Эд Макбейн - Snow White and Rose Red

“Yes. But that would hardly seem—”

“Which, in the mind of someone who was not schizophrenic, would be an apt association. The slant-rhyme with Silas, the obvious patch over one eye. Very good. Sarah, however, is schizophrenic, albeit — as you say — quite intelligent. And imaginative. Only an intelligent and imaginative person could have constructed a delusional system as elaborate as hers.”

“She seems to feel the system was devised for her,” I said.

“The whole world against little Sarah, right? Everyone persecuting poor little Sarah. And you don’t find that odd, Mr. Hope?”

“According to Sarah—”

“You cannot accept anything Sarah believes as having any basis in reality, Mr. Hope.”

“Dr. Pearson, with all due respect for your professional experience, Sarah is too well aware—”

“Of anything and everything that serves her delusional system,” Pearson interrupted.

“The same thing might be said of any so-called sane woman. That she is aware of anything and everything that serves her well-being.”

“I mentioned nothing about well-being,” Pearson said. “Sarah’s awareness does not , in fact, serve her well-being. On the contrary, it serves only her severe illness. Her awareness, as you will have it, her powers of reasoning, her application of knowledge, her intelligence, her imagination, her alertness, are all being channeled toward supporting a systematized belief that she is being wrongly persecuted, deceived, cheated—”

“Yes, Dr. Helsinger told me all that.”

“Supported by the further belief that this very system she herself has constructed was devised for her by others — against her will, against her powers to resist. That, Mr. Hope, might easily be a classic definition of paranoid schizophrenia.”

“Let me understand this,” I said.

“I’m trying to help you understand it.”

“Let’s take Napoleon, for example.”

“Fine.”

“A person who believes he’s Napoleon.”

“Okay, sure,” Pearson said, and smiled. “If you want to fall back on the cliché, fine.”

My partner Frank once remarked that clichés are the folklore of truth. I did not mention this to Pearson. I did not yet know whether he was honestly trying to help me. If Sarah was right — but Sarah was supposed to be crazy.

“This person believes he’s Napoleon, isn’t that so? I mean, he actually believes it. He doesn’t just guess he’s Napoleon, or feel he’s Napoleon, he knows he’s Napoleon.”

“Yes, that’s true.”

“Does he know he’s deluding himself?”

“In most cases, he does not.”

“Dr. Pearson... Sarah knows about her alleged delusional system.”

“Yes, she’s made this knowledge an extension of the delusion.”

“I’m afraid I don’t understand that.”

“It’s difficult, admittedly. Let’s go back to Napoleon, if you will. If you try to reason with this man, if you tell him he cannot be Napoleon because here is his birth certificate, and the birth certificate says in black and white that he is, in fact, John Jones, do you know what he’ll do? he’ll look at the birth certificate and he’ll say, ‘Someone’s changed the name on it. It’s supposed to be Napoleon Bonaparte.’ And if you tell him no one has changed the name, this is when he was born and this is his name, Napoleon is dead, he died in 1821, the man will say, ‘How can I be dead, when I’m standing right here in front of you?’ Okay, if you tell this man he is going to be taken to another facility, removed from Knott’s Retreat, taken to an island in Georgia, let’s say, he’ll incorporate this into his delusion as well. He is not John Jones being transferred to another mental hospital, he is Napoleon being exiled to Elba.”

“We’re not talking about the same thing, Dr. Pearson. Sarah knows what her delusion is supposed to be. She—”

“Are you familiar with Laing?” Pearson said. “R. D. Laing? His book Knots ?”

“I’m sorry, no.”

“In it, he writes a series of... well, I’m not sure what one would call them. Dialogue scenarios? In any event, they express various patterns of behavior, and one of them in particular might easily apply to Sarah’s case. It goes like this:

‘There is something I don’t know

that I am supposed to know.

I don’t know what it is I don’t know,

and yet am supposed to know,

and I feel I look stupid

if I seem both not to know it

and not know what it is I don’t know.

Therefore I pretend I know it.

This is nerve-wracking

since I don’t know what I must pretend to know.

Therefore I pretend to know everything.’”

“What does that mean?” I asked.

“If we apply it to Sarah by extension, she knows what her delusional system is, but at the same time she doesn’t realize that her knowing it is an integral part of the system.”

“That sounds like double-talk.”

“No, it’s not, Mr. Hope. I wish it were. It would be a very simple thing to say that a person who knows he believes he’s Napoleon is as sane as you or I. Except that being aware of the belief doesn’t in any way change the belief. The man still believes he’s Napoleon.”

“Sarah doesn’t believe she’s anything but what she actually is.”

“Sarah believes her father was having an affair with another woman. He was not. Sarah believes his unfaithfulness deprived her of his fatherly love. It did not, because in fact he was a loving and trustworthy man. Sarah believes she should have been the sole object of her father’s affection, that she should have and could have replaced his imaginary lover. To this extent, she suggested to him — well, perhaps I shouldn’t go into this.”

“Please do,” I said.

“She suggested cunnilingus. She said, in fact, ‘I want you to come here, and get down on your hands and knees, and lick my pussy till I come all over your face.’ ”

“I don’t believe that.”

“She has repeated it on countless occasions to her therapist here. Whether she actually said it is another matter. But she believes she said it. It’s in the records, Mr. Hope.”

“Sarah says the records are falsified.”

“Ah yes. We’re all involved in a deep conspiracy to keep her locked away. Her mother has paid us all off — Mr. Ritter, Dr. Helsinger, Dr. Bonamico, me, the entire staff at Knott’s — to make certain she stays here. We’ve falsified records, We’ve hypnotized her—”

“ Have you hypnotized her?”

“Her treatment does not include hypnosis.”

“What does it include?”

“She is currently seeing a psychotherapist three times a week. In addition we are administering one of the phenothiazine derivatives — chlorpromazine, the brand name is Largactil — in one-hundred-milligram doses t.i.d.”

“What does ‘t.i.d.’ mean?”

“Excuse me, that’s three times a day.”

“Are you using shock treatment on her?”

“It does not seem indicated as yet. In fact, she seems to be responding favorably to the drugs. You should have seen her when she first came to us. I don’t think you’d have recognized her as the same young woman who can now sit with you for an hour or two and have a pleasant, intelligent conversation. Although I must warn you, Mr. Hope, it is not unusual for a paranoid schizophrenic to feel safe and relaxed in a hospital situation — especially with someone who’s trusted, as you seem to be. In such a ‘safe’ environment, the patient will often be able to discourse for hours on end in a coherent, well-informed, and often witty manner — provided the subject matter remains neutral.”