The sixth session

As Dr Elliot Williams crossed behind his desk and sunk into his chair. He takes a moment, studying the file that was on his desk in front of him, and with a reluctant breath, he opens the file and scanned over the first few pages, already considering that maybe one of his colleague’s patient files got mixed in with his. As his eyes scanned the first few pages, his stomach tightens. There it was his handwriting staring back at him from the pages. Every observation, every note along with every single remark in the margins that belonged to him. Even his signature was sat neatly at the very bottom of each page that has been filled.

And yet this couldn’t be his patient. Although according to the patient’s files, he has already had five sessions already over the past three months. And the file states clearly that the sessions always start at 2 in the afternoon and wouldn’t end until 3:30 in the afternoon which was more time than he has had with any other patient before. He had no recollection of a Sarah Nelson. Which made him feel uneasy, he has been a therapist for almost twelve years now, and he has never forgotten a patient before.

So, with a heavy sigh he glanced over at the clock above his office door. It was 1.45 in the afternoon, he noted in his mind focused his gaze back on the file which was set on his desk staring at the file for a good minute or so before he hears it, the simple chime of his intercom. causing him to jump a little in his seat and slump down thinking how much he hates those things, but then her would hear the front desk lady say “your 14:00 is here” before it cut off. Elliot paused for a second before glancing up at the clock above his office door, marked 2 p.m. His eyes dropped to the watch on his wrist which read the same. For a moment or two he simply stares at his watch. Fifteen minutes couldn’t have past as quickly as it did. He was certain he had only glanced at the file on his desk for two minutes at best. The cold knot in his stomach tightened as he replayed the last few moments in his mind, searching for the missing time only to find a blank space.

After what felt like forever, he blinked and lifted his gaze from the file. A women sat in the chair opposite his desk. Elliot jerks back in his seat, feeling his stomach drop and his heart hammer in his chest against his ribs. The old and heavy office door, its hinges would always protest every time someone came through it. yet Elliot couldn’t remember hearing it this time, nor did he remember hearing a knock or footsteps crossing the room and yet here is this woman sat across right from him, she didn’t say anything just stared at him with a small, composed smile. Then he notices how she was dressed; she is neatly dressed in a dark blouse and tailored trousers; she looked as though she was at a business meeting or perhaps a job interview in his eyes. Most of Elliot’s patients would arrive wearing something casual and comfy clothes, so this would was odd for him yet he pushed that aside and that’s when he notices that her smile wasn’t wide enough to be friendly, nor strange enough for her to come off threatening at all.it was simple, resting on her lips as though she’s been waiting for him to notice her patiently.

A sense of unease washed over him. Yet her smile never faulters, she just simply sat there with her hands in her lap. Eliot clears his throat and straightens up in his chair, pushing the uneasy feeling he had. Sarah Nelson? He asked. Sara would not her head, that smile never leaving her face as she says, “that’s right, doctor.” In the back of his mind, Elliot desperately searched for some memory of her yet nothing. So, he clears his throat once more and smiles. “Forgive me Sarah, but it’s been a long day, and I skipped my morning coffee.” He lets out a nervous chuckle hoping to ease the tension that had settled in the room. “Can you remind me how long you’ve been y patient? Hearing this Sarah tilts her head slightly. “Long enough.” She replies.

Elliot would let out a small laugh, though it felt forced even to his own ears. “Now Sarah, before we continue, I’d like to take just a few minutes reviewing what we have discussed in our previous sessions.” Sarah would only nod her head in agreement.

He looks at the file and looks at the first session. “Okay so Sarah, with session one you mentioned that you felt disconnected from everyone and that you also mentioned how you recently moved away from loved ones and you have few friends and along with that you also mentioned that you struggle with social gathers and on top of that you struggle to sleep.” He looks up from the files and looks at her. “Are all these still any issue, have you visited your family?”

the questions hung heavy between them for several moments. Her smile faulters for a split for a moment before settling back into place like a mask and nods her head more than once. “Not anymore and my family visit me al the time now even a few friends.” She says softly.

As he listens to her talk, Elliot couldn’t help but think how oddly she phrased it. For a moment the remark lingered in his mind, but he quickly pushed that thought aside. He didn’t remember her. Not even a little. Yet the notes in front of him painted a clear picture of a lonely young women struggling with distance from her family, and isolation. Yet compared to that she seems calmer somehow. Not happier, just settled.

Elliot offered a smile and spoke softly.” that if good to hear Sarah. It sounds like your making progress.” Sarah gives a small nod, and the room fell silent once more. Elliot glanced down at the files that were on his desk. “With the second to third session,” he began, as he skims over the notes “you did mention that social gatherings had become such a struggle that you felt disconnected from the people around you. You said that it felt like you were watching everyone’s life around you move forward as yours stood still.” Sarah would nod.” I remember.” She said her tone still soft, but something about the way she said it unsettled him. He ignored the feeling letting out a quiet sigh as he looked up to her. “I see and did any of the coping strategies I mentioned in each session help you?” he asks. For the first time Sarah hesitated. When she finally answered, her voice was a little more than a whisper. “None of those ever helped me.” She replied.

The words hung heavy between them. Elliot frowned slightly and he glances back down at the notes from both session two and three. A few questions surfaced in his mind, but he set that aside for just a moment and turned the page, to look at session four notes.

As he read through them his frown deepened. According to his notes, Sarah has seemed to increasingly frustrated that no one appeared to notice how much she was struggling, not even her colleagues. She had spoken of feeling emotionally and physically exhausted and admitted that she was growing tired of pretending that she was fine, when she clearly wasn’t.

He looks up from his notes, a question already formed n his lips. “Sarah- “before he could finish, she cuts him off. “Look at session five notes.” He blinked. “What?” she stares at him, her expression blank. “Take a look at session five notes.” She says quietly. “Read those first. “Something about the way she said it made him hesitate. It was not a suggestion.

Elliot stared at her for a moment before turning the page and looking at the notes from session five.

As he read through the notes from that session, Elliot quickly noticed how much shorter they were then usual. There was barely anything written there, only a reminder that Sarah needed to practice the coping strategies more consistently. A small yet noticeable frown forms across his face. That was it?

He looked back up from the page. Sarah was gone. Elliot shot up to his feet so quickly that is chair scrapped loudly against the marble floor. His eyes darted around the room searching for any sign of her, he checked under his desk and behind the curtains and yet nothing. he even called out to her. “Sarah?” and yet nothing. Just as he felt a rush of panic and confusion, the door to his office opened showing the front desk lady Jamie standing by the door looking at him confused and a little concerned. “Who were you talking to Dr Williams?” she asked softly, her voice laced with concern. He snapped his head looking at her, “what do you mean who am I talking to? I was talking with Sarah; she was right here sitting in that chair.” He said gesturing to the chair that was across from his. Jamie looked even more puzzled. “Sarah who? “He turns and looks back at her. “Sarah who? Sarah nelson my 2 o’clock patient!” he exclaimed now frustrated.” Sir you never had any 2 o’clock patient you were supposed to go on break.” he looked at her as if she was trying to trick or prank him. “That’s not funny Jamie,” he snapped “she was right there.” He points to the chair. Jamie takes a cautious step forward.” Sir, please calm down. Her attempt to reassure him only seemed to make him more agitated.

Moments later, another voice came from the hallway. “What on earth is going on?” Elliot turned to see Michael, one of his close colleagues. Standing in the doorway. Jamie glances at him with relief. “I think Dr Williams is having some kind of episode.” She said quietly.” He keeps talking about some women Name Sarah, but there has not been anyone in his office all afternoon.

Michael froze at the mention of Sarah’s name. for a moment, the room was silent until Michael spoke up. “Jamie,” Michael said quietly but his eyes focused on Elliot, “Could you give us a few moments?”

Jamie hesitates before nodding her head once and stepping out of the office shutting the door behind her as she left, Michael pulls a chair over and sat down pulling Elliot sit on his desk. “Elliot,” he began “I think know wat is going on.” He said gently.

“What are you talking about?” Elliot snapped. “Why was Jamie acting like Sarah doesn’t exist?” Michael sighed. “Sarah Nelson was a patient of yours.” Elliot frowned “was?” he asked confused. Michael would nod his head slowly and look down at the floor as he continued. “A long time ago.” But Elliot shakes his head “no, that is impossible. I just spoke to her” Michael looks back up at Elliot. “You think you did.”

Silence filled the room. Michael took a moment before he leaned forward. “Today “is the anniversary of her death, Elliot. “The words hit Elliot like a punch to the chest. “No…” he said in a weak whisper as he looked to the floor. Michael placed a hand on Elliots shoulder. “you’ve forgotten a lot about that certain period of your life.” Michael continued. “Honestly I personal believe you made yourself forget.” Elliot looks up and stared at him.” Back then you were going through the custody battle. You were exhausted and distracted, not at all yourself.” Fragments of memory started stir up at the edge od Elliot’s mind. “You remember the last session, right?” Michael asked him softly.

“You barely took notes of what she was saying, every concern she brought up, you brushed off and you just kept saying the saying the same thing.” Michael’s voice would drop almost like a whisper. “For here to practice the coping strategies.” Elliot’s stomach twisted as Michael continued. “You cut the session short that da… she felt like nobody would listen to her. Like she couldn’t be helped.” A sharp pain pulsed through Elliot’s eyes. “No…” he said again, though this time he wasn’t sur who he was trying to convince here. Michael hesitated before saying “she too her own life three days later.” The room started to feel much smaller. “I didn’t know how it would affect you,” Michael continued “you blamed yourself. More than anyone else did, so eventually you buried it so deep that you stopped talking about her.” Elliot’s breath now became uneven.

“And now,” Michael said glancing at the notes on his desk, “on the anniversary of her death is all you can think of in the of your mind, you pull out her old file to look at.” Elliot shook his head “No.no, you’re wrong.” Michael didn’t argue just stands up and pulls Elliot along with him taking his car keys put of his coat pocket.” Come with me “the drive was silent. Elliot spent the entire time staring out the car window as Michael drove. Eventually Michale pulled up to the cemetery. Elliot stomach dropped, without a word Michael got out of the car ad pulls Elliot along into the cemetery, without a word Michael led him down the rows of graves till they reached one that said Sarah Nelson. Elliot froze on the spot. The world seems to fell silent in that very moment. The grave was cared for there was fresh flowers more then one laid on her grave even small gifts. A framed photograph a handwritten card sealed in plastic. People stilled visited her. For so long he convinced himself he forgot but he knew the truth. He failed her, so as the flowers on her grave swayed gently in the afternoon breeze and with Michael near him. “I’m sorry “was all he was managed to whisper. And for the first time in a long time the word felt real.