“You look like you need it. Doctor’s orders.”
Despite the roiling in my stomach, I did as she directed. At first, it made me feel sicker, but then a numbing warmth spread over my brain and I felt my muscles relax ever so slightly. It was a welcome relief after what I’d just heard. Dr. G—— gave me a sympathetic look. Dr. A——, however, only looked grim.
“Rose, this miscreant doesn’t need to be comforted. He needs to be debriefed. He might have spent more time actually talking to Joe than most of the others. He needs to tell us what happened with Joe during their sessions.”
Maybe it was the shock of what I’d just heard, maybe it was all my anger looking for a new outlet after everything that had motivated it had been stripped away, or maybe it was the Scotch, but something snapped in me. I was sick of being talked about so dismissively, a naughty child who wasn’t even in the room. I was sick of these revelations being dumped on me without getting a chance to process them. But some things had clicked into place, and more than anything else, I was sick to my stomach at the thought that I might have been set up to fail.
I glared at Dr. A——, filling my gaze with enough contempt to match his cool, disdainful look a hundred times over. “Not a chance, old man. From what I’ve gathered, you and your ‘student’ here put me on a collision course with someone you fully expected to hurt me and didn’t tell me everything you knew before I went in. I wasn’t supposed to cure him, was I? I was just a lab rat for you and her, because you wanted to see what he did to me. Well, I’m done with it. If you want to know what I found out from talking to him, then you have to let me in on what you know. All of it. Like why she tried to commit suicide, or why you gave up on treating him in the first fucking place, or why you kept putting vulnerable patients in harm’s way long after you knew what he was capable of.”
Dr. A—— appeared unruffled, though I could tell that whatever air of geniality he’d tried to assume had dropped as soon as I’d finished speaking. The effect would’ve cowed me if I hadn’t been so full of my own righteous anger. I’d felt like a small animal staring down a predator when facing Dr. G——, but meeting the bloodless, icy gaze of that hunched old man, I barely felt acknowledged as a living being. More like a statistic that had the effrontery to talk back. But I didn’t back down. I met his eyes for a long, terrible moment before he finally settled back in his chair and expelled an irritated snort.
“Well, there’s probably no harm in giving you a bit more information,” he said. “Lord knows I have little enough to do tonight. But understand this, Parker. If you want to hear all the details, then you’ll start by accepting this: There is no curing that horror downstairs. There is only containing him.”
“I’m his doctor,” I said. “I’ll be the judge of that.”
“Yes, I suppose you will,” he said softly. “But just as you were earlier this evening, you are wrong on a very important point: You are not his doctor. You are, and have only ever been, just a tool to get data on him. I am his doctor, and I have borne that cross since he first entered this hospital. It took away my career, and it’s going to take away my retirement. It is my life’s work. It would have been Rose’s when I’m gone, but I don’t intend to leave it unsolved that long. You do not and will never understand what it is to be the last person standing between Joe and a world that cannot understand or resist him. So keep a civil tongue in your head from now on or you’ll find yourself on the curb.”
Anger tempted me to reply, but some part of me knew it would be a terrible idea. This was all the concession I was going to get out of this bitter, proud man, and it was more than I had any right to expect. So, forcing my frustration down to a simmer, I gave him the most deferential nod I could manage. It seemed to appease him.
“Well, then,” he said. “Rose, why don’t you tell him about the last smart, headstrong young doctor to try and treat our pet monster?”
I looked up at Dr. G——, and to my surprise, she wasn’t looking at me with the aloof air she’d worn before. Instead, her eyes were filled with sadness and pity.
“I’m so sorry,” she mouthed, so that only I could see. Then she began speaking in the crisp voice of a scientist presenting her findings.
“When I began to treat Joe, he was only six years old and had been admitted to the hospital barely a month before he was assigned to me. At the time, as you know from reading my notes, my theory was simple: that he was showing the signs of sadistic personality disorder and sociopathy as a result of posttraumatic stress disorder brought on by his years of untreated night terrors, which were so successful at disturbing him because of his apparently comorbid sleep paralysis and acute entomophobia. His evident psychological progeria was simply a defense mechanism designed to make him seem as if he had more control over the situation than he did, and his monstrous behavior was an act designed to make him feel more confident in facing the monster he imagined. Frankly, I thought the whole thing was embarrassingly easy and a waste of my time, as you probably guessed from my notes.”
She paused to collect her thoughts, then continued speaking. “My proposed course of treatment was to get him to face the trauma of his night terrors through a combination of hypnosis therapy, talk therapy, and the use of sedatives when he slept in order to prevent the nightmares from manifesting. This much you also know from the notes. However, what you may not know is that my treatment worked. Spectacularly. Joe barely showed any signs of the disorders I’d heard reported in Dr. A——’s initial diagnosis after the first couple of days. Rather, something else manifested. He became very . . . attached to me.” She swallowed, and I could tell the memories were still painful. “It’s not an exaggeration to say that Joe began relating to me as if I were a surrogate mother. I’d already guessed that his parents were distant, given their conspicuous absence from the hospital, so this was not much of a surprise. Still, the more attached he got, the more he seemed to heal, and the more and more devoted he became. He seemed less and less like a proto-sociopath and more and more like a frightened young child.”
Her voice faltered. “You have to understand something before I go any further. I’d also had a very chilly relationship with my parents from early on and had almost no friends even through my medical school days. I rarely dated, and I’ve never married or had children because I simply don’t let people get close to me if I can help it. However . . . something in the way Joe related to me brought out all my mothering instincts. For the first time in my life, I felt needed and loved unconditionally, and while I tried to keep my professional distance, there was just something about him that made my defenses against affection melt. And the more nurturing I became, the more his condition seemed to improve.”
The tears in her eyes were obvious now, and she blinked them back hastily, even as her voice became brittle with the strain. “I was sure I’d be able to get him discharged around my fourth month, and so, as a final experiment to test his ability to empathize, I let him have a pet. A little cat, because I’d grown up with cats, and I thought he might relate to them the same way I had, being someone who had trouble around other people. I don’t recall what he called her. Something about a flower, I think.”
“Fiberwood Flower,” I said softly.
She looked at me, wide-eyed. “Yes. Yes, exactly. How did you—”
“Just finish the story, Rose,” said Dr. A——. “We’ll be able to find out what he knows much quicker once you’ve finished.”
Dr. G—— sucked in her breath and nodded, her sharp veneer covering her previous vulnerability like a well-worn mask. “Anyway. I gave him Fiberwood Flower and made Dr. A—— agree that if he took care of her properly for a week, that would prove he’d been cured of his antisocial tendencies.”
Her face clouded, but not with sadness this time. With anger. “He treated that poor cat like an angel for six days, and then on the last day, when I walked into his room, I found her corpse lying on the ground with her head ripped off. And just above her corpse, he’d scrawl
ed an arrow pointing down in her blood, with the inscription ‘for Nosey Rosie.’”
Her voice had become as hard as diamonds. “Now, no one’s called me ‘Nosey Rosie’ since I got teased on the playground at his age, and I don’t think he ever heard anyone call me by my first name. He shouldn’t have even begun to be able to guess at that name. But he had. And as soon as I walked in, he started laughing. And—and I’d still swear to this years after it happened—it sounded exactly like the laughter of this one child in particular who used to bully me when I was his age. Between that voice and the bloody mess that had been an adorable cat that this child had mutilated . . . I snapped. I ran out of that room, submitted my resignation, and . . . well, you know the rest.”
Her expression seethed with fury and hurt. I reached an arm up to her out of reflexive empathy, but she swatted it away before I could get very far, with an expression that said no matter how much it hurt to remember this, she still had her pride and wasn’t going to suffer the pity of a subordinate. I settled for trying to give her a look that was both sympathetic and respectful.
Then I heard Dr. A——’s voice from behind her. “So, Parker, you still think you can cure the little bastard? Care to suggest a diagnosis for someone who was able to just instantly pull an old schoolyard taunt out of thin air to mock a woman whose vulnerable spots he’d been able to reach as if by magic? Well?”
Hating myself for it, I shook my head helplessly. “I didn’t know. I didn’t . . . I . . . I don’t know.”
“Of course you don’t.” There was a note of satisfaction in the old man’s voice. “You have no idea what’s wrong with him. What’s more, you’ve bought into all the mythology surrounding him because you’re young, you’re impressionable, and you don’t know any better. That’s why you’re not his doctor. I am his doctor. And I do know better.”
April 20, 2008
Hey, guys, sorry to have taken a little longer to update, but I really did have to make sure I got my memory of this particular series of events as exact as possible, because otherwise my actions from this point onward wouldn’t make any sense. I hope I succeeded.
As he finished his last words, Dr. A—— gripped the legs of his chair and stood up slowly and gingerly, as if every bone in his body might snap if he moved too fast. Despite his age, I could tell that he’d once cut an imposing figure. Even with his slight stoop, he looked to be at least six feet two, and he probably would’ve been at least an inch taller if he’d stood up straight. He grabbed one edge of the desk to steady himself and held out the other hand to Dr. G——, who reached down and picked up an ornate cane made of dark wood with a bronze head in the shape of a falcon. He took it from her and slowly made his way around the desk to me. As he did so, I saw that he was clutching a thick, dusty file, which surely must have been copied from the very documents I’d seen.
He sat down on the desk and gave me another flinty look.
“Before I go on, you have to understand something,” he began. “If I am right about what is wrong with Joe, then we really are doing a service by keeping him here, not just to the outside world, but to Joe himself. If his parents were less endowed with financial and legal power, we would have done a lot more by now. However, we cannot afford the kind of legal battle that my suspicions would bring, if reported. So we are doing the only thing we can do and keeping him here. Got it?”
I nodded, this time with sincere deference. He smiled gruffly in acknowledgment. Then, with a grim flourish, he opened Joe’s file to the first page.
“When I first met Joe”—he rapped the black-and-white photo of a wolfish child—“he seemed like a normal boy with a case of night terrors. But, of course, I got him wrong. Disastrously wrong. When he came back, he was violent and incapable of speech. I was flummoxed. I had no idea what I’d done wrong. What was more, I had no idea why his tactics kept changing. You must’ve noticed. He went from making people feel like dirt to making them too scared to stay in the same room. Well, when I resigned as medical director, I was still no closer to constructing an explanation than I was at the beginning. But retirement’s given me nothing but time to check his old case notes, and the more I looked, the more it slowly started to make sense.” He turned a few pages and poked the file with his finger. “The first brainwave came when I worked out why his delusions kept changing. They shift every time someone calls him a new nasty name. Take when we brought him in. He wouldn’t even speak. But then a nurse called him a ‘bad boy,’ and he suddenly started taunting people. You might not think that means all that much, but I’ve been to see the therapists who treated everyone who survived him during those first few years, and you know what they all told me? All of them, Rose included, said the same thing: he called them names that were directed at them when they were growing up, mostly by bullies or nasty other kids. None of it was too specific, but he seemed to know which playground taunts would work best for every single one of them. You see it now? Someone calls him a ‘bad boy,’ well, he throws taunts until he works out what the worst boy on earth would be for each of them and then acts like that.”
More pages were turned. “Now look at this. After years berating people this way, he finally meets a violent patient who won’t take his crap. But what does that patient do? He beats him half to death and calls him a ‘fucking monster.’ Next thing you know, he’s acting like the monster that used to chase one of our orderlies in his dreams, and probably like the monsters that used to scare the crap out of his other roommates. That’s why the first kid’s heart stopped, why he started trying to rape a sexual assault victim, and why he could scare someone enough to get him to break the iron bars off his window. Because if he’s going to be a monster, he’s going to be the worst monster that each of his victims can imagine. Instead of making them feel as terrible as they felt at their worst moments of feeling like shit, now he’s going to scare them as much as they’ve ever been scared in their lives.”
He lowered his spectacles and regarded me for a moment before continuing. “Now, surely a bright resident like you will have realized that this kind of behavior tells us that whatever else might be wrong with him, we can conclude that Joe is extremely suggestible. At bare minimum, this implies something very unpleasant about his upbringing, because children his age aren’t usually this willing to internalize negative feedback unless they’ve been conditioned by their parents. And we have strong evidence from my first session with him supporting the idea that Joe was horribly abused. Rose, if you would?”
Dr. G—— pulled open another drawer and took out a cassette tape player and two tapes. I recognized them as copies of the ones I had. She inserted one in her desktop deck and hit Play. Dr. A——’s voice flowed out. I’d listened to the session before, but in the context of what I’d just heard, the words took on a grim significance.
Dr. A——: Hello, Joe, my name is Dr. A——. Your parents tell me you have trouble sleeping. Could you tell me why that is?
Joe: 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: It’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 really long fingers. Its body is a worm.
Dr. A—— paused the tape. “Now, flies’ eyes, along with being naturally alien-looking, don’t blink. And the main characteristics he attributes to the creatures’ arms are that they are big and strong, and presumably hairy, hence the reference to spiders. And its body is a worm. In other words, a phallus. So we have something phallic with big, strong, hairy arms and unblinking eyes. What could that be?”
He pushed play again. The voices restarted.
A: That does sound scary. And how big is it?
J: Big! Bigger than daddy’s car!
The Pause button clicked again. “Now, why only call it
‘daddy’s car’?”
“I mean, his parents were rich enough to keep him here since the ’70s,” I said without thinking. “It’s possible both parents had their own cars.”
“Wrong,” snapped Dr. A——. “I asked, and they had only one car, and they both used it. So why use that particular reference point for this monster’s size? That’s quite a specific free association, I’d say. Now, why would Joe free-associate his father after talking about something phallic with hairy arms that held him down and stared at him? Curiouser and curiouser. But let’s not get ahead of ourselves. First, let’s see how his parents react to this alleged intruder.”
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.
“So his parents don’t acknowledge this thing’s existence,” said Dr. A——. “Now, why might that be? If you are following my train of thought, I would think the father’s reason for not seeing a monster would be obvious. But the mother? Perhaps she simply refused to acknowledge what Joe’s father was doing, even with him standing right there by the bed. Joe couldn’t have processed that his mother was in denial, so the only logical conclusion would be that his father must’ve tricked his mother into thinking that he, the father, was part of the wall. It would fit. Now let’s get to the real meat.”
The Patient Page 9