The Face

The spooky season is upon us, and so I thought I would treat you (or trick you) to a short story I wrote several years ago. Happy Halloween.

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Journal Entry, 23/8/2011, Dr Julian Douglas, Departmental Head (locum) – Woodrich Sanatorium

Case-study 17509-b

Winston, Gareth D.

Cursory Exam Notes: Subject is suffering severe psychotic delusions. Often including paranoid ideations about closest friends, family or carers. Intense lack of trust in any and all authority. Pathological victimisation complex.

Patient History: Highly intelligent maths prodigy. Working on doctorate at age of twenty-two. Attacked and assaulted two professors at his university with a ball-point pen. Accused them of stealing his thoughts using the pot plant in their office as “a kind of mental funnel.” Inpatient for six weeks. Prescribed 4mg daily Risperidone on admittance. Responded well at first but progress regression noted recently.

Reasons for psychotic break remain unknown. Long history of OCD type behaviour accompanying limited social skills and high intelligence. Latent schizophrenia is not uncommon in such personality types.

Summary: No certain diagnosis, first interview pending.

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New doctor today, temp shrink. Went to a big shot school. Pretends he isn’t proud but his smugness makes his teeth glow.

Don’t like him.

He looks over his glasses. Stupid half moony things. Hate those kinds of glasses. He looks over his glasses and through me and into my brain. As if he would even understand what he saw.

He asked why I’d stopped doing math. Nobody gets it so of course he doesn’t. I didn’t explain. I hate explaining. I’m more than a calculator. I’m more than a lithium battery.

He asked about the face. That means they’ve been talking about me, I knew they would. I was sure I could hear them muttering. Muttering away like mice in the woodwork. Whispering to me the terrible things they think, between the implied bars of my little cell.

I like my new room. The walls are soft and there are no plants anywhere. I don’t like his glasses. I had a dream about half-moon glasses wanting my soul and belittling my political ideals. I screamed.

He asked about the face and I told him it was real. I told him it had got bigger since last week. Bigger and angrier. I told him the others don’t see it. Or maybe they just won’t, but I mustn’t say that. You say “can’t”. You say “don’t” and they don’t mind. But say “won’t” and they get…upset.

They all want a part of me. The teachers and the doctors and the face. They all want a piece of me, but they won’t get it.

Don’t. Can’t. Won’t.

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Journal Entry, 6/9/2011, Dr Julian Douglas, Departmental Head (locum) – Woodrich Sanatorium

Case-study 17509-b

Winston, Gareth D.

Post interview notes, first session:

Patient was able to clearly and concisely put across what he felt his problems were. Still refuses to do even the most basic of mathematical calculations. No explanation was forthcoming. Suggest targeting of this area as could prove crucial to a greater understanding of his psychosis.

Subject kept pausing mid-sentence to ask about my glasses. Read the description of professors and their wounds. I will not wear them again.

It seems he has a new focus for his paranoia, staff reports of his obsession with this “face” prove to not be at all exaggerated. When asked about it he pointed to the shadow in the corner of the room by the window. It was obviously a pattern in the fabric following a fault in one of the cinder blocks.

Patient shows remarkable descriptive powers. Could prove most persuasive to other patients. Should remain in isolation from the general population.

Increased dose of Risperidone, 6mg daily.

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It is a face. I know it’s a face. With eyes and smiles and teeth. So many teeth. It must be a face. Sure it doesn’t move, not when you’re looking at it anyway, but it is there.

What does it want?

The others don’t see it. Or can’t see it. My friends and family and colleagues and nurses and doctors. They all say the same. It’s just a shadow. A trick of the light, a psychedelic Rorschach. You’re seeing what you want to see. But no one, no one, would want to see a face like that.

No one.

The pills…the “medicine” they want me to take…they will weaken me. I know they will. Somehow…this is all a plot.

Just like the pot plant. Plot pant. Pill pot plant. I won’t take them. I won’t sleep.

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Journal Entry, 20/9/2011, Dr Julian Douglas, Departmental Head (locum) – Woodrich Sanatorium

Case-study 17509-b

Winston, Gareth D.

Post Interview notes, second session:

Patient shows little to no response to increased dose of medication. Strangely it seems to not have any effect on him at all. Still insists that the face is there, I asked him where and he pointed to the same area of wall. Apparently, it’s there in the day but “grows and moves and probes during the night”. I asked him what it probes for he said simply “a way in”.

I believe this “face” is some sort of mental symbol for his care, and his refusal to “let it in” is his resistance to treatment. In fact I suggested that it finding a “way in” would be a breakthrough and help him get back to normal. He told me he’d never been normal, and refused to answer any follow up questions on the subject. He is a most interesting case.

He also reports whispering in a language he does not understand. Bouts of night terrors may be to blame, will have the sleep observation cameras placed in his room tomorrow when he is taken for exercise.

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It glared at me all through my interview with the substitute shrink today. Glared and glared and glared.

It’s my fault. I realise that now. I should have pretended it wasn’t there, that’s why it doesn’t go after any of the others. They all manage to pretend. But I noticed…it doesn’t like being noticed.

I think that’s what its trying to tell me when it talks during the night. Strange words, not screaming or speaking or snarling but sort of all three at once. Scary. I scream.

They all think I’m mad…even the other mad people. I can see it in their voices and hear it in their eyes, but I’m not. The voice is real and not like the others. The voices in my head are nice. They tell me things I need to know…warned me about the mean men and their plant. Helped me stop them, made me realise about the numbers in my brain.

This new voice isn’t nice. It doesn’t like me.

But I know how to win. The nurses and doctors and patients all want the face to win but it won’t. I’ll watch it. It can’t get in if I watch it. It can push and pry and probe but it can’t get past my eyes while they’re open.

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Journal Entry, 4/10/2011, Dr Julian Douglas, Departmental Head (locum) – Woodrich Sanatorium

Case-study 17509-b

Winston, Gareth D.

It seems that night terrors are not to blame for the reported delusions. The recorded footage seems to feature nothing but hours and hours of him staring at the wall. Rough calculations show that he has barely slept in nearly two weeks. According to the staff he is approaching the world record for days without sleep.

While this is remarkable, and several students are currently vying for the right to publish a paper on the man, it will not do him any good in the long-term and should be called to a halt.

The betting pool operating on when he will eventually sleep is deeply inappropriate and has been stopped at my instruction.

The cameras, at least, did the job of calling this to our attention. Also the mystery of the immunity to his medication has been solved. He has stopped taking his pills and been hiding them in a split in his mattress. Shall take his superior intelligence into account in all future treatment, that he managed to deceive the nursing staff this long is a joke. Will take it up with the supervisor.

Insistence that he take his medications in my presence met with violent resistance verging on hysteria. He seemed genuinely terrified of the effect they would have on him.

Unfortunately, the use of soft restraints was called for. Hopefully it will only be temporary.

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They were watching…they were always watching. The voices warned me they would. How else could they have known about my pills? And my not sleeping? And now they’ve stopped me. They’ve stopped me winning. Cheaters…mean cheating meanie cheaters.

The face seems happy I can’t move. It’s laughing at me in my head. Gloating and snarling and trying harder than ever to get a way in. But it won’t have it.

They made me…forced me…to take my pills. And now I’m alone, with out even the voices to keep me company. Somehow the pills scared them off. I must stay watching. Watching all the time. But it’s hard.

The restraints hurt. And I am very frightened.

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Journal Entry, 18/10/2011, Dr Julian Douglas, Departmental Head (locum.) – Woodrich Sanatorium

Notes: Last journal entry before handing over to new, full time, head of department.

Recommendations for future care of: Case-study 17509-b, Winston, Gareth D.

Patient seems to have a remarkable constitution, even once his pills were being taken beyond a shadow of a doubt – he remained completely conscious, and fairly cogent, for another 17 hours. Suggest further study and a referral to an Endocrinologist.

Also recommending complete physical check-ups and blood work, the recent lack of sleep must be taking its toll.

Prescribed short-term course of sedative injections to tackle insomnia (15mg intramusc), recommend monitor sleeping patterns very closely.

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Journal Entry, 9/11/2011, Dr George Peters, Departmental Head – Woodrich Sanatorium

Case-study 17819-c

Thomas, Katherine C.

Admission notes: Patient displays typical “Type A” bipolar. Admitted semi-voluntarily by herself and her family to combat frequent hyper-active and damaging behaviour. (Extravagant spending, binge drinking, see full notes for detailed descriptions).

Patient History: Female, late teens, middle income suburban upbringing. Average intelligence, fully developed social skills. Brief stay probable. Most likely to become out-patient after suitable drug therapies have been trialled and found to have any success.

Addendum 20/12/2011: Subject shows disturbing progression in her condition. Though admitted solely because of her hyperactivity, recent changes show a slide into delusion. Since being admitted she has done nothing but rant about a face that “lives on the wall”.

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