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No therapy today. Observation of patient in day room showed him to be very still and uncommunicative.


Nurses report that patient was not sleeping over the weekend. He apparently kept the weekend staff awake with him. Reports are that there was a great deal of switching even in the context of individual conversations. The staff has been put on 24 hr alert, until we can determine the cause of the current crisis.

Unresponsive in therapy.


Patient still not sleeping nights. Patient appears catatonic during the hours that I am in the hospital, yet is reported to be very active at night. I have tried coaxing him out of catatonic state verbally with no results. Patient has not responded to therapy sessions.


Patient still catatonic. Weekend doctor administered SRI’s without result. I have taken patient off
medication before two week introduction. If patient is still catatonic at the weekend, I will stay the weekend for observation with the hope that I can gain some clues to his state from the outbursts in the evenings.


Patient still unresponsive.

Patient still unresponsive in the day. No outbursts in the evening. I wonder if he knows that I am still in the building.


Still no response from patient. Unsubstantiated report that a nurse noticed a facial response when I was accidentally paged over the intercom system. I am starting to think that he is trying to hide from me indicating that I am getting close to some of the sources of patient’s trauma.


It became obvious that patient would not come out of catatonic state. Left the hospital at 1:30pm.


Weekend staff reported that patient became animated within five minutes of my departure. He was reported to have only shaken his head back and forth with his eyes closed. He is reported to have said many things about “not seeing the light”, “turn off the light”, “it doesn’t hurt”, “I know, I know, I know.....”. I have asked the hospital to install either a tape recorder or surveillance camera in the room. Hopefully I can get better information if patient will perform for a camera or tape recorder when I am not in the building.


Request for surveillance denied. Patient still immobile and unresponsive during the day, and active at night. Nurses gave patient a haircut and general grooming today. They reported he seemed dead. Nurses checked vital signs, and all is well despite his torpor. He has become so unresponsive that he has begun evacuating in his bed.


I have decided to discontinue patient’s therapy for the time-being, and will be taking a one-week vacation. It is my hope that patient will spend enough time without worrying about revealing himself to me that he will not be inclined to return to his catatonic state when I return.


I have informed patient of the discontinuation of his therapy, and received no response from him. I have provided the nursing staff with a hand held tape recorder that I have asked them to use if patient begins verbalizing while I am gone.


Patient had one outburst shortly after my departure, which was recorded. Patient noticed that he was being recorded, and became silent, but very active over the next week. Much of his time has been spent in his room or on the computer in the day room. Notably, staff says he has not spoken a word since he found the tape recorder. My e-mail is filled with messages from Apparently all of the e-mails sent to me were deleted from the source computer. Nursing staff could never find new files after patient would use the computer. When I arrived in the day room patient did acknowledge my presence, but still will not speak. I have not yet read the e-mails or listened to the tape, but will use patient’s therapy hour to review this material. Therapy should resume tomorrow.


Reviewed the e-mail, and found the first one was sent on the 15th. The e-mails were diary entries that began on the 14th. According to nurses, patient would meticulously search his own room every morning when he woke up, and then go to the day room computer and type. I have found the e-mails to be a strange collection of stories that try to construct the identity of a father from debris found in the room, most of which comes from patient’s own body and possessions. I am unsure whether the forgetter is experiencing triggers from his environment, or is simply using whatever he finds closest to him to construct answers to the questions I have asked him. I have responded to the first barrage of e-mails, and am waiting for a reply.

The tape was hard to make sense of, and I am getting a transcript made. The one bit of information I could get from the tape is that patient is very concerned about being held accountable for his remarks.


There was little progress in therapy today. Patient is definitely responding to my presence, but he will not speak, and I can only be half certain that the nodding and shaking of his head is in response to my questions. The only thing that was clear was his denial of responsibility for the e-mail, and the emphatic denial of the veracity of the stories they contain. I have decided that I will not initiate future therapy sessions for a while, I will wait to see if one of the alters will choose to come to therapy on their own. There has still been no response to my e-mail.

Patient still not speaking. No therapy today.

Patient spent all day in bed. Still not speaking.

july august september