Chapter Text
Looking back, Carlos Reyes realized that he had a multitude of warnings before he decided to accept the job offer as a resident for Night Vale Behavioral Health. Maybe if he knew then what he knew now he wouldn’t be sprawled on his back on the couch, nursing a nearly-empty glass of whiskey that did nothing to alleviate the feeling of being utterly overwhelmed.
Cecil Palmer… now there was an interesting case. Eight years of medical school, four years of residency at Night Vale General Hospital, and an additional four years of residency at the State Mental Insitution did nothing to prepare him for that lanky, fair-haired monstrosity of a basket case.
Carlos looked to his coffee table where his laptop was still displaying Cecil’s massive file. Cecil Palmer, age 27, undifferentiated schizophrenic. Symptoms include hallucinations, delusions, paranoia, acute psychosis, memory loss, inappropriate affect, insomnia… the list goes on and on. The poor man was also on a rainbow of drugs that were strong enough to keel over a full-grown bull elephant. Nothing seemed to touch Cecil Palmer.
The dark-skinned man rubbed his temple.
“And this will be your office, Dr. Reyes,” said Dana, a caramel-skinned therapist with a tuff of curly ebony hair on her head. She opened the door and paused. “Oh, Dr. Carlsburg.”
Carlos peered through the doorway and saw a dirty blonde, freckly man holding a cardboard box in his hands. He waved the interruption off. “Don’t worry about it, Dana,” he said. “Just getting a few things.” He caught sight of Carlos. “You must be my replacement.”
“Dr. Carlos Reyes,” Carlos introduced, holding his hand out. The other doctor shook the offered hand cordially.
“Dr. Steve Carlsburg,” he said. “Feel free to call me Steve.” Suddenly he jerked Carlos towards him and hissed into his ear. “Run. For the love of God, man, RUN.” Without further ado he snatched up his box and scurried out.
Carlos scratched his chin and looked to Dana, who sighed audibly. “I’m sorry, Dr. Carlsburg is… well, he’s not well.”
“I can tell,” the doctor said, concerned. “Should I be worried?”
“No, no! Not at all!” Dana said a bit too quickly.
Carlos frowned and as he shoved his hands into his white coat pocket he noticed that Dr. Carlsburg had slipped something into his sleeve. A card, judging by the feel of it. He had an impulse to tell Dana about it, but he squared his jaw and decided to go on with the tour.
Carlos fingered the card. There was only a string of numbers on it, no doubt Steve Carlsburg’s number. Before he knew it Carlos had dialed in in the number on his smart phone and was waiting for the line to pick up.
“Hello?”
“Dr. Carlsburg?”
“Steve,” Steve corrected. “Hello, Dr. Reyes. So, I take it you met him?”
Carlos chewed on his lower lip for a moment. “Yeah.”
“So how long have you been here, Dana?” Carlos asked.
“Five years or so,” Dana replied, obviously proud. “Old Woman Josie’s been at this gig far longer than any of us, though.”
Carlos gawked at her, astonished that someone would address their head administrator with such a title. Dana laughed.
“Everyone calls her that,” she assured him.
Carlos recalled Josie clearly. She was a round, unassuming old woman with graying hair and a blatant grandmotherly air around her. She had interviewed him for the position and, surprisingly, offered him the job on the spot.
“Well, I’m surprised they hired you since you’re so young-looking,” Dana went on. Carlos was actually grateful to hear that since usually his premature touch of gray at his temples made him look older.
“I’m surprised as well,” Carlos chuckled. “This is actually my first official psychiatric position.”
“Oh, really?” Dana was surprised.
"I am a certified psychiatrist," Carlo argues politely. Though he omitted that he barely passed the certification exam weeks ago.
“Well, I’m sure Josie knows what she’s doing. Anyway, here’s the adult unit and if you’ll excuse me, Doctor, I need to get back to work. I’ll see you bright and early tomorrow for your rounds.”
“Creepy bastard, isn’t he?” Steve said.
Carlos couldn’t even reply. Creepy just didn’t cover it. Steve was kind enough to give him enough time to work out a sentence.
“...He certainly is something,” Carlos said at last.
“There’s a reason why no resident doctor lasted more than a few months there. Cecil sends them all running to the hills screaming. I don’t even know how I lasted as long as I did.”
“What is he? Undifferentiated schizophrenia with psychosis doesn’t even begin to describe him. I’ve been doing a lot of thinking and I feel we’re going in the wrong direction. I mean, look at the meds he’s on: Lexapro, Adderal, Lithium, Zyprexa, Seroquel, Ambien, Ativan—Jesus—Thorazine, and Haldol.[1] He’s been on these medications for about a year and nothing has worked. There has to be more too it.”
“Cecil’s had two CAT scans, three MRIs, one X-ray, one EEG, and three CSF analyses. He’s had a psychologist and neurologist take a look at him, both of whom were baffled and terrified. All of the scans show nothing, nada, zip, zero. EEG was normal, CSF fluids were crystal clear. Nothing is wrong with him he’s just… batshit crazy.”
“That, and…”
The next morning, Carlos met Cecil for the first time. After listening to a drug-seeking patient beg for more Xanax and a paranoid schizophrenic claim that he was the son of God and that Carlos’ skin color was an abomination, watching Cecil Palmer stroll into his office with a smile on his face and his arms swinging at his sides was a welcome sight. He was a not-too-tall and not-too-short man with platinum blonde hair, almost white, swooped back in a trendy fashion. He wore a clean, dark-purple button up shirt and black cotton slacks.
“Good morning, Cecil,” Carlos said, turning away from his computer monitor and placing his clipboard on his lap. “My name is…”
“Carlos, right?” Cecil cut him off excitedly. “Carlos the Psychiatrist.” Cecil plants himself down in the chair across from Carlos and sighs happily. “I’m so happy to finally meet you!”
Oh dear, his first day and already a patient was getting way too attached to him. Carlos makes a few notes on his blank sheet under Cecil’s name.
“I’m glad to hear that you’re doing so well,” Carlos replied professionally. “Have you been taking all your medications?”
“Yes, I have. I take all of them even though they taste gross. Yuck!” Cecil made a disgusted face.
“Well, it’s important to take your medications.”
Cecil cocked his head to one side. “They don’t help me,” he said frankly. “Like Steve Carlsburg.” He said the name with extra malice.
“Thankfully, I’m not Dr. Carlsburg,” Carlos said. “Dr. Carlsburg resigned.”
“Good.” Cecil looked particularly smug about that fact.
“Did you want Dr. Carlsburg to resign?”
“He was a jerk.”
“Do you wish harm on him?”
“No, I just wanted him to go away because he was an asshole.”
Carlos resisted the urge to laugh. “I see that the subject of Dr. Carlsburg is upsetting you, Cecil. Would you like to talk about something else?”
Cecil perked up immediately. “Yes, I’d like to talk about you.”
“It’s not appropriate to talk about myself during this time. This time is about you.”
“I want to talk about you,” Cecil insisted.
“All right, how about this: I’ll tell you about myself if you talk to me about yourself. Sound fair?”
“Sounds like Silence of the Lambs, but okay. You go first!” Cecil chirped, scooting to the edge of his seat and looking at Carlos expectantly.
“All right, I’m thirty years old and I’m a doctor.”
“I already know that, I want to hear something more interesting.”
For a moment, Carlos is confused about Cecil’s answer. But he supposes that the information could have been deduced from his appearance and ID badge. “I was born in Mexico and I moved here to the United States when I was nine.”
“I already know that too.” Cecil pouted. “I want to hear something more interesting.”
Already, Carlos felt that he was losing control of the conversation. Perhaps it was time to send Cecil on his way before things got really out of hand.
“Cecil—“
“I want to know why you resigned from your job at Night Vale General. It wasn’t your fault that woman died.”
Carlos dropped his pen. The sound of it landing on the tile floor was like a cymbal crash in the ensuing silence. Even though he knew it was highly unprofessional, Carlos raised his head and stared at his patient.
“E-Excuse me?” he stuttered.
“It wasn’t your fault that woman died. The nurse took a bad history. The woman only spoke Spanish. And the nurse didn’t speak Spanish too well, so when she asked the woman what medications she was on, she didn’t understand that the woman was also on a blood-thinner. So it wasn’t your fault she bled to death.”
“…and he knows things.”