Page 35 of Dark Ugly Places

My eyes move up and spot a slip of paper wrapped around my toothbrush. A note for Emmy and a note for me.

I open it slowly, my hands shaking. Not again. Not right now. I know I need to be here for Emmy. This isn’t the time. The handwriting is simple, almost like a schoolgirl’s. It reads:

You can’t stay numb forever.

What does it mean? Help or a warning? I cannot say.

With Topamax, I’m listless, forgetful, not entirely myself. But that’s what’s so great about it. I can be here, even if I am rather numb a lot of the time. I prefer it that way, actually. Without it? I know the wise thing to do is not to find out.

My head thumps, a sharp pain behind my eyes. I press my hand against my forehead and succumb to taking a couple of tramadol, hoping that with a cold shower, I’ll be able to stop the blood flow to my raging head.

The water hits me, the steady thudding of the jets over my head. I listen to the sound of the old plumbing, my feet heavy on the cold tile floor. Under the cold water of the shower with the pain pills running through me, I begin to rewind.

Pressing my forehead into the tile wall, I get a sudden flash—dark blue carpet. Fluorescent lighting. The ding of cashiers. The sharp scent of something medicinal.

Then it stops. The memory is quick, washed out, like a reel of old film.

The cold, beating spray of the shower hits my back while I struggle to remember. The hardness of the tile floor drives a long, tender ache up the back of my leg, into my side. Soon, the pain settles as the pills take effect. I feel a quick rush of relief, but I know it’s temporary. It’s not Topamax, after all.

The recommended dosage of Topamax for migraine patients is 100 mg, tapering up from 25 mg per day. I’m on 200 mg twice per day. Doctor’s orders. They say to avoid operating heavy machinery while taking Topamax. Side effects may include confusion, dizziness, drowsiness, problems with memory, cognition, language, and the list goes on. If you have suicidal thoughts while taking Topamax, you should stop taking it and call your doctor right away.

Call your doctor. Yes. I remember.

Everything went dark, and now the moments are becoming clearer.

There’s the stale smell of mildew, a hint of something medicinal. Clinical colors, white and blue. A flash of the store behind me—behind her—at my pharmacy. A voice is speaking, low and insistent. Looking down, I spot her hands signing something.

I step out of the shower and immediately dial the number on the prescription bottle. Two tones. They place me on hold. When a man answers, I tell him, “I need to refill a prescription.”

“Date of birth and prescription number?”

I rattle off the number to him and wait, his fingers clacking loudly over the keys.

“I’m sorry, it looks like your Topamax prescription expired.”

“What?” I say, my voice surprised. “Call the doctor. Request a refill.”

“Oh, actually …” he pauses, sounding unsure. “The notes say that this prescription cannot be renewed.”

“What does that mean?”

He sighs, and static crackles as he repositions the phone. “It means you’d have to get a new prescription from your doctor.”

“Are you serious?”

Silence. More keys clacking. “Oh, wait,” he says. “Actually, it was your doctor who discontinued it. It says in the notes. Looks like they won’t renew it.”

“What? Why not?”

More typing and a huff of frustration. “It says ‘patient complained of adverse reactions.’”

Martha. You bitch.

“You’d need a new doctor to prescribe this medication.”

“Any doctor?”

“Well, a neurologist probably,” he answers and yawns.