About a week later, I received a message from the medical director via Dr. P——, who, of all people, had grown strangely upbeat and energetic with the departure of the patient he knew as Joe. It was as though my colleague and I had traded places. I felt discombobulated and depleted, uncertain our work was worthwhile in the face of the damage I saw all around us, while Dr. P—— was animated by renewed vigor. Still, he wasn’t verbally abusing me, so I accepted the change with equanimity. The message he brought from Dr. G—— was a report that Martha M——, Joe’s mother, had committed suicide. A gardener found her two, or possibly three, days after Dr. A—— died. It seems she leapt from the window in her son’s bedroom. There was no mention of anything untoward found in the house or in the bedroom. No mention of a hole chopped in the wall or a crypt for the bones of her young son. I’ve no idea what to make of that, and since I hadn’t seen Dr. G—— since, I was unable to ask her.
The hospital regained some measure of normalcy within the next two weeks or so, but I was in an anxious funk. Despite my record as the one doctor who had come away unscathed after working with Joe, I was an abysmal failure. And there was one more calamity to come.
About two weeks after the fiend disappeared, I was woken by campus police and brought to the university hospital, where I found a bruised and bloodied Jocelyn. The instant I looked at her, I knew everything was wrong. Her normally bright and expressive green eyes were dead and glassy. Her hair was disheveled and tangled. Her expression was manic and brittle, in a way that shocked me. When I tried to put my arms around her to comfort her, she recoiled, as if the very thought of being touched made her ill. Then, slowly, she melted into my arms with a crooked, broken smile that spoke all too clearly that she’d experienced something profoundly traumatic.
The police explained that Jocelyn had been attacked after leaving the library that evening. When asked about her assailant, as you may have already guessed, she described a slight man with scraggly blond hair and unfocused eyes—in other words, to my mind, the human form taken by the Thing that called itself Joe. I could only assume it had somehow followed me into the city.
When I heard that, it took every ounce of sanity I had for my mind not to crumble. How could I, a man who had begun medicine because I couldn’t bear the sight of one of the most significant women in my life, my mother, being broken by neglect, have let the other one be similarly broken by my neglect? It was agonizing to think about, and all the more so because of how deeply I loved Jocelyn, and how much it ached to see her wounded in such a primal, irreversible way. Had she not been severely injured and in need of hospital care, I might have run away from New Haven, from her, and from my entire adult life right then, knowing that the one thing I felt that I was put on this earth to do—to heal and protect people—had been the cause of my failing someone I loved. I realize how unreasonable that probably sounds, but in all fairness, I was an emotional mess.
It was impossible to deny the peril that I may have inadvertently brought to Jocelyn—and the whole world—even for a moment, and almost as terrible was the complete senselessness of it all. Just when I thought I had the fiend figured out, it surprised me again. I had thought it wanted to be locked up, surrounded by the psychologically miserable in our hospital, so why escape now? It had been living comfortably on that ward for decades and had easily neutralized the threat I posed. Why risk its luck outside?
Unfortunately, I did eventually come up with a theory for this last question, and it instantly filled me with guilt. As I recalled the last conversation between me and the Thing, I remembered that its reason for staying in the hospital was that it “didn’t know how to be prey,” which is to say, how to act human. What’s more, it didn’t change its shape in response to my “fluffy bunny rabbit” taunt because I “didn’t believe it.” Furthermore, even though all its means of inflicting psychological torture relied on knowledge a human couldn’t have, they were still methods that a human could use. Therefore, the only conclusion I could draw was that as long as everyone on staff treated the Thing as if it were human, it had to go along with their perception.
So in his own terribly sad way, poor little Joe had imprisoned it by making it pretend to be human. True, one patient had called it a “fucking monster,” but it must have sensed that he meant a metaphorical monster, not a literal one. The patient didn’t believe it was inhuman, so it couldn’t change. And as long as no one else called its bluff, it was trapped in that form.
But then I had to come along and tell it that not only did I believe it wasn’t human; I knew it wasn’t. Which meant that I must have freed it to assume the most effective shape, whether it was a monster, a person, or the wave of piss and blood I had felt in my dream. And with its ability to shapeshift restored, it had no need to rely on our hospital as a sanctuary where people were trained not to believe in monsters.
Such was, and is, my theory for why it escaped. Sadly, there is likely no way I’ll ever prove or disprove it, which means that it will weigh on my conscience, unresolved, forever.
May 1, 2008
I thought the April 30 post was truly my final one, but I simply cannot leave things on such a negative note. I want you to know where we stand now, and what I’ve done to try to make amends in this world.
Jocelyn was deeply scarred by her assault. She spent a couple of days in the hospital, then retreated to our bedroom for further recovery, only to fall into a cataclysmic depression. When she began insisting she had no desire to finish her doctorate, even going so far as to smash her computer and backup discs in front of me, I introduced the idea of moving. We needed our own escape.
Jocelyn dropped out of her program, and I decided to go into private practice. My contacts from residency and medical school enabled us to move. I’ll admit it’s out of the region, but I don’t wish to say where. Assault and trauma change a person. For a long time, I barely recognized Jocelyn, and I suspect she felt the same about me. Still, our love was enduring, so we married about eighteen months later. Every day, we learned each other anew. Our scars are still with us, and I can see Jocelyn still fighting depression. She presents a happy aspect to me but has become a devoted homebody and displays no interest in making new friends. She says I am all she needs.
For my part, I have always needed to make a more meaningful contribution. Maybe because I didn’t grow up cushioned by wealth as Jocelyn did, or maybe because I know I bear responsibility for my part of this story, I will spend the rest of my years atoning.
To that end, I’ve been using the knowledge I gained from that one patient in the best way I can. I’ve opened a boutique psychiatric practice that specializes in treating children with paranoid delusions or fear disorders. Some have been fairly standard cases, while others have involved shared delusions, like the boy whose parents thought he was being haunted by his stillborn sister’s ghost.
Every now and then, I get a child who tells me about a monster that won’t let them sleep. Sometimes it comes from the wall. Sometimes it comes from the closet. Sometimes it comes from under the bed. But wherever it comes from, it’s always the thing they’re most afraid of. Except now there’s another detail, which makes sleep difficult, even for me: sometimes, the monsters goad their victims, saying they’re just children who’ve been turned into monsters and asking the children they torment to “free” them by telling them they’re people, too. Worse, sometimes I’m not sure if those children are really even asking for my help, or if they even are children. Perhaps they are fiends similar to Joe, gloatingly showing off their handiwork to the one person who would know what they are and how to stop them. Sometimes I think they’re laughing in my face behind those terrified, ostensibly innocent children’s eyes.
But whatever the reason these youngsters tell me their stories about what terrorizes them at night, the fact is that some of them definitely are human children. And those defenseless, desperate babes and their families are the people for whom I’m in medicine. Because unlike other doctors, I know wh
at the stakes are. Maybe I’m paranoid, too, but I remember the monster’s words. I remember how it exulted that nothing like me ever got the chance to be prey, and I shudder at the connotations of those first three words, because I know what they mean: whatever “Joe” was, he wasn’t the only one. There might be an entire species of those things living alongside us and only now waking up to the fact that they can live among us.
Well, I’ll be damned if I let another one take over a child’s life. And I guess my suspicions are usually right, because the kids I treat who do suffer from those sorts of nocturnal visitations rarely need a second session after I’m done with them.
Until now, only Jocelyn knew this story. And she believes me. She has been emphatic in her desire that I tell it to someone, so insistent that sometimes I think she seems hungry for it. Until recently, I’ve always told her no.
But just a few months ago, before I started writing this, she told me she was pregnant. And this time, when she asked me to write this story for an audience, she had a damn good reason.
“I want you to remember what a good man you are, Parker,” she said to me. “You don’t understand that you’re the best thing that ever happened to me. You don’t get how free I feel with you. How much I like the person I am with you, despite everything that’s happened. And maybe you never will. But if you don’t know you’re a good man, how can you trust yourself to be a good father to our children? Who knows? Maybe if you tell this story, you’ll be able to forgive yourself. And besides, would a good man let the world go on being ignorant about the things you know?”
Hearing Jocelyn say that, for just a moment, I glimpsed the woman I’d fallen in love with hiding behind the manic, crooked smile she’s worn since her ordeal. With that flash of recognition, I knew I couldn’t refuse her.
So here I am, typing this out and praying you’ll believe me. If you don’t, that’s fine. I’m not sure I believe it myself, or if this is just an episode of some larger psychosis that one day will drive me as insane as my patients. But if you’re parents, or psychiatrists yourselves, and you have patients or children who are telling you stories like the real Joe’s, then this is the warning I am obligated by medicine and by my common humanity to give you:
Whatever you do, don’t tell your child that the monsters they see are only things they created with their imaginations. Because if even a little bit of this story is true, you might be signing their death warrants.
Thanks for reading.
All my best,
Parker
Acknowledgments
Firstly, thank you to Jaime Levine at Houghton Mifflin Harcourt (HMH) Books and Media, who gave me the gift of an editor I could trust implicitly with my mind’s output, knowing she would sharpen and darken it to perfection. Thank you as well to Dr. Harrison Levine for answering innumerable questions about psychiatric practice from an enthusiastic amateur. All mistakes are either mine or what Joe demanded for the telling of his story. I also wish to thank Katie Kimmerer, HMH managing editor, as well as Laura Brady, manuscript and copy editor. Additionally, my gratitude to Wendy Muto at Westchester Publishing Services for guiding The Patient through the nuts and bolts of the production process.
Also at HMH, thank you to my publicist, Michelle Triant, who has fielded all my panicked emails with expert aplomb. Thank you to my marketer, Hannah Harlow; HMH publisher Bruce Nichols; HMH editorial director Helen Atsma; editorial assistant Fariza Hawke; and Tommy Harron and the audio team; as well as Ed Spade, Colleen Murphy, and the entire sales department. Additional thanks to Ellen Archer, HMH trade president; Lori Glazer, senior vice president of publicity; Matt Schweitzer, senior vice president of marketing; Becky Saikia-Wilson, associate publisher; Jill Lazer, vice president of production; Kimberly Kiefer, production manager; Emily Snyder, design supervisor; and Christopher Moisan, art department director. On that note, last but not least, thank you to Mark Robinson for the superbly claustrophobic and disturbing cover design for this title.
Thank you to my manager, Josh Dove, at Stride Management, for taking a chance on me before I thought I deserved one; to my film/television agent, Holly Jeter, at William Morris Endeavor (WME), who managed my entrance into the bright, scalding lights of Hollywood; and to my literary agent, Joel Gotler, at Intellectual Property Group, who stands as the guardian of my creativity in the literary world. Also at WME, thank you to June Horton and Beau Levinson for negotiating tirelessly on my behalf and for braving the slings and arrows of Hollywood’s legal system. Thank you to Ryan Reynolds and Roy Lee, who changed my life forever when they decided to bring my little monster-that-could to the big screen.
Thank you to the many friends who inspired characters and encouraged me to put them on paper. In particular, thank you to my Dungeons & Dragons group (you know who you are), who first pushed me to try my hand at writing fiction. Thank you to McKenna, without whom the patient would not have gotten his name. Thank you to my mother for keeping my imagination alive through childhood and for never ceasing to believe in it even when I had. Thank you to Stephen, the father I should have had. Thank you to Sophie, who relentlessly forced me to keep honing and believing in my skill as a writer. Thank you to IHOP for the bottomless iced coffees that kept me writing the first four chapters of this story before I ever thought of sharing it with the world.
Finally, thank you to every Reddit user who up-voted this story when it made its debut in December of 2015. Without you, The Patient would never have been finished. Without you, it would not be where it is today. Without you, I would be a different man. From the bottom of my heart, thank you.
About the Author
Jasper DeWitt lives in Los Angeles, California. This is his first novel.
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