“Even if I believe you, Joe,” I said, “it’s not like that’s the only thing. Your doctors keep dying or going nuts.”
“And you think I’m doing it?” Joe asked. He waved at his body in exasperation. “Do I look threatening to you, doctor?”
“No,” I said, “but if you’re gaslighting them . . .”
“If I’m what?”
Right, he might not be as familiar with that term. It’s doubtful anyone showed him the movie. “I mean, if you are deliberately trying to drive them insane.”
He scoffed. “Bullshit. They didn’t kill themselves because I was crazy. They killed themselves because they, and everyone who ever worked on my case, knew I was sane.”
My jaw dropped before I could think to stop it. Seeing this, Joe guffawed.
“Oh, I know, I know, it sounds ridiculous, but you can believe me, it’s true. Has been since the second time my asshole parents left me here to get me out of their hair ’cause they couldn’t deal with me and told the doctors to come up with a reason to keep me. Well, like the greedy fucks they were, they made shit up, but at least they knew at first what a farce it all was. Before she came along.”
He growled low in his throat and spat on the ground before continuing. “You know what I was going to be before your precious little Dr. G—— worked here, doc? I was going to be the bitch case. That smug prick Dr. A—— made it more or less official policy that only the lowest-ranking doctors would be assigned to work on me because no one wanted to do therapy with a sane patient who was being kept here purely at his parents’ request. Chalk it up to my bad luck that Dr. G—— was the first one to get that assignment. Because let me tell you, Dr. G——? She was too ambitious to waste her time with that. So what does she do? She spins a little tale about how terrifying I am to work with and leaves a suicide note about it just where the other doctors will find it, and next thing you know, she’s on sick leave, gets to work with real patients when she comes back, and I go from being the case no one cares about to being the case no one dares to talk to. So what do they do? They start sending the doctors they want to fire to work on me, ’cause that would give them an excuse to get rid of those poor fuckers. And those doctors knew that if they failed to cure me, that bitch and her cold-fish mentor would make sure their careers were over, but as soon as they talked to me, they knew they couldn’t possibly do it because there was nothing to cure. The ones who lasted the longest were the ones who were able to talk themselves into drawing a paycheck just to spite this place. The longer they could live with that, the longer they stuck around. And I had to watch the only people who cared about me even slightly lose their minds in the process.”
I still had doubts, but for some reason, the more Joe talked, the more my heart went out to him. If I had to guess what made him so sympathetic I’d say it was his demeanor. I’m not really getting it across here, but even though he was technically defending himself, his voice still sounded hollow and resigned, like he knew that even if I believed him, it wouldn’t help anything. Like he was just giving his defense on autopilot. And because there was so little hope in what he was saying, it made me more inclined to believe he was being honest. I should’ve recognized that this could just as easily be a psychopath’s manipulation, in retrospect, but, given how thoroughly he’d caught me off guard and how inexperienced I was, I was probably far more impressionable than I should’ve been.
That being said, I wasn’t a complete naïf. I knew that any patient who isn’t completely deluded or catatonic can game a first impression. So for the next forty-five minutes, I tried to steer the conversation so as to see if Joe gave any signs of serious latent psychological disorders, signs only a professional would know how to spot. But here, too, I ran into a dead end. Joe showed no signs of any mental illness beyond mild depression and agoraphobia, both of which I would expect from a patient who’d been locked up for twenty-plus years facing doctors whose sanity was gradually deteriorating.
Granted, a very skilled psychopath could’ve faked all of this, but Joe gave none of the indicators that this was the case. For example, during our first talk, I recall that a bird flew into his window and stunned itself. A psychopath wouldn’t have reacted at all, but Joe walked over to the window and watched in concern, his face pressed against the glass, until the bird shook itself and flew away. If there was a clearer sign of healthy empathy, I would’ve been hard put to imagine it.
The upshot of all this was that when I closed the door to Joe’s room after that first meeting, I felt sick, though not for any of the reasons I had expected. The fact was that despite every horrifying story his file contained, I saw absolutely no evidence that this man was anything other than a desperately lonely scapegoat, abandoned by his parents and made into an underfunded, understaffed hospital’s resident freak. Under the circumstances, I would ordinarily have recommended to my superior that he be released, but if even part of Joe’s story was true, that obviously would’ve been a terrible decision. If he was right, then this hospital wasn’t going to let a cash cow like him go, even if he was sane.
Then again, it was just one session, and the accusations against him were numerous. I decided I’d give myself a month of sessions with him before I decided to do anything drastic. Perhaps I’d simply caught him on a good day, and in a little while he’d transform into the nightmare-channeling fiend depicted in his file. Besides, I still hadn’t listened to the audiotapes in his full file, nor had I looked at the unredacted notes from the attending physicians that Dr. G—— had given me.
I shouldn’t admit this, but I took his file home with me. If Dr. G—— was keeping it locked in a drawer in her usually locked office, I didn’t feel safe leaving it in mine. My battered institutional desk didn’t lock, and I didn’t have a reputation for securing my office because patient records going forward were all digitized and I didn’t leave anything sensitive or valuable lying around.
When I got home, I couldn’t immediately start reading. That night was a particularly hard one for Jocelyn and me. Between my new job, which included an obsession with Joe, and her frustration with her research, we hadn’t had a lot of time together. I think that was the week she broke down and told me that her professor had trashed an entire year’s worth of her writing. Mentors are supposed to support their grad students, but this one member of her committee was an intransigent asshole, constantly negging her and her work. I suspected he wanted to sleep with her or, at the least, felt threatened by her. Or maybe this was just his idea of normal, since a lot of apprenticeship programs have weird traditions of abuse that everyone has to get through, a way of “paying their dues.” We had a fight, but it was short-lived. She got me to talk about the nightmare I’d had that had woken her, and I got her to share her problems with her professor. We were so tired in the end that we fell asleep curled together, our respective work put away for a night.
I didn’t get started on Joe’s material ’til the following night, and I decided to begin with the audiotapes. My thought was that the first session with Joe—when he ostensibly was suffering only from night terrors—might give me some clues that other doctors had missed because of its seeming banality.
The audiotape of Joe’s first session was old and more than a little warped, and I was worried that it wouldn’t work when I popped it into my cassette tape player. However, after a few disconcerting grinding and whirring noises, the cassette’s spools began to turn, and the tinny sound of a man’s voice, tinged with a mid-Atlantic accent, flowed from my speakers.
Hello, Joe, my name is Dr. A——. Your parents tell me you have trouble sleeping.
There was a brief interval in which I imagined Joe must have nodded, because Dr. A—— went on speaking.
Could you tell me why that is?
Another brief pause, then a child’s voice answered.
The thing in my walls won’t let me.
A: I see. I’m sorry to hear that. Could you tell me about the thing in your walls?
J: I
t’s gross.
A: Gross? How so?
J: Just gross. And scary.
A: What I mean is, can you describe it?
J: It’s big and hairy. It’s got fly eyes and two big, superstrong spider arms with teally long fingers. Its body is a worm.
I let out an involuntary shudder. Even for an imaginative kid, that was a pretty ugly mental image. Even so, Joe had been listed as an acute entomophobe, so this seemed like a natural expression of that fear. No reason so far to think he was anything more than a typical fearful child. Dr. A—— had apparently felt the same way.
A: That does sound scary. And how big is it?
J: Big! Bigger than daddy’s car!
A: I see. And have your parents ever seen it?
J: No. It goes back in the walls when they come.
A: Something that big can fit in your walls? They don’t break?
J: It melts. Like ice cream. It looks like it is the wall.
A: I see. And it’s what made those marks on your arms?
J: Yes. I tried covering my face so I wouldn’t have to see it. It pulled my arms away and made me open my eyes with its fingers.
A: Why did it do that?
J: It likes when I feel bad. That’s why it doesn’t let me sleep.
A: What do you mean?
J: It eats bad thoughts.
Yeesh. If he hadn’t been locked in the hospital, this kid would’ve made a great horror author.
He was also—to my deep frustration—completely ordinary. As I continued to listen, I cracked a smile at what a brave kid he was. I could also see that the information on the tape largely conformed to the notes in the file, and nothing in the session suggested anything like the horrors that this little boy had visited on the hospital after his second admission. In fact, based only on the tape, everything that followed this session seemed impossible. Something about this story just didn’t add up, which gave me an unpleasant thrill of suspicion that what the adult Joe had told me about being set up might actually be true.
Even so, this was just one set of data. To try to understand what Joe had evidently become while in captivity, I would need to turn to the second tape, the one produced by the orderly who’d stayed one night with him.
On first looking at it, I did notice something that seemed odd. A narrow strip of what looked like very old masking tape with the words “3 a.m.–4 a.m.” written on it had been stuck to the cassette. I was puzzled. Why record only one hour? Then it hit me. The file mentioned that the recording had been mostly silent. This must be the only tape that contained anything of interest. Otherwise, why preserve it? Prepping myself to listen very hard for something over the next hour, I pushed the cassette in and pressed Play.
It was, as I suspected, almost nothing but dead air for the first twenty minutes, and more than once, I had to stop myself from zoning out. Eventually, I resorted to counting the seconds under my breath, periodically looking at my watch as a means of making sure I stayed attentive to something. When I reached the twenty-minute mark, the tape seemed to come to life, and I did hear something.
First, there was the sound of breathing that I’d seen mentioned in the file. Dr. A—— hadn’t exaggerated: this was undoubtedly the sound of someone having an anxiety attack. The breathing went on for about thirty seconds before I heard the sound of something shifting and then . . .
Footsteps. Fast footsteps, as if someone was running, followed by the smack of something soft on something hard. Throughout, I heard heavy breathing, presumably of the person who’d just been running, then a rough voice muttering several obscene words over and over again in increasingly terrified accents. Next, there was the sound of shuffling footsteps, and abruptly, at thirty minutes, the recording seemed to completely cut off.
Annoyed, I rewound it. It was obvious what I had heard. The orderly had clearly been too freaked out to stay the whole night and had made a run for it—that is, assuming the notes were accurate. He might have just decided to go home and faked the scares to keep the legend of Joe alive. However, just to be sure, I thought I should listen to the ten minutes of activity again, to make sure I hadn’t misheard. This time, I pulled out a set of headphones, plugged them into the cassette player, and turned the volume up as high as it would go without hurting my ears.
Again, the same sounds. The rapid-fire, anxious breathing. The sound of a shifting body. The running footsteps. The swearing. The laughter. The shuffling walk away.
Hang on. Laughter? That hadn’t been there before. I rewound the tape again and listened.
At a lower volume, the sound easily could’ve been mistaken for background noise. But through headphones cranked up that high, it was indubitable. While the orderly swore into his mic, I thought I could hear, in the gaps between his epithets, the sound of a low, rumbling chuckle in the background, as if it were being recorded from a great distance. But even from a distance, I could tell that the sound must have been far louder in person to have been picked up by the mic. If not for the poor quality of the recording, which made me doubt its accuracy, I’d probably have been freaked out enough to drop the case right there.
You see, that laugh did not sound like any sound a person should be able to produce. It was too hoarse, too low, and too guttural, almost as if someone had given the rhythm of a human laugh to the sound of a glacier collapsing. But then, it was far away, and the recording was very old, so for all I knew, it was just something innocuous in the background that had gotten warped over years of disuse. I ejected the tape, figuring there was nothing else I could learn from it, and settled down to have a look at the notes.
These I will not bother transcribing, and for this reason: If I’d thought before reading them that Joe was mistaken about being given the worst doctors in the hospital, I was convinced he was correct afterwards. These were some of the most disjointed, unhelpful, and frankly incoherent notes I’d read in my life. They jumped from diagnosis to diagnosis, and medication to medication, seemingly turning on a dime, until I began to wonder if Joe might have simply been slowly driven insane by the many different side effects. Some made reference to having him restrained, or even muzzled, including during talk therapy sessions, which seemed completely counterproductive to me. I mean, what’s the point of talk therapy if the patient can’t speak? Suffice it to say, by the end, I was all but certain that these people were just taking out their frustrations with their own medical ineptitude on a helpless patient, and I shuddered to think how many malpractice lawsuits could’ve been filed on the basis of what I’d read.
The only notes I could even begin to follow were the ones written by Dr. G——, and while they did show a highly competent physician at work, at the end of the day, they all but confirmed Joe’s hypothesis. Dr. G——’s notes were very dismissive at first, and I could practically hear the resentment in every sentence she wrote about him. It was obvious that she thought this patient was entirely beneath her and she wanted desperately to be reassigned. Yet as the notes went on, the resentment seemed to bleed out of her tone and give way to an extreme sense of triumph.
At the same time, they got shorter and shorter, as if she was becoming more and more certain that she wouldn’t need notes because the case was so close to being resolved. This is a good example:
Joe responding well to final treatment. Will check back in a week, if the process even takes that long to work.
Well, whatever “final treatment” she referred to definitely had borne some sort of results. You see, exactly a week later, that brief, almost flippant aside was followed by her final memo, which was so different it was almost whiplash-inducing. That memo I will transcribe here.
Effective tomorrow, I am resigning my post at CSA. I have failed my patients, failed my colleagues, and failed myself. Nothing can ever make up for it. Please do not bother sending my last paycheck, as I don’t deserve it and don’t expect to need it. Thank you for the opportunity to work with you, and I am sorry I let you down so thoroughly. I am sorry. So so sorry.
>
—Rose
Needless to say, this seemed suspicious. True, Dr. G—— could’ve merely picked a disastrously wrong final treatment, but in view of what I’d read and heard, it seemed far more likely that she’d intended only that it would be the final treatment she would provide for Joe because she planned to fake a suicide attempt. Otherwise, why would her notes be so short on details about her seemingly successful treatment?
This, from my perspective, was almost the final nail in the “mystery patient no one can cure” theory’s coffin. Though I still resolved to give Joe a month’s worth of observation, I was already beginning to wonder what it would take to prove to some higher authority in the world of medicine just how much abuse this one poor man had suffered at the hands of the unethical and callous Dr. G——. If I’d thought I might have overlooked something when I’d heard the phantom laughter on the tape earlier, I now wondered if the tape had somehow been altered, since Dr. G—— had been the one holding on to it. Either way, from where I sat, it was Joe who’d been living in a nightmare, not his orderlies, and not his doctors.
No wonder Dr. P—— had snarled at me when I suggested taking Joe on as a patient. In fact, small wonder that Dr. P—— still had a position as a doctor, let alone a supervisory one, at all. He hadn’t been put in charge of that ward to heal anyone; he’d been put there to act as a jailer for the hospital’s one reliable revenue stream. He demonstrated his lack of empathy every time he skipped a meeting or told me to “just medicate them ’til they are numb.” Of course it irritated him that someone like me had showed up on his ward looking to help people. That very impulse was a threat to the means by which he kept his job secure. Less well-qualified doctors who needed a job on his ward, rather than being there by choice, could be cowed by threats to their employment, but my pedigree put me out of reach, which must have galled that overgrown bully even more than the fact that someone with similar qualifications had leapfrogged over him in the race to be medical director. And to think he’d tried to pretend he was helping me by keeping me away from Joe. Bullshit. The old bastard had been trying to save himself.
The Patient Page 6