Mr G Poznansky
The Psychiatric Dept.,
Glasgow Hospital
25 Sauchiehall St
Glasgow GL2 1BY
Dr William Evans
The Psychiatric Dept.,
St Mary’s Hospital
4 Willow Gardens
Edinburgh EZ6 5HT
Ref GWP/MC/290543 29-05-2043
Dear Bill
Re: The patient known as “Mr W.”
I have enclosed some case notes and tapes regarding a patient I have been treating for six months now. I would welcome your opinion on this patient and hope that you will look over the material. I think that this case will benefit from a fresh perspective, for reasons that I’m sure will become apparent when you read the notes. The notes are fairly comprehensive, but I’ll briefly outline the state of play to date.
Six months ago the Glasgow police brought Mr W to the outpatients department of this hospital. He had been sleeping rough on the streets (in very inclement weather) and was unwashed and generally unkempt. Passers-by had complained that he had been standing in the middle of a city centre street and shouting. The police brought him straight here, where he was admitted.
There was no evidence of alcohol or drug abuse, but the patient was obviously disturbed. He talked constantly of his fear of someone, or something. But his behaviour was odd and frightening rather than violent or aggressive. He seemed more of a danger to himself than anyone else. The outpatient staff – as ever – coped very well and Mr W was soon admitted by the SHO on duty, Dr Watts. I have been looking after his case ever since.
One of the most frustrating aspects of the case is that the patient’s real name and identity remain unknown. He is known as Mr W because, when first asked for his name he replied,
“My name is Woe.” Though when talking to the patient we call him Dan, and he responds to this name.
Mr W presents several psychological problems. He has a horror of sleep and goes to some lengths to stop himself from going to sleep. But lack of sleep only exacerbates his other problems. See the notes for my prescriptions. Mr W suffers from various delusions of a paranoid nature, chief among which is an obsessive fear of cats. There is also a strong need for self-punishment. There is a degree of self-hatred and a kind of religious mania. Much of Mr W’s thoughts are focused on a figure who he refers to as The Master.
Mr W comes across as well-educated and I have no doubt that before his breakdown he was a professional person. His accent indicates that he is from the south of England.
I suspect that the key to Mr W’s case lies in finding a link or links between seemingly unrelated elements in his psychosis. Perhaps you will be able to see something that I have missed.
I look forward to hearing from you.
Best wishes
Yours sincerely
Geoff
Mr G Poznansky
Consultant Psychiatrist
House of Glass 