White Washed Walls

The mirror showed a reflection that wasn't my own.

The mirror showed a reflection that wasn't my own.

The mirror showed a reflection that wasn't my own.

Source: A Transcript from a recording taken at 6:45 a.m. Patient Y. 28.3.23

Usually, I am efficient at cleansing my mind of a patient’s delusional rambles. One does not become a successful experimental psychiatrist without developing a cast iron stomach for emotional sludge. Today, however, my usual robust resilience feels somewhat compromised, and I am struggling to draw the necessary line to allow myself to retire for the evening.

I am a man who believes in empiricism. Usually, I would take the daily lab test results, run the numbers and log the standard deviation. This would tell me, accurately and concisely, without any emotional interference, if the administered therapy had succeeded, i.e. if the gap between the perceived independent and collective identity of the patient had reduced.

An example of how I usually document my day:

Patient X is responding well to the treatment. Measures of the independent self, observed using the AIQ-IV (Aspects of Identity Test), demonstrate that the patient's identity is now within 0.4 standard deviations from the mean.

Source: Laboratory Diary Excerpt. 23.3.23

This is an exemplary professional record of that day’s events because it says everything required of it. No more, no less. It says that medical intervention has enabled Patient X to narrow the gap between their perceived independent perception of self and that which the general populous holds about them. It says what it needs to without any unwanted fug. Like a breath of fresh air. Clean and crisp.

It is frustrating that I cannot complete today's report with my usual practical succinctness. If today had been the 23rd, my report would have already been written, and there would have been no need to cancel the golf club dinner or drink four fingers of scotch after supper.

As I say, I am an empirical man. Faith in numbers truly can keep a person on an even keel. All scientists will tell you: follow the numbers, and you will get to the truth. It is my sincere belief that numbers hold the keys to the universe. One day, I have no doubt, humanity will formulate an equation allowing humankind to distil life's essence into a single digit. In this, mathematics has my unequivocal faith.

Still, as my dear departed mother would have said, oddness begets oddness, Charles. Indeed. So, it is not beyond the realms of comprehension that, given the oddness of Patient Y, I, in turn, find myself at odds with having to take the unusual step to indulge in introspection. It would seem that despite my wealth of experience and robust tutoring in professional resilience, I am not entirely safe from the fetters of sensibility. To be honest, it has come as a surprise. However, I must applaud myself because I have already travelled a fair way along the thoroughfare of reconciliation and reached a conclusion that, rationally, every modern professional is allowed at least one day of sentimentality. One could indeed argue it is healthy to do so.

This preliminary conclusion was expediated earlier before I took pen to paper. With the fire rolling in the grate to the side of me, I stole a moment of repose to consider the value of indulging in this type of qualitative data production. Reclining in my Father's old wing-backed chair, I considered the content of all the richly hued leather-bound books that lined the walls in my study, volume after volume of academic rumination lined up like soldiers, edge to edge. As I gazed around, I realised that if the practice of excising one’s innermost sanctuary onto paper was good enough for all my academic forefathers, then tonight, it shall be good enough for me.

So here we are, and as I write, I believe I can extrapolate and take this grain of thought further. Academia’s modern existence, its manifested evolution, has spawned from humankind transferring their thoughts onto paper, to books, and into library collections. Humanity’s decision to document its thoughts enabled its original thinkers to free up the capacity of their minds to make further original thoughts. In doing so, they also made their thoughts transparent and preserved for future original thinkers to connect with. One could very well say, in light of this context, that it is my academic duty to unbridle my mind and release the emotional goblins that have taken to stalking it today.

Ironically, and I am chuckling a little as I write this now, the scotch has clearly helped to ease my mood; the conception of such human connectedness of knowledge and communication plays a substantial role in my field of psychiatric experimentation and exploration. When humankind moved on from books stored in libraries to PDFs stored in clouds and conjecture organised into digital platforms, well, both disassociative collective identity disorders and independent identity disorders went through the roof. Nowadays, with the push of a single plastic button, one social media photograph can bring about a veritable downpour of opinions that can often conflict with an individual's concept or perception of their independent self.

It could be said that my whole field of study began primarily because of this proliferation of connectedness. It has become a societal scourge, a profitable one, I grant you, but one to which none of us is immune. I have treated a plethora of society's celebrated great and good over the years. Many notable people have come to me to help them bridge the gap between perceived independent self and collective perception. I confess that I have even had a few nips and tucks along the way to elevate my self-image to what is expected from a person of my professional standing. As I say, nobody is immune.

As I indulge in this contemplative sojourn, I should take the opportunity to state that I am incredibly proud of how many people I have helped over the years. In fact, I have been so successful that I have recently had the opportunity to take quite extensive pro-bono work. Due to the financial freedoms my work has provided, I can now support a demographic of persons who could not typically afford my services.

One should always do what one can.

Anyway, I drift; the scotch has my mind rambling. Back to Patient Y and what it is about this patient that has me rather needled.

I should clarify that I do not believe what Patient Y said per se caused my consternation. I have, after all, heard the exact words, or variations thereof, spoken by many patients over the years. Most, I have found, speak the words with delight. After my initial cosmetic alignment, I, too, found my first look in the mirror quite extraordinary. Our faces, after all, play a centrifugal role in how we humans identify ourselves and others. I remember thinking that I felt reborn in many ways. I had woken to find that I had the face I deserved. Not only that, I had the face that society expected me to have. I enjoyed the great sense of calm it gave me. It was a soothing experience to align my perception with that of others.

Also, much like Patient Y, I remember pawing at my face quite a lot, perpetually touching the new parts. This is indeed how most patients react, and it is perfectly understandable. It is symptomatic of self-awareness. When one wishes to establish if a child, for example, is aware of itself, one paints a mark on its face while it sleeps and then holds up a mirror to see if they try to remove the mark from their own face or from the one they see in the mirror. The self-aware always paw their own face. The difference is that here, we had to deploy a straitjacket because Patient Y clawed rather than pawed when shown their reflection. Of course, using a straitjacket is not an unusual practice in a psychiatric facility. Still, it is one I feel worthy of noting, if only for the completeness of the record.

It is interesting that I chose the word “reborn” when describing how I felt when I had my initial round of surgery. Interesting because I have tried all day to recall where I had heard a howl like the one that persists in rumbling out of Patient Y as they rock backwards and forwards, muttering in Lab C. Until now, I have not been able to place it, but, my goodness, finally, I recollect where I have heard it before. That noise, that constant, repetitive noise, reminds me of the vagital mewl of babies birthed by drug-addicted mothers in the maternity wards of the community hospitals I interned at.

Yes. Such a relief! Thank heavens I made that connection.

Let me travel along that thought a little further. It is the sort of mewl that comes with a hunger that can never be satiated. The noise created by Patient Y is exactly like this. It rattles around the white-washed hallways of the laboratory as though it is crawling along them, trying to find a door to a reality that can save it. It is a noise of despair, of wretchedness. It is a noise that tells us that it does not want to be alive, that it wishes it were dead.

And there, before I fall foul of putting any more hyperbole into the mix and start a slow disintegration down to the happy-clappy day care centre, in socks and Birkenstocks searching for a job, I shall leave it. It is clear that I have experienced today nothing more than a form of emotional déjà vu. Mere ghostly memories from medical school seeping into the present day. Done. Thank goodness I have concluded that malingering business. Tomorrow, I can continue with my charitable mental health work and carry on removing tramps off the streets to repurpose their faces so they look like what the public expects of a person with such diminished standing.

Marvellous.

Now, if I hurry, there is still time to make it to the club for drinks!