The illness had affected her speech making it difficult to understand. With some effort I could tune into what she was saying but there were some things that I could not understand. It was frustrating for her as her mind was sharp but the words would not come out right. The nerves controlling her vocal cords and her breathing muscles were not doing their job any more. She tried to tell us about her suffering but she could only use short sentences. She hadn’t been able to raise her voice for years, and even if she wanted to scream out loud, only a whisper would’ve been heard.

Her pain was not physical, she could handle physical pain and simple pain relief would have helped. The agony she felt she could no longer describe in words. Her sense of wholeness had long been destroyed, her ability to exist as a person had been torn apart. Mere words could not describe the torment she had lived with for six years. I tried to listen to her actively, I tried to read her situation, her illness ravaged poker face only provided scant clues. Intellectually I had an inkling of what she had lost, but I could not feel it during our first meeting. I needed more information before I could understand.

All was revealed in our second meeting, thanks to a personal item she had brought from home. A simple frame contained a treasured artifact of a happier time. The children in the photo were on the cusp of adolescence, with their straight white teeth showing through their genuine smiles. Between the children was a young looking mother, blond highlights in her hair accentuating her clear, blue eyes. A mother figure so full of life, so full of determination. The confident smile said it all, “I am in charge of my own destiny. I am a force to be reckoned with. I love these kids so much and I would do anything for them.”

Six years later and a shaky, clumsy hand needed assistance to put the beautiful image on the tray table. Without help the picture in the frame would’ve fallen to the floor. The woman in the photo looked so bright, so vivacious, so sure of her self. The woman holding the picture looked decades older, as if someone had pushed the monochrome button, and everything had become shades of grey ashes. It wasn’t just the hair that had lost colour, but the whole person had greyed. Face, lips, clothing. The eyes had long burnt out with not a trace of a spark left.

Looking at the two images before me I finally understood what caused her to feel so tortured. The unbearable disconnect between who she had been, and who she currently was. It was too much for her to handle. There was no simple medication that could fix it, she had been unable to be herself for too long. The indignities kept on accumulating day by day, she knew things could only get worse, but were already intolerable. All she had to look forward to was less and less of herself. She wanted out. She had begged, “Please, let me out.” Her desperation had driven her to seek me out, a total stranger.