Oleksandr Dan - Insomvita

Dr. Alexander Friedman did not look one bit like a psychiatrist. To Robert, a psychiatrist was a serious, stout man in an expensive suit, with the neat hands of a piano player, high forehead and wide, neatly trimmed beard up to the ears. But the man standing before Robert was short, skinny, and elderly, with a small, carefully trimmed beard and a closely clipped moustache. His face, streaked with a web of thin wrinkles, was well cared for, small and feminine by most metrics. His gray hair was neatly cut and combed back in long streaks.

The doctor was very nimble. When he spoke, and he spoke very quickly, his hands flew in a flock of gestures. At the same time, his enunciation was precise and he spoke every word very clearly.

The psychiatrist followed his examination ritual, going from eyes to tongue and throat, massaging hands and lightly swinging the reflex hammer against the knees.

“Everything seems to be in order! Do you take antidepressants? Do you suffer from migraines?”

“No. I’ve never needed antidepressants and I hardly ever take pills,” Robert answered. “For a migraine, I don’t even know what to say. I don’t remember the last time I had one.”

“What about your sleep? Maybe you suffer from insomnia?” The doctor was clearly confused and did not try to conceal it. “You look a bit fatigued."

“Doctor, I sleep like a baby. I can sleep anywhere and in any position.” Robert smiled. “I just got back from a business trip. Haven’t slept for nearly 24 hours – different city, the flight."

“Exhaustion? Sleep deprivation? You work a lot?”

“No, doctor. I'm fine. The question is totally different. I want to know if you’ve seen anything like this before?”

“Did you use to take drugs? Smoke pot?” the doctor continued his interrogation, ignoring Robert’s question.

“Doc, nothing like that. I even have alcohol intolerance. So, I almost don’t drink and I’ve never smoked.”

Robert tried to speak in a steady, calm voice to convince the psychiatrist as his eyes bore into Robert during this interrogation.

“Right…right…right… Oh, got it! Have you been to a doctor with this issue before?

“I’ve already told you that I’ve never been here. Amanda recommended that I see you. She was the one who suggested it."

“Right…right…right… Amanda," the doctor drew out, ignoring Robert’s last words. He got up and began to examine his head again. “You say that you've not had any head trauma. What about when you were a child? Maybe intense stress, mental disorders, phobias, some juvenile anxiety?”

“No, doctor, nothing like that. Actually, I don’t think I’ve ever been seriously ill.”

The psychiatrist looked at Robert in the eyes and resumed feeling around his head. His fingers, like a massage device, slid pleasantly through his hair, leaving no inch of the patient’s skull unexamined.

“If this helps, doc… I don’t know whether it’s a phobia, but I feel really uneasy on a train.”

The doctor continued to ignore Robert and probe his head.

“Why is that, do you think? As far as I know, trains are the safest mode of transport.”

He suddenly stopped, still leaving his hands partially buried in Robert’s skull, leaned in close and quickly asked: “Why are you so scared of the trains?”

“It’s because of the rail crash at Ladbroke Grove in London."

“Ok, tell me about it,” the psychiatrist said.

“This was a long time ago, in October 1999, I think. In the morning, right before getting on the train in Reading, I suddenly felt very sick, right on the platform. I experienced severe dizziness and I thought I was about to lose consciousness. And then I had a vision. I saw myself lying among the dead in the wreckage of a train carriage filled with mangled corpses. I could even feel the heat of the fire on my face that engulfed the carriage. Then suddenly I heard a clear voice in my head instructing me not to get on that train. In the evening, I was watching the news and saw the horrifying rail crash that happened at the fourth kilometer from Paddington Station. Two trains had collided, killing over thirty people and leaving more than five hundred injured. And the first car, which I was supposed to board, suffered the worst."

“Paddington rail crash,” Dr. Friedman said. “I remember reading about it.”

“Right. So, I’ve avoided trains ever since. I think that was a warning from above, a sign. Even now I can see that railway carriage before my eyes – a pile of crumpled metal and charred bodies. It was unspeakably awful.”

Dr. Friedman listened to Robert’s story while continuing to examine his head.

“A vision, you say,” the doctor said after Robert finished. “I think the crash was the result of a faulty signal light, yes? Okay… Have you had other visions?”

“No, doctor,” answered Robert uncertainly. “Just the dreams…”

Meanwhile, having thoroughly examined the head, the psychiatrist returned to the patient’s eyes and tongue.

“Open your mouth again, please… Wider, stick out your tongue, please.”

It seemed he was searching for a diagnosis written somewhere inside his mouth.

“Well, well… So, what were you saying? Never been seriously sick?” the doctor asked Robert while still inspecting his throat. It was clear he wasn’t expecting an answer, as Robert’s mouth remained open.

Robert noticed that the doctor’s eyes were shining with youth and vigor, although he was no longer a young man. Those were the eyes of a child when dragged away from playing.

“What about Amanda?” the doctor suddenly asked, motioning to Robert that he could close his mouth. “Have you known her long?”

“Amanda? No. I, well, Trevor… I… eh… met her only last night.”

“Trevor…” said the doctor thoughtfully. “I’m sorry, how does this Amanda look? How old is she?”

“I haven’t seen her, but I clearly felt and heard her… But somehow now, I realize that I know how she looks. She looks about 30, maybe less. Dark skin, tall, very attractive. And there are… her eyes…” Robert though for a bit and then looked at the doctor. “She has incredible eyes, green and blue, like from a fairytale. They…”

“Do you realize that it is, possibly, your alter ego?” asked the doctor impatiently, cutting Robert off. “And that it was she who advised you to come see me?”

“Well, not you, exactly. She insisted that I see a good psychiatrist here, in my world, or, at least, a psychologist and tell him everything. She said she would need assistance from this side to try and figure out what was happening to me there. Well, to Trevor…”

“This is all very strange, don’t you think?”

“I agree, which is why I am here now. I’ve had a long-lasting interest in dissociative disorders and I want to understand it all more than anyone else.”

“You read medical journals?” said the doctor, raising his eyebrows in surprise. “You see, dear, many psychiatrists, me included, by the way, view disassociation as a symptomatic response to trauma, critical emotional stress; it is connected to emotion dysregulation. However, it seems to me that nothing like that has happened to you, except maybe in the case of the first relapse and your reaction to it.”

“You are right, doctor, in that many scientists believe that dissociative disorder is contrived in nature.”

“Yes, dear, you are absolutely right. Latrogenic in nature or, as you put it, contrived. I am also convinced of that!”

The room fell silent. Dr. Friedman intently pondered the situation. This was the first time he had seen such symptoms and the course of, what he believed, the disease.

“You, Robert, are talking about dissociative disorders. I believe your condition is something else. You see, in order to diagnose multiple personality disorder, or in other words, dissociative identity disorder, you would need memory loss beyond normal forgetfulness in addition to the presence of at least two personalities that would regularly and in turn control your behavior. In this case, memory loss usually occurs when the channels are switched. You, on the other hand, manifest totally different symptoms. And then again, this Trevor…” The doctor paused to think. “You see, your memory clearly relays everything that is happening to you here and there. There are no manifestations of your other personality – Trevor. Only you control your actions, and I don’t see any interference from your alter ego. That's what puzzles me. I’ve never seen anything like that described in medical texts.”

He squeezed his fingers and touched his chin. The knuckles turned white from visible tension.

“By the way, have you taken notice of the name Trevor?" The doctor looked at Robert curiously, as if he just uncovered a secret and was about to reveal it.

“What’s wrong with it?”

“What do you mean what’s wrong? It is a palindrome, a word that reads the same backward as forward. Look!” The doctor took a sheet of paper and wrote several big letters. “Here, this is how it looks. Trevor is the mirror image of your name, Robert."

“Indeed. I’ve never thought about it, but you're right,” Robert said in surprise.

“Yes, Robert, mirror image! Palindrome. By the way, what’s your feeling of time? It is synchronous?"

“For the most part it almost coincides. Life there runs strictly by the rules, even if I don’t sleep here for, like, two days. But usually, in my dream, it’s like I return to the last starting position. Sometimes, it seems as though I enter while it's in progress, but my memory instantly fills with information. I realize that’s what happened only later, when I wake up.”

“So, there are moments you can’t remember?”

“Just as there are in this life, doctor. All feelings are identical. Usually, when I fall asleep, I find myself in the exact moment as before. It’s as if I just push play on a track that was paused. Well, except for the case with Amanda. That was different.”

Dr. Friedman was looking at Robert, contemplating something. He was tormented by doubt and he seemed to be trying to explain to himself what was going on, shuffling through all the cases of multiple personality disorder known to him, comparing them with this unclear condition of his new patient.

After a long silence, the doctor sighed, crossed his arms over his chest and said: “You know, Robert, your condition, even considering your fantasies about night journeys in your dreams, raises no concerns for me. This all falls within the generally accepted standards of psychological deviance. Here’s what does concern me though…” The doctor paused, looking intently at Robert. “Your suicidal thoughts, I believe, are the result of depression, but you seem to be coping with that on your own. And that’s a very good decision, because staying in depression passively is like sitting on the bank of a river waiting for the body of your enemy to float by. I am happy that you are not waiting, but instead trying to find a way out. Seek ways and analyze.”

“You’ve got it a bit wrong, doctor. I have suicidal thoughts not because I don’t see a way out, and they are not the result of some depression. I am fully content with my life here, beyond the dream. I have a good job, successful career, and a woman I love. But…” Robert sighed deeply. “Sometimes all of this does not seem real to me. I’ve thought a lot about it, comparing this world and that one. What if all this is just somebody’s dream? What if you and I and this entire world is just my dream, my imagination, and nothing more? In that case, suicide seems to be a radical way to solve the problem. Do you understand?”