In your case we simply cannot wait too long. Paranoia, in any form, even that of delusional jealousy and hallucinated lovers, can be dangerous. Proper clinical measures might call for a private sanitarium; but perhaps not. One must be sure — one must have sufficient information...
The doctor stopped writing in the spiral notebook. He stared wistfully at the oversized, prematurely balding top of Richie’s head, the way it twisted like a wounded turtle’s.
“Richie? Where are you?”
“Last night. I almost had him.” Richie’s mouth quivered in a baby’s primal snarl. “I cut out early from my Wednesday bowling and caught them sneaking around at poolside. Heard them laugh as I slipped in through the garden and climbed over the patio fence. Same guy I told you about before when I nearly caught them parked in the car out at Hanson’s Lake. I told you about that.”
“Yes, you told me.”
“Same guy. Tall, with the low voice.”
Richie pounded the wall harder. The doctor rose as quietly as possible and rescued a gold-framed certificate before it jarred loose from the wall and fell to the floor. He put it carefully on the glass-topped desk, Columbia Institute of Psychiatry, Bayne Kessler, M.D.
As the doctor turned to tiptoe back to the chair, Richie was elbowed up on his side, his odd, pale sheep eyes straining up with petulant accusation. “You weren’t even listening!”
Dr. Kessler sighed and managed a benign smile. “Of course I was listening, Richie. I always listen.” He sat down and picked up the spiral notebook and pen from the side table. “Please go on, Richie. You climbed the patio fence—”
Richie flounced over onto his back again. “I had him. See?” He breathed hard as he fumbled from under his suede jacket a strip of raveled white cloth and waved it like a banner. “I chased him. Just as he went over the fence I grabbed his sleeve. He tore loose and ran off through the trees. But I got this. It’ll be his neck next time, and I won’t lose my grip.”
Dr. Kessler squinted uneasily. Tom from a shirt cuff, all right, but from whose shirt, and how? Richie often brought in trophies he claimed were left behind when he frightened away one of Lara’s lovers. The cigarette lighter, the fountain pen, the handkerchief, the cigarette butts, the pocketknife, and the rest, like this bit of shirt cuff, never had initials or any other way of identifying their source. Never a wallet, a driver’s license, a credit card, or anything that might separate substance from shadows.
Their faces or any distinguishing body features were never quite clear to Richie. It was always night, always too dark, or he was too far away for them to be anything but fading outlines, fantasies of men who were never caught in flagrante delicto. They would never be caught except in wish-fulfilling dreams; and then, of course, there would be murder most foul.
But how to murder a delusion? Paranoids were clever at turning up substantiative evidence of systematized delusions.
“Know how I knew she’d be with him last night?” Richie waved the raveled snag of sleeve.
“Tell me, Richie.”
“The night before last, Tuesday, I told Lara I was dead from lack of sleep and had to have a good night’s rest. I pretended to take sleeping pills, only they were aspirin I’d put in the sleeping pill bottle. Then I pretended to be really knocked out on the couch. Lara hung around and shook me to be sure. Later, after she left, I lifted the phone and heard her on the extension setting it up with lover-boy for Wednesday night while I bowled. Same voice, like I told you. I felt sort of cruddy listening and spying... but I have to find out who he is so I can get him.” He curled up on his side, fists clenched against his chest like a baby with colic.
Dr. Kessler was conscious of covering his growing irritation with a deliberately low, gentle tone. “And Lara? She, of course, denied again that there was anyone there?”
“Sure. Same old business. Maybe it’s a plot. Maybe they’ve made Lara go along with a plot to brainwash me, to make me think I’m out of my tree and seeing little men who aren’t there.”
“Why would they do that?”
“Some of my daddy’s bank. Nearly a million dollars in community property. Hell, don’t you know? But I don’t care. I know what I see and next time I’m going to get what I see.”
Yesterday upon the stair, Dr. Kessler thought, I saw a man who wasn’t there. He wasn’t there again today. Oh, how I wish he’d go away.
This really mustn’t go on. Continuing treatment depended on knowing the exact nature of the disease. Persisting doubts about the original diagnosis must be settled. Either real or delusional lovers could serve Richie’s defensive needs, but his possible cure could not be served at all by insecure, unsubstantiated diagnosis.
His original, tentative diagnosis of delusional pathological jealousy still seemed right; what evidence he had been able to gather pointed to it. Richie could never identify a lover. He heard their whispers on the phone, in the dark, through walls, in his nightmares and daydreams — but he never turned up a single supportive fact or clue, never any addresses, phone numbers, names, or descriptions. He said they used secret codes, even used telepathic extrasensory perception to frustrate him. On several occasions during sessions, Richie insisted that while Lara waited for him in the car, she was talking with some ubiquitous playmate. When Dr. Kessler looked down there, however, he saw the car, but no one in it — no Lara — no lover.
“There they go,” Richie shouted. “Around the corner!”
Dr. Kessler saw no one disappearing around a corner, or into a crowd, or even into thin air. Delusional jealousy was not uncommon. Many had such a low opinion of themselves they couldn’t imagine anyone not preferring someone else; but Richie’s case added up to a rather extreme, dangerously paranoid form of the disorder. Dr. Kessler still believed that was his problem.
Yet what if that tentative diagnosis had been wrong — or just partly wrong? What if Richie’s “delusions” were based on justified suspicion? What if Lara really cheated? Very discreet social inquiries had turned up nothing about Lara that supported Richie’s claims, but those inquiries had been very limited by necessary prudence.
Dr. Kessler didn’t believe he was wrong, but it was always possible. If he were, it called for a radically different approach to Richie’s therapy.
On the other hand, if he were right, he couldn’t allow a dangerous state of delusion and fantasy to continue; not without direct clinical action.
Irritation flared up suddenly, out of control. Dr. Kessler stood, leaned over Richie, and heard himself using a surprisingly hard and critical tone. “You’re not kidding me, Richie. And you’d better stop kidding yourself. It isn’t getting us anywhere, is it?”
Richie looked up and blinked incredulously. After a while he whispered, “What?”
“You don’t want to find out who these guys are, Richie. And you never will, because you’re a coward. You’re afraid to find out. If you do, you know you’ll find out something else, the final, unbearable truth — that you’re too weak and helpless and afraid to face up to them.”
Richie sat up slowly and slid down the couch away from Dr. Kessler’s shadow. His face was a pale mixture of betrayed trust — and fear. He began shaking his head from side to side in painful denial.
“Yes, that’s how it is, Richie, and in your heart you know it. In your imagination, your fantasies, you enjoy endless plans of bloody vengeance, but all the time you know that in reality you can only face the terror of your own helplessness and cowardly cringing—”
“No,” Richie said. He jumped up and backed away. “You’re all wrong. So wrong it’s ridiculous.”
“Am I?”