The Renfield Syndrome by Clifford Beck - HTML preview

Chapter 24

Reuben and Dorothy had made plans to go out for dinner. Finding the decent restaurant to be next to the Holiday Inn, they made reservations, hoping that Caspian would join them. But when he called out to him, there was no answer. He noticed that Caspian had been rather quiet lately, yet there was nothing in his behavior to suggest any significant changes in his mental state. Ordinarily, he respected his privacy and only entered his room when there was something that warranted conversation. But he was worried that there might be a reason for his sudden isolation, and opening the door, he found his TV was on. The volume had been turned down, but glancing at the screen, he found that Caspian had been watching old black-and-white movies—classics. This movie was Nosferatu. Suddenly, Reuben turned and ran out of the house. Confused, Dorothy chased behind, demanding an explanation. “I think there’s something wrong with Caspian!” he yelled.

This was not an answer, and following him around to the back of the house, both were stopped by a sight so gruesome that Dorothy all but fainted.

As the sky darkened with the approach of night, Caspian could be seen sitting in the middle of the backyard. Surrounding him were every chicken and goose the couple had owned. All were dead; their heads were ripped from their bodies, and sitting in the middle of the scattering of bloody feathers was Caspian, his body rocking forward and back. Reuben approached cautiously.

“Caspian,” he said.

He kept his voice quiet and low, not wanting to trigger anything that could not be managed.

Caspian’s body came to a sudden stillness, and turning to face Reuben revealed more than what he was prepared for. Sometime during the slaughter of chickens and geese, Caspian performed a more personal killing. Running down his face and shirt was the blood of a chicken. Upon closer inspection, Reuben noticed small feathers gathered around his mouth. But moments later, Caspian began retching and falling forward, expelling nearly a pint of blood. One way or another, Caspian had torn off its head and begun sucking the blood from its still twitching body. But according to science, blood is an emetic. It cannot be digested and is almost always expelled. This is probably a good thing given the human species violent nature, but for Caspian blood would become symbolic of power and control.

As shocked as Reuben was to see his foster son in these circumstances, he was able to hold himself together enough to talk Caspian into walking into the house. Once there, he got him to the kitchen sink, where he helped him to wash the blood and feathers from his face. He sent Dorothy to his room to retrieve a clean shirt. She was not faring as well, bursting into tears the moment she saw the carnage Caspian had caused. The chickens and geese were not simply a flock of fowl; they were, to some extent, her children. Now, she would have to collect the bloody pieces and dispose of them. However, because of her present state of mind, she would have to decide how another time and Caspian’s safety took priority.

Again, Reuben called ahead to Amsterdam Memorial Hospital, and once there, they were greeted by emergency room staff as well as security. Unlike his previous visit, security was ready to intervene should there be any violence, wearing black leather gloves and carrying handcuffs. Hospital policy allowed them to restrain someone in a manner similar to police tactics in the event that the safety of others was under threat. Fortunately, this was a rare event.

As they walked towards the entrance of the emergency room, Caspian managed to pull himself together enough that he could avoid an outburst. As in his previous visit, he was required to surrender his clothing in place of paper scrubs. Although he understood why, he couldn’t help feeling as though he was being labeled as someone who could be seen as dangerous. Yet in spite of how calm he had become, the voices still roared in his mind and could no longer be avoided. Soon, Doctor Sinclaire walked in, and going into the treatment room where Caspian sat on the edge of a gurney, took a seat on a nearby chair. He already knew what had happened and had seen it in many patients. “Caspian,” he began. “Why did you stop taking your meds?”

Surprised, Reuben spoke up. “You stopped taking your meds?” he said. “Caspian, why would you do that? Do you realize how sick you are?”

Caspian remained quiet, seeing the questions as something of an interrogation.

“Caspian,” the doctor said. “This is important. If you don’t take the medication, your condition could become much worse. You could lose touch with reality altogether. You could end up in a long-term psychiatric hospital or worse.”

The doctor’s argument made sense, but the idea of being mentally ill and spending his life on medication was one he found intimidating. He saw his entire life ahead of him, but he also saw it beginning to fracture and knew that if he was to avoid a complete breakdown, treatment was necessary. “I get it,” he said. “I just don’t like being on these fucking pills. They make me feel doped up.” With any medication, there is the risk of side effects. It is unavoidable. The doctor thought about other options and went down the mental list of other drugs that Caspian might benefit from. Second-generation antipsychotics were pretty much all the same, yet each was chemically different from the others. In fact, a few could be used for several conditions. The doctor understood that most people taking these drugs experience side effects, but they are generally well tolerated. The key to successful treatment is to find a medication that has the desired effect with a minimum of side effects. “Okay,” the doctor began. “Let’s try something different.”

Writing a note in his chart, Doctor Sinclaire wrote a prescription for Seroquel, an older drug with a great deal of data behind it. As a psychiatrist, he didn’t prescribe it as often as the newer drugs but had seen positive results many times. Handing the prescription to Reuben, he addressed Caspian with a calm tone. “I’m going to start you on a very small dose to minimize the risk of side effects,” he said. “You should feel a difference in about a week. Then give me a call, and we’ll increase the dose.” This did not sit well with Caspian, and he began to feel like a guinea pig. He also started to feel the fear that his condition may be untreatable. “What if we can’t find anything that works?” he asked. “I could be like this for the rest of my life.”

Doctor Sinclaire had been in practice for many years and had heard similar concerns from many of his patients. They are always afraid of being considered crazy and losing control of their lives, but he believed that there was always a way and always found it. “Caspian,” he began. “We’re just at the beginning of treatment. I promise we’ll find something that works, okay? But if there’s a problem, don’t just stop taking it. Call me first.” Caspian agreed and promised Reuben and Dorothy he would bring it to their attention as well. With his eyes tearing slightly, he turned to Dorothy and apologized for the slaughter of her feathered friends. Later, he proposed that he build egg coops so they could raise chicks together. Dorothy excitedly agreed, seeing that Caspian was genuinely attempting to make amends.