The days all started with the briefing room—a wall-to-wall palette of aged pastels and stark, hospital grayness.
In the center of our little room, an oval-shaped table dominated the space with every seat filled with a tired nurse.
From one of the windows, a bar of morning light often slipped stubbornly past the shutters.
It was this drab room where we discussed things such as the population of our current patients and whether to up or down their medications. In a work environment prone to shifting each and every day, such meetings were vital to maintain the facility’s pulse.
As I sipped my morning coffee and slid the bitter warmth down my throat, I could not help but eye the newest face of our staff—a young man with a sharp, short haircut and a stony, unsmiling face.
Throughout the entirety of our meetings, he could never just keep quiet, to sit and listen as we resolved any daily conflicts. No, he had to chime in at every moment he could, bringing everything to a grinding halt to interject with: “I have to disagree—Well, where I came from, we did this—If I could just stop you there.”
A pest indeed.
Every clinic had at least one of his sort—fresh out of college, hungry to get out there and feel out the unit they’d soon be running.
We affectionately referred to them as Weisenheimers—those who can do no wrong. Instant virtuosos of the field.
These people were easy enough to spot, postures tense with self-conviction, nodding impatiently as you speak to them, as though already knowing what you are about to say and that you are simply moving too slow for their patience. And you, only you, are the one doing things wrong.
I can still recall one in particular, a young know-it-all who had become a nuisance during our labs and clinicals, chattering in on how we’d been doing everything incorrectly and not “by the book.”
That is, until one day I’d spied the bag of dopamine she’d secured for a patient draining itself into their sheets. The sheets! Never faster had I seen one’s face flush so red.
And what happens to all that self-importance after moments like this? They are jettisoned out, left to the scorn of those they’d obnoxiously reprimanded. And you can bet your bottom dollar, Alec Barnes will get his eventually.
Reality has a way of compressing our egos.
After the meeting has finished and the Charge Nurse has assigned our patient loads for the days, I set out to complete my daily tasks.
Within the confines of our twenty-five-bed unit, our patients mostly consisted of those recovering from injury, whether accidental or purposely inflicted. Attempted suicide was a frequent conviction here, and most patients were more of a danger to themselves than others.
That being said, there were always those we had to be wary of.
In my years as a psychiatric nurse, I’d been kicked, scratched, bitten, punched, and for the better half of a day, verbally threatened.
Still, I never let it sodden my spirits, no matter how much saliva or curses were hawked at me.
Contrary to how social media or cinematic horrors may portray them, psychiatric wards are not twisted places littered with crazies.
They are places of healing—of alleviation. A haven for those physically alive, but internally tormented.
Yes, some kicked and shrieked in the halls until their throats split, but a good deal held a much quieter, unseen pain.
That was why I was there—to help ease the cold terrors of their futures.
And for the case of our newest arrival, Roland Boulle would become my next big project.
It was raining on the night they brought him in.
I spied him rolling by on a stretcher, his cold face wet and dripping. His eyes flickered with transient consciousness, perhaps barely grasping the shapes and sounds around him.
For a moment, we actually held each other’s gaze as he was whisked away to the intensive care unit.
Ten paper clips, eight marbles, and five drywall nails—these were the objects removed from Mr. Boulle’s stomach.
He was diagnosed with Pica—an uncommon disorder in which one has an urge to ingest inedible objects, though one this severe was especially rare.
Encompassing that fact, he’d also been diagnosed with depressive disorder, severe anxiety, and post traumatic stress.
Despite my history in the psychiatric field, I could not help but feel woefully unprepared for him.
If only I had even the slightest clue.
I stopped at Mr. Boulle’s door, surveyed my notes once more, and carefully let myself inside.
The room was reminiscent of a college dorm with a single window providing a glossy view of the parking lot.
Mr. Boulle was awake and currently hunched over his table, a wilderness of hanging, stringy hair covering his face. His legs were crossed at the ankles, both shoelaces removed.
He appeared to be writing vigorously into a crossword puzzle with one of our rubber ballpoint pens.
I knocked lightly against the door, which prompted him to turn toward me.
“Good morning, Mr. Boulle,” I smiled as I introduced myself, “How are you doing today?”
From out of the mesh of hair, a thin face stared back at me, giving a look I’d describe only as a tight-lipped vacancy. Eyes wide as possible but not quite focused. He appeared somewhere north of his forties.
From across his chin and up his cheeks, a scattering of scars was etched into his features. Possible self-harm, my thoughts mused.
I continued the greeting, “My name is Jason. I am one of the registered nurses here to ensure everything is alright and that your time with us is a good one. Is there anything I can help you with?”
His eyes held tired water between them, inspecting me up and down, trying to get a read on me as I was him.
His mouth then pulled into a small grin, which rumpled the scratch marks. “You have piano fingers.”
“I’m sorry?” I asked, caught off guard by his statement.
He lifted his hands and flexed his fingers. “Piano fingers. Father had them, too. He used to play all the time in his office, mostly the Gymnopédies and a tad of Chopin. Do you play at all?” Despite his craggy appearance, his voice carried a genuine playfulness behind it.
“Not at all,” I chuckled. “My mother had one of her friends give me lessons when I was younger, but unfortunately none of them stuck.” Yes, Mrs. Brown was an avid teacher of the arts, but now I could only remember the reek of bone-broth carrying her breath. “Anyhow, it was nice officially meeting you. Please don’t hesitate to let me know if you need anything. We’ll do everything we can to help.”
“Of course,” he answered, rubbing a finger along his scar-fringed chin.
It was not long before we realized the true extent that Mr. Boulle needed to be monitored.
From the television room, he’d plucked out the power button, as well as both volume buttons from the remote, and swallowed their small plastic bodies.
From his bathroom, he’d twisted the cap off one of the soap dispensers and negotiated it down his throat.
And before we could catch it, he’d already swallowed the flexi-pen we’d given for his crosswords.
As arrangements were made to have them removed, we mulled over different treatment options for his condition.
In most cases, Pica was caused by an iron deficiency in the body, leaving it craving something to replenish the lacking minerals.
Therefore, we prescribed him an iron supplement.
After a few weeks of the dosage, two tablets a day, and an iron-rich diet, his pining for non-food items had considerably lessened.
I was ecstatic about the progress, thoroughly convinced that before long, his symptoms could be entirely gone.
Unfortunately, I would come to find out we were only scratching the surface of Roland Boulle.
As far as the supplements had taken him, we’d soon discover that his hospital bracelet had gone missing, not so mysteriously.
I’d come to find that he stopped taking the tablets completely, hiding them under his tongue only to spit them out later. On top of that, he’d entirely stopped eating anything that we provided him.
The next evening, I stopped by his room to once again check on him.
Roland was yet again seated at his writing desk, his spine stiffly straight and his neck bent towards the window.
A tray of food sat on the bed next to him, cold and uneaten.
I scooped it up for him, “You should really eat something, Mr. Boulle. Otherwise, they’ll have us give you a feeding tube. The food is much better, trust me.”
He didn’t acknowledge me, merely holding that gaze toward the greyish smear of asphalt outside. Protests like this weren’t out of the ordinary, especially for patients coping with anxiety and severe depression.
As I turned to report back on his state, a thin, withered voice crept out of him. “It’s coming.” His lips were shaking.
“What do you mean?” I asked, trying to dissect what he’d just said. “What is coming?”
But it was no use, he’d returned to silence, maintaining the glazed stare out the window.
Evidently, our conversation had ended.
That same evening, a scream resonated down the halls. It was coming from Mr. Boulle’s room.
I was the first to arrive, quickly bursting through the door and witnessing him flailing in his sheets.
His hands clawed and grasped at nothing while his thick heels kicked helplessly about.
Assessing the situation, I tried talking him down first, to calm his nerves behind the frenzied cries.
He was unresponsive, lips curled back from his gums and his eyes squirming wildly in their sockets.
Then in a quick motion, his thrashing hands converged and closed around his throat, locking into a death grip.
I moved to pry his hands off of him, trying to carefully break the chokehold he had on himself.
Even with his throat being wrung in his own grip, a pressed scream still squeezed its way out.
As his grip started to slacken, the howling was suddenly stopped and replaced by an urk-urk sound. The telltale sign of someone about to retch.
Not wanting him to vomit flat on his back, I moved to push his body to the side, all the while looking eagerly towards the doorway to see if more help had arrived.
But as I turned back toward him—everything stopped.
My heart increased to a dreadful acceleration.
I tried to take a breath, but couldn’t.
There is something so dark and different when an unspeakable shock hits you, like every nerve in your body, every sensory input to the outside world, has suddenly been cut. Your voice is too brittle to speak. Your eyes are too afraid to close. Things, perhaps semblances of thoughts, beat desperately toward your brain, only to drown before reaching its surface.
It had happened so quickly, I could only barely process the ghostly outline of Roland’s face, or the sudden misshapen lump in his throat.
Fingers. Long, wet fingers were gleaming between his teeth, reaching outward from the dark, pink depths.
They were bruised with blackish, purple colors. Strings of shiny spittle stretched and snapped between their wriggling joints. A pungent, bacterial odor reeked from their gangrene tips.
Roland’s eyes rolled upward as his body heaved and let out a wretched gargle.
The fingers bent forward, curling over his face like a spider on its backside and began to tug at his jaws, trying to pull them wider.
Their jagged, split nails scraped across his chin, his cheeks, his nose, digging grooves into his flesh.
The sound of footsteps entering the room brought me back. Another nurse had arrived.
I peered once again at Roland’s face, coated now in a webwork of fresh, bleeding weals.
None at all.
Together, the other nurse and I restrained Roland and safely injected him with a dose of B52—2mg Ativan and 5mg Haldol in one needle, 50mg Benadryl in the other.
With the collective effort of three different drugs coursing through his system, the struggles finally ceased.
“A lot of damage,” the other nurse commented, surveying the marks on his face. “We should have put him under long before this.”
I realized then the help was none other than Alec Barnes, the weisenheimer.
Whatever he said next never reached me, I’d already left to get some ointment for Roland’s cuts.
I didn’t sleep well that night, dozing in and out without any hope of catching a dream.
Before long, I was awake and standing over the sink of the bathroom, both hands against the porcelain.
Amidst the rubble of my thoughts, my brain was scavenging for answers, something that could explain what had transpired.
But the answers came up short. There wasn’t enough substance to it, not enough material to grasp onto.
I could only imagine those fingers—their rotting pores—their twitching knuckles—jutting out of a man’s mouth, trying to hoist an even larger something out of the tube of his throat.
The image made my insides feel wretched and rolled a brief nausea around my belly.
Absurd, I snapped back at the disgusting thoughts, Ludicrous. Disgusting. Get a hold of yourself.
To give such a thing credence was unacceptable. It was a stressful moment—a fabrication of a rattled mind in a stressful situation. That is the end of the matter. No further discussion required.
I gargled some mouth wash, clapped both hands against my cheeks, and returned to bed, repeating the same determined tempo.
But when I did finally fall asleep, there was no protecting my dreams.
I was back there again, standing in Roland’s room while his blurry shape screamed and writhed in the sheets.
I tried to restrain him before he could harm himself, only to have my arms reel back on their own and grasp my throat instead. The last whisps of breath pulled out of me.
In the pit of my gullet, something begins to move, clawing its way upward.
I lurched forward, squeezing my eyes open and closed rapidly, trying to wake myself up.
But it’s no use, I can only retch desperately as my head flops back and the thing inside my throat forces its arrival.
My eye finds the wall, just as my shadow spouts a new bouquet of spidery horrors.
The next time I saw Roland in person, it was during his supervised access to the outdoor patio. It was to give patients an airy reprieve outside the ward. Flowerpots hung from the fence that enclosed the space, along with a wall painted into a mural and a few basketball hoops.
Mr. Boulle was adamant that I was the one to supervise him that day.
The new scratches etched into his face had healed, breaking off into faded, fractal patterns.
He took a seat at one of the diamond blue benches and sucked in a deep breath of air. “Rains on its way, you can smell it.”
“Hopefully, not before my drive home,” I sighed, catching a whiff of it myself, the freshness just before a storm.
“Mmm,” he hummed passively, and after a short pause between us, popped the sudden question: “You saw it, didn’t you?”
The question sent a jolt up my spine and, if only for a moment, flashed on my face.
He took notice of this, the liveliness in his voice kicking up an octave, “You did, didn’t you?”
“What are you referring to?” I asked, rolling my shoulders back.
He leaned against the thermoplastic backrest of the bench, “You’re scared to admit it. I get it, I do. But neither of us can be so lucky to deny it.”
My eyes wandered the patio, looking rather self-consciously for anyone else around. We were alone. “You’re going to have to be more specific for me, I’m not quite following you.”
His tired, watery eyes focused on me, “I had to wait for you to see them before I could say anything, otherwise you’d never believe me. I know you wouldn’t.” Then his split lips curled into a smile, “But if you don’t listen now, you won’t know what you saw, and you’ll always be left to wonder.”
I didn’t answer, but perhaps it was the absorbed look on my face that had cued for him to continue.
“It started with ice,” he said, pausing as if to mull over that fact, “I loved the texture of it, the feeling of crunching it between my teeth in tiny, crackling bits. It was one of the few things that could quell my anxiety, and when that wasn’t enough, I turned to chewing on paint chips and sucking on coins for a good while—I was a very anxious boy, you see.”
A gust of wind whistled through the fence and bobbed the hanging flowers. His tongue lapped between his lips.
“I grew up in a wealthy home with wealthy parents, one of them as sweet as can be while the other was emotionally aloof. Can you guess which one Father was?” He asked with a grin, “The stereotypical ‘provider,’ who considered the financial support to our family enough of a bond between us. Naturally, we weren’t very close, and as my tendencies…intensified, he and Mother were thoroughly convinced it was merely a phase. Don’t ask me why it wasn’t, I couldn’t tell you. All I knew was that my cravings for the indigestible only grew worse as I got older.”
I stayed silent and listened, not daring to say anything else to throw him off point.
I felt a responsibility to understand him. He’d finally opened up, no longer disappearing behind that flat stare out the window. Answers were best found during the low tide, after all.
“Surprisingly enough, I wasn’t the only one with compulsions in our household.” Roland chuckled, “Father was a collector. Not for coins or old, dusty vinyl. He dabbled in other things. A canteen once slung over the shoulder of a dead soldier, a worn noose used to break necks in the nineteenth century, even an ancient skull with half its dome cleaved by some horrible means of torture. These were things that interested him, much to my mother’s dismay. Little pieces of the dark he enjoyed finding. I’m not even sure where he got his antique piano, but I know that every so often, I’d hear the same two keys get struck in the middle of the night.
“So, one day, while he and Mother were away on a business trip, I’d snuck into his studio to look at the private collection myself. One of them caught my eye, a piece of jewelry that once belonged to a dead woman, said to have cursed her with an early death. I felt drawn to it, like an impulse had compelled me to believe that somehow it was mine, that it belonged to me. So, I swallowed it.”
A look of distress crossed him, “I was scared that night, absolutely petrified that he’d come back to find the ring missing out of his collection. Then the following night, it had passed through me. I fished it out of my waste, cleaned it intensely, and returned it back to the collection unharmed, my father none the wiser.”
“Soon enough, I did it again, this time with the bone of a black cat used in a Witch’s hex. It had started to feel like a game, but soon became more of a ritual between us. He’d bring something home, I’d swallow it—even if just a piece of it, wash off the blood and stool as I passed it, and placed it back there. Sure, there may have been some pain and slight discoloring here and there, but never enough for him to notice. It felt good—celestial even. Father and I finally found something in common: We both had a liking for objects.”
His face then fell, becoming ghostly stoic has his voice lost its shape, “When it came time for me to move out and on with my life, I had to put an end to our little game. He never did find out what I’d been doing to his collection, and I wouldn’t have it any other way. I’d managed—or so I thought—to wean myself off of them. But as time passed, I began to have strange thoughts about all of those cursed, haunted things, like how they had felt suddenly different in my hands after I passed them. Almost like the energy they once held was no longer there, like it had been left behind somewhere inside me. And what if all that energy, or whatever it was they had, was then left to brew and ferment over the years, until it gestated into something else.” He rubbed a pale hand over his chest, “Something that finally wants out.”
As his voice finally trailed off into silence, I spoke up. “What do you mean by ‘wants out’ exactly?”
The glaze over his eyes had returned, “I’d like to go back inside now, please.”
That was the last, and the longest conversations we’d ever have together, and he was done sharing that day.
I tried to stray my thoughts away from that conversation; it was too much to digest.
For the rest of that day, I no longer felt like myself inside the ward, almost like the weight there had become too crushing, like something were about to crest over the rise and all I could do was brace for an impact I couldn’t see.
What happened next occurred on a late Sunday evening, three days after Roland Boulle’s unshakeable silence.
I was making my usual rounds in the ward and stopped by to check on him.
I knocked three times, opened his door, and stepped routinely inside.
Roland was not in his bed or stationed at his usual spot at the writing desk.
The door to his bathroom was inched slightly open, the sound of a sink running coming from inside.
“Hey Mr. Boulle, just here to check on you. Is everything alright?” I called. There was no answer. “Mr. Boulle? Are you alright?” Still, nothing, only the steady drawl of running water.
Without warning, the bathroom door swung open, rebounding off the rubber stop and then rebounding again off Roland Boulle’s body. He had blundered out backwards on his heels, both hands locked around his neck.
His face was flushed into a darkish plum color. Heaps of foam dribbled out of his mouth, rolling over his lips, which had gone blue. Tears streamed out of his eyes, which bulged from their sockets.
A single sound emerged from him—the gargled note of air trapped in his throat.
Choking, my thoughts screamed, he’s choking!
I grabbed at him, spinning his body around as both of my arms locked around his waist. Never in my life had I performed the Heimlich, but in that moment, it was do or die.
I pressed hard into his abdomen with a quick, upward thrust, practically lifting him off his feet.
His body jerked back, but there was no luck dislodging whatever was inside his throat.
The door opened; someone else had heard the commotion.
I looked feverishly toward them while administering another ineffective thrust. The other person was none other than Alec Barnes. Even amid a panic, I despised his presence there greatly.
“What’s wrong? What’s happening?” he asked, which only infuriated me.
“Choking!” I snapped, yanking Mr. Boulle back yet again. Hot blood coursed through my arms. I forced down a swallow, trying to wet my dry mouth.
But in that same instant, with both my arms fastened around him, I had felt something peculiar—a sudden shift of his insides. An almost tumbling motion. Far too pronounced to ignore.
The weisenheimer stepped back into my peripheral, “Let me do it, I can—”
“I’ve got it!” I hissed at him, hoisting Mr. Boulle’s body upward again, harder than I ever thought I could.
His chest heaved as more strained gasps came out of it. Bits of his spittle slopped over my arms.
He then lurched forward in my grasp. It felt as though his insides had all decompressed at once, like an air-tight container being popped off.
His throat opened.
He let out a watery scream of pain and retching.
Somewhere near us, Alec made a noise. Something that sounded like, “Oh God, dear God.”
Something heavy hit the floor.
Roland Boulle went limp in my arms. Alec Barnes let out a scream.
Frantic movement skittered across the room, like the sound of a fish flopping about a dock, followed by something being torn out of a wall.
My eyes raced around, but the slew of everything at once had sucked all the blood from my brain, flushing its data.
I checked on Roland, who had slumped over like a puppet in my arms. He was unresponsive, with his eyes staring blankly forward and lips hanging loosely open.
I checked for his pulse and found no rhythm.
Lying him on the ground, I lined both hands on top of the other and pumped until the strings of my wrist burned. Then I pinched his nose and forced air down his windpipe. It wasn’t working.
As I did this, my eyes traced the floor, following the thin film of blood and bile that trailed away from us.
First to the bathroom, and then to the vanity, where the air vent below it now hung open, the right side of its grille pulled entirely out of place.
Alec Barnes was frozen in his spot. The shock that distorted his face was almost too vivid to be real, and even as more staff arrived, he still remained there, stricken with fear.
Roland Boulle was pronounced dead by our medical examiner. The manner of death: an esophageal rupture. Several tears had perforated the walls of his throat along with a dislocated jaw, entirely unhinged from his skull.
We weren’t yet sure what caused the rupture as nothing could be traced other than the aftermath of ruined tissue.
Rumors had floated around between staff of possible causes but did not hold much water to them. Truth be told, not many of us knew how to handle the loss of a patient not otherwise terminal.
As for what came of Alec Barnes, he’d quit spontaneously and left without further notice. Tried as I did to pry information out of him, he dismissed me, shaking his head and repeating that he’d seen nothing, end of story. I could see the panic in his eyes, held back by two thin sacs threatening to tear at any moment. Not a single particle of self-importance left.
Perhaps I’ve even felt the same way; that perhaps I did catch a glimpse of something that day, a grey sleek of a shape pulling itself through the opened air duct. Membranous. Slug-like.
But I must avert those thoughts. Sort them out properly. Dissect them one by one. That is the only way I can keep myself together.
Yet, despite all these, the strangeness around our ward has continued to circulate. Patients have been claiming to hear something in the walls. Even some of our staff had reported it as well, a quick, insipid scratching coming from the ducts, to the point where they believe an animal is trapped up there.
As many times as we’ve had the vents checked, there is still no proof for such a claim.
I’ve heard it myself from time to time. Sometimes even awfully close by, just on the other side of the duct’s cover.
But I do not peer inside; I do not even risk what I may see.
The source of the noises.
The ward’s newest arrival.
Credit : Michael Paige
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