by Dr Harper
“Alex, I need you to tell me everything you can about this kid,” I said. “Who is he? What’s his name? How did you meet him?”
“Uh– His name is Ian. I met him on a forum a month ago.”
“You were there to talk about Emma?”
“Yeah.” He was already out of breath. “And Ian understood me. He went through the same thing.”
“Does he go to this school?”
“No,” he said. “He’s older. 24 I think.”
“And he wanted to help you plan this?”
“It was his idea,” said Alex. “He said it would make everything right.”
It explained so much… Alex’s rapid descent into darkness last month. The sudden calm. And the ancient graphing calculator, which students never used anymore. I had to admit, it was a clever way to communicate without leaving a technical trace.
“Alex, I need you to tell me the truth.” I tried to catch my breath. “Do you really want to help stop this, or are you still messing with me?”
He didn’t answer immediately. “I guess I want to help.”
That wasn’t convincing.
I got the sense that Alex didn’t even know what he wanted to do yet. And that scared the hell out of me.
“Because all the stuff I said in my office, it’s true. You can feel better. I promise.” Then I added, “You know Ian’s exploiting you, right? He’s just using you to play out his own fantasies.”
I felt like a lawyer, trying to make my case, to convince the jury to take my side.
Alex nodded, and that was it. Our sixty seconds were up.
We turned the corner and slowed down in front of the library doors. I peered through the glass and saw a group of students huddled by the reference desk. Ian towered over them, pointing his gun.
“Walk me in there, and keep the gun at my head,” I whispered. “Tell him you want me to watch them die, so I can see what a failure I am.”
“What the fuck is wrong with you?” Alex whispered back.
“Just do it,” I hissed. Then I pushed open the doors and we walked inside.
Ian quickly turned his gun to us.
“Why’s the shrink here?”
“To fuck with our heads,” said Alex, lowering his gun. “Like I said on the phone, don’t listen to a goddamn word the snake says. Now give me something loaded.”
What the hell, Alex?
Alex and Ian gave each other big smiles, then walked toward one another and embraced.
“The Glock 19, right?”
“Yeah.”
Ian handed Alex the gun and turned his attention back to the group of students. I quickly scanned the group, and that’s when I saw Emma.
My heart sank. Why was she here? I called her father last night to warn him. Who would send their kid to school after that? He, of all people, should have known better.
It was easy to see why Alex fell for Emma. She was beautiful, but in more of an innocent, unassuming kind of way. She cowered with the other students, tears streaming down her cheeks.
“The cops are going to be here any minute,” said Alex. “Let’s do this.”
The students whimpered. Emma let out a loud sob.
“Shut up, bitch!” Ian shouted.
She cried again and buried her face in her hands.
For just a second, Alex actually looked upset.
And that’s when I realized that Emma being here was actually a good thing. I wasn’t the one who needed to manipulate anyone.
“Alex, she needs you,” I said gently.
He spun around and pointed the gun at me. “Enough out of you. You’re going to watch us kill every single one of them. Maybe that’ll finally shut that fucking mouth up.”
“Look at her,” I continued. “She’s in distress, and you’re the only one who can save her.”
He lunged forward and hit me in the face with his gun.
“Shut. The. Fuck. Up.”
But even from the ground, I persisted. “You can save her, Alex. You can be her hero.”
I looked at Emma and raised my eyebrows, trying to imply that she should play along with me.
She gave me a pained look and closed her eyes.
“Please save me, Alex.”
Yes.
Finally, I saw it. The softening of Alex’s face. Just like in my office before.
“Dude, just kill the whore,” said Ian. “Don’t you remember what she did to you?”
“Please save me, Alex,” repeated Emma through tears. “I need you.”
“Are you fucking kidding me with this shit?” Ian laughed and pointed his gun at Emma. “Here, I’ll get us started.”
Emma screamed.
Then there was a gunshot.
And before I could piece together what happened, Ian was laying on the ground next to me, a pool of blood forming around his head.
I looked up and saw Alex standing over us, white as a sheet.
“You did it,” I whispered. “You did it, Alex. You saved her.”
His eyes brimmed with tears, but I knew he wouldn’t cry.
“Alex, you’re her hero. You rescued Emma.”
His face stayed soft, exactly the state we needed to keep him in until the police got here.
I knew I’d be in huge trouble, but in my book, one dead murderer was better than twelve innocent students.
Call it reckless if you want, but as the sirens closed in around us, I knew I’d sleep soundly tonight.
If it wasn’t for that next fucking gunshot.
Before I knew it, Alex had fallen on top of me, and I felt something warm spilling all over my chest.
“What the–”
I looked up and saw Emma standing above us.
“He’s not my fucking savior!” she screamed.
“Emma, I need you to calm–”
“He’s a stalker and a psycho!” she sobbed. “He made me afraid to come to school.”
“I understand,” I said, still on the ground with Alex bleeding out on top of me. “Can you drop the gun, so we can make sure no one else gets hurt?”
“I’m not dropping it.” She shook her head. “When you called last night, my dad gave me his gun and told me to use it if anything happened. You should have stopped this. You shouldn’t have used me like a pawn. I don’t trust you. I don’t trust anyone.”
Her dad was in the military. He must have taken the threat seriously after all.
“You’re safe now, Emma,” I said calmly. “I promise.”
She wiped her eyes. “I don’t even know what ‘safe’ feels like anymore.”
“I just want to make sure the police don’t hurt you when they see a gun in your hands,” I said. “Can you slide it over to the other side of the library?”
She sniffled and considered it for a few seconds. She finally nodded and pushed the gun away.
I let out a deep breath as the police burst through the doors.
There was shouting and crying, but I didn’t pay much attention.
Instead, I looked into Alex’s eyes, which were mere inches from my face. I saw sadness, but I also saw pride. I saw the face of a young man who felt he had redeemed himself.
I ran my hand through his hair and whispered, “I’m sorry.”
◆◆◆
So, you see, the truth is complicated.
Reckless? Probably. But I’m convinced that phone call saved twelve lives, even if it cost the life of my patient.
Maybe you think I should have just let the hostage negotiators do their jobs. I guess we’ll never know.
Maybe you think I was being manipulative and controlling, but I only do that stuff because I don’t believe people can be trusted to do the right thing.
Maybe you think this will scare me away from therapy forever, but I’ve seen it all… A patient with OCD whose loved ones really did suffer every time he missed a ritual. A choir boy who claimed he was being molested – not by a priest – but by God Himself. A patient with PTSD who gave me nightmares. A husband and wi
fe who accused each other of abuse, and only one of them was telling the truth. A woman who kept her ex locked up as a sex slave. A pedo-ring conspiracy theorist who was actually onto something.
And how could I ever forget, Patient #220.
The problem is, my patients have a habit of dying. Alex isn’t the first, and I’m worried he won’t be the last. Sometimes I wonder if I’m the common denominator. Or maybe that’s just the cost of taking on exceptionally broken clients.
I picked up my crate of belongings and took one last look around the office. I would miss this place and the people, but I would find another home soon enough.
I’ll never stop trying to help.
End of Patient File #107
A Note on Emma
You might wonder if Emma was charged for killing Alex.
Yes, she was.
I actually testified at her trial, but there is very little value to the opinion of a therapist who never treated her.
But I could talk about Alex.
Yes, he was showing signs of a possible recovery. But that didn’t erase his behavior from the months prior.
Alex had stalked her and repeatedly violated her boundaries. He ranted about her to anyone who would listen. In the trial, there was evidence of a relentless cyber-harassment campaign as well. He eventually held a gun to her head, and she believed her life was about to end.
Because of that, I agreed with the defense that Emma could very well have PTSD.
Have you ever had someone frantically obsessed with you? Someone who keeps contacting you, despite your repeated attempts to end that contact? Someone angry and unpredictable, someone who refuses to back down?
You fear for your life every second of the day. You don’t sleep anymore. You have nightmares constantly, as your body tries to keep you alert. The primal fear instincts kick in, and they don’t easily shut down.
Alex may have redeemed himself in his own eyes, but the fact is, he prevented a situation he created.
OCD Rituals
PART ONE
“Love one. Love two...”
As he spoke, Phil held his hand to his heart and raised one finger, then two. Then he bowed his head and whispered one last sentence:
“Sorry for bothering you.”
In my notebook, I finished sketching that pointy S symbol that we all drew in high school. I never actually write anything down, but it gives patients the comforting idea that I’m in the process of “figuring it out”.
“How often do you perform this ritual, Phil?” I asked.
He looked up. “Every five minutes.”
He had a messy beard and a weathered face that made him appear much older than he probably was.
“Five minutes?” I repeated, trying not to sound too surprised. That was unusually frequent, even for a patient with severe OCD. “Do you feel any relief after the ritual is complete?”
He shook his head. “Never.”
“What are you afraid will happen if you don’t perform the ritual?”
He closed his eyes and shook his head.
“Phil, you can tell me,” I said encouragingly. “That’s what I’m here for.”
He took a deep breath. “The– The man with two knives.”
Fear of death or murder was one of the most common manifestations of OCD. But of course, I didn’t want to minimize his fear, which was still very real to him.
“That sounds frightening, Phil,” I said. “Can you tell me more about this man?”
He swallowed. “If I miss a ritual, he comes in the middle of the night. And he– he –”
“It’s okay,” I said gently. “I don’t want to upset you.”
I turned to his wife, who was anxiously massaging his knee with her hand.
“Anne, how has this impacted you?” I asked. “It must be difficult, seeing your husband suffer this way. You must worry every day, especially when he’s at work or traveling?”
“He never leaves the house,” she said quietly. “This is the first time he’s been out in three years. He’s been on disability the whole time. He’s so terrified. And–”
My new assistant, Noah, opened the door.
“Noah, I’m in the middle of a session.”
“Sorry, it’s the school.” He blushed. “They said it’s urgent. They want to talk about Emma’s trial.”
I shook my head and apologized.
“I’ll be right back.”
As I walked out of the office, Noah stood in the doorway and stared at Phil and Anne. Apparently he learned nothing from orientation. But I didn’t have time to deal with him right now.
I stepped out and took the call. The school wanted me to testify in Emma’s favor, which I was already planning to do. I got the sense they were more worried I would try to blame the school, as revenge for firing me.
But revenge is petty, especially at the cost of a young person’s future.
I finished the call and returned to my office.
“I’m so sorry for the interruption,” I said as I took my seat. “Now, there’s good news and bad news here. The bad news is that you certainly seem to be suffering from a severe case of Obsessive Compulsive Disorder. The good news is that you came in for help, and OCD is very treatable.”
Phil leaned forward. “You can stop him?”
“Yes,” I said confidently. “I’m not a huge fan of medication, but I think antidepressants could help take the edge off while we begin a regimen of mindfulness and talk therapy. In a few months, those rituals will be a thing of the past. My whole team is here to help you.”
I didn’t want to refer him out to my colleagues too quickly, but this was a pretty classic case of OCD, and I felt that my resources might be better spent on patients with more unusual issues.
Phil shook his head. “No.”
“I’m sorry?”
“No, I can’t take medications. I can’t stop the rituals.”
“Of course you can,” I said. “That’s why we’re here.”
“No,” he said again. “Otherwise he’ll do it again.”
I was becoming a bit frustrated by this point. “Phil, that’s the whole reason–”
“Show us,” Phil said to his wife.
She winced and shook her head slightly.
“Please,” Phil pleaded. “Show us.”
Anne closed her eyes and lifted up her shirt.
Her torso was covered in at least a dozen stab wounds.
Before I even had a chance to react, Phil held his hand to his heart again.
“Love one. Love two…”
Jesus Christ. Had it already been five minutes?
“Sorry for bothering you.”
PART TWO
I poked my head out the office door.
“Noah, what’s my afternoon look like?”
He took out the iPad.
“Uhh… Two new patients after this one,” he said. “Don Halverson–”
“Noah, we’ve been over this,” I said impatiently. “I can’t remember names. I remember problems. Read from Column B, please.”
“Oh, right,” he said, scanning the screen. “Uh– Guy who intentionally transmitted HIV to eight people.”
“And the other one?”
“Homeless kid who escaped a cult.”
As the words came out of his mouth he raised his eyebrows. “Jeez, doc…”
“Welcome to the wonderful world of pro-bono work, Noah.” I gave him a quick smile. “Please move them to next week. I’m going to need a little extra time with my current patients.”
They both sounded fascinating, but the homeless kid was probably hallucinating from drugs, and the HIV guy was court-ordered, so he wouldn’t be hurting more people any time soon. Right now, Phil needed my full attention.
I returned to my office and saw Phil and Anne embracing each other. They must have been the most exhausted-looking couple I’ve ever worked with.
“Anne,” I began gently. “Now that I’ve seen evidence of bodily harm, I have to report th
is to the police. Do you understand?”
“No!” They both shouted at the same time.
“It’s not really a matter of choice–”
“You can’t,” said Anne. “That’s the whole reason we’re here. If we go to the police, he’ll kill Phil.”
I tilted my head. “How can you possibly know that?”
“Because of Eleanor,” Phil answered for her.
“Eleanor?”
“Our daughter,” said Phil quietly. “She had the same– the same condition as me.”
“OCD?”
“It’s not OCD!” he protested. “Eleanor went to the police last month, and the man with two knives–”
Anne held his hand.
“He killed her, a week after the police detail left our house,” Phil stammered. “The angriest we’ve ever seen him. Stabbed her eight times and dragged her into the woods.”
What the hell had I gotten myself into here?
“Let’s take a step back here,” I said. “Phil, do you have any recollection of when this ritual began?”
“Three years ago,” he said. “We took Eleanor on a trip to Disney, and all we remember is waking up and hearing him tell Eleanor and I that we had to do the ritual every day – from 4am to 11pm – or he would hurt our family. There were 3 rules: No cops, no hospitals, and no skipping sleep. We thought it was some kind of sick joke at first, so we didn’t do the rituals, but then he showed up that night…”
“Do you have any idea what the ritual means?” I asked. “Love one, Love two, any of that?”
He nodded.
“She’s Love One.” He pointed to Anne. “Her sister is Love Two. If I miss either of them, they get punished that night.”
“Wait, her sister gets stabbed too?”
“Yes,” Anne whispered. “She lives with us. And she has two more scars than me.”
“How many do you have?” I asked.
“14.”
Phil bowed his head in shame. But by my calculations, he was nothing short of a hero.
12 rituals every hour, 19 hours per day, 365 days per year, for 3 years.