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tory ego-identity I was speaking the patient’s agitation increased markedly.
He reported that his agitation stems from frustration with the perceived
“limitations of the me in this space-time reality grid” as well as
the “limitations imposed by the quantum probability matrix or novel
run upon this single thread,” I noted that the patient is on a token system
for behavioral reinforcement and can gain access to additional
privileges or resources through good behavior, thus giving him incrementally
greater control over these perceived “limitations”; the patient
called me an idiot.
Seeking to expand our interview into quality-of-care issues, I then
asked the patient to explain these “limitations” to the best of his ability.
He seemed amused, then quickly assumed a flat affect, stating that he
“feels the need to be with, in time, the same being he experiences outof-time.”
He then broke down and began crying inconsolably, repeating
“I miss her, I miss her.”
The patient calmed remarkably quickly for the apparent severity of
his emotional outburst and elaborated on his previous statements
regarding “this single thread,” which I take to mean the patient’s actual
ego-identity. He expressed a belief that emotions are the “super-glue of
the universe,” maintaining an individual’s place in a particular “reality
grid.” When I sought further clarification, the patient likened emotions
to “anchor points” and stated his need to “understand every thought,
every emotion, every sensation,” despite their originating “from
Elsewhere.” The patient was unable to specify where this origin could
be located and became amused when I asked. He indicated to me that
he found my questions specious and simple-minded, and further stated
that “creatures of enhanced brain evolution are unable to communicate
their non-verbal experiences to primates caged in the hallucinatory
here-and-now.”
It was at this point, seeking to change the subject back to quality-ofcare,
which I inquired of the patient as to the nature of the “being” he
sought to “experience in time.” He indicated that he could best express
his thoughts non-verbally and requested drawing implements. Upon
being handed a page from my notebook and a pen, he stabbed me
between the ribs with the pen and nearly punctured the lining of my
right lung. As he was dragged away by the orderlies, he explained his
action in the following way: “You can consider this pen the zen ‘stick
of encouragement.’ Now do you understand the nature of the Being you
experience in time?”
Following this assault, and my confirmation of the patient’s disintegrating
mental status, I requested that he be transferred to D Building’s
high security ward. The initial reports from Dr. Fein have been poor,
indicating the patient’s withdrawal into an increasingly psychotic state.
He is not yet responding positively to increased medication (Chlorpro-
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