The Patient

“Thank you for participating in our annual patient review. Doctor Mondavi, please describe the patient to us, as best you can”.

“Thank you, Doctor Sebastiani.  The patient is a 34-year-old male.  He earned a doctorate in clinical psychiatry at Stanford University, where he met and married Pamala Westwood, a fellow psychiatry graduate student. 

After graduation, the couple opened a psychiatric consulting company in Mountain View.  Those were the boom years of Silicon Valley with dozens of startup companies and thousands of young, enthusiastic engineers and scientists observing a work ethic of hundred-hour weeks, drinking free unlimited highly caffeinated cola and coffee, and sleeping in their cubicles.  Creativity and productivity were richly rewarded, but burnout and mental fatigue were common side effects.

In short, it was the perfect time and location for their company. Business was good and the money was even better.  They bought a house in Atherton; he bought a Porsche and Pamala bought a Mercedes Benz.  Everything was good; and then everything got bad. Very, very bad.

It started with his ties. He enjoyed his collection of cartoon ties, with images of Mickey Mouse or Bugs Bunny, but he preferred to wear each tie only once a month.  He took great care in organizing his ties on his tie rack, but sometimes, when he was out, Pamala would rearrange them.  He never caught her doing this but, since they were the only people in the house, it had to be her.  Of course, she always denied it when he confronted her.

Next, it was the paint.  He wanted to paint their bedroom butter-yellow, but the paint stores refused to make the right color.  When it dried, it was never the color he had specified.  The paint would be too bright or too pale or too yellow or not yellow enough.  How could anyone misunderstand butter-yellow?  How could different paint stores collude to sabotage him; what did they have in common?  The answer, he realized, was Pamala.  She was secretly instructing them to mix the wrong colors; she was trying to drive him crazy!

But the final straw was the news broadcasts.  Pamala had somehow managed to hide radio speakers throughout the house, in his car, and at work, and they constantly played news broadcasts.  How was he supposed to think when news people were incessantly shouting at him?  He tried to find the speakers, but Pamala had been very clever in hiding them.  She even pretended not to hear the non-stop voices.  She would succeed in driving him crazy if he didn’t do something to stop her.

All the radio news stories were about murders.  Guns, knives, a hammer to the head, it did not matter; all the news voices were saying murder.  Interestingly, the radio broadcasts Pamala was using to drive him crazy were telling him to kill her.

The question was not “should he kill his wife” but rather “how should he kill her”.  Guns, knives and hammers were all out of the question.  He was not a violent person.  Not only had he never fired a gun in his life, but he had even signed petitions to outlaw automatic weapons.  And knives were just as repulsive.  In medical school, he had selected psychiatry partially to avoid the thought of cutting someone open.  As for the hammer to the head, that was too gross to even imagine.

And then he thought of his ties.  What poetic justice to strangle Pamala with one of the ties she had deliberately rearranged to confuse him.  His Wicked Witch tie would be perfect for the occasion; the irony was almost intoxicating.

He told Pamala he was feeling much better and suggested they have dinner at their favorite restaurant.  With tears in her eyes, she hugged him and kissed him with more intensity than she had in months.  She should wear that “sexy black dress” and he would wear a suit and tie.  That evening they were both excited with anticipation, though for vastly different reasons.

They enjoyed a bottle of wine with dinner and drove home.  As they undressed in the wrong-colored bedroom, he removed his tie, placed it around her neck, and suggested a little “breath play”.  But before she could object, he pulled the tie tight.  Her hands went to her neck and her eyes pleaded with him to stop.  But he did not stop; he kept pulling tighter.  And after a short while, it was over.

He placed her lifeless body in the Porsche and then disposed of it in a secluded area in the nearby mountains.  Driving home, he was in the best mood he had been in for months, singing along with old Beatles classics on the radio at full blast.

But when he got home and turned the engine off, the radio did not stop. Instead, it switched from Yellow Submarine to the news, and it got louder, and all the stories were about prisoners, judges, juries, and executions.

He grabbed a rock from the driveway and smashed the radio, but the hateful voices did not stop.  He smashed the entire dashboard of the Porsche, but the voices continued.  He screamed and demanded they stop, but they just got louder.

The rest happened very quickly, as if he were in a video on fast-forward.  Neighbors were asking him questions, then the police, and then doctors, but all he could hear were the incessant voices shouting ‘guilty, guilty, guilty!’

And that, ladies and gentlemen, is all I can report about the patient at this time”.

After Doctor Mondavi had exited the room, a female voice broke the silence.

“Of course, as you know, Doctor Mondavi is the patient.  His mind could not accept what he had done, so he invented his imaginary patient to take the blame.  The irony is that he did not kill his wife. I am Pamala Mondavi.  I fought back and called 911, but by the time the police arrived, his mind had separated into two distinct personalities: Doctor Mondavi and the patient”.