Page 38 of Splintered
“But he was facing significant professional pressure to accept the offer and to move forward in the process. To fly to New York for an interview. We met almost every evening to walk and talk.”
Ben sat up. “At Ohlone Park?”
“Sometimes. Sometimes I met him in the city or in Walnut Creek.” He squeezed Ben’s shoulder. “Evan was enduring a test of faith. It is one of the deepest, most fundamental questions: can you get through the hard times as well as the good, together? Together with Godandtogether with those who matter the most to you.” Father Mathew’s gaze burned into Ben. “Evan struggled greatly. In his mind, and in his soul. Ultimately, his struggles became so great that I referred him to Dr. Kao.”
“Youreferred him?” There was one question answered. And a portion of Evan’s secrecy revealed. “Why?”
“You know why,” Father Mathew said. “He started manifesting certain symptoms.”
The irritation, the anger. The distance. The headaches. The missing time. The seizures. The voices in his head. The creepy midnight wakings. The violence.
“I spent all of yesterday and much of last night at St. Ignatius,” Dr. Kao said, jumping in. “And with Father Mathew as well. We are working with Evan, testing him. Interviewing him. We spent sixteen hours with him and observed him under a variety of conditions.”
“And?” Ben waited. “What kinds of tests? And how does this all fit together? How does a priest and a psychiatrist help Evan get better?”
“With everything that was happening in Evan’s life,” Dr. Kao said slowly, “from exploring his faith and his sexuality and what that means for him, and exploring the life he wants to build with you in marriage, and the complications from the professional pressures he experienced from this job opportunity in New York, we believe Evan has experienced a potential trigger event. A combination of stressors that may have triggered an underlying mental health condition.”
He stared. The walls seemed to warp, the light slant. Dr. Kao sounded far away and too close, and he heard his own breath rattling in his lungs.
“We were concerned,” Dr. Kao continued, “that Evan was potentially experiencing early stage schizophrenia.”
“Oh my God,” Ben breathed.
Part of him, some dark part, suspected this was coming. Everything they had been through couldn’t have a happy ending.
“In schizophrenia, the mind, the personality of an individual, shatters. When that happens, parts of that shattered mind can sometimes reform and develop into a hostile secondary personality which can try to attack the original mind of the individual. This isn’t the same as split personality or Dissociative Identity Disorder. It’s a form of schizophrenia where the shattered mind turns on the body, the host, and tries to destroy it. Sometimes it may try to destroy the people around them.”
You should have killed him, because he’s going to kill you. Ben closed his eyes. Dizziness washed over him. “That sounds pretty accurate so far.”
“Not quite,” Dr. Kao cautioned. “Evan has experienced violent episodes, and there does seem to be a personality emanating from him that is acting out violently. That is seeking out the destruction of the host, and of others around him.”
He opened his eyes. Held her gaze.
“But he does not meet the other clinical criteria for a possible schizophrenia diagnosis. Heisexperiencing hallucinations and some delusions. But his cognitive function seems to be intact. His affect, his mood, is labile. It’s not flat. If anything, he’s showing pronounced depression,” she said. “He’s having problems functioning at work and with his personal life, but his behavior doesn’t rise to the level of gross disorganization. He responded initially to medication management, and then the medications seemed to become ineffective almost overnight.”
Ben shook his head. A thousand thoughts stampeded through his mind. He didn’t know which one to seize, to grasp. Which questions to ask first.
“We’ve also run more tests,” she said carefully. “I ordered another round of MRIs and CT scans yesterday. We looked for everything. Epilepsy. Lesions. Tumors. Arachnoid cysts in his brain. Cerebral cavernous malformations. Possible HIV encephalopathy. Ischemic changes, or undiagnosed aneurysms, specifically in the cerebral arterial circle. Infections. Other rare neurological disorders.”
“What did you find?”
“Generally, in patients with schizophrenia, MRIs will show enlarged ventricles of the brain, along with reduced volumes in the hippocampal and thalamic region. The paleostriatum is also often enlarged and there can be a reduction in cortical volume in the frontal and temporal lobes of an individual. These are not diagnostic criteria, but common findings among patients.”
Panicked images of Evan’s brain folding in on itself, squishing and collapsing into jelly, blasted the backs of his eyes. “And in Evan?”
“We did not see any of these features in Evan’s MRI or CT scan. Evan’s brain, on the contrary, looks remarkably healthy.”
The breath punched out of him, an explosive, frustrated sigh. “So there’s no reason for what’s going on?”
“We also ran a full tox screen,” Dr. Kao said. “Maybe there was something he was taking we didn’t know about, or an interaction that was causing these impairments. We didn’t find anything other than his current prescribed medications. No abnormalities with his blood work. We did a complete psychological evaluation. Cognitive testing. Personality testing. Depression and anxiety inventories. Projective testing.
“When Evan was awake, he was lucid and oriented, but deeply disturbed about what has been happening. He’s clinically depressed and has spent much of the day crying. He’s upset about what has happened, both on Friday night and over the long term. He’s scared.”
“What does any of thismean?” Exhaustion poured out of Ben. He wanted to sink to the ground and never get up, lay down and let the world wash over him. Stay in his house until everything outside had moved on, had turned to dust.
“Evan’s symptoms,” Father Mathew said, “suggest another possible diagnosis.”
Silence.
