Five heartbeats later, Josephine joined me, once more the unruffled young woman of high society. Despite her calm demeanor, the mask of her control was cracking: the unconscious flicks of her eyes about my office lingered on the windows and door as if seeking escape. If I did not work quickly, I would lose her to the asylum.
“The beginning. Three weeks ago, I woke up screaming. Even as my maid rushed into my chambers, the nightmare faded. All I remember now is a spiral of symbols and a labyrinth of woods.” Josephine paused, glancing at me.
I nodded encouragement, my pen and my voice silent. It was standard fare so far. Images of being lost or out of control. I wondered what had happened three weeks ago to bring this about. I would have to find out what changed in her life.
“In truth, I do not remember these things. I wrote them in my dream journal. I have always been a vivid dreamer. Almost everyone in my family is. My brother, Leland, he dreamed even more than I do. Such lovely dreams.” Sadness marred her face for a second, then disappeared back into that studied face of cultured politeness. “Even on the medication, I still dream, but I do not, cannot, remember what I dream of.” Her dark eyes flittered over my face, seeking something. “I cannot tell you why the symbols or labyrinth frightened me. I regained my composure and continued my day.” Her hand, with its neatly trimmed fingernails, petted the smooth fabric of her dressing gown.
Again, I said nothing, but gestured for her to continue. Silence was ever my ally. It did appear that Josephine had a rich fantasy life. Not too unusual in the grand scheme of things. The fact that her family seemed to encourage the fantasy in both of their children was unusual. They had clearly spoken of their dreams to each other.
Josephine’s eyes glazed as she looked into the past. “I thought it was a singular folly. Instead, I woke up screaming the next morning, and the next and the next, for a full week. I did not remember these dreams upon waking. I forced myself to forget them. I did not want to remember.” She paused. “Part of me did. But I was too afraid to uncover what made me scream my throat raw each night.
“Two weeks ago, the wounds began to appear on my back. First one symbol—a word, perhaps. Then what I presume was a sentence, to now what you just saw: the paragraph carved into my flesh. I chose to come here for help. I chose you to help me after I discovered you worked here.”
“How did you discover this?” I noted Josephine had begun to weave me into her narrative. She assumed I believed the wounds to be writing. Alternatively, she was not willing to accept that I did not believe the wounds to be writing.
“Dr. Mintz mentioned you in passing to Nurse Heather. I remembered your name from Malachi.” Josephine gave me a sly smile. “As I am here voluntarily, I still have a say in who treats me. I suspect the good doctor is unhappy with this turn of events.”
Again, I suppressed my distaste at the “good” doctor’s experiments. “I would not doubt it. Do you mind, though, if I talk to him about his findings?” I wondered if Josephine had mentioned Malachi—her Malachi, not mine—to Dr. Mintz. It was a name he would know.
No. It was a coincidence. Nothing more. The name, while not popular, was not unusual. She was not referring to my lost patient.
Josephine shook her head. “No, I do not mind. But I will not be subject to his experiments. I have seen the results in some of his patients as the poor creatures pass by my room.”
“Of course.” I considered my words carefully. I did not want to agree or disagree with her. Nor did I want to slam any doors. Trust was still being established. I needed to make certain I understood what she was telling me. A clinical summary would be the baseline for future discussions. “As I understand it, for three weeks you have had nightmares, but no memory of what they are about. Is that correct?”
Josephine took a moment to consider my words before she nodded her agreement.
“Two weeks ago, the wounds began to appear. Were they always on your back?”
“No. The first one was on my side.” She touched her left hip. “It was a single mark. After that, they moved to my back.”
“Do they heal?” I wanted to write out notes, but writing anything down would throw a barrier between us. I would go from confidant to doctor with a single stroke of the pen. Trust, once broken, is difficult to re-establish. I had to rely upon my memory for now.
“Some. Though, they are renewed each night. I fear I will ever carry their scars.”
“Has anything new appeared in the last couple of days?” If they had, it would mean her illness was still progressing. If not, it had stabilized…perhaps with the knowledge I would be her new doctor.
Josephine shook her head. “Not that I know of. But my back is so filled with the writing, I would not be able to tell if there were something new. The pain is the same: a single, widespread ache over my entire back, heightened into sharp clarity when fabric is pulled from it.”
I held my chin for a moment, considering. As a doctor of the mind, I did not physically examine my patients unless it was absolutely necessary. In this case, I believed it was. I had to see the wounds themselves to mark them and determine their healing progress. It would also give me a better sense of what could have caused them to appear in the first place.
Decided, I stood. “Miss Ruggles, I need to see your wounds. I also need to make a written copy and an impression of them. Will you allow this?”
“What will you do with them?”
“I will not know until I have seen them. It matters how the wounds were made. Looking at them will tell me.” I left the door open for Josephine’s remarks about her wounds to be true. I also allowed her the dignity to deny me and to protect her fabrications.
While I did not state I thought they were self-inflicted, I watched as disappointment, fear, determination, and acceptance crossed Josephine’s face, one after the other. She had decided that I did not believe her, but she felt my examination would vindicate her belief that her dreams caused the marks—that she had not created them herself.
I, on the other hand, expected to see what I have always seen—the torn skin of self-inflicted wounds made by fingernails. It did not matter how neat they were.
Josephine inclined her head. “I will allow this. My maid is waiting outside your office.”
Hanna, Josephine’s maid, was a lady’s maid in every sense. She wore a black dress of good quality and a white apron. Her sepia skin was clear and clean. Her hair—black with grey shot through it—was pulled back into a neat bun. Smile lines graced her face and she did not have the calluses of a maid of all work. Instead, Josephine appeared to be her singular priority.
The two women were comfortable with each other and their respective roles to the point of a heightened, silent language. They understood each other on a level few reached. Hanna would go to the ends of the earth for her mistress, no doubt. Perhaps I could arrange a meeting between the two of us to see if there was something the servant could tell me that the patient could not.
I locked the office door as Hanna helped Josephine with her dress. It was rare for anyone to interrupt me during a session, but it did happen. I wanted no mistakes.
A hiss behind me caught my attention. Turning, I saw Hanna peel the linen cloth from Josephine’s back. The maid reached for a soft cloth from the basket she had carried in with her—another foresight of the young Miss Ruggles no doubt. I raised a hand and my voice. “Wait. Please. Allow me to look first.”
Hanna glanced at Josephine who nodded her permission. “Pardon, ma’am. I usually bind her wounds each morning. Except for this morning.”
At first glance, Josephine’s back was a bloody mess, then the marks became clear. I peered close, focusing in on one of the wounds. Her skin puckered outward, as if the mark had been pushed out of her rather than scratched into her. As I stared, the wound became a glyph before my eyes. Then the rows of marks became sentences. It was writing. I felt myself drawn into them. It was familiar and alien at the same time.