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.
“The answer was there all the time.” Dr. A—— stared at the tape player in a kind of disconsolate fascination. “I just hadn’t paid enough attention. Joe was telling us that he was being sexually abused. He described the sensation of being held down and raped by his father in the context of a monster that has all the same attributes of a grown man raping a small boy. He even gave us a clue that his father was a sadist by telling us that the monster ate bad thoughts, which would be what a sadist getting off on his own cruelty would seem to be doing to a young child. What’s more, Joe’s initial passiveness and subsequent extreme suggestibility when called nasty names are consistent with the behavior of an extremely abused child before and after a psychotic break.”
He sighed. At this point, he was talking as much to himself as to me. “Of course, that leaves us with the puzzle of why Joe would mimic his father’s own sadism when we brought him back in. Well, that brings us to the last part of the tape.”
A: I see. Well, in that case, I think I know how we can get rid of it.
J: Really?!
A: Yes. If it eats bad thoughts, then I want you to have nothing but good thoughts when it comes.
J: How’m I supposed to do that? It’s scary!
A: I think it wants you to think it’s scary, Joe. But you know what? It’s not. It’s just your imagination. Do you know what an imagination is?
J: Sorta.
A: Then you know it’s the part of you that comes up with ideas. Sometimes they’re good, and sometimes they’re scary. And ideas can seem dangerous. But Joe, even if your ideas seem scary, they’re still your ideas. And your imagination can’t scare you with them unless you let it.
J: So I can control it?
A: That’s right, Joe.
J: How do you know?
A: That’s my job, to know. My special power is to stop people being scared. Which is why people come here to not be scared anymore. And you know what, Joe? All of those people are only scared because of ideas. Because of parts of them that they can’t control.
J: Wow.
A: Yes. Now, I’ll bet you’re a big boy who doesn’t wet his bed anymore, aren’t you, Joe?
J: Gross! Duh!
A: Well, think of that big, scary monster like wetting the bed. It’s just a part of you that you allowed to get out of control.
J: That’s funny. The monster is my pee-pee.
A: Not exactly. But they’re both things you can control because they’re part of you, Joe. Now, does that monster seem so scary anymore?
J: No! It’s just me scaring myself. And I’m going to tell it that I know that the next time I see it!
Dr. A—— stopped the tape, and I could tell that those last moments had drained him.
“This is why I’ll never let his case go.” His voice was barely above a whisper. “Because I think, in my arrogance, I created the problems he has now. I think that between our first two sessions, because of what I told him, Joe went from believing he was the target of a monster that lives on people’s psychoses to believing he was the monster. Think what that would do to a child who was the victim of sexual abuse. They’re already at higher risk for dissociation. What I told Joe . . . it might have simply pushed him into full-blown dissociative identity disorder, because the thought that he was responsible for his own abuse would’ve been too much to bear. So he created a second ‘monster’ personality to blame it on that mimics the sadism he experienced from his father. And because we didn’t see it, now . . . now that ‘monster’ personality is so completely in control of his psyche that his mind and behavior have begun adapting to fulfill its imagined needs. Even just believing he was a monster this completely would be bad enough, as it would make him probably the purest sadistic psychopath in the history of psychiatry. But this is worse. This particular monster truly believes that he needs to be constantly exposed to bad thoughts in order to survive, the same way you or I need food. As a result, his sense of empathy has evolved to be able to figure out how to trigger psychosis within seconds of meeting someone.
“And not only that, but because of his residual suggestibility, he can trigger different forms of misery on command. His delusions are so strong, in other words, that they’ve tricked his mind into being able to do things no human mind should be able to do. Now, granted, it may be that all the people who say he triggered their bad memories and worst fears are just sharing the same delusion, or might have forgotten that they revealed key details in his hearing. But even if that were true, one thing is undeniable: he’s developed an ability to induce suicide in people as a defense mechanism, much the same way his original personality ‘died’ to make room for the monstrous one. And it’s worked perfectly. Until now.” He flipped the file shut and looked at me again, his eyes boring into mine. “That is why we need you. You aren’t dead and you experienced his tricks firsthand. You might be the only witness we have, aside from Rose, who treated him when he was far less advanced and did it so long ago that we can’t be sure her account is still accurate. You’re the only person who can provide us a fully accurate debriefing on how he went about manipulating you.”
With that, he put one thin, but surprisingly strong hand under my chin and held my face in place as he spoke his next words.
“So I’ll ask you one more time, Parker. Tell me, for Joe’s sake, if not for mine, what happened between him and you?”
At that point, I had no reason to withhold anything anymore. So I told them. I told them about Joe’s seeming sanity, his extremely tidy explanation of his own confinement, and his reappropriation of the Fiberwood Flower incident. I told them about his perfectly calculated story of feeling guilty for his mother’s injuries, just as I had once felt guilty for my own mother’s problems. I told them how deftly he exploited my grief over Nessie’s death. I even told them how Dr. P——, with his warnings not to bother trying to cure anyone and his ham-fisted attempts at intimidation, had made it so easy to believe Joe. They listened attentively to the whole story, and when I’d finished, Dr. A—— looked like he felt his age.
“So,” he said, “he didn’t rely on any details about your own life, then. He simply worked out that you were an empathetic person and played on that. It’s likely a coincidence that he selected something about his mother that mirrors your own feelings of responsibility for your mom. Most boys are sensitive about their mothers. What’s more, he blamed the mistreatment of his pet cat on his father, presumably because that’s the personality that was responsible. So he was finally able to open up about his anger at his own abuse, even if indirectly. You actually might have solved his case, after all, Parker. Thank you. Rose, I think we’ve solved this particular puzzle. We obviously can’t tell Joe’s parents what we know, so just inform them that we’ve concluded that his case really is incurable, and he’ll have to stay here indefinitely for his own good. As for Parker, take him off the case.”
“No!” Something felt desperately wrong about Dr. A——’s explanation. The older man turned to me with an incredulous look.
“No?” he asked. “Parker, the case is solved. You just confirmed our hypothesis, and even if you hadn’t, believe me, it would take a psychiatrist with far more experience than you to even begin to make that poor young man healthy. Even if I were still practicing—”
“But you’re not. You retired. And I don’t think you got it right. Something doesn’t fit.”
“How dare you?! You ju—”
“Relax, Thomas,” said Dr. G——. “If Parker has another idea, I want to hear it. It can’t hurt to get a second opinion.”
Dr. A—— grumbled but wa
ved his hand at me with evident irritation.
Starting to feel nervous again, I cleared my throat and began speaking before the tension could stop me.
“Before I try to advance my theory, I want to ask a few more questions just to make sure I’ve got some of the details right,” I said.
“Oh, for the love of—,” Dr. A—— began, but Dr. G—— put up her hand.
“Yes, Parker?”
“I want to start with the night terrors,” I said. “Did Joe ever mention them after he came back in?”
Dr. A—— looked as if he was about to give a curt reply, but then a thoughtful look flashed across his face.
“Now that you mention it, no,” he said. “Though by that point it might have been too late. Besides, he was sedated, and his father probably didn’t enjoy it without him experiencing the pain.”
“Maybe,” I said, turning to Dr. G——. “But I’m not sure that explanation of the origins of his ‘monster’ is right. Dr. G——, didn’t you say Joe was suffering from entomophobia?”
Dr. G—— nodded slowly. She seemed unsure where I was going with this. “Yes, it was something his parents mentioned when they first brought him in.”
“And was he afraid of bugs when you treated him?” I asked.
“Not particularly,” she said. “We tried some exposure therapy, but he didn’t react much like an entomophobe.”
“Obviously the entomophobia was just a proxy for what he thought he was experiencing,” said Dr. A——. “Rose, really—”
“Dr. A——,” I said, “would you please play that description of the monster in Joe’s wall again?”
Dr. A—— gave me a long, tired look, but he complied and started skipping through the tape until he hit the relevant passage.
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.
“That would upset an entomophobe more than anything, don’t you think?” I asked.
“Again, not surprising if the entomophobia was a result of what he thought was hurting him,” scoffed Dr. A——.
“True,” I said. “But there’s something else. Can you skip to the part where you tell him it’s his imagination?”
Sighing, Dr. A—— ran the tape forward.
A: Well, think of that big, scary monster like wetting the bed. It’s just a part of you that you allowed to get out of control.
J: That’s funny. The monster is my pee-pee.
A: Not exactly. But they’re both things you can control because they’re part of you, Joe. Now, does that monster seem so scary anymore?
J: No! And I’m going to tell it that it doesn’t scare me the next time I see it!
The tape stopped. Dr. A—— appeared increasingly annoyed, and Dr. G—— still looked puzzled.
“He doesn’t sound like a rape victim who’s just been told it’s his own fault, does he? He sounds relieved. He sounds happy. That’s not what you expect from someone going through a dissociative episode. And if he was as suggestible as you say, why didn’t he start acting like he was the monster right then? Why still retain his old self?”
“His mind probably hadn’t fully processed it yet,” Dr. A—— murmured, barely paying attention.
“Or,” I said, “there was no dissociative episode. In fact, what if there was no parental abuse, or even no night terrors? What if Joe really was being tortured by something that knew how to play to his entomophobia and knows how to play just as skillfully to everyone else’s fears? And what if, when he told it that it was part of him, it became the second personality that you think is the result of abuse? What if he brought the monster in here with him when he came back?”
“Oh yes, and I’m sure his head spins on its axis and he spits pea soup,” scoffed Dr. A——, starting to sound legitimately angry. “Stop talking like an overenthusiastic horror fan, son, and get ahold of yourself. You’re a scientist, for God’s sake.”
“Just hear me out,” I said. “I wouldn’t have believed it myself before tonight, but the thing is . . .”
I found myself breathing uneasily. “Look, I know you want to dismiss all that knowledge he has as some kind of fluke or think that people don’t remember what they’ve told him, but I know that’s not true in my case. When Hank was dragging me away from his room, he started laughing in exactly the same voice as something I still have nightmares about. And I guarantee you, after the warning Dr. G—— gave me, I never told him anything about my issues or what frightened me. So how did he know the exact right tone and timbre to use?”
“You heard what you wanted to hear,” Dr. A—— snapped. “You expected a monster’s voice. Your mind reacted by pretending it was hearing the right one.”
“But that’s just it—I didn’t. Remember, I thought he was a sane, mistreated patient when Hank grabbed me, yet I still heard that voice. Just when I would least expect something supernatural, it happened anyway. And what if the others, like Dr. G——, aren’t lying? What if they really did never tell him anything, and yet he still knew how to scare them?”
“He has a point, Thomas. I’ll grant you that I don’t have the notes to prove it, but I have no idea how Joe would’ve found out about people calling me ‘Nosey Rosie.’ I can’t remember the topic ever coming up anywhere that he possibly could’ve overheard it. I don’t think I even remembered that nickname until I found it scrawled on the wall of his room.”
“He might’ve heard your name from someone and guessed it by luck, Rose!” Dr. A—— exploded. “Not many derogatory words rhyme with your name. It’s not hard for a child to work out!”
“You should know better than to dismiss symptoms as coincidence in order to save your theory, Thomas,” Dr. G—— said softly.
Dr. A—— looked furious. “All right.” Venomous sarcasm poured through his voice. “Suppose you’re both right, even though it breaks our entire commitment to science into little pieces. What treatment can you suggest for treating a case of possession by the bogeyman, then? Do we pump his stomach? Drill a hole in his skull to let the demon out? Enlighten me.”
“You said you’d ruled out other possibilities,” I continued. “I don’t suppose you had someone perform an exorcism?”
“What sort of quack do you think I—”
“Oh, stop trying to pretend you’re the purest scientist in the room, Thomas,” Dr. G—— snapped. “Sure, you kept it off the books, but we both know you tried a couple of unconventional things with Joe.”
Dr. A—— didn’t answer her, but for the first time, he looked visibly uncomfortable.
“If you don’t tell him, Thomas, I will.”
“Oh, for heaven’s sake, Rose, we ruled that nonsense out, and you know it. Why encourage this overly imaginative, insubordinate pup you’ve hired with useless data?”
“So you did try an exorcism,” I said coolly. “What happened?”
“What happened was exactly what you’d expect from a troublemaker like Joe,” snarled Dr. A——. “The priest came in, started saying his rites, and it didn’t do a damn thing. All Joe did was fuck with him the entire time, saying he was an angel sent to earth from the right hand of Christ and that the priest was betraying his own God. Exactly the sort of thing anyone would say to discombobulate a religious person.”
“And I’ll bet it really discombobulated that particular priest, didn’t it?” I pressed. “I’ll bet he couldn’t even finish the ritual, could he?”
“He . . . he left early, yes,” said Dr. A——. “What’s your point?”
“And did you try and record the process?”
“Of course not!” Dr. A—— sputtered. “I don’t want anyone knowing I entertained that kind of crankery!”
“Pity,” I said. “Because I’ll bet you anything that if you had recorded it, you wouldn’t have picked him up saying anything. Because the patient you have in there—Joe himself—he’s not the one doing this. Whatever came with Joe is what’s doing this, and it�
�s using him as a scapegoat.”
“You seriously think some bogeyman is living rent-free in our hospital?” Dr. A—— asked, disdainful laughter twisting beneath the surface of his voice. “Rose, you might want to call Hank back with a straitjacket. I think our would-be savior here has gone insane himself.”
“There may be a way for me to see if I’m right,” I said, focusing on the more amenable Dr. G——. “I know it’s a strange hypothesis, but if you let me gather enough data to test it and it turns out wrong, you can take me off the case.”
Dr. G—— tapped the fingers of both hands together and considered me for a few seconds. She looked intrigued in spite of herself. Finally, she waved her hand. “Go on.”
I took a breath. “With your permission. I’d like to have tomorrow off so I can go talk to the only people who can confirm or deny both of these hypotheses, even indirectly. I’d like to visit Joe’s family and have a look at the room where this happened.”
“Oh yes, that will go wonderfully,” sneered Dr. A——. “What are you planning to say? ‘Excuse me, Mr. M——, but did you get off on molesting your child and hearing his screams? Did the property happen to come with a warning that it might have a giant bug infestation?’”
“We both know there are subtler ways than that to look for clues that people are sadistic,” I said, trying to avoid taking the bait. “And anyway, I’m only trying to see if my hypothesis has any sort of leg to stand on, and that won’t set off their alarm bells at all. They’ll feel completely comfortable, so if Joe’s parents are closet sadists, the clues should be fairly easy to spot. And if there’s any evidence that something supernatural lived in his walls, or that the house was haunted in any way, that should be easy to find, too.”
The Patient Page 10