In my time I have been forced to deal with some difficult patients. Some were beyond help and others simply would not accept it. Disappointing as those instances were, I learned to deal with failure. It came with my line of work. Alan was the only patient who made me wish I had never tried.
Iâve always found it a little funny, the way we admire athletes. They set a bar, inform us on just how far the human body can be pushed. What itâs really capable of, but rarely do we separate ourselves from them. âHe should have caught that!â we say, or âWhat the hellâs he doing out there.â As though we feel that, with enough effort, everyone is capable of such feats. Iâm guilty of it myself. It is as if we cheer for the strength of the species, rather than the individual. Less common is the biological paralleling of the human mind. We see madness and horrible acts of violence as something detached from the common man or woman. âThere’s something wrong with him,â or âheâs a monster,â we say. Itâs largely believed that there is a mental defect or malfunction that sends the man to asylums or correctional facilities. That the average man or woman doesnât possess the capability, or lack thereof, to end up in these places themselves.
It is of my opinion, that it is nurture and not nature which sends a person into madness, however in all my years of schooling and professional study I couldnât pinpoint a specific trigger. It was a secret goal of mine to understand what sets reasoning astray so far as to require long term institutionalization. The places we send those we perceive to be mad or violent have a shockingly low rate of rehabilitation. To recognize and prevent the circumstances that lead to an individualâs confinement in the first place, would be a large step for societyâs well being.
The case of Allan krone was a remarkable one. I was used to getting assigned to patients with severe mental disorders, but few who spoke so articulately or with such a colourful past.
He had a long psychiatric and criminal rap sheet. Born to a middle-class family in the suburbs of Massachusetts, he was raised by both a loving mother and a kind father, neither maintained any known addictions nor were there any reported cases of abuse in the household. His grades were above average in school, and there were no instances of bullying he or his parents could remember. The child seemed to blend into any situation quite well. His parents regarded him as a very calm, intelligent, and thoughtful child up until the age of fourteen. This perhaps, was what made his extreme change in behaviour seem so dark in contrast to the years leading up to it, and yet gave hope that he might, one day, return to his original demeanour and conventions.
Allanâs change was abrupt. Prior to the event that led to his incarceration at a local mental hospital, nobody noticed any angry or aggressive behaviour in him, and there seemed to be no build up to his horrid acts, other than the changes in his sleep patterns.
He had never complained of nightmares before, at least not any more than most children do when theyâre younger. Partly into his fourteenth year, his parents began noticing that he was staying up much later than usual, and was developing dark rings around his eyes. His father came into his room to check on him one night and found Alan pacing and sweating next to his bed. Just a bad dream he said, though when his father checked on him an hour later he was sitting up awake. They wrote it off as stress and hormones. It wasnât until they found him sleepwalking that they decided to take action.
It was his mother who found him. She heard footsteps above her bed and left the room to find the attic stairs outside her room had been extended, but the light was off. She poked her head up only to see a dark figure with its back turned rocking back and forth over a small open box. It was Alan. She walked over and put a hand on his shoulder. He screamed, swatting at the air and running his hands up and down his body. When he finally calmed down she sat him down at the breakfast table and made herself a cup of tea.
âI think we oughta see a doctor about this Alan. You donât look well.â
âIâm ok, just another bad dream.â
âYou’re not sleeping, and I’m getting worried. Your grades have dropped and now I find you up above our room in the middle of the night. What if you slipped on the stairs? You couldâve really hurt yourself,â she said, âThe doctor can help.â
âGood I’ll set up an appointment tomorrow morning. Now try and get some sleep.â
âGoodnight,â she said
âWhose stuff was that in the box?â
âYours from when you were a baby.â
âWhatâs in that vase?â he asked
She smiled and said âNothing, it was just a gift. Go get some sleep.â
The doctor prescribed a sleep aid which he was to take every night before bed. Even with the medication, his parents saw little difference. While his mother was changing his sheets one day she found that he had been hiding the pills inside his pillowcase. That night she made him take the pill in front of her and checked up on him later to make sure he was asleep, and sure enough, he was.
The morning of his first psychotic episode started like any other according to his parents. He got out of bed at the appropriate time, made himself breakfast and packed up his book bag for school. His mother noticed he was quiet, but simply assumed it was a side effect of the medication. She wished him a good day and he started on the walk he normally made to the class. Everything seemed alright until a teacher noticed his absence and called Alanâs parents as was customary for the school. After the boyâs mother assured the teacher that she had seen Alan leave for class, a town search was underway.
After all main roads were examined the police spoke to the family’s neighbours for information. Jennifer, the elderly woman in the house next door said she hadnât seen him, but added that her dog Lucy was nowhere to be found. Another neighbour thought she saw him walk down the trail to the old stone bridge in the woods.
The police found Alan about a half a mile down the trail, his shirt soaked with blood. A couple yards away, they found a leash was tied to a nearby tree. The other end was clipped onto the collar of Lucy, or rather, what was left of her. I will spare you the details, but needless to say, it was quite an upsetting scene for those who saw her. His eyes were glazed over, but once the police began talking to him he began to shake and weep hysterically, clawing at his stained clothes. It seemed he hadnât fully comprehended what he had done until presented with an audience. Alan spent the next four years of life in a mental institution specializing in violent adolescents.
Upon entering the institution, nurses reported him as being quite paranoid and uneasy around others, but his most notable condition was in his sleep pattern. He stayed awake hours later than the other patients, sometimes for several days, and when he did drift off he tossed, turned, and inevitably woke up covered in sweat, yelling loudly. Once awake he would run his hands up and down his body vigorously checking for something that wasnât there.
Initially several of the nurses and staff members expressed how hard it was to act polite with him simply because such a heinous act was tough to forgive, but over time they learned to tolerate his presence. Towards the end of Alanâs stay, as he grew more comfortable around the staff, some of the older, more desensitized nurses reported liking the boy. One went so far as to describe him as fairly charming and witty. He continued his school studies in confinement and though, many of his instructors condemned him for his act, they would be lying if they said he was not an extremely gifted child. He was released back into society at the age of eighteen with plans to attend a community college and begin taking steps toward re-integrating. At the time of his release, he appeared to show deep remorse for his previous actions and a drive to seek moral redemption, yet his time out of confinement was temporary.
The second display of aggression was discovered by police, however this time the subject was not a pet. A young male only a year older than Allan was had been skateboarding after dark at a local middle school, making use of the handrails going down the back staircase of the building. The police reported that Allan approached the young man carrying a knapsack, saying something about how he wasnât very good and wanted to learn. The man had agreed to show him some of the tricks he knew, and try to give Alan a few pointers. Only five minutes after his arrival, Allan attempted to grab the skater and secure his hands to the rail with his belt. Luckily, the man was able to fight him off. He hit Alan with the board. The metal trucks connected with his right temple, and he dropped unconscious. The man threw his board through the school window and the alarm was triggered. When the police arrived they arrested Alan for assault and battery and took him to the station. After discovering the contents of the backpack, the charges were later raised to attempted murder. The next ten years for Alan were spent behind bars at a penitentiary.
Alanâs time in jail didnât go as smoothly as it did in the ward. When Alan woke up screaming, his cell block woke up with him. After enough beatings, they took him out of general population, but all he ever complained about were the dreams.
Upon release, he was to be on a probationary period for two years. He was to live with his parents, who were both as happy to have their son return as they were timid. They agreed to house him, as long as he was to be checked regularly by the state and under the supervision of a psychiatric rehabilitator. I met him at the gate and was the first person he saw coming out of jail.
He was a tall man with short buzzed brown hair. He was very pale and had a slender build. His face was long and he had a stern look about him. He looked very serious and somewhat worried as he walked over. He kept his head down as he approached me.
âHi, Alan, hows things? My names Dave, I’m going to be your counsellor for a while. Iâm just gonna help you sort things out until your back on your feet. Sound good?â
âYea, nice to meet you,â he said avoiding eye contact
âNice to meet you too. I know you’re tired and havenât seen your parents in a long time, and I’m sure there are a million things youâd rather do besides talk with me after coming out of there, but if you donât mind I’d like to go for a drive to the park so we can sit somewhere and chat in private. Iâll make todayâs session short for you.â
I bought him a hotdog and a cab ride then followed him to the park in my car. Nothing, in particular, jumped out about Alan at the time. He seemed like a lot of my other patients, quiet and antisocial.
We sat on an unoccupied chess table where the seats were facing one another, he seemed reluctant to talk or open up and didnât say anything to me unless asked a question. I didnât pressure him at first. Though he was sent to prison for a good reason, ten years is a long time, especially in a cell. I offered him a cigarette, lit my own and waited until they burned out to initiate conversation. It was a nice afternoon outside, the leaves were just beginning to turn red and the park was empty beside the few joggers and dog walkers. I waved as they passed our table. Alan fixated at the edge of the table in front of him with a rather focused stare. He didnât fidget much but he seemed nervous for some reason. His body language didnât reflect nervousness, but there was a feeling I got just being around him that he was deeply uncomfortable. I stubbed out the filter and I turned to face him with a small smile.
His eyes met mine reluctantly as I said, âI’m just here to help you stay outside those bars, I want the best for you, and I mean that. There’s nothing you can say to offend or disturb me, trust me, I’ve dealt with much worse. Feel free to think of me as a friend,â I said, expecting no answer
âFunny, how can I consider a person who clearly has a professional interest in my sanity, a friend? A person so financially tied to my well being is not a friend, rather, a reluctant guardian.â
I was a tad caught off guard by his statement, by both its substance and how articulately it was spoken. The files did mention his intelligence.
âI donât. Iâve hit the ground and it hurts, and thatâs nowhere near the worst of it. He does terrible things. He seems jealous. I know him from somewhere, but I donât recognize the face. Look, I know theyâre just dreams. It’s all in my head people say, as though I’m complaining of a hangnail. I wouldnât have listened to myself either. At first, they were just dreams to me too, but then they began to sting. I just wanted comradery. I wanted someone else to truly know what I felt. Iâm rational enough to know my experiences are mentally conjured up, but that doesnât make the pain less real. What I did to that dog leaves me heartbroken, but not so shaken that I didnât try to repeat the act on another man. I have all my senses about me, but any sympathy is overridden by the desire not to experience these horrors alone. Iâm a horrible person. A monster, but I donât want to be, and I wasnât always this way. It is fear and jealousy for others that drives me to hurt, but I still have a conscience. I donât want to do these things, but I feel compelled to. I want to die, but my living conditions in these prisons strip me of any means to do so, and I canât let my parents be the first to find another disappointment from me.â
âDonât talk like that!â I replied, âYou’re in a position where you can have a new future and I can work with you on those thoughts. Your sleep shouldnât dictate your life when youâre awake. Iâm looking at you right now. You could stand to eat a little moreâ, I said jokingly, âbut thereâs no scars, no bruises, no marks. Whatever happens, itâs only a dream and there are people here for you to talk about them.â
âThen you donât understand.â
âLook what you said to me today was the best thing you could have. We can get you out of this cycle and back to what you were destined to become. Your condition is treatable and though it will be difficult I’m gonna see that you succeed. Go home and try and do something to take your mind off this. Do something you enjoy, and remember above all else, even if nobody else understands what you’re going through, I do. I assure you I’ve dealt with this before. I understand your pain.â
He looked displeased and left but not before saying, â I guess I’ll see you later.â
I couldnât let such an important session end like that, âAlan, wait. Take these,â I handed him the bottle of pills, âIâm not supposed to do this, but these will help. Take one before bed tonight. It will stop the dreams, or at least you won’t remember them. Itâs not a permanent solution, but itâs something for now. Iâll see you tomorrow.â
I left the park that morning feeling good about Allan. I felt I could make some real progress with him, and maybe he could go on to do great things. His level of intelligence applied to the right area could produce great results. It took me the rest of the day to produce a report for the state. I was to let Alan remain in his current conditions and after a couple weeks trying to fit him for a job or the training to obtain one. I finished the report around nine and before bed, I tucked in my daughters and had a celebratory glass of wine and a cigar. I caught the end of the news and fell asleep.
The next morning after dropping my daughter off at school, I waited for Alan in the park. After about an hour past our meeting time, I called the house. His parents had said he left that morning, so I waited until another hour passed, and got back in my car. I wanted to wait longer, but my job was on the line. I called his probation officer, then made a follow-up call to the police. After all the progress I thought I was making, we were back to square one, and Alan would be back in the hospital by the end of the day. I went home. Frustrated, I hit the dash of my car hard enough to hurt my hand. I tried to calm down, it was out of my control now. I set an alarm for the time to pick up my daughter, then tried to take a nap
I woke up to my alarm. As I tried to sit up, I noticed my arms and legs were restrained. I looked around panicked to see a figure sitting in the chair in the corner. It was Alan. My screams were muffled by a makeshift gag. He saw that I awoke and moved over to the bed, my heart was pounding. He brought over a small revolver.
He picked up the revolver, âThis is for me, but before I say goodbye I wanted to show you how little you know. My pain, my suffering and the pain of all the others you think you know. Iâm here to show you that you donât understand. Before I leave I assure you that you will.â
He walked back to where he was sitting and picked up a backpack.
He opened his backpack and I looked away as not to see the tools of my own demise. He was in a hysterical state, crying and talking loudly to someone only he could see. I had enough wiggle room to get the bit out of my pocket. I tried to time the flicks to the clatter of what was in the bag until finally, the flame caught. I waived it against the cloth over my torso until the fabric singed away on one side. With his back turned to me, I removed the gag and picked up the revolver he left nearby. He turned around as I set the spring in the hammer.
âDonât do it, Alan. We can get past this. I want to help you,â I said, but his grip only tightened around the pick in his hand. He grimaced and looked like he was fighting against himself. He said something under his breath, and then a wave of calm seemed to wash over him.
He rushed toward me and lifted the pick, and I turned away. The pressure on the trigger built and gave way. I donât remember hearing the shot, just the ringing in my ears, and the thud as something I would not look at crashed beside me.
I was put on paid leave and spent the next month at the house, painting and spending time with my daughter. After enough time had passed I drove down to Alanâs home. I met with his parents. I would like to write that it was to console them and apologize, but really I hoped they could ease the weight of the guilt I felt. Tom and Mary were understanding. We talked over coffee and did the best we could to ease each other’s minds. Still, something she said continues to bother me. It was in response to my observation of how hard it must be to lose your only child.
âItâs been difficult, but weâve dealt with death before.â
âThe doctor said we were blessed to have two children. Twins. Unfortunately,â she dabbed under her eyes with a tissue, âgod had other plans. we never got to meet poor Jeremy.â