Chapter 1: Mental Prison

Stephen could not remember the last time he felt normal.

He stepped into Dr. Ray's office, forcing a smile as he walked in.  Behind the desk, the psychiatrist was skimming over his notes.

"Have a seat", he said, still staring at his portfolio.

Stephen liked it when people didn't make eye contact.  That way he knew for sure they weren't reading his thoughts.  He looked out of the window behind Dr. Ray.  The sun beamed down on the rush hour traffic.  Stephen always made it a habit of staring out windows.  He needed to make sure that no one was watching him. 

Dr. Ray looked up, "Welcome back", he said.

Stephen turned away and looked at the green bobblehead on the psychiatrist’s desk.  "Umm, I uhh..."

"There's nothing in there Stephen", Dr. Ray gave a slight smile. 

I know, Stephen thought.  Or at least he thought he did.  Everything was a little fuzzy since he ran out of medication.

"So have you seen improvements, has the medication been working?”

"Yes." That was true.

Dr. Ray’s radio was playing Beethoven's Moonlight Sonata.  For a place that sees depressed people on daily basis, wouldn’t be better to play something more uplifting?  Stephen hated this song ever since his dad passed away.  His dad used to play it every day when he was practicing on the piano. 

"Steven...Steven? " 

Steven turned away from the radio and looked back at Dr. Ray, "Huh...what?"

"I said are you continuing to have any auditory or visual hallucinations?"

"No."  That wasn't true. 

"No unusual side-effects?"

"None"

"Well I guess that settles it.  I'll prescribe you another dosage and we'll be on our way"

Stephen hand tightened around the arm of the chair.  "Is that it?  For the last three sessions all we have been doing was prescribing medications”

"What else is there to do.  You said yourself that the medication is working"  Dr. Ray said.  Stephen looked down at the portfolio and could see that it was the profile of some other patient.  Apparently it was a busy day or he wasn't important enough to be attended to.

"I’m not looking to feel just a little better doc.  I want to be cured.  What about a therapy session?"

"You have been doing therapy for six years prior to coming here.  We both know therapy hasn't been successful, but if you want I can schedule another appointment with Amy.”

Steve could feel a lump in his throat.  This was the 3rd psychiatrist in the last year.  None of it worked.  CBT, psychotherapy, different doctors, pills, it was all shit. 

Dr. Ray sighed.  "Ok, is there anything new that you wanted to bring up" 

"Yes" If you aren't too busy, Steven thought.  He wished he said it out loud.

The doctor touched the rim of his glasses in order to straighten them, and then placed his notes down.  "Go on", he said.

Steven paused for a moment, thinking if Dr. Ray would consider sending him to an asylum.  Just another loony in the loony bin, the voice said.  The radio changed its track to Fur Elise, and while the afternoon sun shined through the window, the room still seemed dark and claustrophobic.  A chill ran down his spine.  Maybe she didn't want Stephen to tell the doctor.  Secrets are better left kept, the voice said.

Stephen placed his fingers on his temples.  Sometimes that helped him ignore the voice.    He couldn't let his psychiatrist know the voice was still there.  They would send him away for sure.  Funny, Dr. Ray told him one day that most schizophrenics refer to their auditory hallucinations as voices, but Stephen referred to his as "the voice".  It was always one voice and always female.

"Stress?", Dr. Ray said.

"Yes", Stephen put his hand back on the chair's armrest.  "I've been having strange dreams when I sleep...well...nightmares.  I'm not sure what they are" 

Tell him and you'll regret it, the voice said.

The doc leaned forward and rested his arms on his desk.  He now seemed interested. 

"When did this start happening?"  Dr. Ray said.

"It started two weeks ago, and it has been happening on and off.  Seven out of fourteen nights for the last two weeks" Lucky number seven, the voice said. 

Steven continued, "I'm not sure whether to call it a nightmare or a dream.  Because it starts off peaceful, you know?  Like most of my dreams, peaceful and trivial.  It could be a picnic with my sister or a day at school.  But then..."  Stephen palms were cold and moist; he was sweating.  "Then something strange happens.  I begin to feel an intense fear.  It is like I'm having a panic attack.  I feel like the room is closing in on me, and everything is getting darker.  Like someone is dimming the lights."  He could feel sweat perspire on the back of his neck.  He adjusted his collar.  "Then I hear this laughter, a woman laughing, like she is taunting me, and I see something, something that scares me even as I tell you this" 

The doc kept a blank stare, Stephen continued, "And after that I wake up sweating. Sometimes quiet, sometimes screaming"

"What do you see Stephen?"

Stephen didn't want to tell the whole truth.  "You know what the scary thing is doc?  Nightmares are supposed to be different every time, at least mine were.  After the laughter I see a figure in the distance.  It is a person in a brown bathrobe with long gray hair.  She gets closer and closer with every nightmare, but I always wake up before she gets too close, before I can see her face" I never want to see that face.  "Every time I see that person, I know it is the same woman laughing.”  Steven paused, unsure if he should say what was next, then said, “The scariest part about my nightmares is, I swear she is with me when I’m awake.” 

Dr. Ray raised his eyebrows, "The same woman?"

"The same woman"

There was a moment of awkward silence.  Stephen wondered what his doctor was thinking.  Does he think I'm insane?  He probably always thought that. 

After what seemed like minutes Dr. Ray finally said, "I'm going to prescribe you something new.  It’s a new antipsychotic. But just a warning, it's a little stronger than the last."  The psychiatrist stood up and walked towards the door.  "Just give me one moment while I write the prescription", he said as he closed the door behind him. 

Go look, the voice said.  It's open.

The moment his psychiatrist left Stephen jumped out of his seat and ran towards the filing cabinet.  Stephen couldn't believe it.  Dr. Ray had left his drawer open.  He quickly pulled out his file, and then skimmed through the notes: 

Name: Steven Goldstein; Age:  21;  Diagnosis:  Paranoid Schizophrenia. He opened the notes halfway, and read:  Patient continues to show signs of delusional and magical thinking.  Even with medication, he still has trouble separating myth from reality.  It is my recommendation that he receives a stronger...

That wasn't what Stephen was looking for; he turned near the end:

Patient shows improvement since he was first incarcerated.  Unfortunately, while the medication is showing a positive effect and he has no more signs of hallucinations, he still has problems with trust that borders on paranoia.  Looking again at his patient history, since his diagnosis 12 years ago, he has been treated with nearly every form of therapy and medication modern psychiatry has to offer.  Therapy has no positive effect.  While medication initially works, the symptoms eventually return worse than before, eventually resulting in receiving a new prescription.  The patient's options are running out, because presently there is only one antipsychotic he is responsive to, and the effects have been gradually mitigating. I regret to say this, but if one were to ask me if the patient will ever again function at a normal level in society, I would say that the chances are slim to impossible. 

Impossible.  Hopeless. He threw the file across the room and heard a thud as it landed against the wall.  He felt the afternoon breeze from the open window, and Stephen swore he heard a faint noise that came with it.  It sounded like laughter.