Ad Nauseam

LUNCH DATE WITH LOA LOA



“Mr. Hanks? Dr. McDonald will see you now.”

“Thank you.” Mark stood up from his seat, tossing a well-worn copy of National Geographic onto the waiting room’s coffee table. Following the pretty, blonde nurse, he wondered if she would be impressed if she knew he had taken some of the pictures in that magazine.

I doubt it, he thought, thanking her once again when she showed him into an exam room. Ordinarily he would have taken the chance and brought it up anyway, but he was too preoccupied for any attempt at flirtation.

Another nurse knocked before entering, this one much older and far less attractive, her salt and pepper hair cropped short and her face cast into a permanent frown.

“Please roll up your shirt sleeve, Mr. Hanks.” She stuck a thermometer in his mouth, then strapped the blood pressure cuff around his bicep and pumped it brutally tight, her fingers pressed firmly on his inner wrist.

“So what brings you in today, Mr. Hanks?”

“Dere’s a womb in ma aye.” He muttered around the thermometer.

“I’m sorry, what?” She released the cuff and scratched some numbers on a pad of paper, finally glancing at Mark, who raised his eyebrows and pointed at his mouth with his free hand.

“Yes, of course.” She removed the thermometer and held up a finger to prevent him from speaking as she scratched more numbers down. “Now what were you saying?”

“There’s a worm in my eye.” Though his tone was calm, Mark’s insides twisted just saying it.

“A worm in your eye.” The nurse frowned.

“Yeah.”

“Any other symptoms?”

Mark thought about it for a moment before answering, doing a mental inventory of his body. “Some soreness in my joints, a rash that comes and goes, and a lot of pain in my eye when it moves.”

“It moves?”

“Well, yeah. That’s when I noticed it.”

The nurse stood, giving him a strained smile.

“The doctor will be in to see you.” She said, handing him a blue and white gown. “Take off your shirt and slip this on. You can keep your pants.”

“No foreplay then?” Mark joked, as she turned on her heel and left the room.

“I guess not.” He said with a sigh, slipping into the gown and sitting on the exam table with his hands hanging between his knees.

He wasn’t afraid of the doctor’s office, but wearing the thin linen gown made him feel like a child. Though he’d been healthy most of his childhood, it seemed his entire youth had been spent in rooms like this one. His mother had been a paranoid sort, rushing him in for every sneeze and sniffle.

“Hey Mark, how’s it going?” Dr. Alex McDonald didn’t knock before entering; they had been friends for many years. He sat on his stool and wheeled over to shake Mark’s hand.

“Been better, Alex.”

“What’s going on with you?” As he spoke, Alex palpated Mark’s neck, checking the lymph nodes, then looked in his ears.

“Well, I guess there’s a worm in my eye.” Mark cringed as he said it.

“A worm in your eye?” Alex laughed, his brow furrowed.

“Yeah. This morning I had a bad pain in my left eye and when I looked in the mirror I saw it. Not much thicker than a thread, but fairly long. It wiggled across the white of my eye, under the surface. Freaked me the f*ck out.”

“Can you feel it now?” Alex looked concerned, his smile fading. He pulled back Mark’s eyelids and peered into the left eye with his ophthalmoscope.

“Not really, but my joints have been aching off and on and I keep getting a rash that fades after a few days. I thought maybe I was getting the flu.”

“How long have the other symptoms been present?” Alex scribbled on a notepad, much like the unpleasant nurse.

“Oh, maybe a few months.” Mark felt the sting of tears in his eyes, his palms sweating. He knew parasites were a job hazard, could handle the thought of a tape worm or chiggers, but in his eye?

“Okay, Mark. We’ll get to the bottom of this. From the looks of your chart, I gave you a malaria shot around three years ago. You were going to Africa, am I right?”

“Yeah. I went to the Congo to photograph a group of western lowland gorillas.”

“Yes, yes. I remember that now. Stunning photos, by the way.”

“Thank you. Do you think I picked something up in Africa?”

“Possibly. I have an idea what’s going on here, but give me minute to do some research. I’ll be right back and we’ll figure out what to do, bud.” Alex patted Mark on the shoulder and disappeared out the door.

Mark waited on the table, nervous. After what seemed like an eternity, the doctor walked back in the room and sat on his stool, his mouth set in a serious line, though his eyes danced with excitement.

“Well Mark, it looks like you’ve picked up a case of loiasis. Have you heard of it?”

“Sounds vaguely familiar. What is it, in English please.”

“What you saw in your eye is a Loa loa worm, otherwise known as an African Eye Worm. You can get it through the bite of an infected mango fly and it may take years to present any symptoms. The worms themselves can live up to seventeen years and cause all kinds of trouble from colonic damage to testicular swelling. We will have to do a blood test to be sure, but I’d bet my eyeteeth that’s what it is.” Alex laughed when Mark cringed at the term eyeteeth. “Sorry, man. I know it’s freaky. I would’ve never guessed I‘d actually get to see a case of Loa loa in person.”

“Glad I made your day, Doc.” Mark said sarcastically. “What do we do now?”

“Well, from what I’ve read, the best chance of detecting the microfilariae in your blood,”

“English, Doc.”

“The baby worms. Anyway, the best chance we have of detecting them in a blood test would be to wait until around noon tomorrow. That’s when they are present in the highest concentration. So you come back at, say twelve-thirty tomorrow and we’ll do the tests. Think of it as a lunch date with Loa loa.” Alex smiled and Mark grimaced.

“Funny. Okay, so then what?”

“If you test positive, we will get you on some medication to kill the worms.”

“Worms?” Mark felt his stomach lurch.

“Oh, yeah. If you have one, there’s probably hundreds more.”

***

The following afternoon, Mark once again sat waiting in an exam room for Alex. His blood had been drawn and they were awaiting the test results. The doctor finally entered and shook his hand again, before clapping him on the shoulder and taking his seat.

“The tests were positive. Your little buddy is in fact a Loa loa worm.” Alex did his best to look grave, but Mark knew he was delighted to add this to his list of unusual cases.

“Okay, so what do we do to get rid of my little buddy?”

“There are a few options. We could surgically remove it, but we have to catch it when it’s actually crossing the eye, and that’s not going to be easy. Also, that would leave the rest of the worms in your system. There are a few drug options, some more effective than others, but they have risks of side effects. Most of the side effects happen in a person who is heavily infested, but the good news is that you are not. I would like to hit this hard with the most powerful drug, DEC. It runs the highest risks of complication, such as encephalopathy and death, but you are strong and healthy, with a relatively mild infestation.”

“All right.” Mark shuddered, horrified that he had the parasites, no matter how mild the case.

Alex scribbled his prescription on a notepad, then tore off the top sheet and handed it to Mark.

“Take this to the pharmacy. I doubt they have it in stock, but they’ll be able to order it. You will take the pills three times a day for the next three weeks.”

“Three weeks?” Mark said, dismayed at the thought of living with the Loa loa for three more weeks.

“Mmm-hmm. We will retest your blood then. Only about fifty-percent get by with one round of DEC. There’s a chance you might have to go another three weeks on top of that.”

“Fantastic.” Mark grumbled.

“And Mark, no alcohol at all during this time. A large number of subjects with adverse reactions reported to have consumed alcohol. So no alcohol, okay?” Alex fixed him with a stern look.

“Alright, Doc. I’ve got it. No fun.”

***

The Loa loa made its appearance five more times during the first couple of weeks Mark was on the DEC. It always started with a sharp pain in his left eye, coupled with the previously unsettling and now awful feeling of movement under his eyelid. Despite the ache in his eye, he could feel it sliding just beneath the surface, inching its way around.

Sometimes it felt like a bubble, wriggling and pushing against the lid. Mark found himself bolting to the bathroom each time to watch its progress. Just under the iris, his sclera would look bubbled, the thread-thin worm starting its trek that took from ten to fifteen minutes. Mark guessed it could be as much as an inch or two in length, but it was hard to tell as the worm wriggled its way across, just beneath the surface membrane of his eyeball.

By the third week, the Loa loa appeared to be dead, and lab tests confirmed that the DEC had removed the larvae from his blood. Mark breathed a sigh of relief and went on with his life. He pointedly avoided looking in the toilet after crapping, afraid he might see what looked like spaghetti in there.

***

One morning, nearly a month later, when the episode with the Loa loa was an unpleasant but fading memory, Mark awoke with a crushing headache. It felt as though someone was pounding the right side of his head with a hammer. Dizzy and disoriented, he got out of bed and staggered to the bathroom to retrieve some aspirin from the medicine cabinet, took four, and collapsed on the couch. At least it was Sunday, and he could stay in his apartment and watch football.

By the afternoon, the headache hadn’t subsided and, even worse, Mark noticed a change in his vision.

I wonder if this is what a migraine feels like, he thought, returning to the bathroom for more aspirin.

He studied his haggard reflection in the mirror. Something was wrong. Leaning in close to examine his eyes, he gasped and took a step back.

“What the f*ck?”

Mark looked at his eyes again and shook his head in bewilderment. His right eye was still the familiar pale blue, but his left pupil was now ringed in brown. Squeezing his eyes shut for a second before opening them again, Mark felt a sharp pain shoot through the right side of his head. He gripped the sink for support, his vision blurred.

After the world stopped spinning, he looked in the mirror again and closed just his left eye. His vision cleared and the dizziness retreated. He closed the right eye, leaving the left open and his stomach lurched.

Darkness.

Mark was blind in his left eye.

***

“I don’t know what to tell you, Mr. Hanks.” The ophthalmologist sat back and scratched his chin. “From all my testing, it seems your eye is working just fine. It reacts the way it should to light and other stimuli. I have no idea why you can’t see through it.”

Mark had called Alex right away, but was told his problem was beyond the scope of his practice and was immediately referred to an eye doctor. Now the eye doctor was telling him there was nothing wrong with his eye.

“What about the color change? What would cause that?” Mark turned his useless left eye away from the doctor so he could see him better through his right.

“That’s strange. I have heard of brown-eyed patients suddenly turning blue, but that is an anomaly that only occurs in centurions and no one really knows what causes it. But blue eyes turning brown? Not after two years of age or so.”

“Is there anything we can do?” Knowing he had been harboring a worm in his eye was bad, but it was nothing compared to the fear of going blind. Mark panicked, thinking of how many changes this would cause in his life, one of them being the end of his career as a photographer. “Is my other eye at risk?”

“It’s hard to say, but I doubt it. I’ve never seen anything like this, but if I had to hazard a guess, maybe the Loa loa did some damage in your left eye that I can’t detect. Short of having your regular doctor order an MRI, I don’t know how to proceed further here.”

“I’ll call Dr. Alex and ask for an MRI. I need my eyes.” Mark was frustrated by the ophthalmologist’s perplexed attitude.

“Okay, tell him I would appreciate it if he would send the copy of the report to my office right away.”

Mark walked out the door, the bright afternoon sunlight stinging his freshly dilated right eye, forcing him to put on his sunglasses. As he slipped into the driver’s seat, his glasses slid down his nose and he caught sight of his eyes in the rearview mirror. Despite the blurriness in his good eye, he could see instantly there had been a change. No longer just ringed in darkness, his left eye was now completely brown.

***

Mark was in the toiletry aisle of the grocery store the first time the voice spoke to him. It was so clear and close that he stopped immediately and looked around. He was alone.

Minutes later, at the meat counter, it spoke again.

“Nipe msaada!” I need help!

Looking around again, Mark caught the eye of a man waiting at the other end of the meat case.

“Excuse me.” Mark smiled at the portly man, who returned the smile hesitantly. “Did you just hear someone speaking Swahili?”

The other man shook his head, then looked at his watch and mumbled something about being late before hurrying away.

The voice spoke to him for the third time as he sat at his kitchen table, eating a meal of beef stew and French bread.

After a thorough search of his apartment, including closets and under the bed, Mark came to the unsettling conclusion that the voice was coming from his own head.

Mark sat on his couch with the television on, but couldn’t pay attention to the show. That foreign voice in his head kept jabbering, sometimes laughing and other times sounding angry and harsh. His pulse raced as he fought to quell his rising panic.

What the f*ck is going on with me?

Unbidden memories of his mother raced through his head. His mother worrying over a random fever, wringing her hands so hard her knuckles cracked. Her harassing phone calls whenever he went to a friend’s house, certain the other parents could never take care of him as she could. Then the time he found her in the shower, curled into a fetal position and shrieking. The paramedics took her away in restraints as she wailed for her son. She ended up killing herself with one bullet to the roof of her mouth after leaving a hastily scrawled note of apology to her only child.

“No.” Mark said to the empty room, then again with more force. “No!”

He was not going crazy. He had worked too hard to get where he was in life to let it be ruined by some inherited insanity. He would ignore it. He would will the voice away. He could do this.

Mark went into the kitchen and pulled out a rocks glass, filling it with ice. A bottle of bourbon sat on the counter, untouched since he’d started taking medicine for the Loa loa worm. He poured the amber fluid into the glass, his nervousness causing him to spill a bit on the counter. Not bothering to wipe it up, he started back to the living room, then returned for the rest of the bottle.

The bourbon burned down his throat, but he liked the feeling. When the glass was empty, he made to fill it again but changed his mind, swigging directly from the bottle. He felt the warmth of a pleasant buzz as the voice seemed to quiet down a bit, its interjection coming less and less.

Mark kept drinking.

Hours later, just before he passed out on the couch, Mark heard the voice speak one more time. He couldn’t help but laugh as the phantom in his head slurred in Swahili.

***

The MRI hummed and clicked around him, but Mark lay on the table unfazed, drifting in and out of consciousness from the sedatives the nurse had given him. He’d learned years ago, after a failed MRI for a torn rotator cuff, that he was claustrophobic and needed sedation to remain still for the forty-five minute procedure.

Drifting into sleep, Mark found himself in the jungles of the Congo once again, his guide speaking softly in accented English. The man’s pleasant face swam in and out of focus, but he could hear him warning of the dangers of the jungle.

“The gorillas aren’t the only things to fear in the jungle, Sir. It’s a haunted place, full of many bad spirits. You be careful one doesn’t hop inside you.”

A mango fly bit his leg and Mark watched it drink his blood, knowing he should slap it away, but unable to move.

“Stop.” He giggled drunkenly. “You’ll give me the Loa loa.”

Something crashed to his right, unseen in the deep darkness of the inner jungle and he was afraid. The gorillas. He had to be careful not to anger them. They could be lethal. The foliage parted and something huge and pale reared up before Mark. Not a gorilla, but a Loa loa worm, freakishly large and bearing down on him with an open mouth full of razor sharp teeth.

Mark awoke with a cry.

“It’s all right, Mr. Hanks. The testing is done.”

He was laying on the table, his arms held down by his sides with heavy blankets and his head wedged into place by foam cushions on each side. A nurse removed the folded washcloth from his eyes, and he blinked at the sudden brightness of the overhead fluorescents.

“Oh my God.” Mark said to the nurse, his right eye opened wide in alarm, his left still half-lidded from sedation.

“What is it, Mr. Hanks? Are you going to be ill?” The nurse looked concerned, placing a gentle hand on his brow.

“I know. I know what it is!” Mark tried to sit up, but a wave of dizziness overcame him. He needed to throw up, barely making it into the wastebasket the nurse held before his face. When he was finished, he wiped his mouth with a towel, his shoulders slumped.

“Are you okay?” The nurse asked.

“I don’t know. But I know what it is now. I need to talk to Alex.” Mark felt cold sweat trickle down his sides, tickling across his ribcage. He tried to stand, but the nurse put a restraining hand on his shoulder.

“I don’t think you should stand just yet, Mr. Hanks. Let’s give the sedatives a chance to wear off.” She pulled up a stool and sat in front of him, patting him reassuringly on the knee. It felt like a weird gesture to Mark, not something a stranger would do. His mind spun with the knowledge his dream had uncovered.

“I have to talk to Alex.” He said, then vomited again.

***

“I’m not crazy, Alex.” Mark leaned across the table, his eyes boring into his friend’s.

“Not saying you are, bud. It’s just a precaution.” Alex sipped his beer and shrugged. “Given your Mom’s history.”

“She was schizophrenic. I’m not schizophrenic. When have you ever known me to be anything other than on an even keel? Have I ever done anything crazy around you? I mean, Christ Alex, we’ve been friends for years. You of all people should know I’m not insane.”

“I know, Mark. The MRI was clear, but maybe that worm did something we can’t see. Changed your brain chemistry, or something. I just think it wouldn’t hurt to talk to a psychiatrist. If there’s damage we can’t see, maybe he can prescribe something to make your hallucinations go away. Hell, he might be able to get you the sight back in your eye if the cause is psychiatric. Please. Just go see him. Dr. Whitehead is the best. It’s a place to start until we can figure out where to turn next.”

Mark sat back and closed his right eye, but the left stayed open of its own accord and looked around.

“I don’t know.” He rubbed his temples.

“Come on. It can’t hurt anything. If nothing else, it will prove you’re not schizophrenic. And you can’t tell me it’s not digging away at the back of your mind that it’s hereditary.” Alex smiled, but his eyes remained concerned. “Just do it for me. If Dr. Whitehead can’t help you, I promise I will hook you up with whatever specialists you need.”

Mark finished his beer and grimaced as the voice yelled its foreign gibberish in his head.

“All right. Schedule the appointment.”

***

Dr. Emmanuel Whitehead was a pleasant looking man, with just a trace of a foreign accent that lent a certain trustworthiness to his words. He appeared to be anywhere from fifty to seventy, with grey hair, slightly stooped shoulders, and compassionate blue eyes.

Under different circumstances, Mark would’ve enjoyed the man’s company; but given what his appointment was for, he felt anxious and skeptical instead. Dr. Whitehead had him sit in an overstuffed armchair identical to the one the doctor sat in. Mark recognized the tactic, making him feel as though they were equals. He wondered if it worked on crazy people.

“So tell me what you think is going on with you, Mark.” Dr. Whitehead smiled and glanced at a notebook on his lap. He began to scratch down notes before Mark even spoke.

“Well, I know that the Loa loa is gone, and the eye doctor can’t explain the change in my left eye—”

“The change?” The doctor raised a brow.

“Yeah, my eye changed from blue to brown and I lost the sight in it, though the eye doctor said everything seems to work in there.”

“Blue to brown? It hasn’t always been that way? Fascinating. What did he suppose happened there?”

“I told you he doesn’t know. Anyway, there’s nothing on the MRI and I’ve started hearing a voice in my head.” Mark glanced up from his hands, trying to gauge the doctor’s reaction, but the man simply regarded him without expression. “The voice seems to be speaking Swahili.”

“How do you know it’s Swahili? Do you speak Swahili?” Dr. Whitehead’s brow furrowed a bit.

“No, I don’t. But I spent some time in the Congo a few years back. I’m a photographer and I had an assignment to photograph the gorillas. My guide spoke English, but a lot of the people I encountered didn’t. The voice sounds like they did, and I recognize a few words.”

“So you don’t know for a fact that it’s Swahili.”

“No. I guess not.” Mark frowned, unsure where this was going.

“Would it be safe to say that the voice may not be speaking a language at all? That it could be gibberish?”

“No. It’s not gibberish. I don’t understand what he’s saying, but I know it’s a language and it sounds like Swahili. He said I need help, at one point.”

“He?” The doctor tilted his head, looking quizzical.

“What?”

“You just said he. Up until now, you have referred to the voice as it.”

“What the hell does that matter? So I said he. The voice sounds male, deep like a man’s. I mean who gives a f*ck?” Mark stood and began to pace the floor. “I told Alex this was a mistake.”

“Please, Mark. I’m just trying to help you.” Dr. Whitehead’s placating tone made Mark want to punch the man in his pleasant face.

“That’s better.” The doctor said as Mark reluctantly returned to his seat. “Do you have an idea as to the identity of this speaker in your mind?”

“Yeah.” The anger ran out of Mark in a rush and he wilted in the chair. “It came to me in a dream during the MRI.”

“A dream?”

“If you keep repeating everything I say, I swear I’m out the door.”

“I’m sorry, Mark. I will try to refrain. You were telling me about your dream.”

“No I wasn’t. I don’t want to talk about the dream.”

“We can’t get to the bottom of this if we don’t discuss it, Mark.”

“Discuss it? You just repeat everything I say and scribble in your goddamn notebook! And you keep saying my name to make me feel like we’re buddies, but I doubt you’re even paying attention to me.” Mark glanced at his watch. “The hour is almost up, anyway.”

Dr. Whitehead set the notebook and pen on the table between them before leaning forward in his seat and folding his hands between his knees. He stared unflinchingly at Mark with his soft eyes and smiled.

“I’m listening, Mark. I mean, I’m listening. Please tell me about the dream. You have my undivided attention.”

“No. There’s no time left. I’ll tell you what I think, though.” Mark stood. “I don’t know how it happened, and I don’t know why, but somehow one of those jungle spirits got into my head. Maybe he hitched a ride on the Loa loa and took up shop in my brain when the thing died, but he’s there. And he’s taken over my left eye. That’s why it turned brown and I can’t see out of it. Sure it still works. But it’s working for him. And I need to stop this before he takes over something else.”

Dr. Whitehead said nothing at first, just sat there and looked thoughtful, as if he was honestly considering the possibility of Mark’s story. He then picked up the notebook and flipped back a few pages, squinting at his own illegible writing as he reviewed something in silence. When he looked at Mark again, his face looked both grave and sympathetic.

“Mark, it says here that your mother was diagnosed schizophrenic—”

“F*ck you.”

***

Mark sat at the kitchen table with a makeup mirror purchased from a secondhand store propped up before him. He could hear the water on the stove boiling, signaling it was almost time. He waited, just the sound of the water and the prattle of his Swahili ghost to keep him company. It had been almost a week since he had stormed out of Dr. Whitehead’s office, and Alex had called him no less than thirty times before Mark finally told him to stop.

Someone pounded on the door and Mark got up to peek through the peephole. It was Alex, his face distorted by the lens.

“What do you want, Alex?” He yelled through the door.

“Let me in, Mark. I want to talk to you. I’m worried about you.”

“Nope. Go away. I don’t have anything to say to you.”

“Goddamnit, Mark! Open up or I’m calling the cops!” Alex’s voice broke at the end, and Mark thought he might be close to tears.

“No good, old friend. There’s no law against refusing to leave your house. But there is one against trespassing.” Mark walked back to the table and sat down. When his cell phone rang, he shut it off without looking, certain it was Alex again. The f*cker had been talking to Dr. Whitehead. He wasn’t a friend of Mark’s anymore.

Almost time, Mark thought, leaning in close to the mirror. Better test this out first. He raised his finger toward his left eye. It snapped shut, protecting itself from the questing digit. He heard the foreign voice in his head complain, but he ignored it. Prying the lid open with the thumb and forefinger of his left hand, Mark pressed on the eyeball with his right index finger, causing the voice to shriek in pain.

Just as I thought. I can’t feel a thing.

Mark stood and wandered into the kitchen to collect his tools. A bottle of rubbing alcohol awaited him on the counter and the pot still bubbled away on the stove. Turning off the burner, he used a pair of tongs to retrieve a long thin blade from the boiling water and set it on the counter. Finding a pot holder in the drawer, he carefully wrapped it around the handle of the knife and grabbed the alcohol in his other hand, then returned to his seat.

Mark hadn’t enjoyed a moment’s peace in almost a week. All day and night the voice babbled, disappearing just long enough for him to fall asleep, only to wake him moments later with mocking laughter. It was a game for the spirit, one Mark was losing. He stopped eating altogether and only drank whisky, hoping to get the ghost drunk enough that it would allow him to rest. But nothing worked. Mark knew if he didn’t do something soon, he would die of hunger and exhaustion, leaving his body vacant for the spirit to completely take over. He refused to let that happen.

Transferring the wrapped blade carefully to his left hand, he squeezed the bottle of alcohol between his thighs, unscrewing the cap with his right. The alcohol made a hissing sound when he poured it over the knife, giving off a cloud of astringent steam that burned his good eye. Before he could lose his nerve or allow the knife to cool anymore, he touched the tip of the blade to his left cheek, just under the eye and pushed. It was amazing how easily the blade cut through the flesh of the lid, spearing the eyeball beneath with a pop. The voice in his head gibbered its agony, wailing in a language he didn’t understand, but conveying a terror that satisfied Mark.

“Take that, you bastard!” Mark twisted the knife in the socket, his stomach churning as thick jelly and dark blood welled from the wound, running down his face in a viscous rivulet. He felt nothing but triumph as he kept cutting, slicing away at his eyelids, carving out a raw, red hole in his skull. There wasn’t as much blood as he had expected, the hot blade cauterized most of the blood vessels, but soon the knife cooled and he no longer smelled the scorched tissues.

Mark threw the knife back into the pot and returned it to a boil.

Not done yet.

He didn’t have to understand the language to know the spirit was alternately pleading with him and cursing him. He felt no sympathy as he waited for the knife to heat again. He was going to get rid of it even if he killed himself in the process.

Mark regarded his face in the mirror, too tired to feel any real shock as he looked at the ragged red hole where his left eye used to be. Thick fluids still oozed down his face, and he did nothing to clean them off.

You look like shit, old boy! he thought, unable to stop the manic giggle that bubbled up from his chest. Almost done here. Then some rest.

With the hot blade back in his right hand, he probed the empty socket with the tip, trying to determine the best angle for his task. Bracing himself for the force that would be required to breach his skull, Mark halted at the last second, adrenaline making his heart pound in his chest like a tribal drum.

“Oh shit! Oh shit! I almost f*cked up bad there.” He said to the voice in his head, which had gone eerily quiet. “You would’ve liked that wouldn’t you? You wanted me to make that mistake. F*ck you, though. I aced anatomy.”

Pulling the tip of the knife out of his ruined eye socket, Mark winced when the blade touched the flesh beneath his right eye. This was going to hurt like hell, but it didn’t matter. He could take it. He could take anything to quiet that voice. He had come close to f*cking it all up, but had remembered just in time. That’s right, one Anatomy class fifteen years ago had saved him from disaster. He smiled as he pressed down, ignoring the flaring pain. The left eye is controlled by the right brain.

***

“This next case is an unfortunate one of Schizophrenia left undiagnosed.” Dr. Whitehead led a small group of residents down the hall, telling them the details of the patient in each room. As they walked, the men and women scribbled furiously in their notepads, trying to cram in every word the well-known psychiatrist said. “Jonathan, if you would.”

A large orderly stepped forward, produced a ring of keys from his pocket, and unlocked the door. They all took turns peeking into the room, their manners silent and respectful, though one young woman winced when she saw the man.

“Is that self-mutilation?” the lady asked.

“Yes.” Dr. Whitehead nodded. He looked in, seeing the patient had once again removed the dressings from his face, exposing dark, gaping eye sockets and the scarred flesh around them. The patient turned his face toward the sound of the doctor’s voice and smiled, his head lolling slightly from medication.

“His delusions caused him to believe that a ghost had taken up residence in his head. I only had the preliminary visit with him before a neighbor reported screaming from his apartment and called the authorities. By the time the door came down, the patient had already removed both his eyes and pushed a hot knife into the right side of his brain.

“Fascinating. He’s lucky to be alive,” a male student remarked.

“Yes. But there have been a great many people who have survived with only half of their brains. Then again, most of those cases have involved surgery of a more orthodox form than this one.” Dr. Whitehead smiled and the students chuckled politely.

“Does he still hold the delusions that a ghost resides in his head.” The same woman as before spoke, looking up expectantly from her notes.

“That’s hard to tell. Since he regained consciousness, the patient acts as though he can’t understand English.”

As if to prove the point, the patient spoke. “Nipe Msaada.”

“Gibberish?”

“Actually no.” Dr. Whitehead frowned a bit, nodding to Jonathan and watching as the orderly relocked the door before answering. At the sound of the lock turning, the patient began to yell and Dr. Whitehead listened for a moment to the cadence of the speech before speaking. “This patient is speaking Swahili.”