RPOV

I once again was here at the New Directions Center. Today, I would have a session with Tom first, followed by Cathryn. I'd had another flashback last night while I was in my apartment. I'd was trying to work up the courage to call Stephanie when it happened again. It is frustrating the flashbacks continue, but I am feeling a little relieved that I've moved past the paralysis that had defined the last few months and had a plan in place for getting better.

Tom met me at the door again. He was wearing his prosthetics today, and I remembered he mentioned an appointment to get them adjusted yesterday. We greeted each other and began the walk to his office.

"Coffee?" he asked.

"Water, please."

His lips tipped up slightly. "Cathryn's influence?" he asked.

I chuckled. "Just a bit. I realized while I was in your office on Friday that my increased coffee intake wasn't helping my anxiety symptoms any, and it wasn't good for my insomnia either. I'd already cut it out before she told me yesterday that she recommends her patients avoid it."

He nodded. "You're right. I should have made the connection on Friday. Cathryn tends to have a better handle on the dietary influences than I do."

We arrived at Tom's office and both took our seats. He grabbed a notepad and pen from the table next to his chair.

"So let's start with sleep. Any improvement? Are you taking the melatonin like we discussed?"

"Yes, I started taking melatonin Friday night, as promised. My sleep issues are improved but not yet resolved. Beginning with Friday night, I've been able to get between six and seven hours of uninterrupted sleep each night," I reported.

"And how much sleep were you normally getting before?" he asked with a raised eyebrow.

"Four hours most nights, with some nights as little as two."

"I want to see a full eight hours. Since you've experienced improvement, we will hold off another week on the psychiatrist. Any flashbacks since Friday?"

"Yes, last night in my apartment." I paused for a second, debating what to say about Friday afternoon, before adding, "I also had a situation occur in the gym at RangeMan. It wasn't a flashback but I became so lost in my inner thoughts that I was unaware of my surroundings."

"I told you we would work on identifying triggers today. I want to know about last night but tell me about Friday first. You wouldn't have mentioned it if you didn't think it was significant. What happened?"

"I was pissed off at Tank and was taking my aggression out on the heavy bag. He caught me off-guard and took me to the floor before I had time to react."

Tom's eyes narrowed as he regarded me. "Explain."

Just as I'd feared, the unwelcome anxiety began to spike as I thought back to Friday. I felt the tremors start in my arms and hands and the acid churn in my stomach. I clasped my hands together to try to still them and dropped my eyes to avoid Tom's gaze. "Can we come back to that later?" I wanted this feeling to go away. I know I need to address it with Tom but right now, the fight or flight instinct was coursing through my body and I was choosing flight.

Tom was quiet for a few beats. "You sure about that?"

My head was still down. I closed my eyes and took a shaky breath. "Yes." Images of Stephanie started flashing in my mind. Images of her with me. Images of her with my men.

"What are you thinking about right now?" I heard Tom ask.

Without thinking, I answered truthfully, "Stephanie."

"Carlos, look up and focus on me. What about Stephanie?" Tom's voice seemed far away. My vision narrowed and Tom's office faded away as more images flooded my mind. Interspersed with images of her were flashes of white walls and medical equipment. Shit. My breathing grew more labored. I felt myself gasping for air. My surroundings were completely replaced by an unwelcome sight. The hospital room at Walter Reed.

"Breathe, Carlos."

I tried, but I couldn't seem to get enough air into my lungs.

"Breathe, Carlos. Slowly, deeply."

I was still gasping. I was in that damn hospital bed. Prone. Laying on my stomach and fighting to get oxygen into my lungs.

"Carlos. Your lungs are clear. You're having a flashback. You can breathe."

The monitors were beeping and hospital staff flooded my room. They are all decked out in protective goggles, masks, and coveralls.

"Breathe, Carlos. There's nothing stopping you from breathing now. Look around you. We're in my office."

But I couldn't breathe. I was still struggling to get air in my lungs. I heard the doctors say it was time to intubate me. I was being flipped over and positioned to get the tube in my lungs.

"Breathe, Carlos. Slowly, deeply. You can breathe."

I can hear Tom Flanagan's voice. What was he doing here in Bethesda?

"Breathe, Carlos. You can breathe. Your lungs are clear."

I feel the paralyzing drug enter my system as they prepare to intubate. I can't move. Oh God, please. I know I don't deserve another chance, but please. I want one more chance to tell Babe that I love her. One more chance to tell Julie how much I love her and how proud I am of her. One more chance to hug my mother and tell her I love her.

"Breathe, Carlos. You aren't in Bethesda anymore."

Where am I then? I can't be in heaven. With all I've done in my life, there's only one place I'm headed, and it will be very hot there.

"Breathe, Carlos. Your lungs are clear. You can breathe."

I'm still gasping for air. I can't get enough oxygen. I feel like I'm drowning.

"Breathe, Carlos. Deep breath. In…two…three…four."

I'm fighting for it. I'm forcing my lungs to take in the air.

"Hold…two…three…four."

My mind latches onto Tom's voice. I still don't understand why he's here, but he's coaching me to breathe.

"Out…two…three…four."

I trust Tom. I have to listen to him.

"Hold…two…three…four. In…two…three…four. Hold…two…three…four."

Slowly, as I'm focused on his voice, the tightness in my chest starts to lessen.

"Out…two…three…four. Hold…two…three…four."

He's right. I can breathe.

"In…two…three…four."

My body begins to calm as I listen to his calm, steady instructions. My breathing gets easier as I follow the pattern he is dictating.

"Hold…two…three…four. Out…two…three…four. Hold…two…three…four. In…two…three…four."

The images fade away, and I'm sitting in a chair in Tom's office.

"Flashback," he says. It's not a question, but a statement. He knows exactly what just happened.

I nod, not trusting my voice just yet. I continue the breathing pattern as my body continues to relax.

"Let me know when you're ready to talk."

I nod again and continue to feel the air enter and exit my lungs unimpeded. After several more minutes, I finally trust my voice enough to speak. "Thank you."

"Glad I was with you to help. You ready to talk?"

"Yes." I'm continuing the deep, slow breathing.

"You were thinking about Stephanie when this flashback started."

I drop my head down and nod, concentrating on my breathing, trying to keep the flashback from returning.

"Is that usually how they start?"

"Frequently… Usually, but not always."

"What triggers you the other times?"

"Beeping sounds, like the monitors. But I don't come in contact with that much around the office and my apartment."

Tom nodded. "The triggers aren't surprising, given what you went through. Have you made the connection yet?"

"What connection?" I looked up, confused, unsure what he's referring to.

"Why thoughts of Stephanie are triggering your anxiety and PTSD episodes. The connection between Stephanie and your flashbacks."

I shook my head. "No."

"You told me last week that for the three days you were in the hospital before they put you on the vent, you fought for every breath, and it was thoughts of Stephanie that had you fighting for every breath."

"Yes." I nodded, keeping my eyes on Tom, hoping that if my attention is focused on him in this current time and place, my brain won't deceive me into thinking I'm back in that hospital.

"Your brain linked thoughts of Stephanie with the feeling of fighting to breathe and the fear you felt, lying in a hospital bed, all alone, uncertain if you were going to live. Your only human contact was with doctors and nurses that would come in dressed in full protective gear. That's not very comforting. Now, when you think of Stephanie, your brain produces those feelings of struggling to breathe, fear, and loneliness. Stephanie appears to be your primary trigger for your PTSD."

The whole time Tom was talking about my hospital experience and the link to Stephanie, I was desperately trying to keep myself in the here and now. My heart was pounding, and I could the tremors coursing through my body again as I tried to keep my anxiety from exploding. Tom noticed and paused to coach me again.

"Remember. Slow, deep breaths. Counts of four."

I nodded and was counting in my head. Four counts inhale. Hold for four. Four counts exhale. Hold for four. And repeat. Slowly, my body began to calm after a few cycles. When I felt able to talk again, I asked the question that had been on my mind for weeks. "How do I get over this?"

"Well, Carlos. A lot of guys identify their triggers so they can avoid them as much as possible, but if I'm not mistaken, your plan is to spend the rest of your life with your trigger. Couldn't make it easy on me, could you?"

The unexpected joke was just what I needed. I let out a wry laugh, and the corners of my mouth tipped up slightly in a smile. "I have to make sure you earn your money, Tom. I want to get my money's worth."

Tom smiled briefly but turned serious again. "Your life plan does present a challenge but not an insurmountable one. How is it you've been able to be around her at all? You are having pretty strong reactions to just thinking about her. I can't imagine what you are going through when you are with her."

I shifted uncomfortably in my seat. Tom, observant as always, raised an eyebrow at my sudden restlessness. "Um, I haven't really been around her much. A few short times when Tank's dragged me down to the bonds' office when he knows she's there, but that's it."

"How do you talk to her?"

I shifted in the chair again. Why was this chair suddenly jabbing at me? "I haven't," I replied softly.

"You haven't?" Tom asked, incredulous.

I shook my head slightly.

"Not at all?"

I shook my head again, confirming for him my cowardly behavior.

"We've got our work cut out for us." He smiled lightly at me, then looked down at his watch. "Unfortunately, we're running close to your time with Cathryn, but I think we've covered some good ground today. As I told you Friday, I want to use the EMDR process again, since it worked well for you previously." I nodded, remembering that part of our conversation. "We'll get started on that on Thursday. In the meantime, keep up with the melatonin and see if you can extend your sleep further. Tell Tank you are offline if you need to, so you can have the time you need to sleep."

"He'll love that," I said sarcastically.

Tom leveled a look at me. "I know Tank well enough to know that he would do just about anything for you."

I dropped my head, knowing Tom was right but having a hard time reconciling Tank's commitment to me and his commitment to following my rule that Stephanie came first. Shit! How did this all get so twisted up? I let out a sigh and stood from my chair. Tom rose as well and followed me to the door.

"No need to go to the waiting room. You'll be Cathyn's first patient of the day. I'll just escort you to her office. Be sure to tell her about your flashback this morning. She'll want to factor that into her treatment protocol. And no medical dramas."

"Medical dramas?"

"She'll ask you what you want to watch for the neurofeedback, and I'm telling you don't pick a movie or TV show that's going to involve any beeping medical equipment, or a character named Stephanie." I nodded, and we headed over to Cathryn's office. Her door was open.

"See you Thursday, Carlos," Tom told me before he shook my hand.

"Thanks, Tom. See you then." I stepped into Cathryn's office and closed the door.

Cathryn motioned for me to sit in one of the visitor chairs. She was holding two sets of papers and handed one to me as soon as I sat. She sat in her desk chair and swiveled so she was facing me.

"This is your brain map. I want to go over this first and talk about the protocol I've chosen," she began.

I nodded and looked down at what she'd handed me. It was about five or six pages, each page had 20 outlines of a brain and all were showing various colors of the spectrum from red to blue.

"Based on what you and Tom had relayed to me about what you've been experiencing, what showed up from the qEEG is what I expected," she started. She tilted her set of papers towards me so I could see what she was referencing and pointed to one particular diagram. "See this large red area?" I nodded. "That's the measurement of high Beta waves, and the red means they are present far in excess of what would be considered normal. In this particular area of the brain, on the right side, that indicates extremely high anxiety." I nodded again, and she continued. "I want to tackle this first. I think it will give us the most immediate results in lowering your anxiety. It's not the only area of concern, but it is the largest."

She turned the page and pointed to another diagram and went on to explain what she saw. She spent about 15 minutes pointing out areas of concern and explaining their significance and where she thought they ranked in order of importance. I was fascinated by it all.

When she was done reviewing the brain map, she had me sit in the overstuffed chair in front of the large computer monitor. "Now, what do you want to watch while we train your brain? I have Netflix, Hulu, Disney+, or you can watch something on YouTube."

"It doesn't matter to me. Whatever you want to put on. Tom wanted me to share with you that I had a flashback in his office this morning. Based on the triggers we identified today, I need to stay away from medical shows and anything with a character named Stephanie."

Cathryn looked at me with an eyebrow raised. "I understand the need to stay away from medical shows, but when we get your PTSD better controlled, I want the story on the other," she said with a smile. "But there has to be something you'd like to watch. If you don't pick something, it becomes my choice," she teased.

I shrugged my shoulders. "Not The Notebook, or anything else like that. My sister tried to force me to watch that the other night. Otherwise, you can pick."

"You can't complain about my choice then. Let's get you hooked up first." She proceeded to attach a clip to my earlobe. "Monitors your pulse rate," she explained. She then attached two EEG leads to my scalp, one above my right ear and another further back.

She sat down at her computer and brought up Disney+. I groaned, and she chuckled. "I told you no complaining was allowed." She typed in a movie title and clicked when it appeared.

"The Princess Bride?" I asked. "Do I look like the kind of guy that would enjoy a Disney princess film?"

"No, but you do look like a guy that would have fun storming the castle," she quipped back. I wasn't sure what she meant by that and raised an eyebrow in question. "This probably isn't what you are thinking. It wasn't made by Disney. They acquired it when they bought 20th Century Fox. Just give it a try. If you really don't like it, we can watch something different next session. Keep an open mind, and you might like it. It's my favorite movie of all time, so I try to slip it in on clients whenever they are waffling about what to watch." She grinned mischievously at this.

She clicked several things on her computer and the screen began flickering. "Alright, I started the training protocol, just keep your eyes on the screen for the next half hour. We can talk if you want, but just make sure you keep your focus on the monitor." With that she clicked play, and the movie started.

Just a minute in, I was confused. "I thought this was a princess movie. Isn't that Peter Falk?"

Cathryn snickered at me. "Yes. That's Peter Falk."

"What's Columbo doing in a princess movie?"

"I told you it probably wasn't what you were expecting."

I shook my head and went back to watching, only to comment again. "Buttercup?"

"Yes, Buttercup. Why?"

I shrugged. "Just don't care for the name, a little too much like Cupcake."

"Do you have something against cupcakes?"

"Yes, especially as a nickname."

"Care to share?"

"No."

"Is it a problem? I can switch to something else."

"No, it's fine." I didn't feel my body reacting negatively to the name, so I didn't feel the need to ask her to switch the movie.

"Okay. But just so you know, I'll be asking about that later. It sounds like there is a story there."

I shook my head ruefully.

"Do you always talk through movies?" Cathryn asked.

"No, hardly ever. Most people accuse me of not talking enough."

Cathryn snorted, and we went back to watching. I was quiet for the remainder of the time. I originally thought the flickering of the image on the screen would annoy me, but I adjusted to it quite easily. Surprisingly, the movie wasn't half bad, and I found myself chuckling. Before I knew it, Cathryn announced the time was up and she paused the movie and began to remove the electrodes.

"That's it?" I asked. It was exactly as she had described, but for some reason it seemed too simple.

"That's it," she confirmed as she tried to clean some of the gel from my hair with a paper towel. Once she was done, she handed me a business card. "This has my cell number on it. Don't hesitate to call if you have any concerns or questions. Please call me if you experience any headaches or adverse changes in behavior, such as an increase in depression, irritability, or anger. I don't expect any of that with the protocol I ran, but I'd rather make sure you know what to do in the off chance it does happen."

"Does that happen often?"

"Not often, but I've had clients experience it on occasion. Just call if it does. Otherwise, I'll see you Thursday."

I nodded my understanding and showed myself out. My plans had been to head straight to Haywood, get a shower, and start work. Instead, I found myself headed further west, towards the Delaware River and a small hiking trail I knew northwest of Trenton, Goat Hill Overlook. It offers a nice view of the Delaware River and is a peaceful place to sit. For some reason, I just wasn't quite ready to face work yet today. I stopped off at a convenience store to pick up a bottle of water before arriving at the trail head. I parked and shot a quick text to Tank, letting him know I was going to be later than I had anticipated.

It had been a strange summer so far weather-wise, stretches of hot and humid days with cooler than normal days interspersed. Today was one of the cooler days, comfortable for a short hike. I started up the trail, enjoying the sunshine and the quiet. Out in the open, unprotected by anyone, is the last place I'd want to experience a flashback, so I worked to keep my mind on my present surroundings and off of my triggers. When I reached the overlook, I sat with my back against a tree, unscrewed the top on my water to take a drink, and surveyed the river below. It's said that Washington used this spot to surveil British forces during the Revolutionary War. Washington and the Revolutionary War have always fascinated me. How was this man able to lead an army of untrained, common citizens against superior forces and prevail despite inadequate necessities like guns, gunpowder, and even food? It helps put my own struggles in perspective.

Realizing the direction my thoughts were starting to go, I quickly decided it was time to head out. I looked down at my watch and was surprised by the amount of time that had passed. I'm sure Tank is ready to pull his hair out with me not at Haywood, if he had hair, that is. I got up and began the walk back to the trailhead and my car, but kept my pace slow, soaking up a little more fresh air and sun to help me face the day ahead.

A/N: So this is the last consecutive chapter that I have completed. I have the next chapter partly written and some other chapters completed, but the completed chapters are later in the story. So posting is going to be whenever I can get it done.