Estimated reading time — 16 minutes
In light of recent events, I think it is my public duty to share what I know about this case and the person it pertains to, patient confidentiality be damned. My name is Doctor Ian Liang. I am a psychiatrist at the St. Christina Institute for the Mentally Disturbed in Ithaca, New York, and I was Ella’s caretaker.
The beginning is not a good place to start this story, as I believe that the progression of her disorder and what led to the conclusion of my part in her life is far more important. No one knows how Ella came to be this way, not even herself I think, and therefore I feel that her background before being admitted is not worth discussing. I will, however, give a detailed account of the events that led to her diagnosis and explain the extents to which I tried (and ultimately failed) to keep her sanity in check.
When eighteen-year-old Ella Reid was literally dropped off on the doorstep of St. Christina’s by her mother and father, none of the staff had any idea what to do. It was clear, however, that she was not normal. For one, her dull auburn hair had been chopped off with what must have been a pair of blunt scissors just below her shoulders, as it was uneven in length and texture. Next, we noticed her clothes. It seemed to us that she was clad only in a long silk nightdress, with no shoes on her feet and no coat or jacket. This was especially odd since it was the middle of January and this winter was particularly bitter.
But the confusion over these strange details vanished when we saw her skin. While only her face, neck, hands, and feet were exposed, we could determine that she was covered in wounds, as there were splotches of blood staining much of the purple fabric of her dress. The wounds that were visible were horrifying. Her hands had sustained the most damage, as they were littered with scratches and gouges, some of which had begun to scar but had been reopened, and many more that were infected. We also observed that three of her fingernails were either torn out at the roots or had been partially ripped off. There was even a slight scratch on the cornea of one of her hazel eyes.
Immediately, she was rushed to the on-site clinic, where a thorough examination was done. Judging from the extent of her injuries and the manner in which her parents abandoned her, our first thought was that she was the survivor of extreme abuse. Therefore, we began to ask her questions about her relationships with her parents, siblings, and friends. But to each question, she either shook her head slowly or refused to respond altogether. Trauma, we concluded, and after what must have transpired to result in such a horrendous outcome, it was no wonder she was unwilling to relive the memories.
Just as we were about to try and find the contacts of the poor girl’s parents and possibly get the police involved, one of the medical personnel stopped me and beckoned me to him. He instructed Ella to turn her hands over so that her palms were facing upward and then pointed under her fingernails. There was flesh caught under them. A lot of it. I was initially confused, not understanding what he was insinuating. Yes, there was skin and blood under her nails, but could those not have been defense wounds? I looked up at Ella to confirm my hypothesis, but all of the words died in my mouth when her gaze met mine. And I realized the truth.
Her stare was blank, face void of any emotional inflections, yet there was an indescribable look in her eyes as they bore into mine. She knew I had figured out what really happened and those hazel eyes were daring me to challenge her on it.
She had inflicted those wounds herself.
I tried to get her to answer a simple question: Why did you do this? But when she failed to respond, I gently took her left hand in mine to show I meant no harm; that she was safe.
The once calm and stoic girl violently ripped her hand out of mine with a howl of anguish, causing me to reel back in shock. Her eyes were wild and crazed and she took her right hand and began to dig the battered nails into the flesh of the left, right where my touch had been. With no restraint and seemingly no regard for pain, Ella proceeded to tear back and forth against the skin, quickly drawing blood that spattered against her dress and onto the floor with the force of her thrashing. Her teeth were grit, her brow was furrowed, and her lips were quivering as she verged on tears. It took three security officers and a mild sedative to finally bring her under control.
Ella had two more ‘episodes’ that same day after the one at the clinic. The first appeared to be, again, triggered by physical contact. After she awoke from sedation, one of the nurses tried to touch her shoulder in comfort and Ella reacted just as strongly as before, clawing at the skin and crying out in distress.
But the second followed immediately after restraints were put in place to keep her hands immobile. By the response she gave, one would have thought she was slowly being burned alive. She began wailing and screaming so loudly and emotionally that staff even from across the ward began to accumulate in the hallways, wondering what was going on. Ella’s eyes were filled with suffering and her face was twisted in agony. She thrashed viciously as she attempted to rip her hands out of the straps, fingers flexed and nails raking against the fabric uselessly. But it was when she began trying to lunge her face toward the restraints, teeth bared and snapping in an attempt to gnaw them off, that she was once again put under. The pure savagery and lack of self-control was astonishing to everyone who had witnessed these events.
Contrary to normal procedures, Ella was officially institutionalized that very evening, as she was deemed a hazard to herself and others and fit all the criteria needed to qualify for treatment at St. Christina’s. Since she was technically an adult, her parents were not legally obligated to meet with us to discuss the state and current situation their daughter was in. Even so, I had expected to collect from them at least a record of Ella’s psychiatric or behavioral history in order to gain understanding as to how I could help her. But they refused to answer all calls and emails except one, where they firmly stated that they were terrified of their child and wanted nothing to do with her. Therefore, since I was designated Ella’s primary caregiver, I had to start from scratch when crafting a treatment plan for her.
My first insight into what was actually wrong with Ella came after she woke up from her last fit. I sat by her bedside as she slowly came to and watched as tears began to well in her eyes and slide down her scarred face. She immediately began to struggle once more against the restraints, but her movements were more sluggish and less violent than before, likely due to exhaustion and the after-effects of the drugs.
I tried to coax her into explaining to me why she reacted so negatively to people touching her and why she thought harming herself was a good response. Was it a coping mechanism? A distraction? A sort of reverse punishment for the ones who touch her?
After a few more moments of unintelligible screaming, Ella began to speak. But her words were not in answer to my questions and were not even attempts to convince me that she did not belong in an institution. Instead, through her sob-distorted mumblings, I realized that she was begging me to release the straps so that she could ‘rub it off’ and that the ‘feeling was still there’ and that she ‘would die’ if she ‘didn’t make it stop.’ I had no idea what she was talking about. Rub what off? What feeling?
And that was when the revelation hit me. Ella wasn’t trying to escape, she was trying to reach her strap-covered wrists so that she could scratch them as she had done the previous times! I began to think that perhaps this was a rare extension of a sensory disorder that made her want to (as she put it) ‘rub off’ the feeling of physical contact from another person.
But no one had touched her since she awoke. So when I realized that she was responding negatively only to the rough straps and not the silk dress that was also touching her, or the soft cotton pillow and mattress that supported her, I finally felt that all the pieces had fallen into place. With only a few day’s more research, I diagnosed Ella Reid with Sensory Processing Disorder (SPD) with emphasis on texture aversion. The most extreme case of it I had ever seen. This would explain not only her violent reactions to certain textures like the straps or even people’s hands, but also her tolerance toward ones like silk and cotton. I also determined that her concerning habit of harming herself in response to different textures was a twisted attempt to erase the uncomforting feeling. In her own words, “If it hurts, it doesn’t bother me anymore.” Unfortunately, Ella shortly became one of my hardest patients to care for, as predicting which objects would trigger her disorder was nearly impossible and trial and error proved to be traumatizing for her.
Four more months into her worryingly unfruitful treatment, Ella began showing aversions toward sound. During the first of these incidents, what was once simply the hum of the air conditioner became the catalyst for a reaction that rivaled those of her fits about texture. She began to scream. But these screams were not ones of discomfort or pain as we were used to, but just one long, continuous screech that was released at the top of her lungs. When we entered her room, she was in the fetal position in the center, her fingers tearing and clawing at her ears.
As usual, all attempts at questioning and conversation were ineffective, and so it took three similar occurrences for us to discover that it was the sound of the air conditioning that was to blame, and that her screams were efforts to drown out the noise. After these incidents, more and more regarding sound began to mix with the regular ones regarding texture. Noises like chewing, loud footsteps, tapping, humming, and squeaking became just as necessary to avoid as textures like wood, concrete, Velcro, sequins, and fabric woven with yarn.
Violent repulsion to smells and taste came soon after, with sight tying them all together, as even seeing the source of a potential discomfort became grounds for a fit. Day by day, Ella was slipping beyond our help, becoming consumed with agitation.
Over the next year, both myself and my team of highly trained psychiatrists tried many methods to calm her disorder. Among those attempts were exposure therapy, Cognitive Behavioral Therapy, and even Eye Movement Desensitization and Reprocessing Therapy. All ended in failures of a most horrific nature. Medication proved ineffective as well, as her disorder made it impossible to administer them in any form, be it liquid, pill, or injection. Ella herself was extremely uncooperative, and (as any doctor knows) you can’t help a patient that does not want to help themselves. Nevertheless, we refused to give up on her.
But results did not come fast enough, and Ella’s condition deteriorated at an alarming rate, with consequences that turned our concern for her recovery to fear it would never come.
All we could do to preserve her remaining sanity was to put her in an environment that was completely controlled. There was to be no seam in the walls or chip in the floors that was not noticed and eliminated. To stress just how crucial a completely monitored environment was to her mental health, I feel it necessary to give a brief description of her room and the accommodations made for her, as this was the basis of Ella’s treatment and the only method that was effective:
Entry into Ella’s room could only be obtained through a large steel door with hinges that were oiled every six weeks. The room was kept at a constant seventy-one degrees Fahrenheit, with absolutely no detectable breeze or noise from the air conditioner. There were no windows in the room, since I knew (as stated before) that even seeing or listening to something ‘not pleasant’ could potentially send her out of control. There was to be no cardboard, textures with bumps or ridges, metal mesh, sand, plants, or anything sticky allowed in the room. The only scent permitted was light lavender and orange that was infused through the air via an essential oil diffuser. The only furniture was her bed, with custom cotton sheets and silk blankets and pillowcases, and one small table and one chair. All of these furniture items were made of smooth metal, as I feared wood could potentially splinter or have rough patches. The walls were painted deep purple (a color Ella seemed to respond quite positively toward) and the floors were dark linoleum with no gaps between the planks. Even the lighting was monitored, with bulbs spread out evenly over the entire room so that the levels of soft yellow light were consistent.
Ella herself could only wear silk, must have her hair completely straightened with no frizz, have her fingernails filed and trimmed every day, never be given food that was not perfectly pureed, and never be allowed to peek outside her room. All personnel that would encounter her had to be clean shaven with their hair smoothed back, no facial blemishes such as acne or scars, follow the dress code exactly, and speak in a smooth, even tone. They must never wear cologne or perfume, have neat and unblemished fingernails, never show their teeth while smiling, and most important of all: never touch her.
Of course, the full list of accommodations is even more extensive, with additions and corrections being added nearly every day, but I was more than happy to do anything I could to help my patient survive her own mind.
Ella became violent toward others about a year and a half into her stay. For months, it had become increasingly apparent that her disorder was slowly consuming her entire being, making it nearly impossible to do any kind of activity, whether it be talking, drawing, reading, or playing a board game. But within her little environment, her fits became fewer and far between, and when she did hurt herself, her wounds were much less severe. Although she was becoming more and more detached with reality, she seemed calmer and more at peace in her own head. Perhaps even happy.
But everything changed when the animal therapy group came to visit. My reasoning for bringing in such a group to Ella was simple: Now that I thought I understood her disorder and her fits had become more preventable and less serious, I believed she was ready to begin taking steps toward her eventual integration back into normal life.
I was wrong.
It quickly became horrifyingly apparent that Ella’s mind was so far gone that she could no longer recognize life and living creatures, only good and bad sensations. To her, I believe she only saw sleek black fur and glassy emerald-like eyes (both very appealing to her disorder) and not a living, breathing cat. So even when the poor beast was screaming, she couldn’t understand that it was in pain and that she was killing it.
But when it began scratching and biting at her arms in a desperate attempt to save itself, something in Ella snapped. My theory as to why she mutilated that cat comes down to the fact that in the past, her self-harm came from herself only, triggered by an unpleasant but not hostile source. Never before had another living creature drawn her own blood. Therefore, in some twisted way, Ella felt that eliminating the feeling on her own body was no longer enough to appease her disorder. She now had to eliminate the source.
Before we could enter the room to save it, she had already broken the cat’s neck and was in the process of tearing out clumps of its fur. There was no remorse on her face; no horror at what she had done. No humanity.
From that point on, Ella was changed. With increasing regularity, staff would be forced to flee her room as the now almost twenty-year-old lunged at them after perceiving some unacceptable sensation. Three times, staff she once tolerated were sent to the emergency room with deep scratches and even bite marks on their faces, arms, and hands.
New procedures had to be put in place to protect the personnel caring for her: While only one person was allowed inside the room with Ella at any given time, no less than two others had to be on constant watch from the monitor outside, ready to intervene at a moment’s notice. One security officer armed with a taser and sedatives had to be positioned by her door constantly. The girl’s nails now had to be trimmed to just below her fingertips to prevent any possibility of scratching, and lastly, there were to be no more visits by anyone from outside the facility.
Ella’s physical conditions worsened as well as a result of her mental shift. She began harming herself more violently than ever before, opening up closed wounds and tearing out her hair and even her eyelashes. One morning, after scraping her toe against the corner of her table, her mind reacted so severely that she took the appendage and broke it, leading to all of the furniture in the room being removed. She even began to complain that the very skin on her bones was causing her agony and that she would rather have it all ‘removed’ than endure it any longer. She retreated farther and farther into her own mind, becoming distant from the world and others.
Eventually, about a year later, Ella’s situation became so extreme that her needs exceeded what we could provide at St. Christina’s. In her state, what she required was to be moved to a place where she could live out the rest of her life safe and undisturbed, not in a hospital for those who can get better. Therefore, I made arrangements for her to be transferred to the Massachusetts Long-Term Care Facility for the Insane in Boston. This facility specialized in uncommon cases and even had a program called Unusual Mental Illness in Youth (or UMIY) that focused on studying and bringing awareness to strange and rare mental conditions. Doctor Timothy Wallace, the president of this organization, assured me that not only would Ella be well cared for, but that her life at his facility would benefit the world. Once the meetings were finished and the paperwork was signed, Ella’s life was officially taken out of my hands and was placed into his.
However, even after many weeks of briefings regarding the specific details and necessities essential to caring for Ella, Dr. Wallace never seemed to wholly comprehend just how violent Ella had become. He appeared to think more romantically than scientifically, believing that nature and loving care could be alternatives to medicine. I attempted to make it bluntly clear that underestimating Ella and her capabilities was a potentially deadly mistake. But although he promised he understood, I was sure he never did, as he had no security officers with him. It would be this misunderstanding that led to his death.
The day Ella was to make the five-and-a-half-hour drive from Ithaca to Boston was warm and sunny, with not one cloud to clutter the bright blue sky. For over three years, the young woman (who was now nearly twenty-one) had never set foot even outside her room, and I was very concerned about the potential repercussions a change as large as transferring facilities could have for her disorder. However, I knew that I could at least guarantee a safe ride for both Ella and the doctor, as I gave the latter two syringes filled with a heavy sedative: One to administer now, and one for when the first wore off exactly halfway through their trip.
With the first dose applied, Ella was taken from her room and loaded into the specially-designed trailer with no problems. All of her files, belongings, and medications were given to Dr. Wallace (who I recall being extremely excited) and with one final wish of luck, they were sent on their way. My part in Ella’s life was now over and I expected to never hear about her again. I believed that she would struggle and likely cause trouble both for herself and the staff at her new home, but would eventually settle down. I knew that recovery was impossible, but I hoped that with the UMIY, her life would at least be as peaceful as her disorder would allow.
You can therefore imagine my surprise when I was called by the Albany Police Department not even four hours later with a mandatory request for my immediate presence. Once there, my worst fears were confirmed: I was informed that at approximately twelve-thirty that afternoon (less than an hour before I was called), a young family walking through a park discovered a man, dead and mangled beyond recognition, lying on the ground. When police arrived, he was identified as Dr. Wallace and further investigation of the vehicle he was leaned against, the trailer, and their contents revealed the purpose of his journey and the other person that was supposed to be inside.
Ella was gone.
At once, I directed investigators to the two audio-less cameras that were located in the transport vehicle: one in the trailer to monitor the person inside, and one between the driver’s and passenger’s seats, facing out the windshield. Both were recording at all times during the trip to ensure that the driver was safe and that the patient was treated correctly. But instead of two and a half hours of smooth, uneventful driving, the footage recovered revealed unimaginable horrors.
This footage has not yet been released to the media, as the investigation is still ongoing and the images are appallingly graphic, but I have been given express permission to describe what everyone saw:
The timestamp on the videos read eleven-fourteen when Doctor Wallace pulled into the empty lot of a small park in Albany to administer the second dose of sedative, as the first one was wearing off. The camera inside the trailer recorded as he pulled open the door, stepped inside, and reached for Ella’s arm. The young woman was now awake, but since she was still under the final few minutes of the drug’s effects, she was calm and compliant, not at all aggressive or agitated as she usually was. She sat with her head hung low, limbs weak and eyes unfocused, unresponsive to his presence.
Just as he was about to administer the dose, Wallace paused and looked outside at the sky. Then, smiling, he said something to Ella as he unbuckled her from her seat, and I watched in disbelief as he pulled her out of the trailer and into the sunlight. For the first time in years, Ella was in a completely uncontrolled environment and I knew this could only end in disaster. It was also at that moment that my suspicions regarding Wallace’s incomplete understanding of Ella’s behavioral conditions were proven correct, as he was content to stand beside the unpredictable and potentially violent woman with no forethought to possible consequences. I believe that he did not accept my diagnosis and warnings of her extreme hostility when I briefed him. After all, he had only ever seen Ella when she was highly medicated and had never experienced one of her rages. Therefore, it is my guess that Wallace had an idealistic vision that she was a poor, trapped girl who just needed to be out in nature to trigger some kind of inner peace.
Unfortunately, it only proved to do the opposite. They were now out of range of the trailer’s camera, but the one between the front seats displayed the two in the corner of the frame though the passenger’s side window. I could only observe with mounting dread as the doctor began speaking to Ella, gazing up that the sky and gesturing to the landscape. Her face was partially visible through the window as she began to come out of her drugged haze, the sedative finally wearing off and allowing her senses to absorb what was around her. As a person who had grown to know Ella very well through her time in my care, I could hardly stand to watch.
First, I observed her eyes. They widened, the pupils constricting as she drank in the scene before her: the uneven terrain, the leaves scattered randomly across the ground, the rust on the playset, and the faded paint of the parking lot. Immediately after, she slapped a hand over her nose as her sense of smell was assaulted by a typhoon of scents: grass after a recent rain shower, dead leaves, barbecue, exhaust fumes, and the doctor’s cologne. Next her head began to shake from side to side in what I knew was a characteristic attempt to rid her ears of ‘unpleasant’ sounds that were currently all around her: screeching tires, bird chatter, honking horns, distant conversations, dogs barking. Her shoulders began to tremble as her head-shaking became more violent and she started to claw at her face. Her mouth was open, and I knew she must have been crying and shrieking in agony.
But then Doctor Wallace made his fatal mistake. Immediately noticing the panic attack Ella was having and realizing that he had just made a grave error in exposing his new patient to extremely triggering conditions, he touched Ella’s arm.
The young woman turned on him faster than I could comprehend, teeth bared and fingers splayed like claws. Her eyes blazed in desperation and fury as she charged toward him, and before Wallace could ready the sedative in self-defense, Ella tackled him to the ground and out of view. The silence of the footage only made the tension more unbearable as a few seconds crept by with no movement. But suddenly, the video began to shake when the vehicle itself jolted from side to side as something heavy was repeatedly slammed against it. Out the passenger window, I could see Wallace’s flailing legs, proof that a major struggle was occurring and that he was losing.
But with one final jolt, a splatter of blood hit the window and nearly all visibility through it was lost. A few moments of stillness followed, until I saw movement. Someone had gotten up, and it was Ella.
The last image I saw of her was as she crossed in front of the hood of the vehicle and in direct view of the camera. She looked demonic. Her face was blank, but her eyes were wide and unseeing, as though her mind had finally snapped once and for all and her consciousness was gone. She was covered in gore, blood coating her face, neck, and body, with bits of sinew and chunks of flesh caught in her hair and clothing. She stumbled and twitched randomly as she walked, movements slow but undeliberate, as if her senses were no longer relaying proper information to her brain; as if her mind was disconnected from her body.
I am not sure how long she will be able to survive on her own with her disorder, but by giving this account of Ella’s history and condition, I hope to God that the public will hear and heed my warning: the person Ella Reid was is gone. Truly, I believe her disorder has devolved her humanity into that of an animal driven by deranged senses. She has taken a human life with no second thought, and will likely do it again. If you encounter her, under no circumstances should you engage with her in any way, as logic and compassion have long since been absent from her mind. I pray that this ordeal is sorted before further blood is shed.
Thank you for your time.
Credit : The Human Botfly
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