A World Without You(80)

Sofía Muniz.

I pull out all of our files in one armful, spreading them across the desk.

I reach for Sofía’s file first, but a wet hand slams across the folder. I look up. Carlos Estrada shakes his head silently.

“Why?” I demand.

“What?” Ryan asks, not turning from the filing cabinet.

“Nothing,” I say.

Carlos Estrada removes his hand, leaving behind a big wet stain soaking into the red file folder. He is still shaking his head no as I shift Sofía’s folder to the side. I blindly pick another one from the desk.

Gwendoline Benson.

I flip the folder open. Glued to the right side is a sheet of information about Gwen—a small picture of her, generic and square, her parents’ names, her address, her dad’s address, a list of pills. I had no idea that Gwen was on so much medication. I read the names of the drugs silently in my head, stumbling over the long, unpronounceable words.

On the left-hand side of the folder is a list of notes in the Doctor’s scratchy handwriting. Across the top, typed in bold letters, is one word:

Diagnosis.

My brows furrow as I read the words the Doctor has scribbled underneath. Impulse control disorder (pyromania). Trust and abandonment issues.

I slide Gwen’s folder away and open the next one. Harold’s. It’s structured just the same, with information on one side, including a list of medications and a series of diagnoses that don’t make sense. Ryan’s folder is similar, although I can recognize most of the notes on him: extreme narcissism, power complex, calculated manipulation, need to be in control, anger issues. Sociopathic tendencies. He likes to play with emotions, the Doctor notes, for fun, but when there’s something he wants, he’ll use any means to get it. His narcissism makes him believe that normal courses of events are directed at him; if there are no apples at breakfast, it’s because the staff hates him for being so clever, and he plots a revenge against them, either psychological or physical. The closer he is to a person, the more this tendency escalates.

When the officials came, he thought they were out to get him. He always presumed that their arrival would doom him to military school. That he was the only one who had anything to lose.

I look up, expecting Ryan to turn around and catch me in the act of reading about him, but he doesn’t. Carlos Estrada is gone.

I open my own folder.

There’s my name. My parents’ names. Phoebe. My address. A note that I had an “episode” while at school, another one during spring break at home.

A list of medications.

But . . . that’s not right. I’m not on any medications. I don’t take pills or shots.

The Doctor said he was going to put me on meds, but aside from those pills that made me sleepy when I first got back to Berkshire, I haven’t taken any.

Have I?

My eyes skim over to the right-hand side of the folder to my diagnosis. DSM-5 is written near the top and circled several times.

Bo’s case is far more complex than I previously suspected. Bo has exhibited signs of having a break with reality following Sofía Muniz’s death. His symptoms include prolonged delusions and, more recently, paranoia, both of which are exacerbated by insomnia. The lack of REM sleep likely feeds the symptoms, though Bo is unaware of the problem, often entering into a delusional state instead.

Blood work indicated that no additional or recreational hallucinogenic drugs have been ingested, and Bo’s insulin levels are well above diabetic range. Scheduled brain scan and additional blood work within two weeks, at off-site facility in Boston, to examine the possibility of brain lesions. No neurodegenerative diseases in his immediate family history, but the prolonged delusions may indicate peduncular hallucinosis.

FURTHER NOTES: Private sessions and group therapy show that Bo is experiencing a dissociative fugue with select amnesia indicative of something far more serious than his previous diagnosis. This is supported by the mental break he had while visiting his parents April 13–20. Although Bo’s paranoia has risen and he therefore is more reluctant to talk during therapy, he has alluded to hallucinations that seem to tie back to Sofía’s death.

At parent conference prior to spring break, I discussed possibilities of a prolonged complex visual hallucination and grandiose delusion diagnosis and what that might mean for his parents. Sister indicated that some proclivity for violence existed prior to diagnosis and treatment. The tendency for violence has diminished with medication and therapy, replaced by more personal delusions that lead to withdrawal rather than demonstrative frustration.

The last sentence is written with a heavy hand, making it stand out on the page.

Regardless of the fate of the school, it is recommended that Bo be relocated to a more secure facility that can more closely monitor his health.

I let the folder drop, and the sound makes Ryan turn.

“Find anything?” he asks.

Ripples radiate around him. The filing cabinet melts like candle wax, then I blink and it’s just the same as it was before.

“Here, look at this,” Ryan says. He uses his telepathy to float a folder from the filing cabinet to me, but I don’t open it.

“These papers make us sound crazy,” I say finally, staring at the closed folder.

Ryan snorts. “Well, obviously.”

“No, but look.” I hold up the folder detailing Ryan’s medical history, expecting Ryan to use his telepathy to bring it closer to him, but he just slams shut the cabinet drawer and walks across the office toward me.