As for me, I am tormented with an everlasting itch for things remote. I love to sail forbidden seas, and land on barbarous coasts
― Herman Melville, Moby-Dick; or, The Whale

When Paul arrived at Mercy, he was taken to the behavioral health centerpsychiatric ward. There he was provided with a hospital gown, and put into a locked room. When he started banging on the door, demanding to be let out, he was given a heavy sedative by the nursepsychiatric nurse on duty. He fell into a deep sleep.

When he awoke, Dr TereshkovaDr. Arocha was there, sitting at his bedside.

“I understand you’ve had a serious breakdown, and the University had you brought here. Is that correct?”

Paul remembered going to the University, but could not recall the reason for his visit. He looked down at his arms, and found both of them bound with leather restraints.

He said, “I did go to the University. I don’t recall why, but I know it was important. I’d just returned from a long trip in a van. That is all I recall. Would it be possible for you to have these removed?”

Dr. Arocha was writing some notes, and without a word, pushed the buzzer next to Paul’s bed. burly orderliesTwo burly orderlies entered the room. She spoke with them in rapid Spanish; each of them went to either side of Paul’s bed and removed the restraints. Paul rubbed his wrists where the leather cuffs had chafed the skin.

Dr. Arocha said, “I cannot keep you here for more than 48 hours. If you remain calm and continue to improve, I will discharge you to the custody of your brother. But you have to promise to do as I ask. Can we agree to that?”

Paul nodded, and then – with a raspy voice said “Yes, yes we can agree to that. May I have some more water?” Dr. Arocha nodded at the orderly standing next to the cart with the carafecarafe. He brought it and the cup over to Paul’s bedside. He poured some liquid into the cup and handed it to Paul. With a shaky hand, he managed to get a few sips, and laid back down on the bed. He smiled at Dr. Arocha.

“Thank you for your help – I really am feeling better now.”

Dr. Arocha said, I think yours is a case beyond my capacity to assist you. To be quite frank, I am afraid you will end up hurting yourself or someone else. As a result, I would like to recommend that you check yourself into another hospital. This one is in New York. I’ve heard about some new work on schizophrenia being done at armory picNew York Presbyterian Hospital. The head of the department there has made some real progress in treating schizophrenia. Would you be willing to try this for some reasonable length of time?

Paul said, “Is this really necessary? Honestly, I think I just need some rest and time to work. Ishmael and I made some real breakthroughs when we went to the MD MarathonMoby Dick Marathon reading in New Bedford. At first I thought Ishmael was just an hallucination, but now I’m not sure.”

Paul thought for a moment, and then said, “Perhaps you’re right Dr. Arocha. I do seem to be having some difficulty sorting out fantasy from reality. Maybe a change would do me some good.”

The next day, Paul was discharged from the hospital. Dr. Arocha made the arangements with the head of the psychiatry department at New York Presbyterian Hospital. Paul notified his brother of his plan, per Dr. Arocha’s requirement. He took the 12:40 Delta flight to JFK. A cab took him from the airport to the hospital. Thus far, he’d had no hallucinations, and heard no voices.

“Maybe that’s a good omen – I guess I’m doing the right thing with this hospital stay.”

Paul checked in, and met his new psychiatrist, who tells him ‘just call me Dr. V’. Almost immediately, Paul began a new therapeutic regimen of drugs at NYP, including invegapaliperidone palmitate, trade name Invega.

He began to improve immediately. After two weeks of improvement, Paul asked Dr. V if he could visit other parts of the hospital. Dr. V suggested he stay in the psych unit, but arranged for him to join a group sessiongroup therapy session to talk with other patients.

The therapy session was already in progress when Paul joined them. The coordinator introduced Paul to the other participants. They discussed their progress, and eventually Paul spoke about how much he enjoyed being there, working with Dr. V. The coordinator pointed out to the group that Paul was a mathematician, and that his doctor expected him to make a full recovery. Paul was pleased about the attention, and the recognition of his prior accomplishments.

When the 45 minute session was up, everyone rose from their chairs and went to leave. That’s when Paul noticed a girl looking out windowwoman, sitting on the window ledge, looking at the outside world. He felt compelled to walk over and speak with her.

“Hello. My name is Paul. Are you OK?”

The woman replied, “Yes, I am doing better since I got here. I killed my mother’s dog, and threatened to do the same to her. So maybe I still have a lot of work to do. How about you?”

“I’m actually much better. My name is Paul Fitzgerald. I’m from Miami, and used to teach at the University there.”

The woman’s gaze, up until now, had never left the window. Now, her head snapped around and she stared at Paul. “My name is cecilia avatarCecilia Vasquez. I am also from Miami, and used to teach at the University there.”

Paul responded, “That’s quite a coincidence. How long have you been here?”

Cecilia replied, “My psychiatrist, Dr. Arocha, sent me here 16 days ago. But the truth is, I’m actually just sort of hiding here. I don’t need to be here, but there’s this guy that’s been trying to kill me. He thinks I’m responsible for some bad things that happened to the people of his planet.”

Paul felt this strange sense of deja vu at everything the woman had just said, but the feeling quickly passed. It was replaced with a feeling that this woman might be even crazier than he.

“Dr. Arocha was my psychiatrist as well. Another coincidence. Say, may I buy you a cup of coffee or tea? I think I’d like to get to know you better.”

Cecilia looked at Paul, and replied, “The cafeteria downstairs makes a decent cafe con lechecafe con leche. If it’s OK with you, I’d prefer that.”

Paul said, “Let’s go.”

As they took the elevator down to the first floor, Paul felt a strange sense of calm with this woman. He was encouraged to believe that, despite her mental illness, he’d found a woman with whom a relationship was not out of the question. She was attractive, articulate, and obviously they had a fair amount in common. Maybe they could help one another with this schizophrenia thing. Paul was excited at the prospect.

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