To silence the sound in my head is a tall order. This static noise, like a television without service. There is no off switch, no button to make it disappear. Maybe it's best to treat it as a song or a tune of some sort. If you spend enough time lying to yourself about something, your brain has a funny way of believing your own words. Most often this kind of thinking leads you into a string of nasty name-calling, but in this case it seems appropriate. No one really deserves to hear this.

I am no lunatic and there are no voices in my head. Whether I’m healthy is another question entirely, but I don’t think I’m crazy. If they were voices that might be better because I could at least talk to them. It would be even better if they were a mess of unfiltered thoughts because it would give my mind something to do besides wanting to eject itself from my skull. Actually, the noise itself isn’t all that bad. It just takes up far too much space for something that has no physical construct. It occupies so much of my brain that time feels like a blur and memories pour out of my mind. And if I weren’t so accustomed to this way of living, I probably would have gone mad.

It’s difficult to distinguish reality from thought, so in this case thought becomes reality. But I’m not crazy. Well, at least I have lied to myself enough times to believe that. As much as we know how fickle a self-imposed standard is, I could not characterise myself as insane by my own measure. Usually when someone is saying they’re not something, it’s their way of telling you they are. Maybe the diagnosis they shared as fact is wrong. Maybe instead I have schizophrenia, and this noise can qualify as voices even though I have no way of discerning words from them. It still surprises me that I can even entertain these ideas in midst of all this buzzing. But enough about noise, my head has gone numb again. All this thinking has somehow increased its volume, almost as if it knew that I was trying very hard to question it. I guess it has a mind of its own. And my conscience is not strong enough to overcome this to pursue it anymore. It’s best to leave it alone.

Where am I now? I seem to be sitting in an empty subway car, or at least it feels empty. Realistically there’s probably one or two passengers because it’s rare to find yourself completely alone in a subway car. Honestly, I’m not sure how I got on or where I’m going. I like riding the subway. Sometimes I hop on a line and go from one end to the other just for the hell of it. There’s something peaceful about riding the subway, hearing the rattling of the squeaky wheels under your feet and feeling the bumps from the uneven rails. If you ride long enough, you start to discern some sort of rhythmic pattern, even though it’s probably just random movement. The mind is good at looking for patterns, especially in things that lack one. Guess it’s a way to make sense of the world. Forgive me, I'm digressing. The subway car right now is empty and the noise has finally dampened a little so I can finally hear my own thoughts. It’s these moments that make me feel oddly appreciative. Maybe it respects me enough to give me a little break from time to time. Or maybe even noise gets tired of being noisy. Who knows.

But just as I am finally able to gather my thoughts, the announcement comes on and startles me. Have you ever noticed that all conductors sound the same? As if they were trained to announce things in that particular tone. I’ve observed that on airplanes too, when the pilot announces that they’re about to take off or brace for landing. A pilot’s voice is always relatively deep, with a calm and reassuring tone. It made me wonder whether they were trained to speak like that or if they were born to be a pilot. The conductors have a different sound, one without any inflection. Almost as if they’re bored of announcing the stops, which is very understandable. Occasionally you’ll hear an announcer who sounds like those jolly conductors in movies, if you can imagine that. Most often though, the announcement is just an automated man’s voice.

Anyways, they announced the stop and my body seemed to know that I should get off here. Just before the subway actually stops I make the mistake of standing up and falling over a little. I always try to tell myself to wait until the car has made a complete halt before getting up, but I’m an impatient person. I get off the subway to figure out why I’m here as I push against the crowds of people trying to catch the subway. It’s so difficult meandering through a mass of people, like a fish swimming upstream. Or a black sheep trying to weave out of its herd because it clearly doesn’t belong. Though, I’m sure everyone feels that way in certain situations.

The location for my appointment is two hundred and thirty seven feet away from the subway stop. You know you’ve been somewhere way too many times when you can quantify the distance, though for me it was already pretty effortless. I must've been here on this day at this time so often that I forgot where I was going. When your brain goes into auto-pilot you tend to do things almost unconsciously. Probably a way of increasing mental efficiency by turning certain actions into muscle memory instead of a deliberate action. There’s no logic behind thinking about something you’ve already done so many times. I finally enter the building and quickly squeezed a drop of hand sanitizer from my coat pocket. I’m not a germaphobe, but the door handle was greasy from the dozens of other people who touched it and I didn’t like that on my own hands. Plus, when you’re in a hospital you can never be too careful about germs.

I hurry through the lobby to the elevators. I don’t even know what the inside of the hospital looks like anymore. It’s been so long since I really paid attention to it. But the ding coming out the elevator and the distinct sound of doors rolling open was a happy familiar. Some elevators have a little automated voice that says “going up” which was always nice to hear but this one didn’t. I walk in and stand in the front corner of the elevator. If someone else is there, I would ask them kindly to press the floor for me. If not, then it’s a good thing I stand close enough to the control to try and press the buttons myself. But I always get it wrong.

Elevators don’t make me claustrophobic, but I don’t like them. When the elevator rises, there’s a sinking feeling that travels deep into your stomach. Then the halt that pushes the feeling back up to your throat is even more unpleasant. But ride the elevator enough times and you learn to almost appreciate the fact that you can feel discomfort at all.

I’ve taken the elevator to the same floor so often that I know it takes exactly seven seconds to get there. When I arrive, the receptionist greets me by my first name and I never have to fill any papers or make social niceties to them. The doctor usually takes her time with other patients because I come here so often. So I sit in the waiting room, taking in that weird hospital smell and listening to the cries of the dying.

The noise has returned but it’s not all that unpleasant. It helps me drown the anxiety I have from being here. Every minute of me waiting for the doctor to call out my name is drowned by this noise again and it’s nice. The first time I was here I could hear every tick of that clock.

The doctor finally calls me and I give her a cursory smile. I used to be genuine about it, but it got too hard to be. She asks me how I’m doing and I say I’m fine. Though we both know I wouldn’t be here if I actually was. Common courtesy, I guess.

She asks me to sit on the bed-table thing. I grip my hands together and rest them on my lap as I sit down. She finally starts the examination, the routine I knew so well. She used to do a full examination, but now she only focuses on one thing. The only thing I cared about. The only thing I lost. She opens my eyelid and shines a light in my eye, which you would think is probably not the smartest thing for a doctor to do. But when you’re already blind it doesn’t matter much.

“No improvement in sight.” Her voice seemed to trail off, but I could still hear the pained disappointment. She was an incredibly kind-hearted doctor, which is why she chose to take on terminal cases like this in the first place. To see me That didn’t mean it was any easier to deal with the severity of it all. Constant exposure and emotional impact are not directly related. It just teaches you how to manage your feelings better.

“I see.” I reply.

I couldn’t hear my voice. Just noise.