THOSE FIRST days’ shakes rattle her teeth; the hot cramps sear through her guts. She becomes so dizzy that the stupid sunset photograph turns on its side. But the nightmares are worse than the physical symptoms. Her dreams humiliate and terrify her. She moves through the underbellies of dark, unrecognizable cities, where she’s chased, attacked, beaten. In one, she is swallowed whole by a creature that looks human but can unhinge its jaw and consume her in a single gulp. She’s in the wet insides of its body, screaming and using her fingernails to claw her way out. She dreams of children she went to elementary school with, who lay her out on the teacher’s desk, tell her that her stomach is filled with worms and cut her open while she’s awake. They pluck the worms out, pink and thick, dangle them over her eyes. She tries to scream but finds that her mouth is stitched shut, even though she can feel them writhing under her skin.

Over the next seven days she sweats through her sheets until they smell sour and ammoniac, like pure animal fear. She pictures that tower again, the people free-falling away from the flames, reminds herself that this is her way of answering that card’s demand. And it is more terrible and torturous than anyone tells you. Even sleeping is full of effort. Her jaw aches from grinding her teeth in her dreams.

And then one day she wakes, and the room is clean and bright. She recalls snippets of troubled dreams, but in the morning they yield to something like peace. She realizes that’s her problem, has always been her problem. Peace feels too much like emptiness. She wonders if chemically, neurologically, she’s missing something that would help her differentiate between the two.

The doctor confirms that the worst is over, and talks to her about therapy, about group meetings, about methadone, but she stares past him, at the sunrise photograph on the wall. The metaphor well worn, clichéd, but maybe, just maybe, true.