K-PAX
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K-PAX
Gene Brewer
K-PAX is a novel about a psychiatric patient who claims to be from another planet (K-PAX), his relationship with his doctor (Gene Brewer), and with the other patients at the hospital, some of whom show remarkable improvement after speaking with "prot" (rhymes with "goat"). The novel was first published in March, 1995 by St. Martin's Press (New York), and subsequently in 20 countries around the world. K-PAX was nominated for the Arthur C. Clarke award in 1996. Reviews have been excellent (see Amazon.com). The paperback version appeared in March, 2001.
St. Martin's Paperbacks ISBN: 0312977026
When we successfully treat a patient ... we experience a burst of joy because we have helped a suffering person who is happy to have known us. But we also feel a secret joy, because we have come to know him, and in knowing him we know more of ourselves.
-SYLVANO ARIETI
Prologue
IN April, 1990, I received a call from Dr. William Siegel at the Long Island Psychiatric Hospital. Bill is an old friend of mine, and a distinguished colleague. On this particular occasion the call was a professional one.
Bill was treating a patient who had been at the hospital for several months. The patient, a white male in his early thirties, had been picked up by the New York City; police after being found bending over a mugging victim in the Port Authority Bus Terminal in midtown Manhattan. According to their report his answers to routine questions were "daffy" and, after they booked him, he was taken to Bellevue Hospital for evaluation.
Although he was somewhat emaciated, medical examination revealed no organic abnormality, nor was there evidence of formal thought disorder, aphasia, or auditory hallucination, and he presented a near-normal affect. However, he did harbor a rather bizarre delusion: He believed he came from another planet. After a few days' observation he was transferred to Long Island, where he remained for the next four months.
Bill was unable to do much for him. Although he remained alert and cooperative throughout the various courses of treatment, the patient was completely unresponsive to the most powerful antipsychotic drugs. At the end of it all he remained firmly convinced that he was a visitor from "K-PAX." What was worse, he was able to enlist many of his fellow patients to this fantasy. Even some of the staff were beginning to listen to him! Knowing that the phenomenology of delusion has long been an interest of mine, Bill asked me to take a crack at him.
It couldn't have come at a worse time. As acting director of the Manhattan Psychiatric Institute I was already swamped with more work than I could handle and, indeed, had been phasing out patient interaction since January of that year. However, the case sounded both interesting and unusual, and I owed Bill a couple of favors. I asked him to send me a copy of the man's file.
When it arrived I was still bogged down by administrative duties, and a few more days went by before I found it lying on my desk under a pile of personnel and budget folders. With renewed dismay over the prospect of another patient I quickly read through the chart. It summarized a puzzling history indeed. Although our "spaceman" was quite lucid and articulate, and demonstrated a strong awareness of time and place, he was unable to provide any reliable information as to his actual origin and background. In short, he was not only delusional, but a total amnesiac as well! I called Bill and asked him to make arrangements for the transfer of this nameless man, who called himself "prot" not capitalized-to my own institution.
He arrived the first week in May, and a preliminary session with him was scheduled for the ninth, a Wednesday, at the time I usually set aside to prepare for my regular "Principles of Psychiatry" lecture at Columbia University. We met at weekly intervals for several months thereafter. During that period I developed an extraordinary fondness and regard for this patient, as the following narrative, I trust, will show.
Although the results of these sessions have been reported in the scientific literature, I am writing this personal account not only because I think it might be of interest to the general public but also, to paraphrase Dr. Arieti, because of what he taught me about myself.
Session One
MY First impression, when he was brought into my examining room, was that he was an athlete-a football player or wrestler. He was a little below average in height, stocky, dark, perhaps even swarthy. His hair was thick and coal-black. He was wearing sky-blue corduroy pants, a denim shirt, and canvas shoes. I didn't see his eyes for the first few encounters; despite the relatively soft lighting, he always wore dark glasses.
I asked him to be seated. Without a word he proceeded to the black vinyl chair and plopped down. His demeanor was calm and his step agile and well coordinated. He seemed relaxed. I dismessed the orderlies.
I opened his folder and jotted the date on a clean yellow pad. He watched me quite intently, envincing a hint of a smile. I asked him whether he was comfortable or needed anything. To my surprise he requested an apple. His voice was soft but clear, with no detectable regionale or foreign accent. I buzzed our head nurse, Betty McAllister, and asked her to see if there were any available in the hospital kitchens.
While we waited I reviewed his medical record: Temperature, pulse, blood pressure, EKG, and blood values were all within the normal range, according to our chief clinic physician, Dr. Chakraborty. No dental problems. Neurological exam (muscle strength, coordination, reflexes, tone) normal. Left/right discrimination normal. No problem with visual acuity, hearing, sensing hot or cold or a light touch, handling platonic solids, describing pictures, copying figures. No difficulty in solving complex problems and puzzles. The patient was quick-witted, observant, and logical. Except for his peculiar delusion and total amnesia, he was as healthy as a horse.
Betty came in with two large apples. She glanced at me for approval and, when I nodded, offered them to the patient. He took them from the little tray. "Red Delicious!" he exclaimed. "My favorite!" After offering us a taste, which we declined, he took a large, noisy bite. I dismissed my assistant and watched as "prot" devoured the fruit. I had never seen anyone enjoy anything more. He ate every bit of both apples, including the seeds. When he had finished, he said, "Thanks and thanks," and waited for me to begin, his hands on his knees like a little boy's.
Although psychiatric interviews are not normally recorded, we do so routinely at MPI for research and teaching purposes. What follows is a transcript of that first session, interspersed with occasional observations on my part. As usual during initial interviews I planned simply to chat with the man, get to know him, gain his trust.
"Will you tell me your name, please?"
"Yes." Evidence for a sense of humor?
"What is your name?"
"My name is prot." He pronounced it to rhyme with "goat," not "hot."
"Is that your first name or your last?"
"That is all of my name. I am prot."
"Do you know where you are, Mr. prot?"
"Just prot. Yes, of course. I am in the manhattan psychiatric institute."
I discovered in due course that prot tended to capitalize the names of planets, stars, etc., but not those of persons, institutions, even countries. For the sake of consistency, and to better depict the character of my patient, I have adopted that convention throughout this report.
"Good. Do you know who I am?"
"You look like a psychiatrist."
"That's right. I'm Doctor Brewer. What day is it?"
"Ah. You're the acting director. Wednesday."
"Uh-huh. What year?"
"1990."
"How many fingers am I holding up?"
"Very good. Now, Mr.-excuse me-prot: Do you know why you are here?"
"Of course. You think I'm crazy."
"I prefer to use the term `ill.' Do you think you are ill?"
"A little homesick, perhaps."
"And where is `home'?"
"K-PAX. "
"Kaypacks?"
"Kay-hyphen-pee-ay-ex. K-PAX."
"With a capital kay?"
"It is all capitals."
"Oh. K-PAX. Is that an island?"
He smiled at this, apparently realizing I already knew he believed himself to be from another world. But he said, simply, "K-PAX is a PLANET." Then: "But don't worry I'm not going to leap out of your chest."
I smiled back. "I wasn't worried. Where is K-PAX?" He sighed, tolerantly it seemed, and shook his head.
"About seven thousand light-years from here. It's in what you would call the CONSTELLATION LYRA."
"How did you get to Earth?"
"That's somewhat difficult to explain...."
At this point I noted on my pad the surprising observation that, even though we had only been together a few minutes, and despite all my years of experience, I was becoming a little annoyed by the patient's obvious condescension. I said, "Try me."
"It's simply a matter of harnessing the energy of light. You may find this a little hard to believe, but it's done with mirrors."
I couldn't help feeling he was putting me on, but it was a good joke, and I suppressed a chuckle. "You travel at the speed of light?"
"Oh, no. We can travel many times that speed, various multiples of c. Otherwise, I'd have to be at least seven thousand years old, wouldn't I?"
I forced myself to return his smile. "That is very interesting," I said, "but according to Einstein nothing can travel faster than the speed of light, or one hundred eighty-six thousand miles per second, if I remember correctly."
"You misunderstand einstein. What he said was that nothing can accelerate to the speed of light because its mass would become infinite. Einstein said nothing about entities already traveling at the speed of light, or faster."
"But if your mass becomes infinite when you-"
His feet plopped onto my desk. "In the first place, dr. brewer-may I call you gene?-if that were true, then photons themselves would have infinite mass, wouldn't they? And beyond that, at tachyon speeds-"
"Tachyon?"
"Entities traveling faster than the speed of light are called tachyons. You can look it up."
"Thank you. I will." My reply sounds a bit peevish on rehearing the tape. "If I understand you correctly, then, you did not come to Earth in a spaceship. You sort of `hitched a ride' on a beam of light."
"You could call it that;"
"How long did it take you to get to Earth from your planet?"
"No time at all. Tachyons, you see, travel faster than light and, therefore, backward in time. Time passes for the traveler, of course, and he becomes older than he was when he left."
"And how long have you been here on Earth?"
"Four years and nine months. Your years, that is."
"And that makes you how old now? In Earth terms, of course."
"Three hundred and thirty-seven. "
"You are three hundred and thirty-seven years old?"
"Yes. "
"All right. Please tell me a little. more about yourself." Although I recognized the unreality of the man's story, it is standard psychiatric practice to draw out an amnesiacal patient in hopes of obtaining information about his true background.
"You mean before I came to EARTH? Or-"
"Let's start with this: How did you happen to be chosen to make the journey from your planet to ours?"
Now the patient was actually grinning at me. Though it seemed innocent enough, perhaps even ingenuous, I found myself poring through his file rather than gaze at his Cheshire-cat face in dark glasses. He said, "'Chosen.' That's a peculiarly human concept." I looked up to find him scratching his chin and searching the ceiling in an apparent attempt to locate the appropriate words to explain his lofty thoughts to someone as lowly as myself. What he . came up with was: "I wanted to come and I am here."
"Anyone who wants to come to Earth may do so?"
"Anyone on K-PAX. And a number of other PLANETS, of course."
"Did anyone come with you?"
"No."
"Why did you want to come to Earth?"
"Several reasons. For one, EARTH is a particularly lively place as seen and heard from space. And it is a Class III-B PLANET."
"Meaning ... ?"
"Meaning early stage of evolution, future uncertain."
"I see. And is this your first trip to our planet?"
"Oh, no. I've been here many times."
"When was the first time?"
"In 1963, your calendar."
"And has anyone else from K-PAX visited us?"
"No. I am the first."
"I'm relieved to hear that."
"Why?"
"Let's just say it would cause a lot of people a certain amount of consternation."
"Why?" .
"If you don't mind, I'd rather we talk about you today. Would that be all right?"
"If you wish."
"Good. Now-where else have you been? Around the universe, I mean."
"I have been to sixty-four PLANETS within our GALAXY."
"And on how many of those have you encountered life?"
"Why, on all of them. The ones that are barren don't interest me. Of course there are those who are fascinated by rocks and weather patterns and-"
"Sixty-four planets with intelligent life?"
"All life is intelligent."
"Well, how many have human beings such as ourselves?"
"EARTH is the only one with the species homo sapiens that I have visited so far. But we know there are a few others here and there."
"With intelligent life?"
"No, with human life. The PLANETS that support life number into the millions, possibly the billions. Of course we haven't visited them all. That is only a rough estimate."
"We' meaning inhabitants of K-PAX."
"K-PAXians, NOLLians, FLORians..."
"Those are other races on your home planet?"
"No. They are inhabitants of other worlds."
Most delusionals are confused to the point that they stutter or stumble considerably when trying to answer complex questions in a consistent manner. This patient was not only knowledgeable about a variety of arcane topics, but also confident enough of his knowledge to weave a cogent story. I scribbled on my pad the speculation that he might have been a scientist, perhaps a physicist or astronomer, and made a further note to determine how far his knowledge extended into those fields. For now, I wanted to learn something about his early life.
"Let's back up just a bit, if you don't mind. I'd like you to tell me something about K-PAX itself."
"Certainly. K-PAX is somewhat bigger than your PLANET, about the size of NEPTUNE. It is a beautiful world, as is EARTH, of course, with its color and variety. But K-PAX is also very lovely, especially when K-MON and K-RIL are in conjunction."
"What are K-MON and K-RIL.?"
"Those are our two SUNS. What you call AGAPE and SATORI. One is much larger than yours, the other smaller, but both are farther from our PLANET than your SUN is from yours. K-MON is red and K-RIL blue. But owing to our larger and more complex orbital pattern, we have much longer periods of light and darkness than you do, and not so much variation. That is, most of the time on K-PAX it's something like your twilight. One of the things a visitor to your WORLD first notices is how bright it is here."
"Is that why you are wearing dark glasses?"
"Naturally.
"I'd like to clarify something you said earlier."
"Certainly."
"I believe you stated that you have been on Earth for four years and-uh-some odd months."
"Nine."
"Yes, nine. What I'd like very much to know is: Where were you living for those four or five years?"
"Everywhere."
"Everywhere?"
"I have traveled all over your WORLD."
"I see. And where did you begin your travels?"
"In zaire "
"Why Zaire? That's in Africa, isn't it?"
"It happened to be pointing toward K-PAX at the time."
"Ah. And how long were you there?"
"A couple of your weeks altogether. Long enough to become familiar with the land. Meet the beings there. All beautiful, especially the birds."
"Mm. Uh-what languages do they speak in Zaire?"
"You mean the humans, I presume."
"Yes."
"Besides the four official languages and french, there are an amazing number of native dialects."
"Can you say something in Zairese? Any dialect will do."
"Certainly. Ma-ma kona rampoon."
"What does that mean?"
"It means: Your mother is a gorilla."
"Thank you."
"No problem."
"And then where did you go? After Zaire."
"All over africa. Then to europe, asia, australia, antarctica, and finally to the americas. "
"And how many countries have you visited?"
"All of them except eastern canada, greenland, and iceland. Those are my last stops."
"All-what-hundred of them?"
"More like two hundred at present, but it seems to change by the minute."
"And you speak all the languages."
"Only enough to get by."
"How did you travel? Weren't you stopped at various borders?"
"I told you: It's difficult to explain..."
"You mean you did it with mirrors."
"Exactly."
"How long does it take to go from country to country at the speed of light or whatever multiples of it you use?"
"No time at all."
"Does your father like to travel?" I detected a brief hesitation, but no strong reaction to the sudden mention of prot's father.
"I imagine. Most K-PAXians do."
"Well, does he travel? What kind of work does he do?"
"He does no work."
"What about your mother?"
"What about her?"
"Does she work?"
"Why should she?"
"They are both retired, then?"
"Retired from what?
"From whatever they did for a living. How old are they?"