Indicating the chair across from her, Lisa sat down and faced Jun. "Any information you could give me will be extremely helpful, so I appreciate your speaking with us."
"Of course." She fidgeted nervously in her seat, obviously uneasy.
"Where do you both live?"
"In Japan." She corrected herself. "Actually we used to live in Japan but for the last six months we've been traveling all over Europe."
"And where are Kazuya's parents? Does he have brothers and sisters?" When she seemed uncomfortable, Lisa, urged, "Jun…"
Reluctantly, she admitted, "His mother died, I don't know how, but it was when he was a baby. And his father…His father…"
"Go on."
"Please don't tell him I told you this, he'll hate me!" she pleaded.
"I won't tell him," Lisa promised solemnly.
Staring at the floor, she said, "I met Kazuya when I was five. He was vacationing near my home with his grandfather who was taking care of him. We were playing together and all of a sudden, Kazuya's father picks him up and carries him to the edge of the cliff that I lived by. He told him that if he was truly his son, if he threw him down that he would be able to climb back up." Her voice shook. "And then, just like that, he threw him over! I don't know how, but somehow he survived and he came to stay with me and my father, but he's been acting stranger and stranger with every passing year."
She hadn't expected such an interesting story. "How so?"
"Well, the year immediately after the accident, sometimes I'd catch him saying things like, 'Who's there?' or 'Who said that?'. It became more frequent the year after that and then he decided he wanted to go train in a karate dojo in another part of Japan. He was away for almost nine years before I saw him again. I thought he was just visiting but it turns out that his sensei kicked him out of the dojo. I'm still not sure why. Kazuya said it was something about him being evil and then he spent the next two years wandering Asia participating in different fights."
Lisa was trying to take down what she was hearing as quickly as possible. This was probably one of the most interesting cases she would ever see in her life. "And what was he like when you saw him after nine years?"
"Different. So Different." Her voiced revealed that she was troubled deeply by the change.
"Go on, tell me more."
"He was so…I don't know…"
"Withdrawn?" Lisa offered.
"Exactly!" Jun was amazed that she seemed to already know what she was thinking. "And he spent a lot of time mumbling to himself."
"Was he talking as if someone was there but no one was?"
Jun's eyes widened. "Yes! How did you know?"
Lisa jotted down a few more sentences and looked at Jun. "Has Kazuya ever spoken about hearing voices when no one else could hear them?"
Her ability to describe Kazuya's behavior in spite of never having met him was beginning to frighten her. "Yes. He…he said that it was a devil or spirit that talked to him, but only he can hear it because the voice is inside his head."
"And what does this voice tell him?"
"He says that it takes care of him, that he's a friendly presence."
"And how old was he when he first met this 'devil'?"
"It was after he was thrown off the cliff by his father."
"I see. Does he seem suspicious or paranoid at all?" she asked, scribbling a few more notes.
Jun thought for a moment. "You know, come to think of it, he was always closing his door and when I asked him certain questions, he seemed to not want to answer."
"Interesting," Lisa noted. "And his demeanor, his expressions, were they atypical in anyway?"
"Well, he seemed kind of…apathetic or indifferent."
"Flat?" she suggested.
"Yes, that's a good way to describe it." Unable to continue in this vein, she nervously asked, "Doctor, what is going on? What's happening to him?"
Unsure whether or not she should inform the girl of what was at the top of their differential diagnoses, Lisa decided it was only fair to at least warn her of the possibilities, but given the extra history she had learned, the outlook was not good. "Jun, do you know what Schizophrenia is?"
"What's that?" she asked blankly.
"It's a psychiatric condition caused by an overproduction of the neurotransmitter Dopamine. The excess Dopamine causes a psychosis that is characterized by paranoia, disorganized thinking or catatonia. The patient often has severe delusions and a loss of what we call reality testing. They tend to see or hear things that don't actually exist and sometimes these visions or voices tell them to do disturbing things."
Jun recalled how Kazuya refused to answer her when she asked what he and his demon talked about. "How can you tell if someone will have it?"
Lisa leaned back in her chair. "Well, often times the psychosis, which is referred to the positive symptoms is preceded by a long prodromal period of negative symptoms. These include social isolation, neglecting aspects of self-care such as eating, bathing, changing clothes and things of the like. Sometimes the person becomes extremely suspicious and also appears to have a flat, somewhat emotionless appearance. Does this sound like Kazuya to you?"
Nodding, she looked disturbed. "But this would mean that he began becoming sick at the age of five. What does that mean? What caused him to get sick like this?"
"This type of illness is genetic, but often severe stress can precipitate a psychotic episode. Unfortunately, as he was so young when it happened, this means that he will likely have an extremely severe form of Schizophrenia. The younger the age of onset, the worse the prognosis and the greater the resistance to the treatment."
Tears began to form in her eyes. "There must be some way to treat it!"
"Well, there are medications but unfortunately they have a lot of problematic side effects to a lot of patients have a hard time taking them." Seeing her expression, Lisa knew that Jun would require some time to process the news she had just been bombarded with.
Drawing in a shaky breath, she steadied herself. "Can I – can I see him?"
"Of course." Standing up, Lisa motioned for Jun to follow her and led her to the seclusion room.
Seeing Kazuya bound to the hospital bed, she winced and turned back to her. "Is that really necessary?"
"For his own safety and the safety of our staff, I'm afraid so," she affirmed grimly.
Walking to the bedside, Jun tentatively called, "Kazuya? Kazuya. It's Jun. Are you awake?"
Hearing her voice, he turned his head and startled both women by trying to sit up. "Get me out of here!" he shouted.
"I'm trying, Kazuya," she said in an attempt to appease him. "But the doctors are worried that you may be ill."
"I'm fine! The people here, they want to hurt me. You have to get me out of here. You can't trust them!" He continued to strain against his bonds.
"I'll do what I can," she promised. Leaving the room, she turned to Lisa. "I can see what you mean. I'll come back later and try to convince him to stay a little longer, but I don't know if it will help."
"Thank you, that's much appreciated."
Scribbling some information on a scrap of paper, she handed it to the doctor. "Here is the suite number and telephone of where I am staying. Please call me if you have any further question or news of any change in his condition."
"Absolutely." She tore the bottom half of the paper off and wrote the unit number. "If you have any questions, you can always call the floor and ask for me. Again, it's Dr. Yanagi."
Bowing deeply in gratitude, Jun softly whispered, "Domo," and left the ward. As she stepped outside, she saw a person who looked like Lei walking out of the emergency room. "Lei?"
"Jun? What are you doing here?" He was holding a cold pack to his face.
She went to where he was standing. "I was going to ask you the same."
"Your boyfriend gave me quite the thrashing," he said somewhat sheepishly, pointing to the bruises on his face. "The doctors wanted me to come and get a head scan to make sure that nothing had been ruptured. What are you here for?"
"I came to see Kazuya. He's…there's something wrong with him."
"He didn't seem too well last night," Lei agreed. "Where are you headed?"
"Back to my hotel."
"I'll walk you there," he offered cheerfully.
Jun wasn't sure that it was such a great idea but Kazuya wasn't there so she simply nodded. "Lei, can I ask how old you are?"
"Twenty. How about you?"
"Sixteen." She suddenly felt unbelievably childish next to him. "Almost seventeen."
Lei grinned at her obvious embarrassment. "No worries. Where are your parents?" He knew he'd erred when her face fell.
"They're dead," she said softly. "My mother died when I was very little and my father was killed about six months ago in an earthquake."
"So you're all alone?" he asked incredulously.
"Well, not all alone. Kazuya takes care of me." Again she felt a twinge of remorse when she thought of how Kazuya had acted towards Lei.
Whistling in admiration, he remarked, "Wow. Must be quite an adventure for the two of you."
When they'd arrived at her hotel, she was caught off guard when Lei said, "Well, I guess I'm staying with you."
"What?"
He laughed at the frightened look she gave him and explained, "I'm staying here as well. I didn't mean to scare you."
"I wasn't scared," she shot back defensively.
"Of course not." Putting his hands in his pocket he cocked his head to one side. "Well, Jun. I guess we part here. I'm in 2407 if you ever feel like you need some company."
"Uh, thanks," was all she could come up with. "Uh, see you around."
"Ja-na." He waved pleasantly and got into one of the open elevators.
At the inpatient psychiatric ward at Bellevue, Kazuya was doing his utmost to conceive a way of freeing himself. Oddly, he hadn't had much help from his demon since he had arrived on the unit. Worthless, he thought to himself. Always bothering me when I don't need him and now that I actually could use his help, he's nowhere to be seen. What was even more aggravating was the constant stream of people who shuffled in and out of the room to monitor him. It was starting to make him feel like an animal of some sort being put on display.
"Hey Lisa!" Turning at the mention of her name, Lisa saw one of the other residents beckoning to her from his office door and went to go join him.
"What's up, Chris?" She closed the door behind her. Sometimes the patients tried to sneak in after them in order to attempt to escape the unit.
He grinned mischievously and lowered his voice to a conspiratorial level. "So, any more fun info on the nut job in the seclusion room?"
"Chris!" She shot him a disapproving glance. "Keep your voice down, you ass!"
"What?" He shrugged innocently. "I'll bet you twenty bucks that this guy has a long history of behavior consistent with schizophrenia and I'm dying to know if you found out stuff that supports my guess."
"He does have a really interesting history," she had to admit.
"Interesting as in fascinating or interesting like a bad haircut?" he asked.
"Both actually." She shook her head sadly. "Poor kid's had a really rough life."
Looking at his watch, Chris suggested, "Wanna tell me the good parts over lunch?"
"Isn't that a HIPPA violation?" she reminded him.
"Hey, so long as we don't use names, it's all good," he said, unconcerned.
She couldn't help cracking a smile. Chris was well liked for his quirky sense of humor. "Fine. But don't talk to anyone else about it."
He feigned appearing wounded by her warning. "Hey, I'm all about doctor-patient confidentiality," he promised, making a grave face.
"Okay, okay," she laughed. "Come on. I need some calories."
domo: thank you
ja-na: see you
