***The following excerpt from Chapter 1 contains references to suicide, substance abuse, sex, and other adult-related content including explicit language. This book is recommended for ages 17+ as material contains adult themes. Please use discretion.***

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CHAPTER ONE

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    My keystrokes echo through the stillness of the office, where the only other sound is the uneasy shifting happening in the chair on the opposite side of the room. There’s another rustle, like she’s going to get comfortable by moving positions. I want to tell her that talking will help, but I keep the thoughts to myself and continue typing up my notes.

Housing. Click. I select the topic to pop open the text box and type: 

Patient noted that she has not established stable housing, continuing to live with “different friends here and there.” Counselor referred to meet with case management. 

Mental Health. Click. 

Patient reported she is out of her medication for Anxiety and Depression. No reported thoughts of suicide in the last 90 days. Reported substance use within the last seven days. 

We haven’t really dug into that part of the conversation yet, but I already know the basics. She at least got that far in her story before clamming up. 

Substance Use. Click. 

Patient reported last use of opioids as over 2 days ago. Patient reported currently experiencing withdrawal symptoms, including cold sweats, nausea, aches. Patient reported— 

The cursor blinks back at me with expectation, but I stop typing long enough to look up at the woman sitting across from me. She stares past me, and silence creeps across my office as I clench my jaw. I hate taking these damn notes. It feels so impersonal with my computer between us like a wall. I push the laptop off to the side of my desk, angling it out of the way so there's nothing separating us. 

I slowly exhale as I look at her again. 

Amber.

She's thin, with a bony face and haunting grey eyes. At first glance, she looks frail, like she might crumble if someone touched her. A deeper look in those eyes, though, reveals an undeniable spark. They warn, I'm a survivor. Don't fuck with me. 

Her brown hair, layered with neglected highlights, is bunched at the top of her head in a messy bun. I can't help but notice the way her faded-blue sweatsuit hangs around her small frame. She's lost some weight since I last saw her. Worry creeps in as I try not to stare at the dark stain on her left sleeve. I wonder how long it’s been since she was able to do laundry. As if reading my thoughts, she finally moves, plucking at her collar like she's desperate for oxygen. Like she's trying to release the pressure of life's relentless chokehold. 

I tear my eyes away from her clothes to look back at her face. I always forget that Amber is only a few years younger than me. She looks much older, with her permanent frown-lines and those eyes that are both too young and too old at the same damn time. It's clear that she's seen way more life than your average twenty-five-year-old. I can't help but feel a pang of sympathy when her eyes meet mine, but I brush it away. Pity won't do a damn bit of good. 

I sneak a glance at my watch to see our hour session is almost up. Despite my carefully crafted questions, Amber has spent most of the time giving vague, one or two-word answers. I cross my legs and start bouncing one foot, trying to tamp down the nervous energy creeping over me. We're running out of time, and I want to make sure we're able to talk about the reason she scheduled this appointment. And why she missed the last one. 

Plus, selfishly, I want to make my own meeting tonight, which is halfway across town. I take a steadying breath, forcing myself to calm down and focus.

"Go on…” I say, with as much gentleness as possible. 

Her eyes shift to rest on mine again, and I notice her twisting a loose strand of hair back and forth around her finger.

"What happened after that, Amber?" I ask, prodding her to continue the story she started a few minutes ago. 

She needs to get this off her chest. She said as much when she first came into my office, but now she's struggling to talk about it. The hair twisting continues, picking up speed. If she keeps this up, it's going to fall out. That irrational concern sticks with me until the twirling ends. Amber shifts in her chair again, sighing heavily, and I brace myself. 

Here we go.

"I called Jim," she mutters under her breath. 

Shit. 

It's an exercise in self-control to hide my reaction. I know how it feels to backslide into old habits. I can already guess what's coming next, but I ask her anyway. 

"And how did that go?" I try to convey empathy in my tone as I ask the question, hoping she knows there’s no judgment here. I've spent the past six months building up her trust, trying to show her I'm on her side. The world hasn't been so kind. 

There’s a hollowness in Amber's eyes as she whispers, "I blew him for some dope." Her quiet tone is laced with disgust.

That fucker. 

Jim’s involvement is going to mess with her progress, but I don’t bother pointing out what she already knows. In fact, I manage stay silent, clenching my jaw to keep my face neutral and hateful thoughts about Jim to myself. Amber needs to work this out on her own and sure as hell doesn't need me giving my two cents yet. Despite my internal rage, I provide a supportive nod and encourage her to continue her story. 

"I felt so sick and wanted it to end, you know?" She looks at me with pleading eyes. I nod again. 

I do know. 

I notice myself absentmindedly rubbing my left forearm, my own memories creeping in. I shudder, trying hard to ignore the pull of the past, and force myself to stay focused on Amber instead.

"I knew that he'd bring a gram over if I called and couldn't see another way," she admits, shaking her head. I stay silent, letting her guide the conversation. "I hate what happened. But…" she pauses, and I watch her tiny frame straighten up in the chair, eyes flashing with defiance, "I'm here now." 

"Yes, you are. And I can't stress enough how glad I am to see you." A smile tugs at the corners of my mouth, a reflexive reaction from one kindred spirit to another. She gives me a sheepish grin in return, which I take as a small victory. "I'm proud of you, you know. For coming in. For having the courage to keep going… to keep fighting." 

Her smile grows with the encouragement, and I'm tempted to lean across the desk to wrap her in a bear hug. I resist, though, not wanting to distract from the seriousness of this discussion. I hesitate before asking my next question. It's not going to be an easy conversation. 

None of them are. 

"Amber, we don't have to talk about it right now if you don't want to. But I wanted to check in since I'm guessing it's related to what you shared….” Her smile fades as a pained look takes its place. She knows where this is going. "How are you coping, you know, with your mom's death?" 

I hate to bring it up with so little time left in the session, but the loss triggered Amber's relapse in the first place. That's my theory, at least. Sure, she’d been struggling to stay sober over the last month, but she had still been making an effort to attend appointments. And I'd thought we were progressing toward her treatment goals. She had even called me the day her mom died, letting me know that she wouldn't be in for our regular weekly session. "Family emergency," she had told me. Her mom had been sick for a while, so I knew what she meant.

As her counselor, I took her openness as a good sign, but I should have known better. It was a goddamn red flag.

After that, she stopped responding to any attempts at communication. When she missed her scheduled doctor's appointment, I knew something was very wrong.

“Not well," she answers me after a considerable pause.

"I'm sorry again for your loss. Death is never easy to deal with."

"Thank you," she says, staring at the floor. "I mean, she had been sick for a long time, and I thought I was ready to handle it. But then it actually happened, and it fuckin' wrecked me. I couldn't handle it. Numbing the pain felt like the only way to get through." 

"For sure.” I know the truth in her words all too well. Dealing with your shit is hard. "But, like you said, you came in today, which is a step in the right direction. Processing your mom's passing is going to take some time, but I'm here for you. We'll work through this together, as long as you keep showing up," I tell her. 

Color starts to creep along Amber's cheeks, and I wonder if I hit a nerve with those last few words of tough love. I'm trying to balance understanding and accountability, knowing that she needs the support system now more than ever. 

"I will," she mumbles, her face returning to its usual pale hue. 

Our conversation continues, and I listen as Amber talks through a new relapse prevention plan. 

"The next time I'm feeling triggered, I'll do one of the meditations you showed me. It should clear my head long enough to fuckin' think straight," she plans out. I nod encouragingly, thinking about how far we've come in the last six months. 

When Amber started seeing me for counseling, she spent the first two sessions sitting for an hour in complete silence. A stalling tactic, I'm sure. She'd been to therapy before and coming to our facility was just another court-ordered round of treatment in her mind, at least at first. Unfortunately for her, silence is something I'm comfortable with. 

I stifle a chuckle as I remember her annoyed outburst during our third session. Apparently, she finally got tired of our extended staring contests, which she told me in some colorful words. She then spent the rest of that hour telling me her story, and I've been earning her trust ever since.

"Mackenzie?" My gaze focuses back on Amber as she asks me about the time. 

"I can take you back for med pick up," I assure her, sensing the anxiety in her tone. It's been a long day for her since she also had a medical appointment before seeing me. Her relief was palpable when Dr. Manning passed me the chart notes earlier that cleared her to restart medication management.

My expression shifts into something more solemn, hoping the gravity of this conversation sticks with her. 

"I was worried about you, you know. If something like this happens again, even if you don't show up here, please give me a call to let me know what's going on?" 

Her head dips in agreement. While it's not a promise, I feel my shoulders sag slightly in relief. I just lost a patient yesterday to an overdose, and the ominous thought of it being Amber next time still lingers in the back of my mind. Like the goddamn grim reaper himself. 

Fuck heroin.