Whenever I come upon Phyllis, or any other difficult and perplexing patient, I am reminded of how tenuous is the line between sanity and mental illness. A seemingly minor insult to the brain, particularly to the frontal lobes, can result in all kinds of bizarre consequences for the rest of one’s life. A mild viral illness, an encounter with a doorknob, a subtle age-related deterioration—virtually anything can cause the structural or chemical damage that changes the way a person perceives and deals with his surroundings. In the extreme, a woman might seem perfectly normal one minute and become Joan of Arc the next. Sometimes these metamorphoses can be reversed with treatment, or even disappear on their own, but usually they are intractable. And such afflictions, like the various forms of cancer, can happen to anyone, regardless of social standing, intelligence, or anything else.
Cotan’s is one of the oddest and rarest syndromes in the annals of psychiatry. A patient with this condition believes that nothing exists. In a bizarre variation on this theme, called Cotard’s Syndrome, a person might think that some of his body parts are missing. In a kind of worst-case scenario, Phyllis believes that all of them are missing, i.e., that she is totally invisible. Thus, she thinks she can get by with stealing others’ food, clothing, or the like without being detected. Never mind that the clothing would be recognized on her “nonexistent” frame; with disorders of this sort, logic takes a back seat. But why in the world would a minor incident produce such a fantastic aberration, especially when none of the thousand other functions are in any way impaired? Or perhaps in Phyllis’s case it has nothing to do with brain damage. There may have been other events in her background that we don’t know about. It’s quite possible that she only feels safe if she can’t be seen by anyone.
She got up to go somewhere, at which time she farted quite noticeably. Any normal person would be embarrassed by this, or would smile sheepishly or apologize in embarrassment. Not Phyllis. In fact she gave her fernad a good scratching before shuffling off. Obviously there are certain advantages to being invisible.
I wondered again whether fled might somehow be able to help this unhappy woman and all the other patients, and I reminded myself to ask her whether she could, in fact, read their otherwise inscrutable minds. But I was getting the feeling that it had better be soon.
At this point several of the inmates came barging in, chatting animatedly in small groups and nearly knocking over poor Phyllis, who was still making her way across the lounge. Even some of the antisocial patients were participating. They were so engrossed in their conversations that they didn’t seem to notice my being in their midst. The subject of their discussions was fled. A few days ago they were leery of her; now they were excited and happy—all because of her pregnancy.
It’s rare that a mental patient conceives while confined to a hospital, though it does happen occasionally. Sometimes, too, a patient who is already pregnant arrives. Our most recent such case was Lou, now the “mother” (thanks to a sex-change operation) of a ten-year-old girl and living in another city. It’s amazing how solicitous the other inmates can be of a new “Mona Lisa,” giving her extra food or helping her with certain tasks and so on. Suddenly it appeared that fled would be reaping the benefits of everyone’s care and concern and—yes—love. For all we knew, in fact, she might have been planning this from the beginning as a way of gaining the patients’ sympathy and trust.
Or, as Bill Siegel had suggested, she might be faking it, perhaps for the same reason.
* * *
I had allowed an hour for Dr. “Sauer” to examine fled. Since we already had her EEG on file, I presumed he wanted to check her ability to identify playing cards or to describe certain pictures he held in his head, or maybe even to photograph any “auras” or the like encircling her own, in order to determine how she might be able to read his mind.
The subject of paranormal phenomena is likely to raise the hackles of any respected scientist. Contrary to popular belief, it’s not that they are biased about such matters. It’s that science is based on evidence (and nothing else), and there is very little that supports the occurrence of paranormal events of any kind—UFOs, ghosts, feelings in plants, and, yes, auras—and what little there is is shaky at best. Yet, belief in such phenomena, like that of religion, is often strong, and unsettling claims sometimes arise. Are all these reports merely manifestations of wishful thinking, or are the scientists missing something? My personal opinion is that the subject is not yet closed, but until I see (or feel) the evidence for any of these events myself, I will remain unconvinced. (I would be happy to take part in any legitimate study of paranormal events but, to date, no one has asked me, including “Sauer” upstairs at this very moment with fled.)
Because it was still raining outside, Darryl and Georgie began to toss the latter’s worn football back and forth in the lounge. I started to tell them they couldn’t play inside, then I thought: what the hell—I don’t work here anymore. I was heading for the dining room to get a cup of coffee when Rothstein came by. Kathy is one of the most intense, and certainly the most reserved, of the MPI staff, tending to keep her thoughts and opinions to herself. I have no problem with that; she performs her duties conscientiously and well, and her methods and her personal life are her own. So I was quite surprised when she sought me out to discuss a couple of things that were bothering her. I thought: here’s someone who doesn’t think I’m over the hill! “Sure,” I told her. “What’s on your mind?”
One of her patients was Mrs. Weathers, now over a hundred years old and barely able to see or hear. Both of those conditions are treatable in her case, yet she refuses to have anything done about them. “I’m more than a century old,” she once told Dr. Rothstein. “I should be blind and deaf!”
That isn’t quite true, of course. There are some 15,000 centenarians living in the U.S. today, and many are healthy enough to experience a considerable measure of enjoyment of their lives. A few even continue to work. Their effectiveness might be open to question, but the point is they are still able to get to the office and perform whatever functions they are capable of. And, of course, the numbers are increasing all the time. But a hundred-year-old woman was almost unheard of when Mrs. Weathers was growing up, so she’s certain she’s going to keel over at any moment. In a real sense, though, it’s her mindset that’s old, more than her body. Indeed, she could well live another decade or more.
Kathy wanted me to speak to Mrs. W about her defeatist attitude, which included conserving her energy by barely moving all day. I demurred. Who knows—perhaps the old bat’s right: whatever her program, it’s worked for more than a century. And what if we encouraged her to start running laps around the back forty and she dropped dead on us? I suggested we let nature take its course. Her only comment was: “I hope I never get that old….”
The other matter she wanted to discuss was more problematical. She had just had a session with Rick, and felt she might be on to something. She had asked him whether he wanted to go to K-PAX with fled. It was a variation on the old conundrum, “I am lying.” If this statement were true, it would also be false, and vice versa. This created a dilemma for him. If he lied and said he didn’t want to go with fled, he would have to stay on Earth. She had hoped he would become flustered and confused, and see, perhaps for the first time, the difference between the truth and fiction. But Rick, who’s no dummy, replied, “Please tell fled that I want to go to K-PAX.” In fact, Kathy had been trying to catch Rick in the truth for some time, only to be thwarted again and again. She confessed that she was at her wit’s end.