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The Worst Fear Excerpt Chapter Five

Chapter Five

3 min Read

Dr. Katz regarded Madison over her reading glasses, perched halfway down her nose the way they always were. “How was this month’s meeting?” Her tone was neutral, casual, interested but not overly inquiring, as if asking about the lunch you’d just eaten, or some other mundane matter. Dr. Katz was like that, she could put practically anyone at ease, just by the way she asked a question. Of course, there was nothing casual about what she was asking Madison; far from it. “Were you able to share this time…?” she added lightly, as if an afterthought. There, that was the real question, and both Madison and Dr. Katz knew it.

Madison sat half-reclined in the well-worn leather armchair, facing Dr. Katz in her office, which was on the small side for a Harvard-trained psychiatrist. In all the years that Madison had been sitting in that recliner, week in and week out, she had been asked that same question in the session that came after each monthly meeting. And like all the times before, Madison hadn’t responded, at least not verbally. But she didn’t have to. Dr. Katz just had to study her face. The same face she had been studying since she’d first encountered Madison all those years earlier as a heartbroken, severely traumatized seven-year-old. 

The transformation was nothing short of remarkable. Madison was all grown up now, almost a mirror image of her mother: five-seven, lithe and shapely, and blessed with her mother’s high cheekbones and narrow chin that exuded elegance and femininity. Madison’s  full lips and perky nose gave her face a softness and almost childlike innocence, while her naturally curly blonde locks perfectly complemented her emerald green eyes that sparkled when she laughed, which was a rarity. She wasn’t just attractive, or even everyday pretty; she was strikingly beautiful, stunning. Pure and simple, she was in her own rarified league.

But as Dr. Katz watched, a heavy pall descended over her beautiful patient as her expression darkened before her therapist’s eyes. It wasn’t just the usual ‘normal’ shade of dark that Dr. Katz was used to seeing. This was different. More intense. This was deep, on-the-precipice dark. That said everything to Dr. Katz. 

“You had the dream again,” she concluded, and jotted a note in Madison’s file.

“Why…?” Madison’s question hung in the air. Then, her feelings spilled out, “Why?! The same dream!! Over and over!! All these years later! Why?! My dad isn’t coming back! I know that! What is wrong with me?! I am so pathetic! A total fucking loser! I wish I was dead!”

Dr. Katz listened calmly, ignoring the language and focusing on the emotion. She had heard this same wounded cry from her patient many times before.

The psychiatrist leaned forward and gently took Madison’s hand in hers. “Madison, you know we’ve talked about this many times. The type of severe trauma you suffered is especially serious in the developing brain of a child. It can take years, decades, sometimes even a lifetime, to heal. What’s important is you’ve made great progress – and you are far stronger than you know –”

“—No!” Madison interjected, “I’m not -- I’m weak –!”

Dr. Katz continued making her point, “One day, you will find that strength –”



Dr. Katz patted her hand, “When you’re ready. When you need it most.”  She said it with such sincerity and confidence that as Madison stared at her, she could feel her rage subsiding ever so slightly. Dr. Katz always knew just what to say to her.

The doctor regarded her patient for a moment. “Any self-harm? Or thoughts of it?”


They were pointed questions that she asked Madison in every session, but her light, almost casual tone made them sound less probing than they really were.  Madison hesitated for a split-second then shook her head. “No,” she replied, hoping Dr. Katz would leave it at that.

Dr. Katz made a note in Madison’s file, then handed her a slip of paper. “Now, this is Dr. Wells’ office in Palo Alto. He’s an old friend, since medical school. He’s expecting you.”

Madison studied the slip of paper: ‘Physician Referral’ it said at the top, with the details for Dr. Wells printed below. She nodded soberly to herself – this was yet another piece of evidence that the big life change she was about to embark on was really happening.


A wave of self-doubt suddenly came over her. “Dr. Katz —” 

“Yes, dear…?” answered her therapist, still writing in her file. 

Madison bit her tongue; she didn’t dare ask the question that was suddenly foremost in her mind, didn’t dare reveal her sudden stabbing anxiety about her impulse decision to move clear across the country for a new job.  She had convinced herself, with her mom gone now, there was really nothing keeping her in Boston; her friends were getting married, a few had even started a family.  The more she was around them, the more she was reminded of the fact that she was nowhere close to doing either.  So why not go out to California, she had asked herself; it’s the land of fresh starts -- no one cares where you’re from, or what you’ve left behind. And yet, on occasion, her self-doubt returned and reared its ugly head at the most inopportune times, like right then and there.

Dr. Katz looked up and studied Madison’s face, reading her expression, and seeming to read her thoughts. She smiled reassuringly, “I think this will be the best thing that ever happened to you.”


Madison pondered this prediction; it was what she secretly hoped for, too.

“But remember -- it’s important you keep going to the meetings.”

Madison made a sour face, “Do I have to? It feels like they’re a waste of –”

Dr. Katz gently cut her off, “— The Bay Area group meets the third Monday every month. It’s important for your healing. Pinky swear, remember?” She held out her little finger, and Madison instantly recalled the moment when the two of them had solemnly linked their pinky fingers, all those years ago. “Promise me you’ll go, once you’re settled?” Dr. Katz was smiling at her now, a smile that Madison knew well. A smile that said, in her matronly, non-threatening way, ‘I’m not asking you; I’m telling you.’

Despite herself, Madison found she was smiling back at Dr. Katz. Her therapist really did have a way to make her feel better, and to get her to agree to certain requests, even if they were against her wishes. And for that, and for so many other reasons, she was really going to miss her. In some ways, and for many years, she felt that she was closer to her shrink than she had been to her own mother.

It was as if Dr. Katz had read her mind again. “I’m going to miss you!” she exclaimed as she walked Madison to the door. “You’re like one of my daughters, after all these years!”


“Thanks for everything, Dr. Katz,” said Madison. “Really, I don’t know where I’d be without you.”

“This is a new chapter, Madison. I want you to embrace it!” Dr. Katz pulled her into a maternal hug.

“I’ll do my best,” was all Madison could manage. For despite the emotional history and strong connection she had with her therapist, she felt awkward and uncomfortable, almost unbearably so, with any close physical contact with anyone other than her late mom. She had been that way since, well, since the last time she had hugged her dad goodbye, that morning at the airport. After that, Madison recoiled at the thought of being that close to another living soul, especially one she cared for to any degree, never mind loved and cherished the way she had loved and cherished her father.


And so, as soon as she thought she could do so without appearing to be rude or ungrateful, she eased out of her doctor’s caring hug, and, keeping her eyes averted, quickly gathered her things and left the office. 


As the door closed behind her, Dr. Katz’s proud, supportive smile faded from her lips and was replaced by a look of grave concern.

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