The Delusional and the Deadly
It was a
gloomy Sunday on which the brothers of my deceased colleague visited the
hostel. They were evacuating the room. A motley band of hostel mates were
helping, and I was one of them.
In
the course of retrieving the articles from one of desk-drawers I found a diary.
And as I flipped through the pages, I realised that it was a personal diary.
You
might say that I am a mean SOB, when I tell you that I decided to keep that
diary. I thought the personal memoirs would be filled with local wisdom that
might help me through my years in the medical college.
If
you thought it was mean then it might comfort you to know that I have suffered
immensely after I went through that diary cover to cover. My suffering was not
inspired by emotion, but by dread.
The
pages that I hereby reproduce recount what transpired in the lives of some
unknown people in some distant place. Yet, after reading their experiences, I
could not help but feel that I know them personally and that’s what troubling
my nights and perplexing my days.
So,
with selfish and cathartic motives, I reproduce the last entry from the diary
of my senior and colleague who died in a train accident a month ago.
Apparently, he fell on the track while running and trying to board the train!
Below
are supposedly his last written words:
Date:
22nd August 2011
The incident that I have decided to commit to paper has violently shook
scepticism out of me, and I can scarcely doubt that whoever reads this
account-- which in fact is only an abridgement of what underwent with me--would
not be forced to revise their belief systems and ideas rooted in rationalism
and nourished by empiricism.
So,
without further ado, I begin the narrative that could not but lie as an outcast
among peer-reviewed papers and theses; the sagas of testable realities.
I
am a student of medicine, for my MS I have opted for Psychiatry. I am doing my
internship at one of the largest and the oldest mental hospital in the country.
Its establishment dates back to the colonial times.
It
was during a normal Tuesday’s after hours when an orderly of the hospital, who
has gotten quite familiar with me, approached me and requested me to meet an
inmate, who he said speaks “Madrasi”.
In the course of my tenure people have come to know that I am a South-Indian
and Madrasi was the colloquialism in
currency among the workers and inmates.
He
said that the inmate draws beautifully and then erases his work. He seldom eats
and is averse to playing cards. I naturally asked him why he wanted me to meet
him and he simply replied that all the inmates are curious to know what he
says. The expressions of the orderly convinced me that this inmate has become
quite an enigma for others.
As
I had a penchant for the odd, I agreed to meet this inmate, who, from now on, I
shall call Mr. K, a 26-year-old schizophrenic. Prior to meeting him, I
requested the warden his case file, which he eagerly handed over to me. He was
one of the youngest patients in the hospital, where the average age of the
inmates must have been somewhere between 37 and 45.
His
case file read like a text-book case of hebephrenic schizophrenia in which the
patient has the tendency to regress to his childhood. Mr. K typically regressed
to his early-adolescence. He would, in the course of his pathological episodes,
talk like a ten-year-old with a penchant for story-telling. I thought I have
found the reason why the other patients find Mr. K amusing.
According
to the file, the inmate raved and ranted for hours on end as if narrating a
story. I concluded that these rantings and ravings are the part of a delusional
construct, little did I know that those utterings held facts that even the most
fantastically bent mind would find hard to conjure up.
I
obtained the permission to meet him the next day. At the first sight, I noticed
his glassy eyes that seemed fitted externally on an expressionless face.
Frankly, his demeanour and outlook disappointed me, not that I was expecting to
meet a Hannibal Lecter, but I find the lad too dull to engage with and I
regretted accepting to meet him. I was soon about to be faced with an avalanche
of terse narrations emanating out of a “convoluted” mind, which upon being
deciphered would bury me under the realisation of the mediocrity of my
knowledge of the human mind.
He
was talking like a ten-year-old, apparently narrating an episode from his
childhood. I was hardly listening intently until the words “he died” hit my ear
drums and Mr. K, from that point on, commanded my attention fully. I was aware
that he might not be able to repeat himself verbatim, owing to his pathology, still
I tried. And he began--
“Vaasu
Anna (brother) was
playing in the courtyard. Kaaki (paternal
uncle’s wife) asked me to get her a glass of water. Vaasu Anna stuck his leg out and made me trip
and the water to spill. I went back to Kaki and told her, she made me sit
beside her and said that she will give me something. She retrieved her old trunk
but the key jammed in the lock. Kaaki
called Vaasu Anna to come and help.
He shouted back, “I am too thirsty to walk just like Kaaki, thirsty all the damn time, I will throw in the village pond.
Let her drink up the whole damn pond dry”, and then chuckled. Vaasu Anna never came and Kaaki and I couldn’t open the trunk that day even after trying for
an hour. Vaasu Anna died that night.”
I
must admit that it embarrasses me to admit that I was taken aback after hearing
the abrupt end of the story that was being narrated by a certified
schizophrenic, whom I was not treating or counselling, yet listening to
intently.
Anyways,
I was conscious enough to make mental notes of the names that appeared in his
story, I exactly don’t know why. But I can justify it by saying that I wanted
to understand the origins of the pathology, as death of close relatives are
potent triggers.
I
was too vain to ask a schizophrenic, who I wasn’t counselling, to elaborate the
end of his story and so I decided to call it a day. I couldn’t believe till
this day that Mr. K held my hand and made me sit back as I was about to stand
up and leave his eyes now as expressive as a Broadway actor, yet that’s what
happened and I sat back again, this time as a captivated audience.
“A
day before Onam, Puva (Father’s
sister)
was looking frantically for the comb which I was playing with and when she came
in the Kaaki’s cabin, I was combing
her hair with it. I used to comb and braid Kaaki’s
hair. You know, Puva sneered, threw
things at Kaaki, hurled abuses and
called her a bald-headed witch, before snatching the comb from my hand and
slapping me. Puva died that year
before Diwali.”
At
that point, I became increasingly convinced that Mr. K’s pathology is making
his subconscious link the death of his family members to Kaaki’s annoyance. This, I though, was typical run of the mill
magical thinking that such patients exhibit.
I
may have reached my banal conclusions about him but Mr. K surely wasn’t done,
he began without even stopping for what could viably be called a pause.
“Kaaki had begun to wet and soil her bed
every night, I cleaned her and her bed. One morning, I was out to buy milk,
when I came back, I saw my sister-in-law berating Kaki. She was saying to her
that she should eat to live, not live to eat and she should be dead and it’s a
curse on the household that she is still alive.” There came a pause and I was
strangely relieved that this one did not end with someone dying. And then it
came like a lightning bolt “Kadambari (I deduced that he was talking about his
sister-in-law) died two days before Kaaki’s
death, she drowned in the village pond.”
Mr
K. finally fell silent, and this time when I stood up, he did not look at me.
Although, I bid him good bye he remained laid back in his chair like a man
relaxed after a cathartic session.
I
couldn’t help but think about the frequency of deaths in the family of Mr. K’s
story. If it were true, it would be the news of the town, let alone the
village. The police must have been involved. In all there were four deaths and
it can be deduced that the deaths happened in quick succession, as the narrator
remained more or less the same age until the culmination of the story.
I
can’t decipher why but next week I met with the Doctor who was originally
handling the case. I requested for the case file. On the condition that, I will
not make any notes. I didn’t want the doctor to get the impression that I have
been keenly attending to the grape vine and operating on my whims. Therefore, I
took great care to explain to the Doctor that I was interested in it for
scholastic reasons as I suspect that his delusions are deeply associated with
the folklore. And I told him that we are from the same geographical regions. He
had no reason to deny me the case history, his treatment regime could not have
been shared and I was hardly interested in it.
The
file was in my hand and I wanted to ascertain through my reading of it what
emotions are exactly triggering his episodic regressions and wherefrom his
delusions emanate. I, up till that point, suspected that he might have invented
the names of the family members and that all of them perhaps existed only in
his imaginations.
I
started with the family history. As it turned out, Mr. K had a brother named
Vaasu and the Kaaki, who was at the centre
of K’s story actually existed. She was the maternal aunt of K’s father and had
bequeathed her property to his nephew in exchange for care and shelter. And lo
and behold, there was a cousin whose wife was named Kadambari.
Now,
I was intrigued. All the characters in his story were real, where was and what
was the delusion then. I was investigating the reality of a delusion; I was
grappling with a paradox.
I
convinced myself that the delusion must be inherent in the instances of the
lives and sequences of the deaths of the members of the family. The file also
mentioned the deaths that had occurred in K’s family between his tenth and
eleventh year. The deaths were explained from K’s perspective only and it said
that they seemed to have not affected him instantaneously, as he continued to
live normally under his father’s care for several years before his symptoms
began to appear.
The
information had instigated an unhealthy curiosity in me and then the next thing
I did would be termed unprofessional by many but I was as if under an
unexplainable influence.
I
contacted my friend who was in state police department of the state from which
I and K come from. I asked him to get me the police reports of the deaths and I
was sure there must be post-mortem reports, as certainly all the deaths except
that of Kaaki’s were unnatural.
My
friend obliged and I got the copies of the report after nearly a month.
Vaasu,
K’s elder brother had died at age fourteen. The cause of his death was
documented as Cerebral Edema caused by water-toxemia, in short, Vaasu had died
of water intoxication. It is an extremely rare cause of death and my medical
training had afforded me the knowledge that water if ingested at a rapid rate
in quantities larger than the kidneys could process and expel, then it causes
electrolytic imbalance and if intervention is not made and the brain cells
start to swell, death follows.
It
was uncanny, Vaasu died of drinking too much water, too fast. I remembered in
K’s story, the words “I can’t come I am too thirsty..." were attributed to
Vaasu.
I
feverishly began to search for the reports of Puva’s death and post-mortem, the cause of the death was GI
obstruction and intestinal rupture. I read the medical history and it struck me
when I read that she was suffering from Trichotillomania, (the
compulsive feeling to pull out one’s hair). The GI obstruction was caused
by the hairs she ate after pulling them out of her head. A shiver ran down my
spine, as I remembered that in K’s story, Puva
had berated Kaaki concerning her
baldness.
I
was shaken to the core and I wished I could find something, somewhere in those
files with which I could refute that weirdo’s narrative and the horrors it
implied.
I
began to read again. The sister-in-law’s death was ruled suicide by drowning.
It was the medical history that challenged my wits. The lady, at age 27, had
developed faecal and bladder incontinence. She had lost voluntary control of
her bowel movements and bladder which made her extremely depressed owing to the
stigmatisation it incurred her. She, in all likelihood, took her own life due
to her illness which is equally, if not more, in young people as water
intoxication and trichotillomania are. And, at this point, I couldn’t help but
look at the corresponding sequence from that, ungodly story of the strangest
hebephrenic I will ever meet in my life who had a distant grandmother with
mystical powers.
My
scepticism made a final attempt and I reasoned to myself that may be the story
was made backwards i.e. the boy invented the sequences of unpleasantness the
victims had with Kaaki afterwards.
But then I thought about the rarity of the conditions and the fictional
acrobatics that kind of story invention would require.
I
couldn’t sleep that night and remained tormented for weeks. I read all I could
about mysticism, psychic powers, telekinesis, curses, psychological anti-placebo
and what not.
I
was failing to restore my faith in the exclusive authority of science over
reality and my cynicism and scepticism were moribund.
Today,
I went to Mr. K once again and this time I tried to induce him to tell me how
he ended up in the asylum. He stared at me without saying a word. I was unable
maintain eye-contact with him, maybe subconsciously, I was guilty about
betraying him by fact-checking his story.
Suddenly
he spoke, will you play chess with me?
It
amazed me that K could really play chess, I still though chess to be one of
those past-times of the sophisticated. I stood amazed for a moment, collected
myself and then agreed. My afterthought was that we might establish enough
rapport for him to divulge his entire story to me. I sent an orderly to get the
chessboard but he came empty handed. We would have to wait for at least two
hours for someone has thrown away the chessmen out of frustration of defeat.
I
explained the scenario to K, “I will make the chessmen with stones,” K replied.
I said to him that it’s better that we take a rain check as I have a train to
catch. K was visibly displeased. Then I stood up and made my way through the
corridor, leaving the mysterious K behind.
I
couldn’t catch the train today, my colleague insisted that we take the bus
together. I have promised myself that I will never speak about this incident to
anyone, not even to my friend whose connections got me those medical and police
files.
And
I will play chess with him some day, I hope they don’t put him on a heavier
dose of chlorpromazine as it would take the chess out of him. But what can we
do?
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