Patient 44

Dear Dr. Rathshaw,

I feel that time is running out for the patient we discussed earlier this week. I am surprised that you have not responded to any more of my emails and phone calls on this matter. Given the serious nature of her condition, I thought for sure you would leap at the chance to study this phenomenon firsthand. From our conversation, you seemed extremely interested. This case has taken a most unfortunate turn. If you do not get on the first plane here, tonight this chance will be forever lost to you. I cannot stress how important your presence would be here. This is a once in a lifetime event. You’d be a fool to sit it out. I give the patient 48 hours, possibly 72 but I think that is pushing it.  Please come.

Sincerely,

Dr. Jeffrey Reinhart

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A woman with a gentle face adorned by closely cropped, brown hair stares intently through the glass at the room beyond. A frown creases her forehead before she looks down to make notes on her clipboard. Glancing at her watch, she seems impatient. The doctor should have been here already. How long was she going to have to monitor this post before the screaming starts again? Another round of that and she would go mad herself. Flipping through the charts, she updated the forms and notated the time. Still no change. Movement caught the corner of her eye. Finally, the doctor. She could give him an update and be home in time for her favorite show to start for once.  A pleasant smile caressed her face, lighting up her hazel eyes.

“Good evening doctor. Any word?”

“No. Not yet. Don’t you fret. The night is still young. How’s your evening been thus far?”

“It was rambunctious earlier.  I didn’t think I could bare the screams any longer. Luckily, they subsided about an hour ago.  Since then, all has been quiet.”

A scratching is heard through the glass. The pair turn their heads in unison towards the sound, surprise on their faces.

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“This is Dr. William Reinhart. It is October fifteenth, two-thousand and twenty-four. The time is two forty-five pm. Please refer to case number 25487-65488 for video records and taped recordings of all sessions with Karen S. Cheryl please use this dictation to catalog the patient’s file in chronological order.  I will start with the first session and work my way to present day.”

Karen first came to see Dr. Reinhart after the deaths of her husband and her small children. Everyone understood her grief, but none thought it was healthy to turn the entire house into a shrine to her lost family. Since she was left a sizeable inheritance, she had no need for money. Day after day she would walk the empty hallways of her once happy home, stopping here and there to pick up a photo or a toy. Tears flowed so freely from her face and so often that her eyes were always swollen.

Karen barely ate. She barely slept. Her food and household goods were delivered once a week by the neighbor boy who also took out the garbage, maintained her lawn, and picked up her mail. Karen’s sister, Alice came every day for the first few months. Seeing that her sister was only getting worse, Alice called Karen’s friends. A night on the town would do them some good.

When Karen refused to open the door or return any of their phone calls, they stopped trying. Gradually, Alice’s visits became less and less. Their mother Rachel tried next. She too, could do nothing with her drowning daughter. Feeling utterly defeated and hopeless, she staged an intervention. It was difficult to get Karen’s friends and sister to agree. Too many times had their good intentions been thwarted by a barrage of verbal threats if they got a reaction or answer at all.  Rachel was determined to try. If it did not work, she could at least have a clear conscious that she did everything that a mother could do and that would have to be enough.

The day of the intervention finally came. After months of hard work, Rachel had finally convinced two of her daughter’s friends, Emily and Grace, to join the cause. They decided that the best way to gain access to Karen’s house was a blitz attack. Alice and Rachel had a set of keys to both the back and front doors. Instead of knocking and begging to get an answer at the door, they would just march right in like they owned the place. Once inside, the plan was to corner Karen and make her listen to reason. It was four against one after all. Each lady was instructed to try gently to get her to see the light. If that did not work, they would slowly escalate.

Rachel hoped that it did not come to that. She loved her son-in-law and grandchildren. To destroy anything that had once belonged to them pained her, but if it was the only way to get Karen to snap out of it, then she was prepared to do the worst. To keep from raising suspicion, Rachel and Alice stationed themselves at the back door.  Emily and Grace manned the front. The curtains were drawn. There was no way to know where Karen was in the house. Taking deep breaths, the ladies entered the dark home.

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Their footsteps echoed as they gathered in the kitchen. No sign of Karen downstairs. Walking as quietly as possible, the ladies went up to the second floor with Rachel in the lead. Halfway up the staircase, a loud scream followed by a hollow thump froze the women in their tracks. Deathly silence hung thickly in the air. Rachel took a hesitant step upwards when the second scream cut through her bones. The blood ran out of her face and settled in her belly. Her knuckles turned as white as her complexion as she gripped the bannister.

Slowly, she turned to the other women. Waxy faces with bulging eyes met her. A final scream that cut off in the middle of the crescendo, followed by a loud bang, broke Alice’s paralysis.  She pushed past her mother and bolted up the remaining stairs calling Karen’s name. Her voice was much too shrill. It split through the trio still locked on the stairs.

Doors banged into the walls as Alice searched the upstairs bedrooms frantically. Calling down to the others, “Get up here! She has to be in the attic!” No one moved. Alice ran to the top of the staircase. “I said, GET UP HERE! NOW! MOVE YOUR ASSES!” The tone of her voice left no room for argument. In a tussle, the women raced up the stairs. Alice led them to the open doorway leading upward.

Their hearts boomed in their ears and their ragged breathing quickly warmed the cramped space. Peeking around the door frame at the apex, Alice searched the intermittent gloom for her sister. Her eyes were wild and darting around much too quickly to focus on any one thing too long. Inching her way into the room, followed closely by the others, she tried in vain to see into the shadows.  The pull chain for the single overhead bulb was somewhere close by, if she could reach it, some headway could be made. Reaching blindly into the unknown, her hands searched for that slender chain of hope hanging in the gloom. CLICK!

Bright white light flooded the immediate area, momentarily blinding the quartet. Blinking rapidly to adjust her eyes, Rachel whispered, “Spread out.  She might be unconscious behind one of these piles of boxes. Watch yourselves ladies.” They nodded and moved as if swimming through thick liquid, their fear growing each second. A curious scratching sound like nails on glass drifted through the quiet space. Emily paused, looking more like a frightened bunny than a grown woman. “There!” Alice hissed through clenched teeth, pointing at a stack of boxes in front of Grace. Grace proved to be useless. Sheer horror had her in its icy grip. She ran out of the attic door, banging her shoulder on the door frame as she fled.

“Three little Indians now.” Emily said with a nervous laugh bordering on madness.

A shriek stopped her laughter cold. Karen exploded from behind the boxes screaming, knocking Emily to the ground. With her fingers hooked into claws, she climbed on top of her helpless friend, pinning her to the ground. Spit ran out of her mouth in streams. Karen leaned close to Emily’s turned head and whispered in her ear, “They’re coming. You are all too late.” before rocking backward in a fit of sobs. Mother and daughter stood watching this display in abject horror as Karen curled into a ball and continued to sob.

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Dr. Rathshaw,

It has happened. You must come now!

Reinhart

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Talking once again into the tape recorder, “Cheryl, I had to stop after explaining the way that Karen’s family found her. That poor woman. [ TIRED SIGH] Anyway, please locate the medical files to correspond to the condition in which Karen was admitted and began her care with me. It will be easier to refer to them instead of me rehashing it all here. I would like it to go on the official record that the events that I have just described were confirmed by all parties present. Judging by the detailed police reports and corresponding photos, I have no reason to doubt their stories.  I also wish for our stringent policies to go on the record as well. I feel that they are justified and it is extremely important that you get them down.”

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“Oceanview Resort is not a resort nor is it located anywhere near the ocean. The building is sequestered on a fifty-acre lot outside of the nearest town. High fences cut it off from the woods that grow unchecked around its borders. Admittance is by appointment only. Before the wrought iron gate allows visitors to grace the grounds, a lengthy questioning process by the guard has to be completed. Your vehicle is searched. You are searched. The name of the patient is requested. How long you plan to visit is demanded. Everything but what your fifth uncle’s, twice removed on your mother’s side, tattoo on his left butt cheek is required. If you pass, you are given a pass, and the heavy gates open. One more lecture on driving straight to the parking lot attendant is barked at you as you drive away.”

“The attendant ambushes you before you even have a chance to stop completely. You are almost pulled from your vehicle as your pass is examined for authenticity. With a curt nod of the head, you are directed to the waiting orderly that will escort you to the front desk. Here, you are required to fill out a thousand and one forms. Your identification is checked. They don’t go as far as to fingerprint you but it is pretty damn close. After your forms are thoroughly checked and double checked, you are led to a small holding room. The head orderly for the floor you wish to visit enters to explain the rules you must obey once you leave your little “haven”.

“You’ve gotten this far. Most do not. If you wish to get any further, you will adhere to our rules at all times. Any deviation will not be permitted. You will be immediately removed from the grounds and will not under any circumstance be allowed to return. Our patients’ safety trumps everything. We take great pride in ensuring that each and every one of them receive the absolute best care. You compromise their care, and we will prosecute you to the fullest extent of the law. Are we on the same page here?”

“You nod in the affirmative. After an hour of endless rules, you are finally permitted to leave. You are given another pass and escorted by the head nurse to your destination. Once you arrive, you are turned over to the duty nurse for that floor. Here, you sign in your name, reason for your visit and the patient you are seeing that day. Your pass is verified and the attending doctor is called to meet you. The doctor escorts you to a private room to give you an update on your loved one’s care and progress before you are permitted to see them. This is vitally important.  Please make sure to emphasize this point, Cheryl. No visitor is allowed to see a patient without full knowledge of their condition first. After the initial chat, visitation takes place. If things go smoothly, the entire experience is pleasant and goes as planned. If not, then the visitation is cut short by the attending doctor and the visitor is escorted off the property to allow the patient to calm down and receive treatment that is absolutely vital to their recovery.”

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Karen’s condition was so severe when she was admitted that the doctors had to sedate her around the clock. Her body was a withered husk, drained of vital nutrients needed for continued survival. The first several weeks were spent trying to keep her alive. A few times, they thought they had lost her. In the end, she clinged to life’s threads. Here was a fighter, strange as that seems. The process was slow going, but the doctors finally saw enough improvement to allow her to wake up. She was still heavily drugged after she tried to pull the IVs out of her arms.

Restraints became necessary. The anger took the longest to drain from her eyes as she eventually gave up resisting. Weeks became months. Karen’s condition steadily improved to the point that the restraints were removed. She was given a room with a solitary window. Granted, there were bars on it but there was at least a view. She would sit in her chair for hours and stare out it. Never did she speak. Dr. Reinhart allowed this to go on for a while. To face her demons, she needed her strength back first. For now, she merely existed in her own world.

The first session was uneventful. Dr. Reinhart gently tried to engage Karen in polite conversation. Ultimately, she did not speak. After ten sessions, she met his gaze. This was new. Normally her eyes remained unfocused on some distant point. Progress. On the twenty-third session, she spoke. Oh boy did she speak. Her eyes were clear this day. She even attempted to brush her hair.

“Karen, how are you feeling today?”

“Rather fine doc. How are you?”

“I’m good Karen. Great, in fact.”

“I’m pleased to hear that.”

“I’m pleased that…..”

“When are you going to talk about the rats, doctor?”

“The rats? I don-“

“Yes the rats. I know you have seen them. You always want to know how I feel, but you never talk about the rats. Why?”

Puzzled, “I don’t follow, Karen. What rats?”

Giggling, “The ones eating your legs doctor. You can’t tell me that you don’t feel them.  They scurry here. They scurry there. Can’t you feel them nibbling on your flesh as we speak?”

“Karen” looking down at his legs, “there are no rats on my legs.”

“Silly doctor.” She said chillingly. “You feel them. Not much meat left now.” Smiling, knowingly, “Not much left at all. What do you think they will munch on next?”

Launching from her chair, Karen grabs Dr. Reinhart’s crotch. Leaning in closely, “I think they might be in the mood for something sweeter doc.” Caressing his most private of parts, “Oh yes. I see it in your eyes. You know what they want, what they crave. It only takes one, you know. Only one to find this sweet meat. Then it is chomp, chomp, chomp.”

She lets the mortified doctor go as she returns to her chair. There she sits like a queen attending court, giggling like a school girl peeking into the boy’s locker room for the first time. Dr. Reinhart is clearly shaken by the experience as he calls for the orderly to return Karen to her room. Better up her meds. This is progress but not the kind I wish for.  Better up her meds. He thinks to himself as his new admirer is escorted out of the room.  I hate rats.  He shivers as the door closes, leaving him to his thoughts.

That was the last outburst from Karen. The next week, she behaved like a normal, middle aged woman. Dr. Reinhart believed that the new medication regime was the contributing factor to her steady recovery. They worked their way up to that fatal night’s events. Karen was resistant to his prodding, but eventually talked about it in detail. He was pleased how once it was all out, she seemed to be at peace. Three years after she was admitted, Karen was released from Dr. Reinhart’s care.

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“It is starting again. Better get everyone down here. I think we have made a break through.  Tonight is the night. I feel it.”

“Mmmm hmmm. I think you are right doctor. Do you think he will come this time?”

“Yes, absolutely. Everything is in place.  Call the others. They will want to see this for themselves.”

The pleasant faced nurse leaves the doctor to his charge as a raspy, muffled voice says a solitary word, “You!”

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Home. Karen was absolutely delighted as her mother pulled into her driveway.  It felt like ages since Karen had been here. Parking the car, Rachel hesitated as she killed the engine.

“How are you feeling, Karen?”

“Peaceful mom. It is good to be home finally.”

“Before we go in, I want you to remind you that your sister and I have made a few changes. It is nothing major but I want you to keep that in mind as you enter.”

“I know how hard the two of you have been working. I can do this.  Really. I want to go inside.”

“Are you sure? We can go to my place if you don’t think you are ready.”

“No. I need to do this, mom.” Karen said as she exited the car.

The inside had changed, drastically. Karen clenched her jaw. The shrines she had meticulously built to her lost loved ones were gone. All that was left was an ordinary house with ordinary objects. She moved from room to room. The old sadness started to fill her. She did not see one thing to remind her of her family. It was as if her mother and sister had erased them from existence. The upstairs bedrooms had been converted into an art studio and a library. One room remained. The attic. Rachel stopped Karen outside the door.

“I know what you are thinking my dear. I saved this room for last for a reason. Let me guide you from here. I promise, there is a lovely surprise waiting for you at the top of those stairs.” Rachel explained gently with a smile.

In a daze, Karen allowed her mother to lead her up the narrow staircase. She was dazed and felt like she was stuck in someone else’s body. Her feet and arms felt a hundred pounds heavier. Each step was a chore. There was nothing in this room that Karen wanted to see. The attic was a hollow place that filled her with trepidation. She was unsure why it bothered her so. It is, after all, just a room.

Her throat tightened as her mother reached for the door knob. She wanted to yell at her to stop. She wanted to run down the stairs. She wanted to scream out. Don’t open the door. They are in there. Why these thoughts bounced around her head like a run-away tennis ball, she could not fathom. Before Karen could voice her rising terror, Rachel opened the door and led her inside its walls. CLICK!

Instantaneously, her fears drained out of her as soon as the light brightened this once dark room of despair. Her family had created a haven for her. The old boxes had been removed. The walls were painted the most cheerful shade of yellow. Comfortable, overstuffed chairs were placed in the corners. Bookshelves lined with photos of her family adorned the walls. The children’s favorite toys were tucked here and there. Slowly, Karen moved around the room, pausing every now and then to pluck a treasure up. Silent tears of joy caressed her checks. A lovely smile lit up her face. Her eyes sparkled. Rachel’s heart glowed, watching her daughter’s delight.

“I know your doctor wanted you to move on with your life. Alice and I thought you were strong enough to be able to have this little piece just for yourself. We wanted this to be your sanctuary. When your days get hard, you can come up here and just be in a room filled with love. The day will come when you won’t need this room any longer. Until then, it is all yours.”

“Thank you mom. This is perfect.” Karen exclaimed as she hugged her mother tightly.

——

“Damn. This is taking longer than I thought. The others will be here soon.”

“Patience doctor. This is the moment we have been waiting for. Let it take its course. Keep thinking of the payoff. We are so close now.”

“You’re right. It is best to let it blossom as it needs to.  I just hope he shows this time.  I grow weary of waiting.”

—–

Karen was happily humming to herself while making lunch. Turkey on rye with extra mayo and Swiss cheese sounded positively delightful after a morning of yard work. Her arms were sore and her back ached but it was a good pain. She felt fulfilled. As she munched on her sandwich at the small dining room table, she saw something move out of the corner of her eye. Turning her head in that direction, she saw the kitchen curtains blowing in the breeze from the open window.

Smiling at herself, she continued to eat. Another shadow moved just outside of her field of vision, causing her to pause in mid bite. Once again, she turned her head in that direction. There was nothing there but her kitchen. Warm sunlight flooded the room. No corner was darkened. Strange. Must be all that fresh air this morning. Maybe I need a hot shower and a nap to clear my head.

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The shower had felt so good. All of Karen’s tight muscles felt unwound. She retired to the attic with a cup of tea. Settling into her favorite chair, she wrapped a blanket around her and picked up the book she was determined to finish. At some point, she drifted off to sleep. The book hit the floor with a soft thud. Soft snores escape her as she fell further and further into dreamland. Her forehead creases. She pulls the blanket up around her throat, tightly.

The solitary bulb in the center of the room changes from a bright white to a sour yellow. It casts ugly shadows around the room as the walls degrade from the happy yellow to the worn gray of concrete. The cream carpeted floor erodes to a dirty brown cement. Excited voices, muffled as if behind some unseen barrier reach Karen’s ears.

She begins to thrash in her sleep, her panic rising to the surface. Scratching. Scratching. Growing louder. It echoes harshly on the barren walls. Louder and louder it grows. Karen awakens with a scream stuck in her throat. Her eyes are feral as she scans the room around her. Everything is as it should be. Shaken, she flees the room, locking the door behind her.

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Weeks pass. Karen refuses to enter the attic again. After a while, the strangeness of that day have faded from her mind. Yet, whenever she nears that door, fear causes her to leave it untouched. Instead of facing this irrational fear, she decides to arm herself first. An appointment with Dr. Reinhart is just what she needs. He has helped her before. Why not now? She picks up the phone to make the call when she hears glass shattering in another room. Dropping the phone back into the cradle, she searches for the source of the noise.

Above the fireplace in the living room, an ornamental vase has fallen off the shelf. It lies in ruins upon the floor. Thinking that she must have placed it too close to the edge when she was dusting, she turns to retrieve the broom and dust pan from the hallway closet under the stairs. She never makes it that far. Movement at the top of the stairs stops her. Somewhere upstairs, a door slams.

White hot anger consumes Karen. An intruder in her house!  Oh hell no! Running back to the fireplace, she grabs a fire poker and returns to the stairs. Another door slams as she bolts up the staircase. Karen moves from room to room like a hurricane. All of them are empty. The only space to check is the dreaded attic. Standing at the threshold, panting harshly, Karen hesitates. The door is open. Darkness greets her. Hollow footsteps and a woman’s laughter creep down the stairs. Scratching noises followed by more thumps come next. Boldly, Karen ascends into the blackness.

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A musty dampness assaults her nostrils. She reaches blindly for the pull chain, unable to find it. Waiting for her eyes to adjust, she realizes that there is a faint light. Shapes are distorted but it is not her attic that she is looking at any longer. As she moves into the room, the smell of decay gets stronger. Stale urine and the metallic twang of blood becomes overpowering. Shaking her head to try to dislodge the funk, she moves further into the room. Shadows dance along the floor. She cannot make out what is moving there. Something brushes against her leg. She stifles a scream before it can escape her lips.

The room seems much too large to be her attic. The light grows and turns a sour yellow. She can discern its source. A single cone shaped light fixture hangs from a dirty chain from the ceiling. The cone is caked with dirt and dust. Here, she can make out what the scurrying shadows are, rats, maybe fifteen in all. One brushes against her legs again. Its fur is sticky and leaves goop behind. Doing a mad tip toe to avoid another one from touching her, she backs into something hard, nearly knocking herself unconscious. Dazed, she stumbles awkwardly in a circle. The shock of what she discovers next is enough to send her into the blackness of artificial sleep. Her body thumps loudly onto the floor as she passes out.

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“Doctor! They are here. Security is escorting them to our location as we speak.”

“It is about time. The last phase is beginning. If they don’t hurry, they will miss it.”

“The last phase? Really?” she says, her normally serine face alight as she leers into the room beyond once more.

“Yes. It just started. Oh, I do hope they hurry the hell up.” The doctor says in listlessly.

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Alice and Rachel pound on Karen’s door. Rachel shifts a casserole impatiently in her hands. Sensing her mother’s growing displeasure, Alice retrieves her spare keys and opens the door. Every light in the house is on when they enter.

“Karen?” Alice calls out as a sense of déjà vu overcomes her.

“In here.” Karen calls back weakly from the kitchen.

Worried, the ladies rush into the kitchen to find Karen slumped in a chair with an ice bag held to her hand. Her complexion is ashy gray. Dropping the casserole onto the table in a rush, Rachel snatches the ice bag out of Karen’s weak grip.

“What happened? Let me see your head. Do you need stitches?” she blurts out.

“I hit my head in the….the attic.”

“It doesn’t look like it needs stitches but you have a nasty bump. I think we should take you to the hospital. You might have a concussion.” Alice explains gently while staring at her mother harshly.

“No. No more hospitals. I am fine. I just have to get my bearings. I would take some aspirin though.”

Exasperated, Rachel goes to the bathroom to retrieve the medication. Alice replaces the ice bag and tilts her sister’s head up so she can get a better look at her eyes. For a moment, they are a dark brown. Jumping a little, she looks again. They are the same emerald green they have always been, a little glazed but otherwise normal. Sitting opposite of Karen, she asks, “What is the last thing you remember?”

“I went into the attic to, um, I’m not sure why I went up there. Um….”

“Take your time Karen. Your head must be really pounding so just take your time.”

“Thanks sis. Um, I went up there and….and it gets a little fuzzy, then I remember stumbling around in here looking for the ice pack.”

“Do you remember what time it was when you went upstairs?”

“Um, no. It is all fuzzy. I remember….um….damn. It’s gone. I just don’t know.” Karen replies getting distressed.

“Shhh. Shhh. It is ok. It just means that you hit your head really hard. You really should let us take you to the hospital.”

“No. I’ll be ok. I just need some medicine. What is taking mom so long?”

“I don’t know. Look hold this. I’ll go see if she needs a hand.”

Nodding, Karen watches her sister go upstairs after their mother. An unsettling smile stretches across her face. Laughter that is not hers slips softly out of her lips.

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The hallway has become crowded as the doctor’s long awaited guests have finally arrived. Stern looking faces, etched out of granite stare into the only window into the room. The doctor nervously bites his thumbnail as he stands to the far side of the others. The last phase was progressing along as he had predicted. All he needed was one last person to finally show his face.  So much was at stake here. If he did not show, all of the doctor’s research would be discredited. “Come on you bastard. Quit hiding and show your damn face.” the doctor whispers under his breath as his nurse joins him.

Looking at her , he says, “It’s time. You may begin.”

With a curt nod, the nurse enters the room beyond the glass.

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Alice checks all of the upstairs rooms and her mother is nowhere to be found. One room remains, the attic. Why her mother would go up there was beyond her. She was starting to feel like the last sane member of her family. Frustrated, Alice climbs the stairs and enters the room beyond.

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The nurse retrieves a tiny vile from her front pocket and a syringe from the other. Filling the syringe with liquid, she hears the scratching intensify. Smiling, she sticks the needle into Patient 44’s arm before turning to leave the room. As the door closes, the screams begin.

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Alice is confused as she enters the attic. Her mother is standing across the room motionless. Terror is frozen on her face. Alice rushes to her side.

Shaking her, she yells, “Mom! Mom! What is it?”

To this, her mother’s face contorts as she tries to form words. Rachel points to something behind Alice. Afraid to look but petrified not to, Alice turns to where her mother is pointing. The cheery attic dissolves around them. Alice clutches to her mother as the odor gags her. Rats scurry this way and that along the hard concrete floor. Mad laughter rings out, echoing throughout this chamber of hell.

“What’s the matter? Don’t like the accommodations?” Karen cackles again from the doorway.

“Karen, what did you do?” Alice demands.

“Me? Oh sister. You should know better by now. I thought you were seeing everything clearly. Tisk tisk. This just won’t do at all. I guess I should leave the two of you in here for a bit longer. Then, oh then, you will see.” With this, Karen bolts out of the room and slams the door behind her, locking it.

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The stern faces have changed to those of absolute wonder and mortification as they watch Patient 44. Each member present seems to both holding their breath and panting as they are consumed by the events unfolding before them. The doctor smugly smiles at them. They wanted a show. They were getting one. Tick tock. The clock strikes twelve. It’s time for the big finale.

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Huddled in the poorly lit room with the rats, Alice and Rachel begin to scream. Karen listens with her back pressed against the door humming softly to herself. Hours turn into days. The screams become less frequent as the ladies’ throats become raw from overuse. Gingerly, Karen stands up. She stretches this way and that. When her back pops loudly, a content sigh escapes her. Humming once again, she enters the attic.

“Ladies, oh ladies. Now where are you? You know there is nowhere to hide in here. Come on out of the shadows and tell me. Can you see yet?”

“Yes. We can see now but can you?” A much too clear and calm voice speaks out of the shadows.

“Come out here and let me see you!” Karen roars angrily.

“We are right here. Step closer so you can see us better.” The voice replies, again much too calmly.

Filled with rage, Karen storms across the room and stops dead in her tracks. Under the sour yellow light is a body strapped to an examination table. At first, Karen sees herself lying there. Then she sees her sister Alice. Next the body morphs into her mother Rachel. Her husband and her children follow. Shaking her head violently from side to side, she starts a feverishly whispering, “No. No. No. No. No. No.”

“Do you see? Do you see clearly?” the voice implores.

Karen squeezes her eyes shut and places both hands on her ears. “No. This isn’t real. No. No. No.”

“But it is real. Look damn it! Open your eyes and see!” The voice demands harshly.

Karen stands still for a long time before complying. On the table, she once again sees herself transform into her love ones. Their screams of pain and terror ring in her ears. Each time they cycle through, their bodies are more damaged. The children’s legs are gone, eaten away by rats. Their faces badly beaten.

Alice is missing both eyes and arms. Nothing remains of Karen’s husband. His body has been defiled with such malice that his features are no longer discernable. Rachel’s body has been lacerated repeatedly. She is missing the flesh from both her arms and her legs. The rats must have been at her the longest. Shreds of torn tissue hung from her in rotten ribbons.

Karen’ body appears. Hers is still intact. The rats had not been allowed to feast upon her. She is emancipated. Her skin is stretched much too thinly over her skeleton. Her dress and hair have been carefully arranged. Both are completely clean. A poor makeup job adorns her face. It does not disguise her decaying features. The last body in this smorgasbord of death and torment is that of Dr. Reinhart.

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The rats had indeed been at his legs. At some point, they had discovered his hips. The damage was not as severe in this region. The rats had only left gnawed bones and fine pieces of meat on everything below the hips. His privates were completely decimated though. They have must have found them sweet after all. All of his fingers had been removed. Judging by the tears along the knuckles, it was by a blunt instrument. His jaw was broken and he was missing all of his teeth. Only one eye remained, fixed on Karen. It stared accusingly at her when the screams of all of the victims tore through her again.

Falling to her knees, Karen tried to drown out their tortured voices with her own. Abruptly, they all stopped as she felt something prick her left arm. Thinking of the rats, she bolted to her feet. The pleasant voice in the darkness spoke up again, “You are so close, yet you still refuse to see everything. I want you to really look at that table and tell me what you see.” She said sternly.

Karen walked on shaky legs, making a scratching sound on the concrete. Rats weaved between her feet but she did not notice. Leaning over the table at herself who had chosen to appear once more, Karen focused on the body before her.  Each member showed themselves again and again. Karen did not want to look anymore. She tried to turn away when the voice roared, “Don’t you dare look away!”

Karen stared harder this time as the faces changed faster and faster. With each transformation, their voices cut through Karen like a knife. Faster and faster they morphed. Karen thought her head was going to explode. Her heart was racing so wildly that she was sure that it would shoot out of her chest at any moment. Her eyes felt like they would liquefy right out of her head. Gripping the table until her knuckles turned a bright shade of white and panting wildly, Karen watched this freak show from hell. Something snapped in her brain. The faces started to slow one change one last time. Alice. Children. Husband. Rachel. Karen. Dr. Reinhart. Dr. Rathshaw.

“No. This isn’t possible. No. No. Not him. It can’t be. Not him.”

“Yes. It is him.  I’ll ask you again Dr. Rathshaw. Do you see?” the pleasant looking nurse asked over the intercom.

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Lying on the examination table is the decimated body of Dr. Rathshaw. Convicted of kidnapping and torture of Dr. Reinhart, Alice, Rachel, Karen, and her husband and children. Because of the extreme methods of torture that he had visited upon this family, the courts had decreed that he should suffer the same fate as his victims. Claiming insanity as a defense, he was sent to participate in an experimental study under the care of Dr. Henry Bird and his wife Elizabeth, his attending nurse.

The crowd gathered today were from the District Attorney’s office who were asked to witness the Patient’s execution. Before the execution was to take place, Dr. Rathshaw was subjected to the same tortures. Caged rats were bolted to the table and left to eat his legs and hips. His right arm was cut off with a blunt hacksaw, in pieces. Each time a piece was removed, the wound was cauterized and left to fester. He was not allowed any bathroom privileges. Any bodily excrements were left for him to soak in.

He was denied food. In order to keep him alive, an IV drip administered fluids only. He was given no pain medication. One of his eyes was removed with a spoon. His right arm was left from the elbow up. The rest was removed with rusty hedge trimmers. His face and torso was cut and sewn crudely back up. This too was left to fester. All of his wounds were infected. Flies had laid eggs in some of the cuts. Others oozed pus and rot. He was dying.

So far, he had been given the two of the shots required to end his life. These did not ease his pain. In fact, it intensified it. The regime that Dr. Bird had devised use a combination of hallucinogens and hypnotherapy. Dr. Bird had saved his new drug for last. Under hypnosis, Dr. Rathshaw was made to relive every moment of his victims’ final days.

After three days of sleep and sensory deprivation, the final test could be administered. The “good” doctor had finally become the objects of his obsession. A curious side effect of the treatment occurred then. Dr. Rathshaw not only began to talk like his victims, but his features actually changed into theirs to an extent. Over time, he stopped being himself, even though he was not hiding himself very far below the surface. Intrigued by this development, Dr. Bird decided that it was time to test his prized drug.

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The results were astounding. By combining reptilian DNA with certain neuron uptake inhibitors, he was able to force Dr. Rathshaw to change completely into his victims. Since Karen was the trigger for his obsession with her family, Rathshaw had chosen her to be the victim and the perpetrator of his heinous crimes. He had become obsessed with her when Dr. Reinhart had asked for him to observe her treatment.

Karen was part of an experimental drug trial to treat depression in women who had lost children during a difficult child birth. She had responded so unpredictably that Dr. Reinhart thought that since Dr. Rathshaw was an expert in abnormal behavior, he could suggest an alternative course of action. It was then that he became overcome with the need to have her. Patiently, Dr. Bird and his wife upped his dosage until he came to the critical tipping point. Once this was within grasp, Dr. Bird called the DA’s office. He had his results. He no longer cared for Patient 44 and his antics. There were even bigger fish out there that he was dying to get his hands on now.

“Dr. Rathshaw? Do you finally see?” Elizabeth asks once again over the intercom.

Staring into a mirror on the ceiling above his bed, the once renowned Dr. Rathshaw answers, “Oh yes. I see. I finally see.” Mad laughter erupts out of him as he feebly tries to move his legs to escape the rats that are there to seal his doom. Manic scratching sounds of bone on metal are heard through the observation glass as the assembly of men and women watch in morbid fascination while Dr. Rathshaw’s execution is carried out. Death by rats.

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