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Submitted Literature

But Inside I'm Screaming

By Elizabeth Flock



Elizabeth Flock’s novel But Inside I’m Screaming examines the breakdown of Isabel Murphy, a high-flying TV reporter. Following her very public disintegration on live television while reporting the death of Princess Diana, the novel tracks Isabel as she ponders suicide:


“Thirty-five years of living, thirty-five years packed with classes she excelled in, jobs she succeeded at ... Isabel’s thirty-five years all boiled down to one moment, an image she pulled out and focused her inner eye on whenever she despaired. [...] How did that little girl end up alone and desperate in a cold New York City bathroom trying to decide whether to slash her wrists of swallow a fistful of pills?

What else is there? What else can I do?” (p. 21)


Following her suicide attempt, Isabel is admitted to a psychiatric unit for treatment, and while initially she goes willingly, the patronising and infantilising reactions of the staff on the unit quickly make her want to leave. Within 24 hours, Isabel is clear that she “is surrounded by the dregs of society”, other patients who in her view are “Losers” who “look like rejects from a One Flew Over the Cuckoo’s Nest casting call” (p. 27). The rest of the novel looks at Isabel’s need to accept that she is indeed ‘one of them’ in order to face her demons and begin the long road to recovery. Interspersing sections that focus on Isabel’s ward life are fragments of memory, recollection and news reports from her old life, providing a clear division between ‘then’ and ‘now’ elements of psychiatric illness alongside the highlighting of notions of then bleeding into now and vice versa.


Perhaps slightly out of kilter with current treatment guidelines – certainly in the UK – is the very swift use of ECT in Isabel’s treatment without alternative treatments seemingly being given long enough to work in the absence of severe risk to life.


Like many novels of this ilk, Flock is sketchy around symptom and diagnostic specificity. What comes across in Isabel – and other characters like the tragic Lark – is the variety of manifestations and experiences of psychological distress, and in this respect Flock is noteworthy.  

Key Themes:

  • Depression
  • ECT
  • Professional / Occupational Stress

Significant Quotes / Pages

117 – “After swallowing the controlled substances that will beat back nature until the next dispensation – all have foreboding names packed with too many late-alphabet consonants like Serzone, Zyprexa, Traxodone – she shuffles back to her room and crawls back into bed, this time assuming the fetal position.

Doesn’t anybody else see how meaningless this is? How we are all consumed with our chores, which are ultimately useless because with the swipe of a broom we can all be swept away into the abyss. Here I am in a mental institution, trying to get better so that I can go back into the world and rush from job to job, killing time until I die of something other than suicide. I take medicine to help me deal with the nothingness of my life. Millions of us have to take pills to distract us from the sheer boredom of it all. We hurry from thing to thing like ants when we’re all going to end up suffocating anyway."

Reference: Elizabeth, Flock. 2003. But Inside I'm Screaming. Mira Books, 2006


- Charley Baker
Date Review Submitted: Monday 22nd February 2010