“I HEAR THEM! THEY ARE CALLING ME A CHEAP PROSTITUTE!”

Her shouting is like a gas: It completely fills the space, regardless of the size of the container. The sound originates deep in her abdomen and bellows from her mouth before reverberating throughout the room.

“THESE DISGUSTING MEN,” she shouts, “KEEP CALLING ME A WHORE! I AM NOT A WHORE!”

Her wrinkled hands flecked with liver spots loosely hold a fashion magazine open. Long strands of her gray hair are falling into her dark eyes.

“I HATE ALL OF THEM! THEY ARE SO DISGUSTING!”

Spittle flies from her chapped lips as she roars. Her eyes are focused on the empty chair directly across from her.

“IF THEY KEEP CALLING ME A DIRTY WHORE, I WILL SLIT THEIR THROATS! ALL OF THEM!”

A receptionist, a doctor, a nurse, and a dietician all stand around her in the waiting room. The shouting woman is waiting for her appointment. The staff are waiting either for her to calm down or for the last cue to escort her out.

Silence fills the room like a gas. The woman’s lips are stretched into an uncomfortable grimace.

Seated directly to her right is an older man. He still has not looked around the sheet of newsprint he is holding. He has not shifted position. The newspaper does not rustle.

Seated to her left is another man who is holding a small cell phone in his right hand. His right thumb periodically pushes a button on the phone and his eyes remain fixed on the small screen.

Two men and one woman are seated across the room. The woman continues to dip her crochet hook into the yarn; the hook has not stopped since the shouting began. One man has his arms crossed; his chin is tucked in and his eyes look closed. The other man rests his elbows on his knees, his fingertips lightly touching, and his eyes stare at the floor. If he has flinched, no one has noticed.

“STOP CALLING ME THAT!”

This story isn’t about her. It’s about the other people in the waiting room.

What happened in their lives that gave them the stoicism to completely ignore her?

They didn’t get up. They didn’t change seats. They didn’t stare with curiosity or fear. They didn’t look at each other with knowing eyes.

None of them had met her before, but they were already familiar with her behavior.

What happened to all of them?

Did their parents only scream at them? Was a shouting parent more comforting than silence, as that meant that at least a parent was present? Did they learn to tune out the shouting when they were incarcerated? Were they beaten as adolescents, such that shouting like this was a benign alternative? Did strangers only shout at them, making this situation nothing out of the ordinary?

How did they learn to cope like this? Who or what trained them to react like this, to react with nothing at all?

Maria Yang is a psychiatrist who blogs at In White Ink.