“Mhmm.  Well, I’m really sorry to hear that you’ve been having such a tough time, but just to reassure you that you’ve done absolutely the right thing by coming to speak to us,” I said solemnly, nodding in an unconvincing display of what was supposed to resemble reassurance.

The last few minutes had been spent listening to Ali recount the details of her life and of her struggling mental health.  Long story short, she had been repeatedly raped by a friend of her step-father when only a child, however speaking out had, at the time, brought nothing but scepticism and disbelief from those closest to her.  Age was the only thing that had been capable of bringing this nightmare to an end.  More recently, she had been forced to relocate after the release of an ex-boyfriend from prison.  An ex-boyfriend who, some twenty years ago, had murdered her brother in cold blood before threatening that she would suffer the same fate.  Decades later Ali still feared that this would become a reality.  Even more of a concern for her was the safety of her teenage daughter.  Ali often worried about her daughter.  The lack of a male role model, the exclusion from school, the bulimia nervosa.  The thought that murder could potentially be added to that list brought tears to her eyes.

Safe to say, I was well and truly out of my depth, Marianas Trench-style.

A discreet glance at the computer screen revealed that time was pressing on, the next patient would be waiting.  The next patient was Ali’s daughter.  Treading water would have to suffice for the time-being.

Ali was, unsurprisingly, very much not reassured by my attempt at reassurance.

“So, just to help me better understand your perspective, what is it that you were hoping to get from today?”

For the next few minutes Ali explained that she had a strong desire to end her life.  She knew how, she had an idea of when.  Her responsibility for her daughter was deteriorating in its ability to motivate her to continue breathing.  She did, however, want help, something that might just yet prove to be worth its metaphorical weight in gold.

The rest of her story was equally overwhelming to hear.  What it must have been like, what it must still be like to experience, was unimaginable.

When all had been disclosed I fled downstairs to discuss the case with Dr James, informing Ali that both of us would return shortly and thanking her for her patience.  Running down the staircase of the practice through a slalom of elderly patients that remained oblivious to my presence, I was met with a closed door and muffled voices from within, two signs which made it clear that Dr James was occupied with a patient.  The name panel on the door of his room appeared a dull-bronze colour, seemingly in desperate need of some loving care and attention. Studying it closely I waited for Dr James, suspecting that even the most delicate refurbishment would find it impossible to resurrect the brilliant, metallic sheen that had once glinted in the sunlight so readily.

When the opportunity arose a short time later, we discussed Ali’s tale. Unsurprisingly, she was well-known to the surgery.  Even in her absence, mention of the details of such physical and emotional trauma brought a strange, sombre atmosphere to the room.  The air seemed to muffle the sound from outside, as though the walls had been freshly coated by invisible snowfall.

We returned to the room upstairs to find it empty.  Ali was gone.  The waiting room was also empty.  It was impossible to determine her reasons, but the pangs of guilt were unavoidable.  A doctor would have been able to help, to make it better, but instead she had left the surgery in the same tormented state in which she had arrived.

As I drove home I could only pray that she had not decided to do anything silly and act on her suicidal ideation, but there was no way of knowing for certain.  All that could be done was to hope that she would find the prospect of re-visiting the surgery preferable to that of the afterlife.

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