A Lonely and Curious Country (10 page)

A/P:              Patient is a 42-year-old male with a non-specified psychotic disorder on experimental protocol. Proceed with experimental treatment 1/7 scheduled for this afternoon.

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03/05/2017              Subject #314-69-4245              Pre-treatment Interview - Transcript

JH:              This is Dr. Harper. Today is March 5, 2017. The time is 08:35. This is Mr. Denton’s pretreatment interview. How are you feeling this morning, Mr. Denton?

GD:              (inaudible)

JH:              Do you know why you are here?

GD:              I failed.

JH:              That’s an interesting perspective. Can you describe your failure?

GD:              You understand, don’t you? We’re both doctors. It’s our job to prevent illness and death.

JH:              Yes, but Mr. Denton, you didn’t prevent illness and death. You inflicted them.

GD:              If you could save a million people by killing a thousand, would you do it?

JH:              Mr. Denton, this isn’t a sophomore ethics class.

GD:              How about a billion? How about the entire world?

JH:              Mr. Denton—

GD:              I’ll change the context. Triage. Right? In an emergency you save the ones you can, sacrificing some so that others can live. You understand that, right? Of course you do. He knew I understood it, too. I think that’s why he chose me.

JH:              Who chose you? For what?

GD:              What? Nothing. It doesn’t matter. You wouldn’t believe me anyway. I’m crazy, right? That’s why I’m here.

JH:              You’re here, Mr. Denton, because you have been deemed mentally ill and unfit to stand trial for your crimes.

GD:              Was Copernicus crazy? Or Pasteur? Or Mendel? They knew things no other man knew. The Bible says, “You will know the truth, and the truth will set you free.” I know the truth, and now I’m a prisoner to it.

JH:              Can you tell me about this truth? Or about the one who chose you and for what purpose?

GD:              I could, but it would only lead to more death.

JH:              Is that a threat, Mr. Denton?

GD:              No. I’m sorry.

JH:              Very well, we’ll leave this discussion for another time. As we discussed yesterday, you will be receiving an experimental therapy to treat your illness. Later today you will undergo the first of seven treatments, but before that can happen, I need to ask you a few questions so that we might better understand your response to the treatment. First question: On a scale of 1-10, one being not at all and ten being definitely, if you were to be released today, how likely would you be to resume killing?

GD:              Ten.

JH:              I see. Question two: On a scale of 1-10, one being none and ten being extreme, how much remorse do you feel regarding your crimes?

GD:              Ten. I didn’t want to hurt anybody. One. I did what I had to do. Ten. It wasn’t enough.

JH:              So, ten?

GD:              (inaudible)

JH:              Very well. Last question: In your own words, how would you describe your religious beliefs?

GD:              There is no God.

JH:              Really? It’s my understanding that over the past year you spent a significant amount of time in church, and not five minutes ago, you were quoting Bible verses.

GD:              There is no God.

JH:              Very well. What about a higher power other than God. Do you believe in that?

GD:              (inaudible)

JH:              Mr. Denton, are you all right? You look pale. Would you like a glass of water?

GD:              (inaudible)

JH:               Are you sure?

GD:              (inaudible)

JH:              Very well. Let me know if you change your mind. I’m sorry? Would you please repeat yourself?

GD:              Belief is irrelevant.

JH:              It’s relevant to the data analysis. The presence or absence of religious beliefs is a standard question we ask all study participants.

GD:              I’m not talking about your study.

JH:              What then?

GD:              You’ll see.

***

Treatment Note: Subject #314-69-4245 Session 1/7

Date: 03/05/17

Procedure start time: 13:07:00

Procedure end time: 13:14:37

Total time elapsed: 00:07:37

Total dead time: 00:02:27

Complications: None

Subject comments: “The angles are wrong.”

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03/07/2017              Subject #314-69-4245 Post-treatment Interview #1 - Transcript

JH:              This is Dr. Harper. Today is March 7, 2017. The time is 16:07, and this is the first of three post-treatment interviews with Mr. Denton. He has completed one of seven treatments. How are you feeling today, Mr. Denton?

GD:              I’m tired.

JH:              You didn’t sleep last night.

GD:              I did not.

JH:              Would you like me to prescribe something to help you sleep?

GD:              I would not.

JH:              Very well, but insomnia is a common side effect of the therapy, and I’d be happy to prescribe something if you change your mind. Now. Can you tell me about your experience on Sunday?

GD:              I was murdered.

JH:              How did it feel?

GD:              It didn’t feel like anything.

JH:              What did you experience following the injection?

GD:              (inaudible)

JH:              No sight or sounds? No conscious thought?

GD:              Not conscious. Dreaming thoughts. Dead and dreaming.

JH:              You thought you were dreaming?

GD:              Not I.

JH:              What then do you mean by “dreaming thoughts?”

GD:              He showed me.

JH:              Who showed you? What did you see?

GD:              The Eleventh Plague.

JH:              Can you describe it?

GD:              Undying death returns in the absence of sacrifice.

JH:              What kind of sacrifice?

GD:              The kind that comes before eleven.

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Treatment Note: Subject #314-69-4245 Session 2/7

Date: 03/12/17

Procedure start time: 15:00:00

Procedure end time: 15:24:44

Total time elapsed: 00:24:44

Total dead time: 00:06:51

Complications: Sedative required following resuscitation.

Subject comments: Uncontrolled laughter for 15 minutes prior to sedation.

***

03/13/17

S:              Patient reports poor sleep and nightmares. Decreased appetite. No overnight events.

O:              Mental Status Exam: Patient is alert, but only oriented to self. He is unable to correctly identify the date and when asked where he is, the patient is overcome by seemingly uncontrolled bouts of laughter.

Affect: irritable.

Mood: inconsistent.

Thought Process/Content: Tangential with delusions and obsessive discussion of a coming plague.

Vital signs are within normal limits.

Other than bouts of inappropriate laughter, the patient appears to be in no acute distress.

A/P:              42-year-old male with an unspecified psychotic disorder on experimental protocol.

1. Begin risperidone for psychotic symptoms
   
2. Begin zolpidem for sleep
   
3. Continue experimental protocol as scheduled.
   

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03/14/2017  Subject #314-69-4245              Post-treatment Interview #1 - Transcript

JH:              This is Dr. Harper. Today is March 14, 2017. The time is 11:15, and this is the first of three post-treatment interviews with Mr. Denton. He has completed two of seven treatments. How are you feeling today, Mr. Denton?

GD:              [laughter]

JH:              I understand you’ve been having nightmares. Would you like to discuss the content of your dreams?

GD:              My dreams are not my own.

JH:              Whose dreams are they?

GD:              [laughter]

JH:              Mr. Denton, please sit down.

GD:              [laughter]

JH:              Sit down, or I’ll be forced to—

GD:              [laughter]

JH:              Security!

GD:              [laughter]

***

03/16/2017 Subject #314-69-4245              Post-treatment Interview #2 - Transcript

JH:              This is Dr. Harper. Today is March 16, 2017. The time is 12:55, and this is the second of three post-treatment interviews with Mr. Denton. He has completed two of seven treatments. How are you feeling today, Mr. Denton?

GD:              I’d like to go home now.

JH:               I’m afraid it will be several months before the decision of whether or not you are well enough to return home can be made. I’d like to talk about your last treatment. There were some unexpected side effects, though I’m pleased to see they seem to have resolved. Tell me about Sunday’s session.

GD:              I don’t want to go back. I want to go home.

JH:              Satisfactory progress must be illustrated prior to patient release. You know this. Mr. Denton, you must go back if you’re ever to go home.

GD:              If I don’t go home…

JH:              Where do you go during your treatments, Mr. Denton?

GD:              It’s here. I can see it.

JH:              What do you see?

GD:              A city. Deep. Forgotten. Filled with towers. No! Mausoleums. Built from...not stone. The angles are wrong. They scrape the sky and cry out to dead stars the color of migraines, begging them to live again.

JH:              Mr. Denton, are you all right?

GD:              (inaudible)

JH:              Mr. Denton?

GD:              What day is it?

JH:              What day do you think it is?

GD:              Easter?

JH:              It’s March 16
th
. Easter isn’t for another month.

GD:              Then there’s still time.

JH:              Time for what?

GD:              I’d like to go home now.

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Treatment Note: Subject #314-69-4245 Session 3/7

Date: 03/19/17

Procedure start time: 09:00:00

Procedure end time: 09:19:19

Total time elapsed: 00:19:19

Total dead time: 00:08:01

Complications: None

Subject comments: “The day of resurrection approaches.”

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03/21/2017  Subject #314-69-4245               Post-treatment Interview #1 - Transcript

JH:              This is Dr. Harper. Today is March 21, 2017. The time is 12:41, and this is the first of three post-treatment interviews with Mr. Denton. He has completed three of seven treatments. How are you feeling today, Mr. Denton?

GD:              Like death warmed over.

JH:              Is that supposed to be a joke?

GD:              Everything is a joke. You. Me. That tape recorder.

JH:              How so?

GD:              The problem is that not all jokes are funny. Sometimes the punchline is just mean.

JH:              Tell me more.

GD:              (inaudible)

JH:              No? Very well. Let’s talk about something else. I’d like to discuss something you said during your last treatment.

GD:              Sure. Okay.

JH:              You said, “The day of resurrection approaches.” What do you think you meant by that?

GD:              I think my brain was deprived of oxygen from being killed and brought back to life for the sixth time.

JH:              Third time, Mr. Denton. And I disagree. Last week you thought it was Easter, and this morning, one of the nurses brought me this. She found it under your bed. Would you care to read it?

GD:              “He is not here; he is risen, just as he said.”

JH:              Anything else?

GD:              It just says the same thing over and over again. “He is risen.”

JH:              Do you recognize that phrase?

GD:              Yes. It’s from the New Testament.

JH:              How about the handwriting?

GD:              It’s mine.

JH:              For a man who doesn’t believe in God, you seem awfully preoccupied with the resurrection. Can you explain to me why that is?

GD:              Can you explain to me why Easter falls on different dates from year to year?

JH:              I fail to see the relevance of that question.

GD:              Then you fail to understand the basis of my obsession. The truth that threatens my sanity.

JH:              Enlighten me.

GD:              Enlighten yourself.

JH:              You sound upset, Mr. Denton.

GD:              Your goddamn right, I’m upset! I shouldn’t even be here! I don’t deserve to be here! And I wouldn’t be here if it weren’t for our incompetent guide leading us into that forsaken village! I wouldn’t know any of this! My wife. My son. My granddaughter. [crying]

JH:              Tell me about the village.

GD:              Ravaged. Ravaged by plague. I wanted to help. We had supplies. But it was a trap. I never wanted this! You think you’re the first one to show me what it’s like in Hell? [crying] You have to stop, Doctor.

JH:              Stop what?

GD:              They know about you.

JH:              Who knows about me?

GD:              They’ve seen me come and go. They know you can make them live again.

JH:              Who? What are you talking about?

GD:              Hell’s dreamers.

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03/23/2017  Subject #314-69-4245               Post-treatment Interview #2 - Transcript

JH:              This is Dr. Harper. Today is March 23, 2017. The time is 09:05, and this is the second of three post-treatment interviews with Mr. Denton. He has completed three of seven treatments. How are you feeling today, Mr. Denton?

GD:              Go to Hell.

JH:              No need to be hostile. Maybe this will put you in a better mood. I took your advice and did a bit of self-enlightenment last night. To answer your question from our previous session, Easter is celebrated on a different day every year because it is based on the lunar calendar, falling on the first Sunday following the paschal full moon.

GD:              That’s the long answer.

JH:              What’s the short answer?

GD:              The stars have to be right.

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Treatment Note: Subject #314-69-4245 Session 4/7

Date: 03/26/17

Procedure start time: 17:00:00

Procedure end time: 17:35:06

Total time elapsed: 00:35:06

Total dead time: 00:12:11

Complications: Patient revived after four minutes, but decompensated and required a second round of resuscitation.

Subject comments: Unintelligible. Phonetically interpreted as: “R’lyeh,” “Tharanaak,” and “Gotha hai uln.”

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03/27/17

S:              Patient reports persistent sleep disturbances despite pharmacologic intervention. Appetite better today. No overnight events.

O:              Mental Status Exam: Alert. Oriented to self. When asked to write a sentence, the patient produced the following:

“
Ph'nglui mglw'nafh Cthulhu R'lyeh wgah'nagl fhtagn.”

Affect: anxious.

Mood: anxious.

Thought process/content: evasive, delusions (“Eleventh Plague”), auditory hallucinations (“whispers from the abyss”).

Vital signs within normal limits.

A/P:              42-year-old male with non-specified psychotic disorder on experimental protocol.

1.                   
   Increase risperidone for psychotic symptoms
   
2.                   
   Increase zolpidem for sleep
   
3.                   
   Begin clonazepam for anxiety
   
4.                   
   Continue experimental protocol as scheduled.