Something has to give.

“The doctor will see you now, Miss Moore,” the mid-thirties nurse standing at the door leading to his office calls out to the practically empty waiting room later that afternoon. It’s just me and a man. Older. Jittery. And who I’ve avoided making eye contact with each time he looks my way.

I’ve been here a few times over the last twelve months to treat my insomnia at the suggestion of my primary physician. There have been small windows of times I’ve refused to go to sleep in order to avoid entering that dream and felt ill. That is, until my doctor told me how damaging it is to the body—promised that the prescribed anti-anxiety medication to help me sleep/relax would limit my recollection of each episode.

How there was a chance, minimal but there, that a deep-enough relaxed state of sleep would leave me without dreams.

Bullshit. All of it.

I do dream. Vividly.

And yet, here I am, nodding while walking toward her. She’s smiling, so happy and carefree, and at the moment I’m hating her for it. “Thank you.”

“Of course. Right this way, Miss Moore.” We don’t talk after, and once near to the open door where my doctor waits, she pauses and waves me forward. “Go right ahead. I’ll see you on the way out.”

“Right.” Another fake smile and hers widens, nodding at me as if I’d sent her blessings of health and more money than she could spend in ten lifetimes. The interaction lasts less than ten seconds at most and then she’s gone, speed walking back toward the front while I’m hating every moment of being here. “Come on, Gabriella. Get it together.”

Not the best pep talk, but I turn and walk into Dr. Silva’s office, while the man himself is behind his desk. He’s leaning back with his dark brown eyes on the door, and the light dusting of silver hair that adorned his temples has spread in the last year. With each visit, it has become a little more prominent until encompassing his entire head.

“Nice to see you, Miss Moore. Please take a seat.”

“Glad to be here?”

My psychiatrist laughs at my question and nods, already writing something down in his ever-present notepad. “And how have you been since your last appointment...” his eyes shift to his laptop screen where he squints “...four months ago? It also says here you owe me lab work and a progress report on those dreams and their frequency, if any have occurred.”

“I’ve been busy and just signed the contract for my next show.”

“Congratulations.” The painting to his right is mine, a commissioned piece of his favorite place in the world: a lighthouse in North Carolina. “That’s great news, and we’ll get back to that; I’d love to attend.”

“Once I have the dates, I’ll let you know.”

“Perfect.” Then silence. A long and awkward one, until I cough and he raises a bushy brow. “Answer the question, Gabriella. Are you still having that one recurring dream?”

“I am.”

“How often?”

“Enough that I am here questioning my sanity.”

“How so? Please explain.” Dr. Silva pushes his glasses up a bit, his face so neutral. Not so much as a twitch or smile, fake or not. “Have you been taking your meds as prescribed?”

“I have.” A lie, and he nods as if he knows I’m lying. “One tablet every night an hour before bedtime, and yet, the dreams are getting worse. I’ve gone from wandering through a strange room and empty halls to being sliced open and bleeding out. This isn’t normal, doctor. I really think I’m suffering from night terrors.”

“Let’s go back a bit, Gabriella,” he says, hand gliding across the page of his notebook, the ink filling up line after line. “When you started seeing me, these dreams had a twice-a-week frequency with sometimes bouts of self-induced insomnia in between. No?”

“Yes.”

“Six months ago, they had become a three to four per week occurrence. No?”

“Yes.”

“And now?”

“Almost every night.”

“Almost?” His brow raises, and I know what’s coming next. “Have you been staying awake for days? The truth, please.”

“The last three weeks, I’ve been having trouble falling asleep.”

“Elaborate, please.”

Running a tired hand down my face, I let out a harsh breath. “Sometimes, the meds don’t work. Sometimes the Melatonin doesn’t so much as make me yawn.” He goes to open his mouth, but I hold up a hand. “And then there are those nights when I try them together and fall asleep only to wake up with my heart beating out of my chest two hours after crashing.”

“Why didn’t you call the office? We need to know these things.” His lips purse, and he begins to type something on his laptop, his lips moving but I can’t make out what he’s mouthing. “I’m going to send in a new script for a different medication to your pharmacy on file, and you’ll be discontinuing the other. This one’s just for sleeping and should keep you there throughout the night. You’ll also be leaving here with one for bloodwork.”

I grumble. “Hate needles.”

“And I hate the smell of lavender, but my wife insists we use it in every room of our home.” At that, I laugh and he chuckles a bit, yet his amusement dies just as fast as it came. “And your stress levels? How are you managing? Are you working out or walking—”

“What are the possible side effects?” Cutting him off is rude, but I’d rather he answer my question instead. This one matters. “Because the last one always made me sick the next day.”

“That’s something that varies from medication to medication. We won’t know until you try it, but please call my office right away if you experience any sudden headaches or bleeding from your nose and mouth.”

“Jesus,” I mutter under my breath but he heard, his sad nod telling me as much. “What about the possibility of these being night terrors? Don’t you have some form of testing that can be done to rule it out?”

“I’d rather you start the new medication and see how it goes. If no change, we will move on to the next step.”

“Next step?”

“Another medication, and if that doesn’t work, we’ll do an MRI scan to rule out a physical cause. If neither is found to lead us anywhere, then we will begin a series of tests—polysomnography—to determine if you are indeed suffering from night terrors.”

“How long before we can reach that stage?”

“I’d like to see you in a month again. That is, unless you’re having a problem with this new prescription.”

“Thirty days?” My laugh is sardonic, my chest tightening and I rub the area. I’m sure he can sense the ire beginning to mount within. “Are you kidding me?”

“I’m sorry if that’s not the answer you were looking for, but there’s a procedure to each treatment that must be followed.” Dr. Silva takes his glasses off and places them atop his desk along with his pen. Both are atop that stupid notebook I want to smack him with and then burn. “Please trust us, Gabriella. Trust me that I will do what’s best for you and your mental and physical health.”

“Sure.” Because what else can I say? He won’t listen.

My primary didn’t either.

They think it’s stress-related. That it’s manifesting in vivid dreams.

“Great.” He stands and so do I, following him to the door that he holds open for me. “I’ll see you in a month, and I think you’ll have good news for me. And please remember: keep the stress levels down and always take your meds.”