Poker-faced, she tells me, “You see it, don’t you, the radiation waves, the signals that tell you the game, it’s there, I see it right now.”
“Where?” I ask more out of politeness than actual curiosity.
“See, that shimmer, on your device there, and over there, the computer, it’s talking to each other.” She points at my Palm Pilot.
“And the cell phones, it’s an epidemic, the devil is in the details. The electrical signals, it’s humming in code, the alien code, the one in Voyager calling, always calling.”
I stare at her ashen face, just starting to wrinkle in the worry zones. I look at her eyes; I force mine to look as empty as hers.
I scribble on my clipboard. She’s a little obese, sagging at the chin, heavy at the hips. I’m thinking which pill to try, is she OK for the Risperdal, definitely scrap the Zyprexa. No need to add pounds.
I ask, “Do you feel safe here?” Always have to check, but especially with the paranoia.
She never smiles, never shows relief. “Yes. But I’m telling you, the computers are talking.”
At her age, late 20s, she’s close to first break, no prior hospitalizations. Keep the dose low, start 2 mg at night.
“What are they saying?”
Her eyebrows furrowed. “How should I know? I said it was code.”
“Oh yeah, right.” Even delusions have their internal logic.
She says she lives with her mother. She answers most questions like a robot. She used to work with computers. I end the interview, give my usual spiel about the vices and virtues of medication. She doesn’t want Risperdal. “I had that before. It made me feel funny.”
“I don’t need meds.” Yet again. Who actually wants their meds ever?
I use the usual euphemisms. “It’ll make you think more clearly and focus better. It can even out your mood.”
“My mood is fine.”
She was right about that one.
She almost seemed wistful. “You don’t believe me.”
She’s no dummy, she was a computer whiz after all.
I always wonder a little if they’re onto something, with this energy wave talk. I’ve seen it crop up repeatedly. The manic visionaries say it’s unifying, harmonizing, beatific. The paranoiacs say it’s binding, blasting, dipping us into chaos.
Quantum physics is a bit daft after all. But it’s real.
“It’s not that I don’t believe you.” Some attendings have taught me to challenge delusions, others say don’t bother, cater to their own world.
“Perhaps there’s energy as you say, but it sounds as though it has become somewhat frightening for you, to sense it so clearly.”
She doesn’t shift her gaze. But she nods.
I’m not sure yet if she’ll try the Risperdal.