The day of admission of the patient.
I’ve been assigned a new patient today.
His name is Rahul. He is accused of killing a person.
The defence pleaded mental instability and the evidence corresponded. He had, as a child, pushed another child off the stairs. More recently, he had phoned the police claiming his neighbours were smuggling guns. There was no reason for the police to track that call then but in the trial, the father said that this was further proof that his son was unstable. The police tracked it and it indeed came from Rahul’s flat. So the judge deemed him mentally unstable and now I’m stuck with him.
But I must say the house is nice. In the quiet countryside, there is just me, a few of my colleagues, 3 guards and the patient. They say that the brother of the deceased swore that he would kill Rahul. So this was extra protection. But I still think it doesn’t warrant this type of treatment. I heard the parents were rich and maybe they pulled some strings for this.
Anyway, it’s none of my concern. I have to keep him under observation and treat him for a year. Tomorrow is my first meeting with him. Its going to be long interview. Better go to sleep.
The Second Day of admission
The interview went pretty bad.
Rahul kept insisting that the salesman told that he’d kill him and his father if he did not tell him where the money was. He said that the salesman was going to kill his father first so that he could watch him die and then he would kill him and take the money. Now I read the statement made by his father. It said the salesman said, “It’s a kill. It’s money well spent.” And it was referring to the books he was selling.
Well, it seems the patient is twisting words in his head. I cross questioned him pretending to believe in what he said, but many of his answers are contradictory.
I finally said I did not believe a single word of his. Harsh, I know, and unethical. But the kid was a murderer. If he was capable enough of killing a person, he could handle a little truth.
Better not let anyone see this diary. I could get suspended.
Vanity, I know. But what would you do?
The Third Day of admission
He keeps repeating the same thing. It’s getting on my nerves.
Now he says he wants to meet his daddy. He says that his daddy can confirm what he’s saying. It got so irritating that I had to tell him that his father had already said nothing of what he (Rahul) told has happened and in addition, he was the one to give evidence which supported his instability.
At this, he finally became silent. He had a pure shocked face with disbelief written all over it. One would have thought his father hadn’t met him in prison before the trial (which he did, I know, because I had to read and re-read the whole case to treat him. Aaah, so much paperwork!).
Even knowing this, I felt a little sorry for him. He believed his thoughts so much that he couldn’t accept any other reality, even if it was supported by multiple proofs. I told him that his father had done the right thing, or else he would have been sent to jail, which would not be as good as it was here.
Rahul did not speak after that. I had to end today’s sessions.
The fourth day of admission
Rahul still did not speak.
He just sits on his bed and stares at the white wall. I think he’s withdrawing. It’s not a good sign. Not a good sign at all.
A week after the admission
Rahul finally spoke but all he asked was where he was.
He cried and shouted and two guards had to subdue him. He kept asking where mommy and daddy were and where he was.
God! I must snap him out of this as soon as possible or this is going to be a disaster.
A week and 3 days after admission
After two days of screaming, he finally became quiet. He returned to his withdrawing self though I don’t what else he has to withdraw from.
I don’t know whether to be glad to finally have him quiet or be worried, because I honestly don’t know what comes next.
Two weeks after admission
Rahul called me, “Dad”.
He has developed some sort of selective memory dissociation. He now thinks that I’m his dad and that his mother has gone to a trip.
This is not going well at all.
A month after admission
I think his imagination must be the cause of his delusions. So to limit his imagination, I had everything which ignites thought removed from the house. I told everyone not to talk with him and I passed the message along to the villagers who sometimes came by the house. He can only talk to me and I’m going to be very careful of what I say.
A month and a half after admission
Even though I said that I was going to be very careful of what I say, I went ahead and did a stupid thing.
Rahul kept pestering me that he wanted to talk to his mother. It had been so for the last whole week. Today I got fed up with it and in my moment of carelessness and stupidity, I said if you want to talk to her why don’t you phone her.
Two hours previously, I saw him take up my cell phone and speak into it. Now I was not supposed to keep my phone so freely, but hell, he was always well behaved and after a month of keeping him in his room, I thought letting him roam the house would be better. Anyway, I immediately snatched up the phone and checked the call history. There was no outgoing or incoming call. I asked who he was talking to and he said,
Damn! Damn! Damn! He is not improving at all.
Two months after admission
Rahul now comes into my room every time he wants to ‘talk’ to ‘Mom’.
I told him that there were no cell phone signals here and said that telephone was the only means of communication. At first he argued saying that he talked to Mom on cell phone once in this house. But after a week, he seemed to accept my lie as the truth.
This worries me. He should have clearly remembered his pretend talking on the cell phone. It seems that he is twisting facts to suit the current situation. He is so easy to manipulate.
Three months after admission
Rahul’s reality has now become this house. He calls me ‘Dad’, he thinks his mom went on a trip, he thinks we are vacationing in the countryside for whatever reason.
His memories are becoming more fabricated with each passing day. And I try to help, but nothing seems to work.
Maybe I should give this case to someone else. I can’t treat him.
I should talk to his parents once.
Six months after admission
He finally stopped calling me ‘Dad’.
It seems he realises that there’s something wrong in calling me that. I still see the word spring to his lips at times but he manages not to say it out loud. He knows I notice it but I don’t say anything and so he doesn’t too.
It seems he finally thinks that there is something wrong with the present. Maybe it’s not even that much. Maybe he just feels uncomfortable calling me ‘Dad’. But this is hope. And I won’t be the one to destroy this small progress.
He still speaks on the phone, making a conversation with a voice that isn’t there. The imaginative part of his that his father claimed is at least true. I managed to remove ‘imagination’ out of the house and surroundings but hadn’t been able to remove it from him.
Nine months after admission
The frequency of the telephone ‘calls’ is far less now.
It used to be daily, then alternate days and then once in four days. Now it’s once in a 12 days.
I installed a recorder in the phone long ago to record his conversations and from the recent recordings, I know it to be true that Rahul isn’t comfortable talking on the phone.
A year after admission
I think it’s finally time to let him go outside.
I have to take him to his flat, to the scene of the murder. He’s stable now. He ‘speaks’ to his ‘mom’ only once in 20 days, and he’s pretty uncomfortable being around me. He likes this house but I think he doubts if it’s his home.
I have to use this opportunity and remind him of what he should be aware of. This state of mind where he doubts everything is good. Previously, he was so adamant about his beliefs that he did not believe anything else. And so he did not accept anything he did. But now, I think he’s capable of believing something else. He can handle it.
After all, it’s only when one accepts what he did, who he was, that he can truly change.
I’ll tell him about the trip at today’s dinner.
I’ll take him to his house and make him return to who he should be.
2 weeks after current events
I was released from the hospital yesterday. There was a minor concussion and there was no serious damage.
Who would have thought the salesman’s brother would keep vigilance on the flat and come to kill Rahul when he returned? It was a mistake on our part but seriously, keeping one whole year of vigilance? That brother must be crazy.
Luckily, he survived. He fell on his back and the stab was on his front. Gravity helped him a little and he was barely alive when the ambulance came. He’s in a coma now due to excess loss of blood and they say they can’t tell when he would wake up.
Rahul’s parents were downstairs that day. They came to see their son and it was when they called to tell me of their arrival that Rahul snuck out and met Naveen, his friend. They saw him then, as a boy who looked healthy and well and laughed at his friend’s face, however little time that laugh was. I’m at least glad that their only image after an year would not be of a son covered in blood with a knife in his hand.
Finally, I return again to Rahul. It has been 2 weeks since that day and he’s been in a detention centre all this time. I finally went to meet him today. He looked like a sick person, with dark circles under his eyes and sunken cheeks.
When he saw me, there came a look of recognition in his eyes. “This is not an utter failure,” I thought. “If he remembers, it would be easier to treat him.”
But then he said, looking straight into my eyes,
All hope went out. He returned to the state he had been when the treatment began. And I now fear, it’s the point of no return.
Excerpts taken from the diary of Dr. Charan, a psychiatrist who was assigned to treat the mentally unstable patient, Rahul by the orders of the Court.