doctor’s voice is flat, and I squint my eyes. The four white walls that surround us glow brighter. The buzz of the florescent lights claws at my ear drums.

“It’s not about trying to describe it,” I reply, rubbing my ear against my shoulder. “It’s about how I feel.” The loud tapping of the pen against the clipboard booms like a sledgehammer against my skull. I turn my head to the floor, ears ringing.

“And how does it make you feel?” he asks. I close my eyes to the bright light.

“Isolated. Vacuous. Something close to madness.”

“Something? Are the words failing you again?”

“Like it’s going to consume me from the inside out.” I lean in, pulling at the metal cuffs digging red rings into my wrists. “What is it to feel isolated, doc? It isn’t anything physical. It’s something ethereal. Nebulous. Impacting my physical body. Leading to a paralysis of movement. Of thought. Of lucid thinking!”

“Volume,” the doctor says as he stands, buttoning his white coat. “Perhaps a change in medication is in order, yes?” I yank at the cuffs around my ankles, trying to stand.

“You’re not listening, doc!”

“What if it’s too late?” The doctor whispers as he leans down.

“Wh . . .what?”

“What if the madness has already crept in?” The back of my neck begins to itch, and I pull against the cuffs to scratch it. “You can feel it, right?” The doctor leans in closer, lightly scratching the back of my neck with his pen. “Like insects feasting beneath your skin.”

“No.  They can’t . . . ”

“Maybe you’re just a cocoon as they scurry blindly under the surface,” he says, his breath hot against my face, “chewing their way out.” The doctor stands straight, the florescent lights flickering loudly behind his head. “Or perhaps a change in medication is in order.”

I dig my fingernails deeper into my palms, biting my knuckles as drops of warm blood splash onto the floor in explosions of crimson. The invisible insects scuttle beneath my shoulders and my arms and the doctor stares at me, eyes unblinking as I choke, unable to breathe as they claw their way up my throat.

There’s no one in my apartment to hear me scream myself awake, only the broken slats of the window blinds knocking into each other in the morning breeze.