This is part 3 of a 3 part story. Please find the links below to the other parts.
Dr. George Dennison,
I am writing to you, the Director of the Hospital, in regard to patient Carson Nichols. She is a thirty-year-old former kindergarten teacher who has been with us for a little over fourteen months now. She was brought in by her older sister, Jenna, who was concerned for her sister’s mental health after her husband killed himself in front of her. When Mrs. Nichols was admitted, her sister explained that she began drawing pictures with her students of her bloody husband, which was when she was let go from the school. At that time, Mrs. Nichols was living with her sister and would continue drawing vulgar pictures in her once-cherished books and not speaking to anyone. I was her original doctor when she arrived, and over time she has become delusional: she believes that she and I are a couple. I believe this was Mrs. Nichols’ way to cope with her deceased husband. Her official diagnosis is undifferentiated schizophrenia.
I believe it is in Mrs. Nichol’s best interest to be transferred to another nearby hospital to be treated. Below are my notes over the past year with specific examples as to why I believe this to be.
October 7, 2014: Carson brought a copy of "A Tale of Two Cities" with her to her (first) session. As I was evaluating her, she told me how much she loves reading and writing and making up stories. She blatantly asked me if I would take her to coffee after she was released. Since it was my initial evaluation of her, I did not know it would escalate into what it became.
December 13, 2014: At the end of the session, Carson told me she loved me. She hit herself in the head and quickly corrected herself, saying that she meant to say she was grateful that I was helping her figure out what was wrong with her.
March 19, 2015: Carson was telling me specifics about the townhouse she was planning to move into after “getting out.” She was going down to the last T about the house, and as she was telling me, she told me that her boyfriend was going to be moving in with her. I asked Carson who her boyfriend was, as she had never mentioned having a boyfriend before, and she quickly changed the subject to how she missed drinking coffee whilst reading.
June 25, 2015: Carson told me an elaborate story about how she was getting married. She still would not mention a name, but I checked her visitor records after the session; the only male to visit her was her brother, Jacob. What intrigued me the most was that as she was telling me the story, she would not look at me in the eyes.
July 15, 2015: Carson told me the story about how she became a kindergarten teacher, and how much she missed her students. By this time, it had been over two years since the school board fired her. Then she said something along the lines of, “You love to help people, too. That’s what I like about you, Dr. Jason. You help people like I used to.”
July 29, 2015: When Carson entered, she had a paper ring around her finger. I asked her what it was, and she simply blushed and said that she had a wonderful weekend with her parents. Again, I checked her visitor log: her parents did indeed visit her; however, no one else did.
October 3, 2015: During the past few months, Carson showed signs of improvement. While she continued to wear paper ring after paper ring, she never mentioned her fiancé again until this day. She brought in a picture of a dog she called Krush. It was a picture she colored herself. She then told me that she and her fiancé just adopted him. I asked for a name again, but she never specified.
December 18, 2015: Carson came in today stating that she was going to be having lots of children after she got married because her fiancé just received a promotion. She said this a few days after I informed her that I may not be her doctor anymore as I had just received the promotion to head psychiatrist and the previous Director told me to switch around a few cases if possible. I asked Carson what her fiancé’s new position was, and she said he was an even better doctor than he already was. At this point, I should have seen the signs, but I believed it would be bad for her treatment plan if I were to suddenly switch doctors on her.
January 6, 2016: She told me about Paris and the Eiffel Tower. I asked if she had been to Europe previously, and she said that she just got back last week. I became concerned, especially when she started aggressively talking about all of the sexual activities she was performing with her fiancé. I felt uncomfortable enough to end the session early. As she was leaving, she mumbled that she would ‘see me later tonight at home.’
This brings me to today, March 18, 2016, when I had Dr. Jackson call me from isolation. According to a few of the nurses, over the past month or so, Carson has been requesting more food at meals. Apparently, she was “eating for two.” She was brought into the doctor who then performed a pregnancy test — which came back negative — and then told her she was having a hysterical pregnancy. She started to have a panic attack apparently said, “Jason will be so disappointed. He wants six kids!” During her breakdown, she began to throw items at Dr. Jackson. Carson was given a tranquilizer and brought down to isolation. She will stay there until we figure out where to go from here.
I do understand that I should have reported my suspicions of Mrs. Nichols’ infatuation with me from the beginning, and I also understand that there will be a thorough investigation. Please let me know where to send all of my notes from all of my sessions with Mrs. Nichols and anything else that will help.
Best,
Jason Mahoney, M.D.
Head Psychiatrist, Dennison Hill Mental Hospital
