The Case Study

The Case StudyGreetings, Patients!

Here are all 12 sessions, available for free on my blog.

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I very much enjoyed writing this for you, and I appreciate all of you kind words and encouragement.

And now…

The Case Study

Session 1

When first I set my eyes on the deplorable subject, I was unsure there was anything I could do to help the man who sat before me in the interview room. I am the third psychiatrist assigned to his case; the others before me were unable to make a connection with him.

The police found him naked and babbling wandering the streets of a rural town of Black Hills in the western part of Maryland. The peculiarities of his condition when found boggled the mind – body and head devoid of hair, eyes empty, emotionless and eerie. In the two years of his institutionalization here in Baltimore, he has never given his name, and his identity remains unknown. He had no criminal record, no identification, nothing. And in the few lucid moments he did speak, he never elucidated his name to any of the staff — the only words he uttered made no sense, to the previous attending psychiatrists. He merely said, “They are coming for me.” He never explained the nebulous “they”, but it is my intention to uncover the identity of those who have broken his mind and soul, hopefully, releasing him from this self-induced spell.

This was my first session with John Smith — named thus for administrative purposes. And, it seemed as if he had taken to me, for he told me many things that he had previously not mentioned to the others before me. Something horrible had happened to this man, yet no one could break the spell that enslaved his mind, or rather, kept him in a fog — wanting to forget, but unable.

The man who sat before me was unkempt, and bound in a straight-jacket during the session, as he was prone to unprovoked bouts of violence. Whatever had happened to him scarred the very depths of his soul, and he harbored hatred for those who had perpetrated these atrocities upon him. The first session proceeded as such:

“What is your name?” I began.

“I am a lost one,” he said in a succinct, monotone, not looking at me through the cowl of scraggly hair.

“Why are you lost?”

“I cannot find my soul,” he replied, which oddly sent a chill down my spine. The statement, so factually stated, haunted me.

“When did you lose your soul?” I continued.

John shuttered at the mention of this. I clearly invoked a memory that he seemed to be struggling to suppress.

“They took it from me,” he responded, trembling as he looked up ever so slightly at me with those dark empty eyes, as if seeing my soul, coveting it.

“Who are ‘they’?” I asked again, hoping he would finally give us some indication that would solve the mystery.

He sat motionless for a few moments, and just before I could ask again, he leaned forward in his chair, a scowl forming on his face.

“The ones who will come for all the souls,” he said with malice in his tone. “And you are next.”

This chilled me to my core, the tone and conviction in his voice. All of the patients in Ward C were the most disturbed individuals in the facility. It would not do well to allow their words, their delusions, to affect your own sanity. However, in order to understand the nature of the psychosis, a good psychiatrist must try to see through the eyes of their patient, straddling the thin line between sanity and insanity. I am not yet convinced that John Smith was indeed insane. I feel that he merely suffered from a great trauma.  I merely ignored his final statement.

Unsure of what I should say next, I allowed him to calm whilst I formulated my next question. There were so many that I needed to ask, yet, his mind was already broken. His introversion was unlike any I’d ever encountered. His only true form of communication was the strange drawings that covered his cell walls, despite the paper offered. When docile and freed of his jacket, the staff gave him crayons, a request he made. He drew elaborate scenes and this seemed to calm him. Yet, none of the staff could find any pattern to the drawings. They were random and depicted odd concepts, many of which were religious, or mythological in nature. It did seem as if he were trying to find a way to regain his soul, because, clearly, he felt as if he did not have one. I will write about the drawings in later sessions as I probe into their significance.

“What makes you think they are coming for all souls?” I probed as he settled back in his chair, eyes downcast once more.

“Sunu sa ina etuti absu,” he muttered under his breath in a language I did not know.

“What does that mean?”

“They are coming! Sunu sa ina etuti absu!” He shouted, yet not moving in his chair.

This unnerved me greatly, especially when he turned his eyes back to me, black and piercing. A smile curled his lips.

“Please,” I continued trying to maintain my composure. “What does that mean?”

“Those who dwell in the deep darkness,” he said just above a whisper. “The soul eaters.”

It was at that moment, that I felt I made a breakthrough. There was never a mention of this to my colleagues. But, I found myself increasingly anxious as we spoke, wondering why he chose to speak to me. What did he see in me that suddenly made him open up after two years of silence?

“Who are you?” I asked.

He did not answer. We sat in silence, him staring at me, no emotion in his eyes, the terrible, evil smile still curling his lips. I think that he may have suffered a psychotic break that fractured his tormented mind as a result of his trauma, perhaps splintering his personality.

I asked again, but he merely stared at me — silent, menacing, unmoving.

“Perhaps,” I said masking my anxiety, “we should continue tomorrow?”

Again, no response, so I motioned to the orderly to come into the room and take him back to his cell. As he was escorted from the room, he kept that baleful glance on me turning his head almost impossibly as he exited the room.

I sighed to myself with great relief, and something inside my mind screamed for me to walk away from this case, as my colleagues had, but I am determined to uncover this mystery. John is quite disturbed; nevertheless, today was a profound discovery.

Another peculiarity that I must note, which I only just discovered, as I reviewed the interview tapes, the strange language in which he spoke was inaudible, so I sent it to a language specialist. I am not one taken to superstition or subjects occult in nature, but this requires further research. I cannot explain the phenomenon, but I am resolved to find a scientific explanation. I have deferred the tape to an audio specialist, who will return his findings in the next week.

Tomorrow, I will continue with my examination, before making a final determination on whether John Smith can ever return from the dark recesses of his psyche.

Session 2

Last night I pondered the first session with John Smith, and it unsettled me for reasons I cannot quite explain, presently.  In all my years as a psychiatrist, I have never encountered someone as unnerving as him.  However, I must put those thoughts aside and remain dedicated to my quest to unravel the mystery surrounding this peculiar individual.  At first, I pitied his condition, but upon reflection of yesterday’s encounter, I feel as if the darkness he endured has tainted me.

Today’s session began much as the last.  John was led into the interview room, secured in his straightjacket, yet as he entered the room, he watched me all the while with those dark, soulless eyes, as if he had never taken them off me when he left the previous day.  They perforated into my eyes, seeking what lay beneath, my soul.  Moreover, he coveted it — this I knew beyond reason and doubt.  So absorbed in his delusion of not having a soul of his own, I felt that his true aim was to take mine as a replacement.

“Good morning, John,” I began with pleasantries, attempting to make a human connection with him.

“My name is not John,” he spat at me with hate in his voice.

“Very well,” I retorted.  “What is your name?”

“I am a lost one,” he repeated as he had the day before.  “Those without a soul do not need a name.  A name belongs to the soul.”

“What should I call you?” I asked with an even tone, though I unmistakably appeared demoralized by the man.

“There is no need to call me anything, Doctor,” he said in a matter-of-fact tone.  “They will be here soon, and they will take me away.”  That dark smile curled his lips once more.  “And you, of course.”

“Why would they want me?” I asked, trying to mask my curiosity, yet telling myself this was nothing more than a delusion of a very sick man.

“You know very well why,” John responded without hesitation.  “You simply do not believe the answer.”

This perplexed me greatly.  This case was mine through happen-stance and frustration of my colleagues.  The patients of Ward C are a collection of mysteries of the mind and predominantly lost causes. We spent great deal of effort trying to rehabilitate those beyond the help of man – or even God.  There is no way in which John, the unnamed, could possibly have any prior knowledge of me or my existence.  I had to remain careful in how much I divulged in our dialogues – lest I fall prey to the trick of a mad man.

“This is not about me,” I said with an even tone.  “You have been here for two years, and you’ve not uttered a word about who you are, what happened to you, or where you come from.  Why now?  Why me?”

John simply sat there, staring at me through his filthy cowl of hair, caked with all varieties of bodily fluids.  I returned his stare, resolute in my assertions to remain steadfast in my Hippocratic Oath.   I am determined to cure this man.

“It is all about you,” he replied after a long silence. “At least for now.”

I chuckled nervously at this statement.  This became a game to him, and apparently, he toyed with me as he had with the others.

“Very well, then,” I said unsure where he intended on taking the conversation.  “Give me one answer.”

John merely stared at me with those horrible, piercing eyes — black as midnight, and cold like the void of space.

“Why,” I continued without waiting, “did they find you without a stitch of clothing and bald as a baby in Black Hills?”

John remained silent for a time, then, strangely he answered, albeit cryptically.  “There are things that dwell in the deep darkness.  For a time, I lay dormant within the belly of a creature that fed on my thoughts, my fears, my being.  When I was vomited forth from the depths of its gullet all that remained intact was my skin, as if reborn unto this pitiful world, a child again. Without a soul or memory — both lost somewhere within that unholy womb.”

I blinked at the length of his answer — a step forward once more.  I felt as if the answer was a metaphor for something.  But for what, I cannot possibly imagine.

“How did you come across this creature?” I asked carefully.  The experience, most likely, replayed in his mind. He started to shiver.  “Was it in the mountains?”

He again, sat in silence for a time, and then turned his dark gaze on me once more.  Clearly, a shift in personality happened during the session multiple times.

“It came for him,” he responded in the dark voice.  “And, it will come for you, Doctor.  Oh, you cannot escape it now.  Each tick of the clock brings it closer to you, like a wolf stalking the unsuspecting deer.”

“What is it?” I asked, not allowing him to unnerve me any longer.

Suddenly, he shouted, “Et comestores animarum! Et comestores animarum! Et comestores animarum!”

He jumped up in his chair and fell on the table in front me, growling like an animal. “I can smell your soul.  It calls to me, sweet, and delicious.”

Before he could say anything further, the orderly rushed in and drug him back to his cell, all the while he screamed those words again. Visibly shaken, I ended the session and left the building for the day.  I had much to process, and my prognosis was not yet complete.  He exhibited Schizophrenic traits as well as Multiple Personality Disorder.  Yet, the circumstances under which the authorities found him further complicated the solution to the mystery.  The hair was dissolved in some form from his body, not shaved as one would suspect.  Furthermore, he remained hairless for nearly a year before his hair began to grow again.

As I suspected, none of his responses recorded properly during the session — garbled and muffled.  However, I knew the language he spoke as the orderlies returned him to his cell.  It was a Latin phrase, Et comestores animarum, meaning The Eaters of Souls.  He had now used two different languages in two different sessions.  I still have not heard back from the audio expert.  But what he had spoken in the previous session was not Latin.  But this has provided me with a key; it must be some ancient dead language.  Perhaps my research will allow me to find a sample of spoken languages.  These phrases had meaning.

Tonight I must ponder whether I wish to continue with this case.  Something about this man has given me pause.  I cannot determine whether he is insane, or if something unnatural has occurred.  I have seen a great many strange cases in my time, but this one is far beyond any I’ve encountered before.

Session 3

Last night, rather shaken by the encounter of the previous day, I considered taking a day away from the mysterious patient.  I worked late into the evening, researching all the evidence and events leading up to the institutionalization of John Smith.  I found it odd that there was no other documentation retained, not even a photograph.  It was truly as if he did not exist – an empty shell fallen out of time and space.

It was apparent that he was unknown to the town of Black Hills, Maryland, despite the best attempts of law enforcement to circulate the aforementioned photograph about the town.  Evidently, he was not a resident; none recognized him from the town or county.  He was the perfect mystery.  In that, his story held true – spirited away by some unknown oppressor, truly lost.  However, as the clock rounded midnight, I found myself eerily put off by his statements.  Undoubtedly, I was dealing with something never before encountered.  However, despite my trepidation on continuing with his case, I felt compelled to solve this enigma.

When I retired for the night, my head hurt as I tried to rectify the previous two sessions.  It unnerved me so, and as such caused me to have a nightmare about the events of the previous day – something I’d not had since I was a child.  In the dream, we sat across the table from one another, but he was blurry, out of focus.  He spoke in a deeper, baritone voice, and repeated that atrocious Latin phrase.  Suddenly, without warning, this obscure specter, jumped across the table, grabbed my throat and vomited blood all over my face and in my mouth.

This startled me to wakefulness, my bed clothes and sheets drenched with sweat, frigid to the touch – the rusty taste of blood still on my tongue.  I quickly turned on the light in my fearfulness and immediately noticed the window in my room slightly ajar – a cold November breeze causing the thin white curtains to undulate like a ghostly visage.

The nightmare and the fact that I knew the window was closed upon retiring filled me with fear I’d not felt since my youth.  I grabbed a flash-light, closed the window and locked it firmly, then proceeded to inspect my home for any intruders.  My search turned up nothing.  Too anxious to sleep, I made a pot of coffee and prepared for session three with John Smith.

When I arrived, a bit tardy, to the interview room, John Smith sat in his chair, and watched me keenly as I took my place opposite him.

“Good morning,” I began, a bit winded from my rushed entrance.

John nodded his head, his face still covered in that mess of filthy hair, yet his eyes were distinctly transfixed on my every move.

“Good morning, Doctor,” he said in that dark, unsettling tone.  “Bad dreams?”

I paused and looked up from writing my initial notes.  This sent a shudder through my body.  It was impossible that he could have visited me, or even known about that.  A queer sensation crept into my heart.  I unequivocally denied the existence of the supernatural, yet my intuition, or rather a voice deep in my subconscious, told me I was in error.

“No, I had a very pleasant sleep,” I lied as I gauged his reaction.  “And yourself?”

A dark, sinister smile curled his cracked lips, “You know exactly how I spent my night, don’t you?”

“Of course,” I said. “It must be uncomfortable in your cell.  But we can’t have you stirring up the other patients.”

“My cell,” he laughed darkly at this. “Oh no, I spent my evening walking in the cold.”  He cocked his head to the side quizzically.  “Do you not remember?”

“I have no idea what you are talking about,” I answered without hesitation, though I felt a single bead of sweat run down my temple as his piercing, evil eyes, watched me unwaveringly.

John shrugged. “If you wish,” he said in a smug tone. “What inane questions are you going to ask us today?”

“Us?”  I asked startled.

“Yes, of us,” he continued.  “You and I.”

“This is not about me at all,” I said in an annoyed tone.  “Now, I must insist that you cease these games, and assist me in understanding how best to cure you of the malady that has stricken your addled brain.”

Again, he laughed at me.  “Assist me? I’ve told you, I am beyond assistance.  They will come for me, and then they will come for you.  It is inevitable.”

In an attempt to end this game, I closed my notebook and stood.  “It appears we have nothing further to talk about, I’m afraid.”

“Oh we are way past the point of you leaving, Doctor,” he chuckled.  “You know that as well as I.  They will come, whether you speak to me or not.  Do you think it mere happen-stance that you are involved in my case?  Do you think that you have any control over your pathetic existence?”

“And what exactly do you mean by that?” I asked, taking my seat, opening my notebook once more.  I believed my ruse had let open the flood gates.  He seemed eager, no, desperate to talk, despite his arrogant demeanor.

John suddenly stopped and turned his gaze downwards, his body began to shudder.  “Hush, hush, hush, hush,” he repeated.  “They are near.”

I quirked a brow at this, waiting for him to continue, but he did not.  Finally, I asked, “Who is near?”

“I can smell them. Can’t you hear them as they slither beneath us, swimming through the dirt beneath us?” He looked up at me, hopelessness in his eyes. “They will come for me, for you.”

“Can you please describe them for me?”

“No, no, no,” he shook his head violently.  “I can’t remember, I can’t tell.  I shouldn’t know.  You shouldn’t know.”

“Then,” I asked insistently, “How do you know they are near? How can you smell them?”

“Their foul stench filled my nostrils for a time unknown,” his voice became fearful. “No matter how many times I try to wash their scent from my nose and mind, it lingers, haunting me, reminding me.  There is no escape.”

I looked at him, trembling like a child, as I was the night before and I felt an odd sense of kinship.  The fear I had felt the night before washed over me like a wave to shore.

“That’s enough for today,” I concluded and motioned for the orderly to take John back to his cell.  “We will continue tomorrow.”

The orderly entered and grabbed John by the arm roughly, and dragged him from his chair past him.  He grabbed me by the shirt as he got within reach, hopelessness and fear filling his eyes.

“What if there is no tomorrow?” He whispered as if being overheard by his previous captors.

The orderly dragged him from the room and I sat motionless in my chair.  This case was more than I had bargained for.  I would need to reflect on today’s session, for I am finding that I am not able to grasp the events that are unfolding.

I should seriously consider being removed from this case, before my own sanity is tested.

Session 4

Upon reaching the facility this morning, I asked for dismissal from John Smith’s case.  I came to this decision due to another night plagued with nightmares.  Though, my conscious mind believed the events John encountered caused his insanity, my subconscious mind began to believe that something terrible did exist in the ancient hills of Western Maryland.

I dreamt of a cave in a place I have not visited.  It was a cloudy November day, and the paper birches had shed their reddish-orange leaves, causing them to look like giant skeletal fingers clawing their way from the earth.  The mouth of the cave looked like a gaping maw — sharp stone formations resembling teeth all around the opening.  Compelled by an unseen force, against penetrating fear amassing in my chest with the quickening of my heart, I entered the dark cave.

Barefooted, and wearing my bedclothes, I shivered with such intensity I could barely walk.  The floor of the cave felt like warm, wet moss, and a thick fluid oozed through my toes with each step.  As I made my way further into the cave, the air was strangely warm, and up ahead a dim light pierced the darkness.  I could not stop myself, and as I took ten more steps, I heard moaning up ahead, muffled yet indistinguishable from the moaning I’d become accustomed to hearing in Ward C.

As I went to take my next step, a hand clapped down on my shoulder with force, causing me to call out in terror, as it whirled me around.  It was the same hazy figured from my last dream.

“Not quite yet,” it hissed in a strange, tremolo tone.

I awoke screaming lying in the same sweat soaked sheets as the night before, and the cold November wind streaming in from the open window.

The director of the facility denied my request for re-assignment, due to the circumstances of my progress with the patient.  I implored him to release me, and relayed the growing concern surrounding the stability of my own mind.  He directed me to proceed more cautiously in the future, until they had unraveled the mystery surrounding John Smith.

When I entered the interview chamber, John was sitting there staring at the wall opposite him.  He appeared, at first, to be in a catatonic state — eyes fixated, mouth slightly agape, and no expression on his face.

I took my seat opposite him and opened my notes.  John seemed to be staring at me, yet it felt more as if he were seeing through me.

“Good morning,” I began as usually, retaining my composure, despite the trepidation and dread that shrouded my soul.

There was no immediate answer, and he sat in that state for a few minutes, just staring.  I noted this, then looked back up at him and was somewhat startled.  He had leaned forward in his chair and was looking directly into my eyes, with a terrible menacing grin.

“Are you beginning to believe me now?” He asked in that dark, arrogant voice.

“Believe what?” I feigned my ignorance to what he referred.  His delusions infected me, and as such, I will need to speak with another of the staff to have myself evaluated.

He simply continued to smile at me, and then closed his eyes drawing a deep breath.  “It smells even more delicious now, Doctor. Let us have a taste!”

Without warning, he launched at me as before, yet this time he ran his dreadful tongue over my cheek before I could shrink back.  The orderly rushed into the room and promptly threw him back into his chair, as I quickly pulled a handkerchief from my jacket and wiped his foul-smelling spittle from my face.

John laughed almost maniacally as he continued to stare at me through his dirty cowl. “We must not rush these things, you see,” he said with malice.  “We mustn’t spoil the soup before it’s properly cooked.”

Once again, I regained my composure; I took down notes, my hand trembling.  It was becoming increasingly difficult to hide my outward fear of this man.

“These games,” I continued, “are serving no purpose in your rehabilitation.  They merely make it more difficult for me to see the truth behind your illness.”

“Rehabilitation?”  John laughed at this as well.  “There is no rehabilitating the lost – the soulless.  You must accept that, and worry about yourself now, Doctor.”

“Tell me more of this creature that captured you,” I ignored his continued mockery.

“Very well,” John said in an even tone.  “I must warn you, the things I am about to tell you may not be something you want to know about.”

“So you can describe them?” I prodded.  “I thought you lost your memory?”

“You make many assumptions, Doctor,” he said with that dark smile curling his lips once more.  “Who, pray tell, do you think you are talking to?”

“I am speaking to the one we call John Smith,” I responded flatly.

“I am the one who has come for you,” he said, sending a shiver up my spine that rattled my bones to the core.

“And, how do you propose to take my soul,” I asked, trying to remain even in my tone.

“I won’t take your soul, good Doctor,” he said, then leaned forward whispering.  “I intend to eat your soul, sucking that sweet liquid from your bones, leaving you as I’ve left this one.”

After speaking those chilling words to me, his head hit the desk with a thud, and he lay there motionless.

No words can describe the terror I felt being in the presence of this patient.  In addition, when the orderly dragged him back to his cell, I sat in silence, trying to comprehend incomprehensible.  The events that unfolded seemed to transcend mere psychiatry.  It was time that I consulted with those versed in the matters of the occult, and hopefully, discover an end to this patient’s torment – and my own.

Session 5

I spent the evening speaking with one Jack Trevor, an occultist who is well versed in a variety of subjects from angels to things that have been lost to time and thought.  I explained what I could, in good faith, the particulars of my dealings with John Smith, and the information he had for me was quite startling.

The Eaters of Souls is a myth he has encountered on many occasions in his studies.  However, the manifestation of the beasts have various descriptions — feared in many cultures and worshiped in others.  The facts in the case of John Smith seemed to be validated insomuch that the creatures exist in myth, yet, there is no definitive evidence that anyone has ever encountered one in modern-day, until now.  In every myth, the victim loses  their soul, consumed in some variety dependent on the culture.  Once this event has occurred, the creature releases the victim into the world, devoid of hope and memory.

But, as far as John Smith is concerned, no one has ever recounted the tale of a victim to the degree that I have uncovered at this point.  Moreover, for the sake of posterity, Mr. Trevor asked that I give him as much detail as I can, as the sessions continued.  In return, he promised to continue researching the subject so that I may find an answer to breaking this evil spell that has fallen on my patient.

Fortunately for me, whether due to exhaustion, or my conversation with Mr. Trevor that stretched well past midnight, I was spared the horrible dreams I had the two nights before.  Nevertheless, my sleep was fitful, and I arose earlier than normal.  As such, I decided to go to the facility early and observe John in his cell before continuing with our session.

As I walked into the deplorable hallway of Ward C, moans and wails of the lost assailed my ears.  These pitiful patients were in a constant state of cacophonous ravings.  With such tormented minds, these particular patients rarely slept as their broken minds unable to rest in their madness.  This I discovered to be one of the few things that could be determined by observing the mentally ill.  Furthermore, the lack of sleep causes the mind to slip into deeper madness, requiring that many of the patients be sedated from time to time to ensure they get some semblance of sleep.

I approached Room 34, John Smith’s room, and peered into the small portal affording me a complete view of the room.  John was seated in the center of a magical circle he’d drawn on the floor, with a familiar yet strange pattern.  Though it looked familiar, I would have to research it later in the evening.  What caught me off guard is that he was staring at the portal, before I even approached it.  It was as if he knew I was coming, even before I did.  Those dark, terrible eyes and horrible grin.

I tore my gaze from his, and noted that on the furthest wall, he had made a new drawing.  This utterly terrified me, and I almost ran screaming from the facility.  It was a drawing of the horrifying entrance to the cave I visited in my dream.  How could this be possible?  I had never been to such a place, and I had not mentioned to any of my colleagues.  A queer sensation came over me, and I lost consciousness.

I awoke in the clinic, staring up at the ceiling with a nurse looking over me.

“Ah,” she said with a disingenuous smile.  “You had a bit of a fainting spell it seems, Doctor.”

I was dazed and disoriented, but I soon recalled the nurse, and nodded absently.

“I’ve been burning the mid-night oil,” I said. “This case has had me a bit puzzled.  Perhaps I should take the rest of the day off?”

“No,” she said shaking her head. “The director has instructed that first you must do your daily examination of the patient John Smith, and then you are free to take leave for the rest of the day.”

This stunned me.  It was clear that my mental state was failing, yet, the administration persisted that I pursue this case.  I could not fathom why he, above all the others, had become such an interest.  True, I had made more progress than any of my other colleagues, but I could feel that I was becoming unstable.  I had never had a fainting spell in all my life.  Something peculiar was happening here, but I was unable to understand what exactly that may be.

“Very well,” I responded and stood on shaky feet.  “Tell them to bring him to the interview room and I will be along directly.”

“He’s already waiting, Doctor,” she said.

I simply nodded, a feeling of anger welling in my chest that the administration would not put my well-being over the well-being of a patient. My sanity over his.  There are many things I do not understand, but I will find the underlying cause of it, one way or the other.

I entered that dank, appalling interview chamber once again and took my seat across from John Smith.  I ignored the niceties, and went straight into my question.

“I want you to tell me about the cave drawing in your cell,” I insisted with renewed sense of purpose and control in my demeanor.

“I drew it just for you, Doctor,” John said with that abysmal smile. “So you won’t forget it when you see it again.”

“I won’t be seeing it again,” I maintained.  “I am done with these games, and your torments.  I want answers, or we shan’t be seeing one another again.”

John cocked his head to the side quizzically and asked, “Are you certain of that, Doctor?  It seems to me you can’t get enough of me.”

“You are quite mad,” I continued unaffected.  “I have allowed your rancorous ravings and skewed sense of reality to affect my own judgments.  Either you tell me about the cave and the creatures, or I will suggest other more drastic medical procedures to expose the cause of your malady.”

John laughed loudly, darkly, even with a hint of evil in his tone, “Threatening a madman are we?  Do you think that anything you could possible do to me would be worse than being in this lamentable facility, with dimwitted doctors, such as yourself, attending to someone as enlightened as I?”

I laughed at this heartily, though I know I shouldn’t have.  “Enlightened?  That’s rather rich, considering you are institutionalized, have no ‘soul’, and you can’t remember anything that has transpired since you were found naked and wandering the streets of a far off town.”

I could see this greatly disturbed him, his face contorting into a scowl.  He fought against the restraints of the straightjacket.  “I will rip your soul from your body with such force it will destroy you utterly, you incompetent wretch!”

He growled inhumanly at me, leaning forward in his chair, and then suddenly stopped.  His demeanor returned to that of the frightened patient I’d met when first I started this damnable case.  Fear filled the hatred in his eyes, and he turned them down at the floor. Whatever vestige of the man I’d first met, struggled against his splintered mind.

“They are here,” he said in a fearful, childish voice.  “They’ve finally come.”

“Who has come?” I asked with less anger in my voice.  “Who has come, you must tell me so I can help you escape them.”

“They do not want me,” he said in a languid, sleepy voice.  “You know they are coming for you, Doctor.”

John fell into stupor once more, and the orderly led him back to his cell.

These words, spoken with such certainty, stabbed me to the core like an icicle, penetrating my soul.  The peculiarities of the case compelled me to continue, but I know that if I do, my mind may not survive.  Above all else, I will not allow myself to be incarcerated in this lamentable house of lost souls.

This evening, I will speak with the occultist once more and relay the incident with the cave.  Perhaps that is the answer to this all.  And, if such a cave exists, I am sure that someone has knowledge of its existence.

Session 6

I must state, for the record, that I am in serious doubt of my mental stability at this juncture.  I have had a nightmarish dream with things I could not have possibly created in my mind without some frame of reference.  Despite John’s lack of willingness to describe the creatures to me, I believe I saw them last night in my latest foray into that horrible cave.

Again, I walked down the dark throat of that gangrenous lesion in the hillside of Western Maryland.  I walked, as before, in my bare feet, the warm, ooze squishing through my toes as I walked, almost like warm slime.  The deeper I descended, the more I could hear terrible sounds – a mixture of sucking sounds, moaning and sobbing.  It was as if I was back in the asylum, yet I knew that I was not.  It sent chills through my core, causing the hair on my body to stand on edge — anticipating something dreadful and unspeakable.

As I rounded a corner, there was a pale green light filling the chamber, produced by some variety of bioluminescent algae or moss.  And to my horror, I saw these terrible creatures.  They are almost indescribable as I have very little to equate them to.  However, in my mind, I saw them as giant, armored maggots, with short stubs for legs to propel them across the floor, much like a snake, yet without slithering.  As I stood in total terror, one of the beasts reared up and I could see its face and head.  Around the perimeter of its head were small, bulging eyes that all blinked in unison as it looked at me with hunger.  Its mouth was enormous — enough to swallow a person — with a Medusa-like mass of tentacles, where teeth would be.

The creature lunged at me, and I stumbled back in horror and let out a scream.  I scrambled to stand, but I had become entangled in some sort of webbing that covered the floor, nearly immobilizing me.   I struggled, fueled by fear and adrenaline, and finally broke free of the webbing, but just as I was to get away, the tentacles from the mouth of the beast, grabbed me and started to pull me into its wet, mouth, filled with a dark, viscous fluid.  I screamed in terror, trying to fight as the tentacles made their way up my torso, pulling me deeper into its vile body.

And then I awoke, sitting bolt upright in my bed, shivering from the open window, and the fear that gripped my being.  In addition to the usual pool of frozen sweat, my feet felt odd.  I pulled the covers away to reveal that my feet and bed sheets were covered in some dark, red tar-like substance.  This only intensified my fear.  I gripped my head, willing myself away, repeating “No, no, no, no” over and over again.  Yet, when I opened my eyes, it remained.

I did not go into the office today.  I could not bear to look into John’s horrible eyes, and subject myself to his cryptic threats.  I am losing my grip on reality, and the fact that I had left my house during the night, gave me a deep sense of hopelessness.  I felt as if I were losing control of my body whilst I slept.  The only saving factor was that I was in Baltimore, and the cave near Black Hills is hundreds of miles away.  There is no way physically I could have made such a trek over the course of the night –vehicle or otherwise.

I did not bother calling in to explain my situation.  The phone rang many times, but I did not answer.  Someone even came to my front door and persisted to knock for what seemed an eternity, but I hid in my room, silent and trembling with an inconsolable fear.  I did need to confront John again, but this day was not the day.  I feared that one errant comment from his lips, accompanied by the penetrating gaze, would send me headlong over the cliffs of sanity, into a pit of despair and hopelessness.

Once the phone calls stopped, I consulted with the occultist, Trevor Jack; I am now even more disturbed about the situation.  It seems that a cult worships the Eaters of Souls – The Sect of the Ancient Minions of Urdth.  It is quite disturbing, as the cult has been working secretly in our society since the dawn of civilization, with their first documented beginnings in the cuneiform of the Sumerians.  Their dark ambitions are not completely clear, however, it does seem as if they assist the Eaters by bringing them specific victims, defined by unknown criteria.  The occultist did mention that there is no mention of an entity named Urdth, or any known ancient city.  But it was apparent that this Sect has been active for at least eight thousand years.

This does give credence to John Smith’s plight.  I would venture to say that he was one of these prime individuals that the Eaters found favorable, yet, I cannot understand what the purpose of letting him go would be.  Or perhaps he escaped.  Whatever the reason, I planned on investigating this further with John.

But for now, I must rest.  I am weary from the events of the day, and perhaps those that happened in the land of dreams.  I hope that tomorrow I have the courage to face John again.

Session 7

Thankfully, I did not dream last night — no dreams or nightmares, nothing at all.  It was as if I fell out of the universe and into a silent void.  Though one might find this frightening, I did not because it was much preferred over the horrendous experience of my previous nightmare — terrible imagery no one should have to experience.  However, it did not afford me restful sleep and I awoke irritable, anxious and unwilling to confront my patient.

Upon returning to work today, the director reprimanded me for my behavior and threatened me with psychological evaluation if I did not continue my sessions with John Smith.  A feeling of forlorn had overcome my soul, penetrating to the depths of my psyche.  I felt as if John Smith was watching me no matter where I was, as if seeing through the walls and far across town into my home.  The closer I got to the facility, the more I could feel it, like a demon pressing down on my chest ever harder.

When I entered the interview room, John was watching me with his malignant stare.  I had the sudden urge to leap across the table and strangle him until he was dead, releasing me from this terrible curse.  I felt cursed — I felt it in my heart and withering soul.  I have never contemplated taking a life before, but if I could, I would stab him with this pen, forever ridding the world of such a harbinger of terror.

I sat in my chair and returned his silent stare with one of my own.  I simply sat there, weary, exhausted, terrified of the things that had happened – and what may lie ahead.  He always looked the same, no change in his appearance, or even the remotest change in his condition.  He was beyond my help – anyone’s help – and I have already made my conclusions about his further treatment.  We must lock him away until he is dead, unable to infect anyone else with his virulent psychosis.

“Good morning, Doctor,” He began this time.  “Did we not sleep well?  You are looking a bit peaked.”

“Tell me about the cave,” I ignored his rhetoric.  “What you remember, that is.”

“What makes you think I remember anything?” He replied with that sinister smile.

“Because I have a suspicion you do,” I retorted.  “You must have some recollection leaving the cave, at the very least.  You’ve had more than enough time to reflect on all of this since your incarceration.”

John sat there, and I could tell he was considering his next words with care.  This intrigued me.  The darker persona who addressed me was quite lucid and aware, and the frightened persona remained hidden more often now, buried in the subconscious.

“Let’s see,” he started, glancing around the room idly.  “Do you mean the one I was born from? Or where you went the night before last?”

I opened my mouth then shut it again.  I could not contain my surprise as it overtook me with amazing alacrity, like the bite of a cobra.

He leaned forward menacingly in his chair.  “You see, I know things, Doctor.  I have tried to tell you this on many occasions, yet you continue to ask the same wrong questions.  I would have thought someone with your presumed intellect would have figured this out by now.  But you have not.”

John leaned forward even closer, whispering, “Do you even know the difference between sane and insane anymore, Doctor?”

I shuddered at this, because he was right.  I had begun to question my distinction between the two.  The strange nightmares were bleeding into my waking state and I was unable to rectify the event that took place the night before last.

“Tell me of Urdth,” I said hurriedly, ignoring his question.

“Ah ha!” John exclaimed with glee in his voice. “Now we are getting somewhere. Perhaps you are sharper than I had originally thought.”

“So you do know of Urdth?”  I pressed.

“Of course,” he said, and then turned his gaze away to the window.  “But we mustn’t speak of such things aloud.  Some things should not be mentioned or discussed, Doctor.  Pick another topic.”

This frustrated me beyond words, filling me again with the urge to kill him. This time, I fantasized about strangling him with my hands, the blood draining from his face, lips turning blue, eyes bulging out as he tried to steal that last gasp of breath.  I would bang his pitiful head on the floor until his skull cracked, and his brain matter spattered on the dingy tiles of that miserable room.

“Tell about ‘them’,” I said fully composed, yet seething inside, “the ones who are coming.”

Again, he smiled at me, “The ones who are already here, you mean?”

“Yes,” I said, “if you insist, the ones who are already here.  Tell me about them.”

“You already know everything you need to know, Doctor.  They are here, which means it is only a matter of time before they come for you,” He said casually and sniffed the air, closing his eyes as a euphoric smile curled his lips. “Very soon, indeed.  The smell of your soul is quite intoxicating.”  His eyes shot open, and the room grew cold.  “I am certain that they smell it too.  I can almost hear them, fighting to get to you first, like sharks smelling that first drop of blood in the water.  Oh yes, they will be coming for you.”

“What are they waiting for, if they are already here?”  I asked.  His stare unsettled me beyond words along with his constant threat of this nebulous ‘they’ coming for me.  Does a soul have a smell?

“All things in good time, Doctor,” He smiled again.  “These things take time. And in the end, you’ll understand everything.  But, unfortunately for you, it will be too late.”

“What makes my soul any more interesting than the millions of other souls in the world?  Why my soul?” I insisted, raising my voice.

“That is not a question for me to answer, Doctor,” he replied, mocking me.

“Who then?”  My agitation grew with each passing moment.  He goaded me, as if he knew I wanted to kill him right where he sat, with his smug expression and arrogance.

“You have all the pieces to the puzzle now,” he said.  “Now you just need to figure it all out.  And once you do, I will be there, laughing at your soulless shell, the almighty Doctor who would cure me of my illnesses.  But I do want to ask you just one question, before we end this lamentable conversation.”

“What?” I spat at him derisively.

“Who is the patient here?” He smiled at me.

The questioned chilled me, punctuated by a cracked lip grin and his eyes stabbing me through that tangled mess of hair. I just sat there, mouth slightly agape.

John turned his gaze to the floor, his demeanor changed, and he began to hum to himself, as if trying to soothe his addled mind.  The other persona was back but I could not allow myself to be swayed into having any sense of compassion for this detestable thing that sat before me.  I did not believe in evil until I met this man.  There was no doubt, he harbored deep evil within him.

I allowed myself to be manipulated by his words, made to believe that the events happening to me were real.  It was clear my subconscious was filling in the gaps between his ravings and the information I received from Trevor Jack.  All of this banter was nothing more than a game played by a sociopath.  There is no ‘they’.  He is the sum of his vague answers, sinister smiles and dark stares.  I also am beginning to doubt the other persona even exists.  Nothing more than a construct to garner sympathy.

He is the patient and I am the doctor.  There is no denying who is in the straightjacket and who is sitting at this desk writing these notes.  I cannot allow him to manipulate me any longer.  It has affected my judgment, and made me question my sanity.  But tonight, with a renewed sense of self, I will sleep soundly. In the morning, I will start a new line of questioning with this patient, and ultimately convince the director of the facility that there is no cure for this man. I am the doctor here, and I must conduct myself accordingly.  I will not allow him to affect me anymore.  I have been a fool.

Tomorrow I will follow-up with Trevor Jack and we will see about finding this mysterious cave. Surely, someone in Black Hills would know of such a place, which I believe is a figment of his imagination.  The only thing that will prove his story is true is nothing short of finding the cave and one of the creatures he said took him away and consumed his soul.

I believe he has no soul, but no one took it from him – he never had one to begin with.

Session 8

Much to my dismay, I dreamt again last night.  I’m not even sure I can articulate the level of terror I feel even now, as I sit writing.  And this has been exacerbated by my daily session with that accursed creature we call John Smith.   I am not sure of anything at this point.  I’m not even sure that the dream I had last night wasn’t real.  It felt so real, that I am trembling as I write this.  I am trembling at the thought that I must face John Smith again today.

In my dream, I was once more in the cavern filled with the maggot-like creatures.  Yet, they did not see me –it was if I were floating through the cavern as a ghost, yet I was not in control.  The creatures are more terrifying, seeing them in their normal activities.  A new feature I discovered as I watched their terrible actions is that they all have a long prehensile tail. This they use to hang upside-down from the stalactites and other features in the cave.  Multicolored ooze dripped from their closed mouths and dripped to the cavern floor below.  I was unsure as to what it was, until I floated closer to one, and could hear a muffled, hoarse voice, moaning.  They were digesting the clothing and hair from their victims, as in John Smith’s case.

I floated on deeper into the cavern, and I saw that there were thousands of these creatures.  Most were hanging from their perches, feasting on their victims, but there were others that crawled across the floor of the cavern but I was unsure what they were doing.   As I moved deeper into the vast cavern, I could hear a woman screaming in the distance.  The sound was blood-curdling and mournful all at once.  I saw that one of these beasts was consuming her — her body completely wrapped in the mouth tentacles and being pulled inside.  I was horrified and helpless.  I was forced to watch the scene, reliving my own terrifying dream.  Her screams intensified as the maw of the beast closed, sealing her in.  Once complete, it moved slowly to presumably find a place to perch.

I tried to wake myself up, but I could not.  None of it felt like a dream.  I felt as if I was there, only disembodied.  This caused me to fear that I had died in my sleep, and my mind raced to insanity at the thought.  But nothing prepared me for what I saw next.

As I neared the back of the cave, I could see a creature in the distance, its eyes glowing with a radiant blue.  And as I moved, the creature’s size became frightfully apparent.  It was gargantuan, with large and bulbous eyes that seemed to notice me.  It had legs like that of an elephant, thick and stout, all down the side of its body.  Its body was much the same in its description as the other creatures, except that it had tentacles both inside its mouth, and along its upper torso.  Thick ooze covered the floor around it where large, flesh-colored eggs scattered around.  The ooze dripped from its mouth in massive globs, covering the eggs, presumably for incubation.

Surely, this sight alone should have awakened me screaming, yet, my journey was not complete.  Compelled by an unseen puppeteer, I entered the mouth of the beast, and I screamed silently as I did.  Within the belly of the beast, I was horrified to find organic cells lined the entire belly of the creature.  They were clear and filled with a pale liquid resembling amniotic fluid.  In the pale, bio-luminescent blue light which emanated from nodules between the cells, I could see people – naked, tube-like tentacles in their mouths and seemingly catatonic.  It was at that time, I awoke screaming.  I screamed until I could scream no more, my voice nearly shattering as all the terror washed over me like a tidal wave.

It was still dark, and I sat trembling in my bed, rocking back and forth, as a child would, trying to reassure myself that none of it was real.  It couldn’t be real.  It was just a nightmare, nothing more.  When my damnable sessions with John Smith have ended, I believe these dreams too will fade.  I must believe that.

Before leaving for work, I phoned Trevor Jack and relayed my dream to him.  Despite how mad I sounded, my story intrigued him.  And before I could ask him to investigate Black Hills to see if he could find this cave, he volunteered.  Curiosity got the better of him.  He was so intrigued that he informed me that he would leave as soon as he could pack.  He promised to phone me once he reached Black Hills to check in.  I urged him to use caution.  I reassured myself that he would find nothing of interest, with regards to the cave, but something had happened to John Smith – perhaps perpetrated by the denizens of that region.

I wearily made the long journey down the main corridor of the facility to the interview room.  I could already feel John’s eyes on me before I entered the room.  As I did, he was watching me with that terrible, awful smile.  I wanted to slap it off his face.

“You should get better rest, Doctor,” He began.  “You look a bit ill.”

“I will not remind you again,” I said in a hoarse voice, as I sat and opened my notes.  “My health, my life, my job are of no concern in these discussions.  And quite frankly, I believe I am wasting my time with you.  You are beyond my ability to treat.”

“Ohhh, I wouldn’t be so hard on yourself, Doctor,” He quipped.  “I think you are doing a fine job, indeed!”

“Have you remembered anything else about the cave, or its whereabouts?”

“You know where my cave is,” he smiled that sinister smile again. “But, you’ll know its whereabouts soon enough.”

“Are you originally from Black Hills?” I asked, ignoring his bait to engage in further attempts to unnerve me.

“It does not matter where I am from,” he grinned wider.  “It only matters where I am going.”

“Where are you going?”

“Come now, Doctor.  You know that I can’t tell you.  That would ruin the suspense, wouldn’t it?”

Those thoughts of murdering him outright seeped into my brain like a slow poison.  His arrogance was growing with each session.  The person that sat before me was not the person I originally began treating.  I hated this persona, and I hoped that some foul deed would befall him.  But I have devised a possible way to rid myself of him.  I am going to allow him time with the general populace — interaction with others may stimulate his memory, or get him killed.  It was true that the sessions had made him talk, despite the uselessness of the information.  But, for what it is worth, it is progress, nonetheless.

“Are you still unwilling to tell me about Urdth?” I asked.

“Are you still unwilling to accept the fact that your soul will be consumed imminently?” He retorted.

I sighed deeply, then responded, “I do not intend on allowing you to affect me any longer.  This is to say, that I will not be baited into this nonsensical notion of soul eating and the mysterious ‘them’ or ‘they’.  Do you know how many of my other patients have said the same thing?  Do you think you are unique in your insanity?  This is your last chance to find that last vestige of who you once were and help it to surface, or, we will have no choice but to keep you here for the rest of our life.”

John just grinned at me as I delivered my diatribe, unmoved, unchanged, and completely uninterested.

I raised a brow at him, “Well?”

“Oh,” he said, shifting in his chair. “Are you finished your little speech now?”

“These are not things you should trifle with,” I warned. “Mental illness can be treated in a variety of ways.  Some of which, you might not enjoy.”

“I’ll be leaving here very shortly,” he responded matter-of-factly.  “I told you they were coming for me…and you.  So there won’t be any need for drastic measures, not that you’d be allowed to harm me in any way.”

“Is that so?” I asked curiously.  “And what makes you think that?”

He laughed at me, “You STILL don’t know?”  He guffawed at me, shaking his dirty head.  “You really don’t believe a word I’ve said to you.  You really believe that I’m insane?”

“Stark raving mad,” I said curtly.

“Oh, Doctor, Doctor, Doctor,” he said with a bit of a chuckle at the end. “You have eyes but you are blinded.”

“Blinded how?”

He leaned in and spoke quietly, “You should pay more attention to your surroundings.  They are watching your every move.”

“I said – “

“You would do well to listen.  You are involved with things that you can’t begin to fathom.”

I can fathom such things.  I had terrible dreams that showed me things that I chose not to accept.  All of human history is filled with stories of creatures and boogeymen.  I am a man of science and logic.  And I utterly refuse to accept any of these things to be true.  Once Trevor Jack confirms or denies the cave’s existence, only then will I be able to put an end to this man’s delusion.

“Very well,” I said with resolve, weary of the discussion.  “Where are they?”

“They are right here,” he said succinctly.  “You just are too blind to see them, just yet.”

“And what do they look like?”

“You, me, the orderly, the other patients,” He grinned again.  “You would go mad were you to see their true forms, as magnificent as they are, your little mind would turn to mush, and you would be wearing the straightjacket.”

“Of course, they are,” I nodded.

“And when will they take you away?” I asked.

“You mean us,” he corrected me.

“Of course, when will they take us away?”

He leaned in and whispered, “What makes you think they haven’t already?”

Again, he was trying to bait me, but I resisted.

“I will reflect on that, our time today is finished,” I motioned to the orderly.  “Take him to the day room for an hour.”

The orderly opened his eyes a bit wider, “Are you sure?”

“Quite,” I nodded.  “Perhaps being around others might assist in remembering his ordeal.”

“Come on,” the orderly grabbed John and led him out.

“Sweet dreams, Doctor,” John said as the orderly ushered him out, watching me all the while

I left the facility later than usual, after speaking with the director again for reassignment.  His adamancy for me to continue this case has me gravely concerned.  It is almost as if he is testing me.

When I arrived at my house, I noticed a black van idling across the street from my house.  I felt as if I was being watched as I entered my home.  The phone began to ring the moment I entered the foyer, so I hurried to answer it.  It was Trevor Jack.  He had made it to Black Hills, which had taken him most of the day.  He checked into a small bed and breakfast, and informed me that he would phone tomorrow evening.  After I hung up, I looked out the window, and the van was gone. I must not become paranoid.  My mind cannot take anymore. My nerves are have been tested to the point of breaking. I hope we are at an end to this game.

I must stop this constant terror that has affected me to the point where I only work and sleep.  I have barely eaten in several days.  And now, I cannot get the images from my dream out of my head.  I don’t want to sleep, but I must.

Session 9

These dreams must end!  I am certain any more of these detestable dreams will break my mind.  I am questioning everything that I see or experience.  I have never dreamed such horrible things until I first laid eyes on the scoundrel, John Smith.  There is something very wrong with him, in a way that I cannot at all describe.

The intensity of the dream still lingers with me even now.  I cannot get the imagery and sensations out of my head.  And I know that I have done something horribly wrong.  I dreamt that I was someone else.  In fact, I remember distinctly that I knew I was not myself, so I checked the wallet of the body I inhabited.  I was Trevor Jack, and I entered into that menacing cave with the maggot-like creatures.  I tried to stop myself, stop him, but he pushed me out of the forefront into the subconscious to witness the horror he was about to face.

Unlike my dream before, a creature, waiting just inside the darkness at the mouth of the cave, attacked him.  In his horror at confronting such an unspeakable abomination, he tried to run as he screamed, but it was amazingly fast and grabbed him before he could take his first step back.  His screams drowned out my own screams in the back of his mind as the beast sucked him into its awful mouth, and consumed him whole.  During this entire process, Trevor lost his mind.  He kept saying “No, no, no” over and over again, trying to disbelieve the situation, but it was too late.  Inside the belly of the beast, we felt it move, as I had witness the night before.  After a few moments, his mind could take the experience no more and he lost consciousness, yet I did not. We sloshed about in the viscous corrosive liquid which filled the cavity – helpless and lost.  I endured the entire process of the creature finding a perch, and hoisted itself up by its prehensile tail.  This is when I awoke, yet I was not screaming.  I was thankful that it was not me; however, I knew that what had just happened was not a dream.  Of that, I am sure.

I immediately phoned the bed and breakfast in which he stayed – no answer on his room’s phone.  I then phoned the main desk, and they informed me that Trevor had check out early that morning.  I found this queer, as he specifically told me he would phone me before he left.  Something is terribly awry, and even now, as I sit writing these notes tonight, he still has not called.  I have called his home several times, but there is no answer.

As I left my house this morning, to continue my lamentable sessions with John Smith, I noticed that van once more idling across the street.  As I left, it followed me to the asylum, yet it did not enter the parking lot when I did.  They are watching me.  I have checked several times this evening and the van is still out there, across the street.  I am writing these notes by candle light, so that they cannot see what I am doing.  I do not know what their intentions are, but I suspect they are the ones who have broken into my home, tormenting me while I sleep.

At the asylum, I once again implored the director for reassignment.  He denied my request, rather curtly, and reminded me that my job was at stake.  I had to make a choice between my own mental stability and my livelihood.  The job market was poor, and I was fortunate to have this job.  I’ve been asking myself whether I can continue, but after today’s session with John, the dream and the apparent disappearance of Trevor Jack, I feel that I may not be able to continue.  The events occurring I know now are real.  There are things I cannot explain through any rational thought process.  There is something lurking in the hills to the west, and I must get as far away as I can, before it’s too late.

Yesterday, I had put John in the day room, however, it did not go as I had expected.  The other patients were seemingly attracted to John, and now follow his instructions.  As I walked the long hallway, passed all the other patient cells, each of them was chanting, “They are coming for you, Doctor!”  My plan had back-fired.  John had once again won another piece in our maddening chess game.

I stopped at the threshold in disbelief. John sat without a straightjacket at the table.   I immediately turned to the orderly and asked why he unrestrained.

“The director said that his behavior has improved,” he replied.  “He wants to see if he can be a good patient.”

John just sat there with that terrible grin, and then motioned for me to take my seat opposite him.  “Come now, Doctor.  I owe you a great deal of thanks.”

The orderly closed the door behind me as I sat and watched John silently for a moment.  I opened my notes as usual.

“Do you like my homage to you, Doctor?” He began.

“What homage would that be?” I asked curtly.

“All of my new friends welcoming you, of course,” He said with that dark smile curling his lips.

“Another feeble attempt to demoralize me,” I said, knowing that he was right, they were right.  Something was coming, but I did not let on that I had accepted this lamentable fact.  I have to leave before ‘they’ get here.

“No, not to demoralize you,” He said in a condescending tone.  “This is to enlighten you, Doctor.  Your fate is inevitable.”

“There is no such thing as fate,” I replied, retaining my composure, not allowing him to see even a hint of acquiescence.

“Oh, fate is what brought us together.  Fate is what allowed me to escape that cave.  And fate,” he smirked.  “Fate is what led your intrepid occultist into their hungry mouths.”

“I have no idea what you are talking about,” I lied.

I could feel my mind cracking.  There was a plot behind all of this.  For all I knew, he was the master of the plan.  He was no soulless stranger; he is some sort of cultist with powers beyond my reckoning.  Was he controlling me the whole time?  Had he swayed the staff to make me his psychiatrist?  I still do not know these answers.  I cannot trust any of them anymore.

“If you want to play that game again,” He said with a self-deprecating shrug.  “You can continue to deny it, or you can embrace your fate and be relieved in knowing it will all be over soon.   Your pathetic, empty life.”

“You know nothing of my life,” I spat, losing my temper at his arrogance.

He leaned forward closer than I would have liked, “I know everything about you, Doctor James Marston, a pitiful orphan from Philadelphia who was precocious enough to get a scholarship to Johns Hopkins.  Though you have your intelligence, women find you repugnant and an intellectual snob. That’s why you live alone, traveling to work, to the market, and finally here, to work among these wretched souls, not even worthy of consuming.”  He smiled at me.  “But your soul is delectable, sweetened by your pitiable fear of existence.”

I sat there stunned as he spoke.  I opened my mouth to speak, but found I could not.  It was then that he stood and walked with a cat-like prowess and sat on the table right next to me.  He took in a deep breath as if smelling the fragrance of a flower.

“You can end this, of course,” He said, staring down at me, pushing his filthy hair behind his ears so I could see his black, colorless eyes.  “I possess the power to change your fate.”

I shuddered, unable to move as if his gaze weighed me down in my seat.  I feared he was ready to attack me, yet I could not find the voice to call out to the orderly.

“Simply give me your soul,” He said, running a finger through the sweat on my brow then licking it.  An ecstatic expression came across his face.  “That is the only way you can be saved, Doctor.”

He took his seat across from me, folding his hands on the table before him, watching me with those demonic eyes.

I quickly took this opportunity, gathered my notes, and hurriedly left the room.

I heard him call out behind me, over the chanting of the other patients, “Think about it, Doctor!”

Tomorrow, I must find a way to ease their sense of my growing panic.  I have been horribly wrong.  I should have left before my behavior became erratic.  They are making me interview John, but I do not understand why.  I have wracked my brain to understand why they torment me with this patient. What is its purpose?

Tomorrow I will apologize for my behavior, and perhaps the van will go away.  I keep checking, but it is there constantly now.  Or is it?  I am not sure.  But I must remain cautious.  There is still time to escape, and I will survive this.  I have to keep reminding myself that I am not the insane one, but I am beleaguered by horrible thoughts, and dark visions.

I must reflect on these things.  There is a solution to every problem.

Session 10

I did not sleep last night, my mind spared for just one evening from terrible, haunting dreams of deep caverns in the bowels of our planet, infested with creatures my muddled mind can barely describe with any semblance of sanity.  I do believe that they exist, and it is horrifying to think of what their true designs are.  John Smith must be a messenger, a harbinger of evil.

The black van followed me to the asylum again today.  I am certain that they are ensuring that I do not flee.  I feel as if the director of the asylum, the orderlies and other staff, are all members of this reprehensible plot.  However, I am not able to ascertain their true motives.  And if John is the answer to all this, I must understand him more than I do, before I can escape this wretched ordeal, and be free to live far away from the accursed asylum.

I hope that anyone who reads these notes and assigned to John Smith, they will flee immediately.  You must not allow yourself to become enslaved by these dark villains.  Before beginning my interview today, I checked John Smith’s files.  Strangely, there were no notes from any of the other psychiatrists that had attended his case.  Furthermore, none of the previous doctors is employed at the facility any longer.  Perhaps their failed attempts the cause. I can only hope that they too did not fall prey to the events that I am experiencing.

The day began much the same as it had the day before, with the exception that I can barely keep my eyes open as I recount the happenings of today.  The other patients were chanting a new mantra as I walked that long, damnable hallway to the interview room.

“Give up your soul,” they insisted as I passed all twenty-one rooms.  “They are coming for you.”

I tried to think of other things, but it was as if their words penetrated my being, reverberating in my mind like a bass drum.  And as I approached the interview room, I felt the intensity of John’s baleful stare.  He sat casually, with his hands folded in front of him on the table.  He was still unkempt, but not nearly as bad as he had been in the previous sessions.  His hair was less of a tangle, and his face clean-shaven.  Those black eyes tore into my soul like a hot poker to my chest, branding me forever.

“Good Morning, James,” He began with a casual demeanor.  “So good of you to come again.”

I took my seat across from him, opening my notes.  He must know that I’ve been trying to escape.  Was he a part of this plot?

“Doctor,” I insisted.  “I have earned that respect, and I believe you said that you owe me a great deal.”

“Very well, Doctor,” he said mockingly.  “Have you given thought to my proposal?”

I remained calm and composed, though every moment with this odious man-made my skin crawl.  I can hardly bear to endure his piercing, evil gaze.

“I have given it thought,” I replied.  “However, I think before a final decision can be made, we should discuss some quid pro quo, if you will.”

John smirked at me confidently and tucked his hair behind his ears so I could feel the weight of his terrible stare.  Those black eyes burnt into my retinas as if I looked at the sun too long.

“Quid pro quo?” He replied.  “Very well, what do you want?”

“A few things, actually.  It seems I have a great deal to lose in this exchange.” I replied calmly and matter-of-factly.

John raised an eyebrow, followed by that terrible smile, motioning for me to continue with a flick of his filthy hand.

“First, I would like to speak with your other persona.  The one I first met.”

John laughed at this darkly, “Oh him?  He’s gone now.  That was merely the residue of my soul.  Much like an echo fades over a short period, and then ultimately forgotten.”

“Are you sure about that?” I pressed.  “I’ve seen hints of him in our sessions.”

“Quite sure,” he quipped.  “You clearly have no real understanding of the human soul, do you, Doctor?”

“I am a man of science,” I replied.  “There is no proof that the soul exists.  Only the mind and its thoughts exist without question.  We think, therefore, we are.  And when we quit this body we are no more.”

“Then why not simply give me yours, since you don’t believe it exists?” He responded with a malicious grin.

“Because,” I chose my words carefully.  “I am here to assist you in becoming well again.  And if I recklessly confirm your delusion, you will be lost forever.”

“I’ve told you,” He leaned forward, almost menacingly.  “They are coming for us, so your banter is worthless to me.  I am offering you an opportunity to be spared any more torment, and allow you to exit this world with some semblance of dignity.”

“You say they are coming,” I retorted.  “Yet you’ve not spoken of who they are.  So if you wish to continue this negotiation, I would like to know.”

John sat back in his chair, hands still folded on the table.  “You know exactly who is coming, but if you wish me to speak it aloud, so we can end this deplorable exchange, I will tell you.  ‘They’ are the Urdth.  And in the end, when all is said and done, they will consume all the human souls on this planet.”

I shuddered at this.  I knew what he was saying was true, if my dreams were an indication of what lie in the darkest depths of our planet.

“And then what?” I asked.

“They will move on to other worlds,” He smiled forebodingly.

“And you find this acceptable?”

“It matters not to me,” He said succinctly.  “I will be gone.  And it should not matter to you, because you will as well.”

“Can they be stopped?” I asked, my heart throbbing in my throat.

“No.” He said with certainty.

A sense of hopelessness once more crept into my chest.  The things I had seen in my dreams stopped being nightmares, and settled into my mind as fact.  I had seen all these things, and something within me knew that John was telling the truth.

“What will happen when I give you my soul?” I asked fearfully.

“I will assume ownership, and you will be of no worth to the Urdth.  If you have no soul, then there is nothing to consume.”

This made little sense to me, which prompted my next question.

“Why would they come for you if you have no soul?” I asked with a confused expression shadowing my face.  “Furthermore, why would they come for a soulless man?”

“That is a very good question,” John replied.  “But, I’m afraid I will not answer it.”

“Why not?” I insisted.

“I wouldn’t want to confuse you anymore.  It is a win-win situation for us both, rest assured.”

“Then,” I said with even more trepidation in my voice, “I don’t think I can give you an answer just yet.”

“Suit yourself,” He smiled again. “But, I will tell you once you’ve surrendered your soul to me.  But, I will say this; time is growing very short for you.  You have 48 hours to make your decision, or it will be too late, I’m afraid.”

“Is that when ‘they’ will be here?”

John casually got up from the chair walked to the door, “You’re a very smart man!”

John walked out with the orderly and vanished down the hallway.  I am now sure that there is something dreadful afoot in this asylum.  I need to escape before it is too late.  I cannot bear to think what will happen when the 48 hours is up, but now I had a timeline I could plan.

Unfortunately, when I left the asylum this evening, the black van followed me to my home once more.  Tomorrow I will agree, in principal, to surrender my soul.  Perhaps this will end this madness, and I will no longer be of use to John, thus ending my torment.

I do not think I will be able to go another sleepless night.  I am already nodding off as I write these final notes.  I know the nightmares will return.

Session 11

There is no way to describe the horror I feel as I relay my latest nightmare.  It began with me seated in John Smith’s padded room.  His drawings and mad ravings covered the walls.  Bound by a straightjacket, I immediately felt terror creeping up through my bones.  I sat in a corner, with a full view of the room, none of the drawings made any sense. In addition, they appeared to be done by different artists, each with different styles — planets, strange runic symbols, and other ritualistic trappings.  Varieties of mediums were used to create them — crayon, blood and other bodily fluids.  I remember the room had a foul smell that still lingers in my nostrils even now.  Nevertheless, what I am about to relay assures me that it did not happen.  It could not have happened.

A sickening, slurping sound drew my attention to a drain covered by a grate in the center of the padded cell.  I could only imagine what horror waited on the other side.  I tried to free myself from the confines of the straightjacket — it did not budge.  The sound seemed to becoming closer, getting louder as it did.

Without warning, a mass of thin tentacles burst from the center of the grate, hundreds of them.  They fanned out in different directions — each a sickly, burnt flesh color. I knew they were searching for me.  I screamed and tried to move away as one grabbed my leg.  The rest quickly covered me, squeezing me to the point that I felt suffocated.  They dragged me towards the grate as I continued to scream.  Just when I thought my fear was at its height, my bones began to break under the force of the tentacles crushing me.  I can still feel a hint of the excruciating pain associated with the crushing of each bone.  It pulled me, feet first, into the grate and into the mouth of one of those hideous maggot-like creatures.  Blood squirted from my eyes, nose, mouth and ears, splattering the walls.  Inch by inch it consumed me, and when my head finally was at the grate, my skull crushed in, and my eyes popped from their sockets.  Once again, I awoke screaming.

After I calmed myself, I glanced at the clock. It was past eight A.M and then there was a forceful knock at my door.  In my exhaustion, I forgot to set my alarm.  I was late for work, and I could only assume that the knock at the door came from my unknown watchers. Clearly, I had not quelled the concerns of the director, and it was most assuredly going to be difficult to escape with their constant presence.

I hurried to the front door to answer it, hoping to catch a glimpse of the person driving the van, but there was no one there.  The van sat idling directly in front of my house, waiting.  My nerves about ready to snap like rubber bands, I turned from the door and hurriedly dressed and left.  The van followed me, as always, to the asylum.  Today, I put my plan into action.

With purpose, and the last vestiges of my sanity, I hurried down the long hallway to the interview room, ignoring the mantra shouted by the other patients.  Everyone is in on this evil plot to steal my soul.  I do not understand the purpose of this travesty.  Nonetheless, tomorrow, I will be fleeing this place, never to return.  I only hope that I can recover from the damage my mind has been subjected to.

I entered the interview room, and stopped at the threshold.  John sat in my chair.

“Good morning, Doctor,” He grinned that dreadful grin.

I resisted the urge — which was almost overwhelming — to kill him right where he sat.  Kill him and be done with this ghastly game.  I do not know which would be worse, living on the run, or life in prison.  I gripped my pen in my hand so tightly, my knuckles turned white.

“You don’t want to do that,” John lost his grin, and raised a brow.  “Really, Doctor, I am about to save you from a fate worse than any you could imagine.”  He motioned to the chair across from him, what should have been his chair.

I stood there silently, still contemplating his demise.  I could see his blood splattered all over the walls of this abominable room, begging for mercy as I gouged out his eyes and smashed out his teeth.  I could feel my ears becoming warm with anger, yet my heart thumped with the urgency of a hiding rabbit.  However, I took a seat across from him, not bothering to open my notes.

“So,” I began. “You’ve decided that we should switch roles now?”

“I will be assuming control of your soul,” he said in that dark, unnerving voice.  “It is only fitting that I accept your offering with the tables turned, so to speak.”

“And you are certain I am willing to relinquish my soul to you?”  I asked.

“What other choice do you have, Doctor?”

“You realize,” I spoke calmly, “once I have acknowledged your delusion, you will be beyond help.”

“Oh,” John chuckled, “you shouldn’t worry about me, Doctor.  I will be quite fine, I assure you.  It is you who will be in dire straits if you do not surrender your soul.”  He leaned across the table and whispered menacingly.  “Or have you already forgotten your dream?”

I shuddered at this, and the tone he used.  I still do not understand how they know my dreams.  It is as if they are putting the notions in my head — perhaps some sort of subliminal method.

“Very well,” I said, feigning resolve.  “I will surrender my soul to you.”  The words fell from my lips like petals from a dying rose.  “But, not until tomorrow.  I must sort out my affairs.”

John nodded.  “That is quite understandable.  But, it is the best thing for you, really.  Now you will be safe from the Urdth and I can get on with my existence.  It’s really the only way.”

“Can you at least explain to me why you would do this?” I pressed once more.

“Very well,” he said as if speaking to a child. “I escaped the inescapable.  I should not be here.  I should be in the cavernous belly of the beast, Urdth, surrendering my life force, fueling its return.  However, now that you have agreed to give me your soul, I am renewed.”

“And what of me? What of my existence?” I asked, fearful, yet anxious for the answer.

“You will be soulless,” he said in an even tone.  “Yet, you will continue to exist.  Perhaps with proper help you can live the rest of your life in peace. However…” he paused to smile again, “you will need to remember who you are, as I have, and then you will be free to live this last incarnation, knowing you can never return to this world.”

“What do you mean?”

“It is best you not know the rest, Doctor,” He concluded.  “Tomorrow, you will be free to do as you will.  It will be a slow recovery, but I assure you, when it is all said and done, you will be less worse for the wear.”

John stood, motioning to me, “Tomorrow we will complete our transaction and the Urdth will have no further use for you.  I alone will deal with their treachery, and using your gift, I will stop this insidious plot that has drawn us together.”

John left me alone in the room and vanished around the corner.  The deal was set.  He believed I would surrender my soul on the morrow, but he was terribly mistaken.

After the rest of my day was finished, I withdrew to my home. Dutifully, the van was there, waiting to ensure that I remained at my home.  Would that I could find the driver of that vehicle and pluck his heart from the depths of his atrocious form.

Regardless of their diligence, in three hours, I will flee this place.  And, I will do so at any expense.

Session 12

I know now that my decision to flee is in fact the only sane decision I was able to make.  Last night, after returning home from the asylum, I packed a bag with only my most valuable possessions, for I know that I can never return.  It was nearly ten P.M. when I turned off the lights, as if I were going to bed.  The van sat across the street, silent.  I could not see the driver through the tinted windows, but I knew he was watching.  I cannot fathom how someone could have the tenacity to simply sit and watch a house for hours a time.  That would make anyone insane.

I watched through a curtain for nearly thirty minutes to see if there was any motion.  There was no movement, and no way of knowing whether I was being watched in some unnatural manner.  I decided it was the time to move.  I grabbed my bag, and looked out the back door to see if there was anyone watching from the yard.  From what I could see, there was no one about.  So I crept out into the yard and slinked along to the side of the house where I parked my car.  I slowly poked my head around the corner, somewhat shielded from view by my car.  The van still sat idle, the engine turned off.  I crept hunched over to the driver’s side.  Knowing that the interior light would come on, I got my keys ready, put my hand on the handle, and prepared to enter as quickly as possible.

In one adrenaline rushed move, fueled by fear, anxiety and hope, I swung the door open, threw my bag into the passenger’s seat, and in put the key in the ignition while closing the door.  I started the car, and put it in reverse, just as the van started its engine.  I gunned the engine in reverse, and turned the wheel as to point the car in the opposite direction the van faced.  While I exited the driveway, I knocked over the neighbor’s trashcans, and sped off just as the van tried to cut me off.

I made a series of random turns through my neighborhood, driving wildly, not caring if anything got in my way.  I kept looking in the rearview mirror, but I did not see the van in pursuit.  Once out of my neighborhood, I headed for the interstate and headed south.  I had done it.

I drove for nearly five hours, making it all the way to the south of Richmond where I felt safe enough to stop and get a room for the night.  Tired and exhausted, went to sleep quickly.

Unfortunately, I had not put enough distance between that detestable asylum and myself, for I dreamt another nightmare, and even now, I cannot tell you how horrified and relieved I am.  I believe I had a premonition of what would have happened were I to have stayed and gone along with John Smith’s lunacy.

I was strapped to a table in one of the examination rooms.  I could see hooded figures all around me.   I could not see their faces from the shadow of the hood.  I was gagged and in a straightjacket, and my head was strapped to the table.  Panicked, I struggled wildly against the restraints.  No one said a word, and the only sounds were that of my own muffled protests against the gag.  After a few moments, I saw the director walk in and …


You can purchase Session 13 – Case Closed and the entire story on Amazon Kindle.  You do not need a Kindle to read the book.  You can read it on the site, or download their software.

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2 replies on “The Case Study”

Can’t wait for the ending! I’m impressed with your vivid imagination! I did feel that chapter 12 was a bit short, but enjoyed it nun the less.

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