Make an Effort

The moon was shining through his open window, bathing the room in a silver hue. He lay in the darkness, watching shadows dance on his ceiling. A foreign silence lay over the house; there were no nurses here nor was there the rhythmic beep of a heart monitor or a drip slowly filling his veils with life. His bed felt too soft, his sheets were not scratchy enough. He didn’t deserve it. He didn’t deserve to lay in this bed with its new, clean sheets. An ominous creek filled the silence as someone passed by his room. He lay still, hoping that whoever was there would think he was asleep and keep moving. His ears strained desperately as he listened to their breathing. A moment passed and with it came a horrible sob, muffled by the person’s hand. It was his mother. She was standing at the door, looking down at him. Like a watchman, she checked on him frequently throughout the night. Making sure that he was still there. That he hadn’t disappeared, not this time. The wind howled as it swept through the trees, causing the patterns on his ceiling to swirl and twisted into terrifying, monstrous shapes. His mother’s tears followed him into his dreams as she cried over his lifeless body. A small fan whirred loudly as Ethan sat in the beige coloured waiting room. It was still hot, regardless of how hard the fan worked, and the noise was starting to annoy him. The receptionist hadn’t even asked if he wanted it on. The waiting room walls were covered in posters that said, ‘understanding depression’ or ‘what is anxiety?’ in big bold letters. They were crammed with statistics and pie graphs screaming at Ethan that he was sick, that there was something wrong with him. Ethan wiped his hands along his pants and felt the hair on the back of his neck spike up. Whatever they were trying to do to him, it was working, this was a new kind of torture. It was one thing to think people were talking about you behind your back; it’s another thing to be told to wait outside while they did it. His foot began to tap a rhythmless beat on the polish floorboards and his fingers itched. He was beginning to wish that he had ignored his mum and brought his phone along with him anyway. Anything to take his mind off of the situation would have been greatly appreciated. None of the posters were holding his interest and the whirring seemed to be getting louder and louder with every passing minute. What was taking them so damn long? They had been in there for what felt like an hour. What the hell were they even talking about? He hadn’t thought his mum would want to talk to Dr. Daniels for this long, if at all. What else was there to say except five simple words? The door suddenly opened. Ethan had to stop himself from letting out a loud sigh of relief. Dr. Daniels smiled as she waved Ethan forward. Ethan’s mum stopped him before he went into the ‘treatment room’. Her hair was flat and unkempt, and the bags under her eyes were pronounced, proving that she was not relenting in her nightly ritual. “I’ll be back in an hour, Sweetie, make an effort to get better, okay?” She had said in a shaky voice. Her red, puffy eyes gave way Make an effort. That’s why Ethan was here in the first place, to make an effort. It was hard. If given the choice people would always choose the path of least resistance. Not many people wanted to make an effort. And when you felt like Ethan did, making an effort becomes even harder, after all, there were ways to ‘fix’ yourself without making an effort. Once they had sat down in her office Ethan began to feel even worse. He had become so worried about what his mother had told Dr. Daniels that he had completely forgotten that he would have to talk to her afterwards. His stomach churned violently as if it was actively trying to make him lose his lunch. The couch Ethan sat on felt like it was going to come alive and eat him whole as he leaned back. It didn’t, but he wouldn’t have minded even if it had. “So, Ethan, how are you?” She began, turning to a fresh page on her notepad. “Fine, how about you,” Ethan said, not lifting his gaze from the floor. He didn’t want to see her face, he knew she would be giving that same sad look that everyone else had been giving him. They all looked at him like he was fragile, like he would break if they looked at him wrong. “Ethan… We don’t have to talk about it if you don’t want to this time. Would that be okay with you?” Yes, Ethan wanted to say, that would be great, let’s never talk about it ever. “Ok,” Ethan said instead, counting the number of threads in the carpet. “I know it’s only your second session and we don’t know each other that well so why do we talk about your interests. I want to get to know you better —how about we do that?” She said, voice sickly sweet. “Sure,” Ethan said, still not looking up. “How’s school? Are you coping well with the increased workload?” She asked, putting the tip of the pen onto the page in front of her, ready to write whatever Ethan said like she actually took an interest. “My teachers probably wouldn’t think so.” Ethan had only been at school for a day and already he was regretting returning so soon. The feeling of being surrounded by students talking about classes and complaining about upcoming tests was surreal. He couldn’t imagine being as carefree as them. The very idea was foreign to him. “It’s not always about what your teachers want. Do you think you are doing as well as you can under your circumstances?” “I suppose,” Ethan said. “I’m not failing.” Yet. It wouldn’t take long, the way he was going. He could barely remember going to most of his classes that day. Besides, it was too early to tell if he was failing, he would have to see how he did in his first tests, which weren’t too far away. “Okay, so what do you like doing in your space-time?” Daniels asked, knowing that the topic of school was a dead-end. School just wasn’t important to him anymore. Not much was these days. “Watch movies, listen to music... I don’t go outside much.” It was a generic answer, all teenagers his age watched movies and listened to music. It was one that he gave when he didn’t want to admit the truth; that he didn’t have any. Though last part was as much to do with the heat than it was to do about his lethargy. “That’s okay if your interests are indoor activities. What’s your favourite movie?” Ethan paused for a second. He had just said those things because he didn’t really have any ‘hobbies’. He didn’t really do anything other than school, homework, and sleep. He did watch movies like everyone else, but he didn’t really have a favourite, he didn’t care enough to have a favourite. “I can’t think of any off the top of my head,” he lied. “Well, how about music? What kind of music do you listen to?” Daniels persisted. Her wide eyes magnified by her large glasses that hung precariously on the bridge of her nose. “Music that makes me feel like crap.” He looked up at her finally, his throat had begun to ache. “Why would you purposely want to make yourself feel terrible?” Daniel’s asked, worry creasing her brow as she leaned towards him. That was a good question, a question that Ethan didn’t want to confront. “Because… then, at least it makes me feel something.” His eyes were beginning to burn. “Your Mum said that she has noticed that you’d been cutting yourself. Are you doing that to feel something as well?” She was getting too close, and it made Ethan want to scream. He wanted to scream, yes! I want to feel something. I want to punish myself for being worthless, for being so stupid. But he didn’t. Instead, to his horror, he began to cry. “I think we should talk about how you feel,” her voice was sympathetic. She made no move to physically comfort him instead she handed him a box of tissues. He hadn’t cried in so long and all at once he felt the urge to ball his eyes out and scream until his voice grew hoarse. He felt weak, and he hated it. He felt nothing, and it scared him. It was a feeling he could never fully articulate. Even metaphors were inept at explaining it to someone who was lucky enough to not feel it. The small pile of tissues grew and grew. He felt like a child. Who cries in front of someone they don’t know? Everything had been bottled up inside of him for too long; the pressure of it hurt more than any cut. Daniels handed him a rubbish bin which sat beside her desk. Her large, almond-shaped eyes smiled gently as he threw away his waste. “Did that make you feel better?” She asked, putting the bin back in its place. “Having a bit of a cry can really help some things.” Ethan nodded mutely, knowing that his voice was still too rough to articulate what he really wantedto say. He really did feel like a child, rubbing his eyes with the back of his hand; the emotional exertion was making him feel tired. He had gone without showing emotion for so long that when the floodgates finally opened he was almost washed away. There was a pause as if everyone in the room needed to take a breath. Daniels had told Ethan ain their last session how to calm himself down through breathing. Breath in. Hold. Breath out. Hold. And so on. He wiped hair out of his eyes, though he was looking at nothing. “Good, you remember how to box breathe. Have you used it to calm down recently?” She smiled, and her owlish eyes creased warmly through her large glasses. “Yeah, I can’t sleep unless I do it first.” Ethan shrugged. He didn’t feel like talking about how he had woken up every night with a scream on his lips. “We could always discuss sleeping medication if you think that might help?” That was the thing about Psychologists, he thought, they always said things like ‘if you want’, ‘we could do this’ or ‘this might help’. It was at least true of the few psychologists that Ethan had talked to. They all talked to their patients as if they were made of glass. Or maybe it was just him. “That might be a good idea; I feel tired all the time.” She wrote something down in her notes. Guilt crept into his chest with hooks, digging in and slowly spread throughout his whole body. He was taking three different kinds of drugs to try and help him and maybe they were working. But the side effects seemed to be taking all of the progress that the medication was making and throwing it out the window. Ethan was functioning on barely two hours a night, and the drugs were supper expensive. “I don’t like how I feel. I feel hollow.” His shoes scuffed against the thick patterned rug. He thought of a tree he used to play in with his sister when they were younger. It had been long dead, the trunk; a hollow tunnel. He remembered breaking his arm when he climbed too high. He had become to heavy for the brittle branches to bear. He too had been to brittle to handle the pressure he was under. “Is there anything you like doing that doesn’t make you feel… hollow?” “I don’t know.” No. “Maybe you could try out some different hobbies, see what distracts you.” She suggested, writing that down in her notes. “It seems that your current hobbies aren’t all that helpful.” “Yeah, maybe.” Probably not. A beat. Another dreadful pause that made Ethan feel itchy. The room was a sauna, slowly trying to cook him in his own skin. He could feel it as sweat dripped from his hair and slither down his neck. Why was it so damn hot? The urge to roll up his sleeves was almost overwhelming. No, can’t do that... “It’s not your fault you know; you don’t have to torture yourself over it. You can’t help the way you felt.” She looked like she wanted to reach out, to comfort him through physical contact. But she didn’t, maybe it was protocol, Ethan couldn’t tell. “Let’s agree to disagree then,” Ethan said harshly, stopping the conversation in its tracks with a sharp tug on his sleeves, pulling them over his hands. “Your Mum mentioned that you might be feeling like this because of the… gender thing?” Daniels signed, shifting onto something new. Ethan felt a bubble of hysteria rise through his throat, threatening to burst out into insane laughter. The 'gender thing’. Not even his psychologist had any idea of how to phrase it. For the first time in the session he smiled, a real smile, or at least as real as it could have been, it made his cheeks hurt. It was a bitter, scathing smile that vanished as soon asit appeared. “I’m transgender,” he said, rubbing furiously at the back of his neck. It surprises him when a small smile pulled at the corner of his lips. It wasn’t a bitter smile, it was… pleasent. An odd warmth spread through his chest and out towards his limps, like blood through his veins. It was something that he was trying proud of, discovering who he was without help from anyone else. Discovering that he was different, discovering that he had a reason for feeling the way he did and that he wasn’t a total screw up. But it didn’t come that easy to him; he struggled to see himself as a girl, even though he knew he was one, the mirror didn’t seem to agree. “That seems to make you happy, is it the idea of self-discovery that you like about it?” She smiled back, happy that her patient had finally shown some interest in something other than the floor. “If you don’t mind me asking, what made you come to this conclusion?” “Well…” He wasn’t quite sure where to begin, He had spent weeks over summer locked in his room, scouring the internet for information. Videos, after news articles, after documentaries, he had found his answers. Each bit of information was another piece of a puzzle that was slowly being filled in. “I thought about it and I wasn’t happy with myself like something was wrong with me like I wasn’t myself. So… I don’t know, I did research.” “Was this before or after…?” Again, she faltered, Ethan wondered about a psychologist who seemingly didn’t want to fill in all the blanks. He summed it up to her just trying to be polite, to handle him with care before so he didn’t shatter into pieces. It didn’t matter much to him, he knew what he had done, he knew what she was trying to imply. “Before. Just because I now have a name for the way I’m… feeling... doesn’t mean I’m fixed.” He sounded bitter. Because, ultimately; that was exactly what he wanted to happen, but something had still been wrong, he was still wrong. Even though he had found out what was wrong he still hadn’t felt happy about it. It was like his entire body had become void of happiness the last few months. “No, but it does mean that you can do something about it, explore what makes you happy, do more research. Have fun with it.” She gestured vaguely, it was clear she didn’t specialize in gender dysphoria, she couldn’t give him any concrete answers or treatments. Ethan had expected she wouldn’t be very useful in that area. “Sure.” Because it was now totally okay for him to go down the street in a dress. “Do you have a new name or?” “I haven’t gotten that far yet, I’ll let you know if I come up with anything.” He had scoured the internet looking at lists of popular baby names as well as prodded his mother for her favourite girl names. But none of them felt right, his mum had told him she had used her favourite on his sister and the baby names google came up with were too common for his liking. He didn’t feel like an Emma or a Laura. He didn’t know what he felt like just yet. “Once you start to come out to people, I’m sure you will begin to feel happier about yourself. I would suggest though, because of your emotional state, you should start slowly and make sure that you are one hundred percent certain that this is what you want before doing anything permanent.” What she said made sense. From what Ethan had read, transitioning wasn’t something to be taken lightly, it took years and lots of money. It took effort. “I know another psychologist who specializes in gender counseling who you might be able to get in touch with to discuss the next step if you’re serious.” “My Mum’s taking it hard. I think it’s ‘cause I’m her only son.” “She’s in mourning.” She nodded solemnly, her curling ringlets bouncing against her shoulders. “But I’m not dead, I’m not going to die.” Ethan tried not to yell. He was still here -- she should be happy for him; he wasn’t on death row. “She’s mourning what your life could have been, parents are like that, from the moment your born she was wondering what your life will be like, hoping that you’ll be happy, that you’ll get a job you like and find someone you love.” Daniel’s sounded sympathetic. She was the mediator after all, able to see both sides of the story and understand both of them. “She’s just having trouble coming to terms with the idea that the future she wanted for you can no longer exist.” “I can still do those things.” Ethan felt anger boil deep down. He thought his mum should just accept it. He thought she should feel happy for him. It was selfish to think that, and he knew it but it didn’t stop him from being angry. “I know, and she’ll learn to understand that eventually, you just have to give her time to adjust,” Daniels assured, writing something down in her notes. “Sure.” Another beat passed. An uncomfortable beat. Ethan let the anger inside of him boil down with a few deep breaths. “Ethan, would you be able to elaborate on what we talked about before? How you cut yourself... Would you be able to show me these cuts?” She asked, tentatively. To Ethan, it sounded like she was just trying to tick off boxes in a list. Does he need more drugs? Check. Does he self-harm? Check. Is he lonely? Check. Is he confused about his gender? Check. “Yes.” He said simply, shifting his pants to show the grotesques scars which marred the lower parts of his legs. He wished he could go back and change them. He wished he could go back and stop himself from doing it. They were pale pink reminders of his darkest point and they scared him. But he couldn’t go back, they were with him forever, a constant reminder of how cold and alone he had felt. How scared he had felt in those moments when blood began to bubble up from beneath his skin. He didn’t feel in control in those moments; he felt lost. “Are there any other?” Daniels said, glancing down at his sleeves. Her eyes spoke volumes, she thought he was hiding something. Probably because no one wears a woolen jumper of a forty degree day. “No, I only did it on my legs one or two times.” “And, um, why did you stop doing it, if you don’t mind me asking.” Ethan guessed there was no way of putting that nicely. ‘Why did you stop cutting yourself?’, ‘why aren’t you cutting yourself anymore?’ It gives off the odd impression that you should still be cutting yourself. Like all the cool kids, he thought sarcastically, his stomach giving a horrible twist. “Because it wasn’t helping,” Ethan admitted, looking down at his arms in shame. “It only made things worse.” There was another silence, more comfortable than the last. Dr. Daniels wrote down what Ethan had said, flipping back and forth between his page and what could only be his mother’s page of notes, making sure to add any extra information where necessary. “I didn’t mean to worry her,” he confessed, thinking about how his mother had been crying too. “Sometimes thinking about the people you love helps you pull through things you never could alone. That’s why it’s a good thing to have a support team; a group of people who care about you and know what you’re going through so they can help you through it.” “I don’t really have one of those.” “You have your family,” Daniels frowned as if she wasn’t quite sure what he meant. “I don’t have one at school.” Ethan didn’t even feel like he could talk his family about the way he felt. His sister refused to talk to him or even look at him most of the time. He knew she was mad at him but he didn’t know what to do, he couldn’t change what he did or fix it somehow. He didn’t even know where to begin. His father had also become more reclusive. Of course, he wasn’t the type of man who would carry his emotions on his sleeve but Ethan would say that they were close once. Now his dad could barely look at him, and whenever he did he just looked disappointed. “Well, then maybe we should discuss how you could make one at your school.” “I don’t know how.” That was true, he hadn’t had a real friend since he moved schools a few years ago. Sure he had people to sit with so he didn’t look lonely while he ate his lunch. They never talked about anything meaningful - frankly, it would surprise him if any of them even knew his name. After all, he didn’t know theirs. “You’ve made friends in the past right, I’m sure you’ll-” “Everyone knows what I did.” His ‘friends’ had been giving him weird looks and asking if he was okay. He didn’t understand why everyone acted as though he was fragile like they could break him using the wrong words, or talking too loud. “Oh,” she was stumped, she knew that school was a large part of why he was like this. Peer pressure, the workload, as well as the uncontrollable feeling of nothingness, were all contributing factors which had caused him to do it. And he hated that. He hated what he tried to do. He hated that he hurt his family. He hated that he didn’t have the foresight to see the damage he would cause. “I still believe you should put in the effort, get to know the people you sit with, let them get to know you. Maybe talk to people the year below, they might not know what happened. I want that to be your goal for the future -- get to know people a bit more, begin to build a support group. Keep me updated on how you’re going okay? I’ll see you next week.” Ethan only nodded, feeling numb. He didn’t want to sit with those boys anymore, they were faceless figures that only made him feel lonelier when he was around them. He knew they didn’t like him - he had seen them hanging out together without him - and he had to agree with them. He didn’t like him either. Make an effort. He had to make an effort. The air conditioner roared as it was turned onto full, though sweat only continued to drip down his back. The sun beat down on them through the windsreen, cooking them like an oven. He turned his body towards the window and stared intently at each shopfront and house they passed. He could feel his mother’s eyes burn into the back of his head, but he refused to turn around. He thought his mum would wait until they got home to talk about the session, and by then he could retreat to his room or at least have some time to think up some elaborate lie. “How was it?” His mum yelled over the noise, cutting through his study of a tree as they stopped at the lights. Ethan sighed, he couldn’t even have this one thing, could he? He just had to be stepped on at every turn. “What?” He yelled back innocently. His mother leaned over and turned off the air-con and the car fell deadly silent. She kept glancing over at him worriedly. It was beginning to make him feel uncomfortable, she stared at him with an intensity that made him thnk she feared that he would disappear if she looked away. “How did it go?” She asked. “Okay,” Ethan replied, looking out the window instead of at her. He didn’t want to see the searching look in her eyes, he was afraid she might find what she was looking for, or maybe that she wouldn’t. “What did you two talk about?” “What did you talk about?” He shot back. “Fair enough.” She nodded, turning her eyes back to the road. “What I’m really trying to work out is; is she helping or not” “I don’t know, Mum,” Ethan said. He felt exhausted, physically and emotionally and he really didn’t want to talk about it yet. “I didn’t want to talk about it yet, but I guess she’s given me some good suggestions on how to get better.” “That’s good.” Her voice audibly changed, it went up an octave and she sounded almost younger for a second. “Anything we can help you with?” “No, it was just stuff like make friends and find hobbies that make me happy, that kind of stuff.” “I have made an appointment with the school, they were able to fit it into your lunchtime, so you won’t miss anything important.” “Why?” His heart skipped a beat, he knew his mum had told the school, after all, he had ended up missing more than two weeks of school but he didn’t think he would have to talk to anyone about it. Couldn’t they just leave him alone? It’s not like they would have cared if his mum hadn’t told them. He was just glad none of his teachers had talked to him about it although he knew that they knew. He could tell by their sickeningly sympathetic expressions. “Honey, the school needs to know how you’re feeling, how you’ve been feeling lately,” she sounded tired too. She didn’t want to hurt her son or make him feel worse, but she knew she couldn’t baby him forever; she knew he would have to do something about the way he felt. “We could even bring up the uniform if you want.” “Sure, because I’m not being talked about enough.” He muttered into his fingers while his chin rested on the palm of his hand. “But that’s what you want isn’t it?” “Yeah but… I don’t know, I think we should wait until everyone forgets about me before we talk to the school about what I should wear. I haven’t even figured out a name yet, what would people call me? People would just get confused,” he said, his voice rising in pitch as his brain began to run through all the people who would bully or shun him. He thought it would just be better to wait until school ended before he did anything about how he felt. “Hey, it’s okay, Sweetie, we don’t have to talk about that if you don’t want to, it was just a suggestion. We don’t have to do anything that you don’t want to do.” She said reassuringly, giving his knee a soft squeeze. Despite the heat, she could feel him shivering. “You would tell me if anything was wrong at school wouldn’t you.” “Sure.” “Ethan, your head of school wanted to talk to us about making the school a better place for you. To make sure you can get better. It would also help you if you made an effort to strengthen the relationships you have with your friends. I never liked school that much at your age but the friends I made were important and I still see them to this day.” “Yeah, I’ll try Mum.” There it was again, make an effort. Try harder. Get better. It was like trying to drag himself up a cliff as the cliffside continues to crumble and every rock he grabbed hold of broke away, causing him to fall further away from the top. It’s an endless climb and he just gets more and more tired. If he wanted to, he could just let go and keep falling until he hit the ground below. But Ethan didn’t want to fall. He wanted to get better, he just didn’t know if he had the strength to climb. “The meeting is next Wednesday; we’ll meet you outside the office if you decide you want to come in with us.” His mum said, her voice sounded strained and rough as if she had been holding back tears. They had reached their street by then and Ethan was just glad that it was over, he felt like he didn’t need to talk to anyone for the next week -- today more than made up for it. On top of all of this, it had been his first day back at school, and he was the topic of discussion in every friendship group. As far as he knew something like this had never happened in his school. It was understandable that they would want to talk to him and his mum to discuss how they would handle this. Ethan didn’t even know how they should handle it. All the students had their own theory on what had happened. Some thought he had done it for attention and others just thought he was sick. “Okay, Mum, I’ll remember.”