Chapter 3
Ava
Pain learned her before she learned it.
It woke with her, already awake, already settled, a low animal coil at the base of her spine. Not sharp anymore. Sharp meant new. This was older than that—dull, insistent, patient. It let her brush her teeth, button her shirt, load the dishwasher. It waited until she bent the wrong way, until she forgot herself for half a second, then reminded her who was in charge.
By afternoon it behaved like a debt. Quiet. Compounding. She could feel it accruing interest while she stood at the sink, while she folded laundry, while she answered emails that asked nothing of her body. The pain never rushed. It knew she would come back to it.
The pills weren’t relief anymore. Relief had been warmth. Relief had been a softening, a loosening. What they gave her now was narrower than that. Function. Maintenance. The ability to move through the day without drawing attention to herself.
The difference mattered. Relief was indulgence. Maintenance was responsibility.
She kept the bottle in the kitchen cabinet, behind the flour and sugar. White on white. Sensible. Somewhere a mother would put it. Somewhere that didn’t announce itself.
Her phone buzzed while she was wiping down the counter.
Refill day.
The notification sat there longer than it should have. She stared at it until the words lost their shape. Then she checked the bottle anyway. Seven pills. Enough if she was careful. Careful had become a skill. Careful meant halves. Careful meant swallowing against the burn in her throat and breathing through the spike until it dulled. Careful meant not flinching when her daughter hugged her too hard.
Careful meant not letting anyone see the arithmetic.
The pharmacy sat between the grocery store and the dry cleaners. She had driven past it a thousand times without thinking. Now her hands tightened on the steering wheel as she pulled in, like the place itself could sense her attention.
She stayed in the car a moment, letting the engine idle, letting the ache settle into something manageable. The building looked the same. Same automatic doors sighing open and closed. Same posters about flu shots and smiling seniors who looked like they’d never been asked to beg for anything.
Inside, the air smelled faintly of disinfectant and plastic. The floors shone too much.
He was behind the counter.
He smiled when he saw her. The same smile he’d used on the sidelines years ago, shouting encouragement to a cluster of muddy girls who believed him when he said they were strong. He still asked about her daughters by name. Still remembered birthdays. Still led prayer once a month at church.
“Hey, Ava,” he said. “How’s the back?”
“Some days,” she said, and meant all of them.
He nodded, already turning to the computer, already frowning at the screen.
“Huh,” he said. “Looks like we’ve got a problem.”
The word landed heavier than it used to. Problem. It had learned to mean delay. Scrutiny. A look that lingered a second too long.
He leaned closer. Lowered his voice.
“I can help,” he said. “But it’s complicated.”
She felt it before she understood it. The way the space around her narrowed. The way the air shifted. The way the conversation stepped sideways into somewhere she hadn’t agreed to go.
She didn’t argue. Didn’t ask questions that would force him to clarify. She didn’t say no, not because she didn’t want to, but because the shape of no had already been eroded. The words slid past each other, meaning less than the understanding underneath them.
Later, she wouldn’t remember the exact phrasing. Only the moment where resistance stopped feeling available. Where the decision arrived already formed, like something she’d simply failed to notice sooner.
When she walked back to her car, the bottle was warm in her hand.
She sat in the parking lot with the engine off, staring at the label. Her name printed cleanly in black ink. Dosage. Instructions. Everything orderly. Official. As if nothing about this had gone wrong.
Disgust rose, sharp and unexpected. Not for him—not yet—but for herself. For how far she’d gone. For how quietly the line had moved. For how she’d confused familiarity with safety.
She tipped a pill into her palm. Bit it in half. The chalky taste bloomed on her tongue. Her hands shook. The other half slipped from her fingers and fell into the cup holder with a soft, final sound.
She stared at it. The smallness of it. The way it looked exactly like what it was: something she’d negotiated herself down to.
Her phone rang.
“Hi, Mom,” her daughter said. “Where are you? Can we order a pizza tonight?”
Ava closed her eyes. Just long enough to feel the weight of the lie forming.
“I’m on my way,” she said. “Of course we can.”
Her voice sounded normal. That frightened her more than anything else.
She swallowed the half pill dry and started the car.
By the time she turned onto her street, the world had softened around the edges. Not relief. Distance. Like watching herself through a pane of glass that someone else was responsible for cleaning. She pulled into the driveway and sat there longer than she meant to, hands resting uselessly in her lap.
The keys slipped from her fingers. Clinked once against the concrete.
She didn’t feel herself fall.
Light came back without asking permission. Flat. White. Too close.
Her mouth was dry. Her body felt heavy, like it had been filled with wet sand. Something warm pressed against her hand.
“Ava?”
She turned her head slowly.
Her daughter sat beside the bed, fingers laced through hers. Awake. Steady. Watching her in a way that said she already knew something was wrong but wasn’t going to name it yet.
“I’m here, Mom.”
Memoirs of Madness 