by Gene Brewer
"I am happy you have said that. Perhaps we can learn from each other."
"If you are happy, I am happy too. Now, if you are ready, maybe you could tell me a little about your parents. For example, do you know who your mother and father are? Have you ever met them?"
"I have met my mother. I have not yet run across my father."
It's his father the patient hates!
"Run across?"
"K-PAX is a big place."
"But surely-"
"Or if I have met him, no one has pointed out our biological relationship."
"Are there many people on your planet who don't know who their fathers are?"
He grinned at this, quickly picking up on the double meaning.
"Most do not. It is not an important thing."
"But you know your mother."
"Purely a coincidence. A mutual acquaintance happened to mention our biological connection."
"That is difficult for an Earth person to understand. Perhaps you could explain why your 'biological connections' are not important to you."
"Why should they be?"
"Because-uh, for now, let me ask the questions, and you give the answers, all right?"
"Sometimes a question is the best answer."
"I suppose you don't know how many brothers and sisters you have."
"On K-PAX we are all siblings."
"I meant biological siblings."
"I would be surprised if there were any. Almost no one has more than one child, for reasons I have already explained."
"Isn't there peer pressure or government incentives to make sure your species doesn't die out?"
"There is no government on K-PAX."
"What do you mean-it's an anarchy?"
"That's as good a word as any."
"But who builds the roads? The hospitals? Who runs the schools?"
"Really, gene, it's not that difficult to understand. On K-PAX, one does what needs to be done."
"What if no one notices that something needs to be done? What if someone knows something needs to be done but refuses to do it? What if a person decides to do nothing?"
"That doesn't happen on K-PAX."
"Never?"
"What would be the point?"
"Well, to express dissatisfaction over the wages being paid, for one thing."
"We don't have 'wages' on K-PAX. Or money of any kind."
I jotted this down.
"No money? What do you barter with?"
"We don't 'barter.' You really should learn to listen to your patients, doctor. I told you before-if something needs to be done, you do it. If someone needs something you have, you give it to him. This avoids a multitude of problems and has worked pretty well on our PLANET for several billion years."
"All right. How big is your planet?"
"About the size of your NEPTUNE. You'll find this also on the transcript of last week's conversation."
"Thank you. And what is the population?"
"There are about fifteen million of my species, if that is what you mean. But there are many other beings besides ourselves."
"What kinds of beings?"
"A variety of creatures, some of whom resemble the animals of EARTH, some not."
"Are these wild or domesticated animals?"
"We don't 'domesticate' any of our beings."
"You don't raise any animals for food?"
"No one 'raises' another being for any purpose on K-PAX, and certainly not for food. We are not cannibals."
I detected a sudden and unexpected note of anger in this response-why?
"Let me just fill in one or two blanks in your childhood. As I understand it, you were brought up by a number of surrogate parents, is that right?"
"Not exactly."
"Well, who took care of you? Tucked you into bed at night?"
Utterly exasperated: "No one 'tucks you into bed' on KPAX. When you are sleepy, you sleep. When you are hungry, you eat."
"Who feeds you?"
"No one. Food is always around."
"At what age did you begin school?"
"There are no schools on K-PAX."
"I'm not surprised. But you are obviously an educated person."
"I am not a 'person.' I am a being. All K-PAXians are educated. But education does not come from schools. Education stems from the desire to learn. With that, you don't need schools. Without it, all the schools in the UNIVERSE are useless."
"But how did you learn? Are there teachers?"
"On K-PAX, everyone is a teacher. If you have a question, you just ask whoever is around. And of course there are the libraries."
"Libraries? Who runs the libraries?"
"Gene, gene, gene. No one does. Everyone does."
"Are these libraries structures we Earth people would recognize?"
"Probably. There are books there. But many other things as well. Things you would not recognize or understand."
"Where are these libraries? Does each city have one?"
"Yes, but our 'cities' are more like what you would call `villages.' We have no vast metropolises such as the one in which we are presently located."
"Does K-PAX have a capital?"
"No"
"How do you get from one village to another? Are there trains? Cars? Airplanes?"
A deep sigh was followed by some incoherent mumbling in a language I couldn't understand (later identified as "pax-o"). He made another entry in his notebook: "I've already explained this, gino. We get from place to place on the energy of light. Why do you find this concept so hard to understand? Is it too simple for you?"
We had been over this before and, with time running out, I did not intend to be sidetracked again. "One final question. You have said that your childhood was a happy one. Did you have other children to play with?"
"Hardly any. There are very few children anywhere on K-PAX, as I have indicated. Besides that, there is no distinction between 'work' and 'play' on our PLANET. On EARTH, children are encouraged to play all the time. This is because you believe they should remain innocent of their approaching adulthood, for as long as possible, apparently because the latter is so distasteful. On K-PAX, children and adults are all part of the same thing. On our PLANET life is fun, and interesting. There is no need for mindless games, either for children or adults. No need for escape into soap operas, football, alcohol, or other drugs. Did I have a happy childhood on K-PAX? Of course. And a happy adulthood as well."
I didn't know whether to feel gladdened or saddened by this cheerful answer. On the one hand, the man seemed genuinely content with his imaginary lot. On the other, it was obvious he was denying not only his family, but his school experiences, his childhood itself. Even his country. Everything. Every aspect of his entire life, which must have been quite abominable, indeed. I felt a great deal of pity for this young man.I ended the interview with a question about his "home town," but this also led nowhere. K-PAXians seemed to drift from place to place like nomads.
I dismissed the patient and he returned to his ward. I had been so astonished by his utter denial of everything human that I forgot to call the orderlies to go with him.
After he had gone I returned to my adjacent office and went through his entire file again. I had never experienced a case like this, one for which I couldn't seem to find any kind of handle. Only one other in thirty years was even close, and it also involved an amnesiac. A student of mine was eventually able to trace the man's roots through an analysis of his reawakened interest in sports-but it took a couple of years.
I jotted down what I had on prot so far:
1. P hates his parents-had he been abused?
2. P hates his job, the government, perhaps society as a whole-had there been a legal problem resulting in a perceived injustice?
3. Did something happen 4-5 yrs ago that underlay all these apparent hatreds?
4. On top of everything else, the patient has a severe sex hangup.
As I looked over these notes I remembered somet
hing that my colleague Klaus Villers has professed on more than one occasion: Extraordinary cases require extraordinary measures. I was thinking of the rare instances in which a delusional of exceptional intelligence has been convinced that his identity was false. The most famous example of this treatment is the one in which a well-known comedian graciously consented to confront a delusional look-alike, and a miraculous cure was quickly effected (but not before they both put on quite a show, evidently). If I could prove to prot that he was, in fact, an ordinary human being and not some alien from another planet ...
I decided to do a more thorough physical and mental workup on him. I was particularly interested in learning whether he was, in fact, abnormally sensitive to light, as he claimed to be. I also wanted to have the results of an aptitude test and to determine the extent of his general knowledge, particularly in the areas of physics and astronomy. The more we knew about his background, the easier it would be to find out who he really was.
WHEN I was a senior in high school our career counselor advised me to take the one course in physics our school offered. I quickly' learned that I had no aptitude for the subject, though the experience did serve to increase my respect for anyone who could master that esoteric material, among them my wife-to-be.
We were next-door neighbors from the day she was born, Karen and I, and we played together all the time. Every morning I would go outside and find her in the yard, smiling and ready for anything. One of the fondest memories I have is of our first day in school, of sitting behind her where I could smell her hair, of walking home with her and leaves burning. Of course we weren't really sweethearts at that age-not until we were twelve, the year my father died.
It happened in the middle of the night. My mother came and got me up because she hoped, vainly as it turned out, that I might be able to do something. When I ran into their bedroom I found him lying on his back, naked, sweating, his pajamas on the floor beside the bed. He was still breathing, but his face was ashen. I had spent enough time in his office and on hospital rounds to suspect what had happened and to recognize the seriousness of the situation. If he had taught me something about closed-chest massage I might have been able to help him, but this was before CPR was generally known and there was nothing I could do except watch him gasp his last breath and expire. Of course I yelled at my mother to call an ambulance, but it was far too late by the time it got there. In the meantime I studied his body with horrible fascination, his graying hands and feet, his knobby knees, his large, dark genitalia. Mother came running back just as I was covering him with the sheet. There was no need to tell her. She knew. Oh, she knew.
Afterwards, I found myself in a state of profound shock and confusion. Not because I loved him, but because I didn't-had almost wished him dead, in fact, so I wouldn't have to become a doctor like him. Ironically, because of the tremendous sense of guilt I felt, I vowed to go into medicine anyway.
At the funeral, Karen, without anyone saying anything, sat beside me and held my hand. It was as though she understood perfectly what I was going through. I squeezed hers too, hard. It was unbelievably soft and warm. I didn't feel any less guilty, but with her hand in mine it seemed as though I might be able to get through life somehow. And I've been holding it ever since.
ON Friday of that week we received a visitor from the State Board of Health. His job is to check our facilities periodically, see that the patients are clean and properly fed, that the plumbing works, etc. Although he had been here many times before, we gave him the usual grand tour: the kitchen, the dining and laundry and furnace rooms, the shop, the grounds, the recreation/exercise room, the quiet room, the medical facilities and, finally, the wards.
It was in the rec room that we found prot sitting at a card table with two of my other patients. I thought that a bit odd inasmuch as one of them, whom I shall call Ernie, almost always keeps to himself, or talks quietly with Russell, our unofficial chaplain. The other, Howie, is usually too busy to talk to anyone (the white rabbit syndrome). Both Ernie and Howie have been here for years, sharing the same room, and both are very difficult cases.
Ernie, like, most people, is afraid of death. Unlike most of us, however, he is unable to think about anything else. He checks his pulse and temperature regularly. He insists on wearing a surgical mask and rubber gloves at all times. He is never without his stethoscope and thermometer and he showers several times a day, demanding fresh clothing after each one, rejecting anything that shows the slightest spot or stain. We humor him in this because otherwise he would wear nothing.
Eating is a serious problem for Ernie, for several . reasons. First, because of his fear of food poisoning he will not consume anything that isn't thoroughly cooked and comes to him piping hot. Second, he will only eat food that is broken or cut into tiny pieces so he won't choke to death on something too large to swallow. Finally, there is the problem of preservatives and additives. He will not eat meat or poultry, and is suspicious even of fresh fruits and vegetables.
None of this is unusual, of course, and every psychiatric hospital has an Ernie or two. What makes our Ernie different is that he raises his defenses a notch or two higher than most necrophobes. He cannot be induced to venture outside the building, for example, fearing bombardment by meteorites, cosmic rays and the like, poisoning by chemicals in the air, attack by insects and birds, infection by dustborne organisms, and so on.
But that's not all. Afraid he will unconsciously strangle himself at night he sleeps with his hands tied to his feet, and bites down on a wooden dowel so he won't swallow his tongue. For similar reasons he will not lie under sheets or blankets-he fears they might wrap themselves around his throat-and he sleeps on the floor so as not to fall out of bed and break his neck. As a sort of compensation, perhaps, he sleeps quite soundly once his ritual is complete, though he awakens early to fitfully- check his parameters and accouterments, and by the time he has breakfast is his usual nervous wreck.
How could a person get so screwed up? When Ernie was a boy of nine he watched his mother choke to death on a piece of meat. Unable to help, he was condemned to witness her last agonizing moments while his older sister ran around the kitchen, screaming. Before he could get over that horrible experience, his father dug a bomb shelter in the back yard and practiced using it. Here's how it worked: At any moment of the day or night Ernie's father would suddenly leap at him or emit a blood-curdling screech or douse him with something. That would be the signal to run for the bomb shelter. By the time he was eleven Ernie was unable to speak or to stop shaking. When he was brought to MPI it took months just to get him not to jump and run whenever a door opened or someone sneezed. That was nearly twenty years ago, and he has been here ever since. His father, incidentally, is a patient at another institution; his sister committed suicide in 1980.
Fortunately, debilitating phobias like Ernie's are rare. Those who are afraid of snakes, for example, need only stay away from forest and field. Agoraphobics and claustrophobics can usually avoid crowds and elevators and, in any case, are treatable with drugs or by slow acclimation to the offending situation. But how does one acclimate the necrophobic? How to avoid the Grim Reaper?
Howie is forty-three, though he looks to be sixty. Born into a poor Brooklyn family, his musical abilities became evident early on. His father gave him his unused violin when he was four years old and, in his early teens, he played that instrument with a number of well-respected regional orchestras. As time went on, however, he performed less and less frequently, preferring instead to study scores, other instruments, the history of music. His father, a bookseller, was not particularly concerned with this turn of events and went about his tiny shop bragging that Howie was going to become a famous conductor, another Stokowski. But by the time Howie got to college his interests seemed to cover the entire spectrum of human endeavor. He tried to master everything from algebra to Zen. He studied night and day until he finally broke down and ended up with us.
As soon as his physical health was restored,
however, he was off and running again, and no tranquilizing drug has proven powerful enough to slow down his endless quest for perfection.The strain on Howie is terrible. The circles and bags under his eyes attest to his chronic battle with fatigue, and he suffers constantly from colds and other minor afflictions.
What happened to him? Why does one artist end up at Carnegie Hall and another in a mental hospital? Howie's father was a very demanding man, intolerant of mistakes. When little Howie stood up to play the violin he was terrified of making the slightest false note and offending his father, whom he loved deeply. But the better he became the more he realized how much he did not know, and how much more room for error there was than he had imagined. In order to be certain of playing his instrument perfectly he threw himself into music in all its aspects, trying to learn everything about the subject. When he realized that even this would not be sufficient, he took up other fields of study with the impossible goal of learning everything there was to know about everything.
But even that isn't enough for Howie, who spends each summer cataloging the birds and insects and counting the blades of grass on the lawn outside. In the winter he catches snowflakes, systematically recording and comparing their structures. On clear nights he scans the skies looking for anomalies, something that wasn't there before. Yet these are mere avocations for Howie. Most of the time he reads dictionaries and encyclopedias while listening to music or language tapes. Afraid he will forget something important he is constantly taking notes and making lists, then organizing and reorganizing them. Until that day in the recreation room I had never seen him when he was not frantically counting, recording, or studying. It was a struggle to get him to take time to eat.
I edged up to the table with my guest, trying to catch a bit of the conversation without scaring anyone off. From what I could gather, they were querying prot about life on K-PAX. They clammed up when they finally noticed us, however, and both Ernie and Howie scuttled away.
I introduced prot to our visitor, and took the opportunity to ask him whether he would mind submitting to a few additional tests on Wednesday, our regular meeting day. He not only didn't mind, he said, but he looked forward to it. We left him smiling broadly, apparently in eager anticipation.