Twisted

jailor opened the door. “Dr. Bernstein, you can see the prisoner now.”
    He stood slowly, supporting himself on the door frame.
    The lawyer looked him over and said, “You and I can meet in the next couple days to decide how to handle the case. The insanity defense is tough in New York but with you on board I can make it work. We’ll keep her out of jail. . . . Say, Doctor, you going to be okay?”
    Harry gave a shallow nod.
    The lawyer said kindly, “I can arrange for a little cash for you. A couple thousand—for an expert witness fee.”
    “Thanks,” Harry said. But he instantly forgot about the money. His mind was already on his patient.

    The room was as bleak as he’d expected.
    Face white, eyes shrunken, Patsy lay in bed, looking out the window. She glanced at Harry, didn’t seem to recognize him.
    “How are you feeling?” he asked.
    “Who are you?” She frowned.
    He didn’t answer her question either. “You’re not looking too bad, Patsy.”
    “I think I know you. Yes, you’re . . . Wait, are you a ghost?”
    “No, I’m not a ghost.” Harry set his attaché caseon the table. Her eyes slipped to the case as he opened it.
    “I can’t stay long, Patsy. I’m closing my practice. There’s a lot to take care of. But I wanted to bring you a few things.”
    “Things?” she asked, sounding like a child. “For me? Like Christmas. Like my birthday.”
    “Uh-hum.” Harry rummaged in the case. “Here’s the first thing.” He took out a photocopy. “It’s an article in the Journal of Psychoses. I found it the night after the session when you first told me about the ghosts. You should read it.”
    “I can’t read,” she said. “I don’t know how.” She gave a crazy laugh. “I’m afraid of the food here. I think there are spies around. They’re going to put things in the food. Disgusting things. And poison. Or broken glass.” Another cackle.
    Harry set the article on the bed next to her. He walked to the window. No trees here. No birds. Just gray, downtown Manhattan.
    He said, glancing back at her, “It’s all about ghosts. The article.”
    Her eyes narrowed and then fear consumed her face. “Ghosts,” she whispered. “Are there ghosts here?”
    Harry laughed hard. “See, Patsy, ghosts were the first clue. After you mentioned them in that session—claiming that your husband was driving you crazy—I thought something didn’t sound quite right. So I went home and started to research your case.”
    She gazed at him silently.
    “That article’s about the importance of diagnosisin mental health cases. See, sometimes it works to somebody’s advantage to appear to be mentally unstable—so they can avoid responsibility. Say, soldiers who don’t want to fight. People faking insurance claims. People who’ve committed crimes.” He turned back. “Or who’re about to commit a crime.”
    “I’m afraid of ghosts,” Patsy said, her voice rising. “I’m afraid of ghosts. I don’t want any ghosts here! I’m afraid of—”
    Harry continued like a lecturing professor. “And ghosts are one of the classic hallucinations that sane people use to try to convince other people that they’re insane.”
    Patsy closed her mouth.
    “Fascinating article,” Harry continued, nodding toward it. “See, ghosts and spirits seem like the products of delusional minds. But in fact they’re complex metaphysical concepts that someone who’s really insane wouldn’t understand at all. No, true psychotics believe that the actual person is there speaking to them. They think that Napoleon or Hitler or Marilyn Monroe is really in the room with them. You wouldn’t have claimed to’ve heard your father’s ghost. You would actually have heard him. ”
    Harry enjoyed the utterly shocked expression on his patient’s face. He said, “Then a few weeks ago you admitted that maybe the voices were in your head. A true psychotic would never admit that. They’d swear they were completely sane.” He paced slowly. “There were some other things too. You must’ve read somewhere that sloppy physical appearance is a sign of mental illness. Your clothes were torn and dirty, you’d forget to do straps . . . butyour makeup was always perfect—even on the night the police called me over to your apartment. In genuine mental health cases makeup is the first thing to go. Patients just smear their faces with it. Has to do with issues of masking their identity—if you’re interested.
    “Oh, and