Monday, January 6, 1997	10 am. First Session with Peter Hossfeld. Peter Hossfeld, a programmer at SII, came in for an introductory session. He is 27, intelligent, handsome and neatly dressed, with blonde hair and penetrating blue eyes. His complaint is an odd one: he feels spiritually unfulfilled and he is also convinced that he has some variety of physical ailment although with diffuse and non specific symptoms. He argues that at 27 he should be in the prime of his life, and yet he feels tired, blocked, lost, and weak. He just doesn't feel as happy and well as he believes that he should. Peter has suffered this generalized malaise for awhile and, although expressing a disdain for western medicine, has been active in attempting to explore its roots through a succession of new age philosophies and treatments. He mentioned a few in passing: Zen, Shiatsu, Acupuncture, Hinduism, Homeopathy, Rolfing, Transcendental Meditation, Iridology, Colonic Irrigation (yuck!), taking acid, and membership in a number of cults. I got the impression that he could easily reel off many more. None of them evoked more than a passing enthusiasm which then was discarded when immediate relief was not realized. Peter is putting psychotherapy in the same bin--I suspect that he will come to half a dozen sessions and then be disappointed when he does not find the immediate benefits he is seeking. My job, I suspect, will have less to do with diagnosis and treatment of his underlying complaint and more to do with exploring his feelings of personal inadequacy and helping him cope with his obsessive need for outside systems designed to remake himself.
Monday, January 13, 1997	10 am. Second Session with Peter Hossfeld. Peter came in and told me about an "out of body" experience that he had that week. What he related involved an uncontrolled loss of consciousness with autonomic nervous system involvement. Peter has interpreted the experience as a cross over into a higher plane of existence, but I'm thinking of the more prosaic explanations, like epilepsy or a brain tumor. Adult onset of epilepsy usually starts around Peter's age. I ordered some blood work, an MRI, and an EEG. Peter is quite threatened about any questioning of his spirtual beliefs, but I felt it was important not to screw around on this one.
Monday, January 27, 1997	10 am. Third Session with Peter Hossfeld. In some ways, this was a very illuminating session with Peter. In other ways, I feel that he is extremely difficult to reach. The layers of mystical thinking shroud his own emotions so that everything has to percolate through this morass before being expressed. Does his expressions of rapture over the "heaven" he has experienced during his episodes and his desire to return to that place mask an underlying deep dissatisfaction with his own life? And how do I gauge that dissatisfaction when he wraps everything in a generalized dissatisfaction with western culture and society. He is concerned about the depth of the soul--an "old soul" who has been through many previous incarnations is how he puts it--and scoffs at the superficialities of life, and yet the filter of his own genuine personal truths and life experience has been clogged by a glutinous melange of new age philosophies. I was actually surprised that Peter had the tests performed that I ordered during our last session. I figured that he would laugh them off as belonging to an ossified western medical way of thinking. His blood work came back normal. He underwent a 16 lead EEG while awake and unsedated. No nasopharyngeal leads were used. Under photic driving with a strobe light, some spike patterns in the temporal lobe and diffuse slowing were observed, although not enough to identify a deep seizure focus. I am anxious to see the results of the MRI but I am now leaning to a tentative diagnosis of adult-onset temporal lobe epilepsy. Peter told me about his family. His parents were separated when he was the only child and was quite young--(How young?) His father disappeared with little or no contact with Peter subsequent to the separation. He lived with his mother alone until he was a teenager and his mother remarried. His relationship with his step-father was strained mostly because of Peter's resentment at his mother's remarriage. She went on to have two more girls and a boy with whom Peter seems not terribly close. Peter never really felt a part of his mother's new family. Now Peter has weekly telephone contact with his mother, but little other real contact. Peter has friends, but they sound mostly like work or school related social friends. He went to University of California at Berkeley so still sees some of his old classmates. He is also having sexual relations with several women, but he doesn't consider them to be "girlfriend" relationships. Rather, he sees his relationship with these women as that of friends who service each other's physical needs. Marriage doesn't seem particularly relevant to him, especially because he is almost expecting to be dead within a year. He calmly told me that that was the gist of a prediction of a psychic that he sought counseling from, and he didn't even sound particularly upset by the psychic's prognosis. I tried to reassure him, but with a brain tumor still not ruled out, I thought it unadvisable to scrape this calm veneer of ease towards his potential early mortality.
Monday, February 10, 1997	10 am. Fourth Session with Peter Hossfeld. Peter came in today and we discussed the results of his MRI brain scans. I spoke with Dr. Hardaway, his neurologist, late last week and he told me that the radiologist confirms that there is no evidence of cerebral tumor. There is some evidence in the coronal section scans that there is an oblate irregularity at the lateral cerebral fissure near the temporal lobe. I told Peter that while it is not conclusive, the irregularity is consistent with a diagnosis of epilepsy and, then again, is within the realm of the variation found in a typical healthy brain. Peter was not very satisfied with my report. He still feels that, in some deep way, he has had a profound mystical experience connected with the afterlife. He thinks that the brain studies and my diagnosis is just an attempt to deny the profound but supernatural state of being which he has experienced. He believes that I seek a scientific explanation because my mind set, befuddled by western medicine and science, won't accept a true mystical experience. But Peter is concerned that a diagnosis of epilepsy could impact his employment and his driver's license. I explained that the Americans with Disabilities Act prevents an employer from firing an employee over a medical condition so long as the employee is able to perform the job with reasonable accommodations by the employer, and I left the driver's license issue to his own judgment. Peter lost consciousness again last week. He described in some detail what the episode was like. Since he has had three occurrences so far and since all of them happened while he was in front of his computer monitor, I theorized that it might have to do with the monitor's flicker frequency or a combination of the monitor and the fluorescent lights at SII. While Peter was not receptive to the suggestion that we conduct an EEG exam at work near his monitor, he did say that he would take the monitor home to experiment with at his house and see if it brings on another episode.
Tuesday, February 18, 1997	10 am. Fifth Session with Peter Hossfeld. Peter has discovered that he can induce seizures by a combination of his computer monitor and a flourescent light fixture that he rigged up from a hardware store. But he continues to insist that he is a psychic multidimensional travellor rather than an epilepsy sufferor. I can see how the former is more attractive than the latter, but I am concerned that he is strengthing the pathways and making the seizures more frequent and less controllable than before. Any appeals to reason are dismissed as more western medical propoganda. Dr. Hardaway is an "old quack" and I'm too rooted in western traditions to be able to see miraculous occurences when they happen right in front of me. Peter is having an affair with Serena (not her real name), the psychic who told him that he was going to die. Now, she thinks that he may pull through with her help. They are experimenting with tantric sex in between experiments with altered consciousness and herbal teas. She is helping him direct his male energy to build up his strength so that he can deal with the "heavy shit on the spirtual plane." I asked Peter to come back next week, but he was giving no guarantees.
Monday, March 3, 1997	11 am. Sixth Session with Peter Hossfeld. Against my strong advice, Peter is continuing his experiments with self-triggered epileptic seizures. He described a vision that he had where he engaged in a beautiful weightless dance of light and energy over a surreal landscape with a female entity. Serena, his psychic friend and sexual partner, is physically present when Peter is having these seizures. But Serena is not the woman in the vision. She has told Peter that the reason he is having good experiences is that she is providing him protection from the dangers in the psychic plane. But Peter seems to be beginning to wonder whether Serena is holding him back. Serena is taking on the role of a girlfriend as well as spiritual guide. But Peter doesn't welcome that. Despite Peter's feelings, which he hasn't clearly expressed to her, Serena is quite literally moving in on him, causing Peter some distress. He doesn't want to hurt her feelings and, more importantly, Peter believes that she can hurt him through psychic means. Peter explains that he was drinking with a co-worker who was saying some nasty things about Serena. Suddenly, she was there and angry, having overheard what was said. The co-worker left hurriedly and later it turned out that he had been involved in an automobile accident which caused some lacerations to his face. Peter believes that Serena gave him the "evil eye." So how does he explain to Serena that she was a stepping stone to a higher reality and that he is really not interested in a romantic relationship? Peter left the session disappointed with my unwillingness to believe in the psychic explanations for phenomena that he experiences. But Peter seemed to give me a little more credit when I spoke about human relationships and gave him some advice about dealing with Serena.
Monday, March 17, 1997	11 am. Seventh Session with Peter Hossfeld. Peter came in a hunted man. He is afraid to even think improper thoughts for fear Serena is going to divine them. And it is improper for Peter to ruminate on his unhappiness in his relationship with Serena. She has totally taken over his world outside his job. His social life has disappeared--his friends no longer come over. Peter is accountable for every conversation, every action, every thought. He even said that he is going to have to come up with a simulated therapy session which sanitizes our real discussion about his unhappiness in the relationship. Peter feels like he is losing himself to Serena. Even as Peter feels trapped by her, he finds her services so indispensable that he cannot bring himself to free himself from her. By going through past life regression with Serena, which sounded a lot like hypnosis, Peter now believes that he was a Nazi interrogator for the Gestapo in a past life. Peter described his now vivid memory of participating in a brutal interrogation as the torturer. Now, Peter believes that he must overcome the bad karma which springs from his past lives. And Peter seems to believe that Serena is the only person who can help him do that. Peter described me as his "Earth Anchor" which I felt was quite flattering, actually. Peter said that when he gets too far out there, he asks himself what Dr. Balis would say, and it helps him ground himself in reality. But the solution to Peter's problem with Serena might require quite a different tack on my part. I feel more strongly than ever that Serena is both emotionally abusive and has abused the trust which Peter has placed in her to try to gain herself a boyfriend. Serena cannot be simultaneously both a girlfriend and a counselor, even a psychic one. The two never work well together. But even if I am able to convince Peter to leave Serena, then everything unpleasant or difficult in Peter's future will be attributed to the malevolent exercise of her powers. Perhaps Peter must find another whom he invests with even more power than he does Serena, but who will act more in Peter's best interest. Perhaps I can encourage Peter to find another person who can both act as a spiritual guide for Peter's quest and who Peter believes has the power to protect him from Serena's power. Peter mentioned at one point that he desired extra powers for himself that would make him strong enough to hold her off. Perhaps we should investigate what Peter's belief system will allow Peter to believe about attaining psychic power. It would be ideal if Peter thought himself powerful enough to meet whatever threat that being honest with Serena poses.
Monday, March 24, 1997	10:15 am. Telephone Call from Serena LNU and Peter Hossfeld. I got a weird call today. A woman was on the phone and my immediate impression was one of those imperious alien ambassadors from Star Trek. She had this high, sing song voice that didn't really sound human. Or at least she did in the beginning of our conversation. As it continued, she let it drop somewhat, until I could detect a faint New York accent--Brooklyn would be my guess. She was Serena, Peter's psychic, and she has been successful in sinking her tentacles deep into every cranny of his life. Apparently, my interference could no longer be tolerated, and I was told that my services were no longer required. Naturally, I wanted Peter's verification that this was indeed his wish. But she had anticipated that. A cowed Peter got onto the line and said that he really didn't want to continue our therapy sessions. Peter said that he couldn't be pulled in different directions right now because a concentrated focus on the work that he's doing with Serena is necessary if he is to escape the burdens of his past lives. It's unfortunate, because as Peter said in our last session, I was his earth anchor. Without something to keep him afloat, I'm afraid he'll be swallowed whole into a mire of new age mysticism that will lead him deeper and deeper into his epileptic seizures and further away from proper medical treatment for his condition. And beyond his medical condition, he was clearly crying out for help during our last session. I'm sure he would have felt great relief if he had returned home to find that Serena had left for good. But that's not to be. Serena has tightened her grip. I'm powerless, really, to help Peter. I can't force him to stay in therapy and he did seem to be acting under his own volition without duress during our telephone call. I hope that Peter will be able to sneak away and contact me when Serena is not within earshot.
Wednesday, April 9, 1997	E-mail from Peter Hossfeld. I received e-mail from Peter. He's only able to send me furtive messages in this manner, and he's terrified that Serena will discover Peter's "weakness" in any case. Peter says that he feels like a spider being sucked down a slimy bathtub drain--he sounds quite desperate. But while simultaneously maintaining that he is being buried alive, he also praises Serena for all that she's done for him. He specifically mentions that Serena is responsible for convincing him that he has been responsible for many horrible crimes over all his past lives. And he cryptically says that the one thing that Serena wants from Peter, he can never give her. Peter speaks with praise about the Heaven's Gate group, admiring them for their willingness to leave their bodies behind and take "the journey." Peter also writes that Serena says that he speaks in tongues in his sleep. He says that she has heard him speak in High German, Akkadian, and Aramaic which Peter interprets as his going backward through many past lives. Finally, he reports as "progress" that he can have epileptic seizures without the monitor now, by using mediation and "brainwave control." The situation is intolerable. I really have to get Peter back in here for regular therapy. I am deeply concerned that Peter is becoming so wrapped up in magical thinking that he is unable to assess basic health needs. And I can think of no reasonable way to loosen Serena's grip. Even in his e-mail, personal pronouns relating to Serena are capitalized, while those relating to Peter himself are always in lower case.
Friday, April 11, 1997	I sent an e-mail to Peter, for all the good it will do. I begged him to come back to therapy. I also strongly suggested that Serena was hostile to his interests, and that she is creating his evil past in an attempt to make her valuable to him. I suggested that he tape record the ancient languages that Serena says he speaks while unconscious and submit them to expert analysis. I'm not sure, but I think Professor Anderson could handle that--at least he'd know someone who could. But there's no chance that Peter would do that. He's not interested in "western" verification of the matters he takes on faith.
Monday, April 14, 1997	I received an e-mail from Peter Hossfeld today. Peter responds point by point to my last e-mail, but my attempts there were all in vain. Peter will not come back to therapy, and I'm convinced it is because he is scared of Serena. Peter wants me to somehow work in concert with Serena. He begs me not to tear down what Serena and he have been working towards. And that means that he doesn't want to hear anything negative about her. Somehow she has convinced him that he was such a wretched figure in his past lives that he doesn't deserve anything better than slavery in this one. He also doesn't want me to express my concern about his physical well-being, although he is now suffering from blinding headaches in addition to the increased instability of his epileptic seizures. As Peter puts it, Serena has asked him to pay the ultimate price--romantic love--for her services. Peter is unable to love Serena, or even fool himself into thinking that he is in love with her. Even during sex, Peter is forced to simulate orgasm, although Peter also believes that she knows he is faking both his emotions and his emissions. I'm putting off writing a response to Peter, because I'm not sure what to tell him. How can I be true to what I know Peter needs at the same time as I try to participate in this unhealthy farce?
Tuesday, April 22, 1997	10 am. Wrote an E-mail Response to Peter Hossfeld. I acceded to Peter's request and am trying to give him counsel via e-mail. It is an interesting experiment, made more interesting by the prospect of convincing the HMO that they should pay me for this. But no matter...I'm worried about Peter and the depths to which he is being dragged by Serena. I'm unable to give him the support that he wants, but perhaps I can assist him in keeping him grounded a bit in reality.
Thursday, April 24, 1997	I received an e-mail from Peter Hossfeld. Peter now has a story to go along with all the evil things he did in his past lifetimes. Serena has channeled an entity which told Peter that he loved a woman who spurned him and that he then falsely denounced her as a witch. As she was burned at the stake, she put a curse on him that his sould would be tortured throughout infinity. The "work" that Serena and Peter are trying to accomplish is to contact the spirit of the woman that was burned, get her forgiveness, and also the forgiveness of her god--a female entity named Ishtar. Although I sensed a little waivering at the end of his e-mail message, indicating that I might someday succeed in getting him back to a neurologist, mostly he was steadfast in his praise for Serena's work. I have to consider carefully my response to Peter.
Tuesday, April 29, 1997	12 pm. Ninth Session with Eliza Raven relating to Peter Hossfeld. In a series of bizarre coincidences, Eliza hooked up separately at her concert with two of my other patients, Peter Hossfeld and Christina Herald. After the concert, Eliza made contact with Peter Hossfeld, with whom she sensed a psychic connection. She said that she thinks he was the one with whom she had a romantic involvement on the astral plane. Eliza talks about Peter with all the enthusiasm of a preteen girl who has a crush. Peter, in the meantime, seems to think that Eliza is the sorceress with whom he needs to make his peace in order to remove the curse which dogs him through each reincarnation. So Eliza and Peter went off to some all night coffeehouse and talked.
Wednesday, April 30, 1997	Wrote an E-mail response to Peter Hossfeld. I told him it took about 20 minutes to respond to one of his e-mails. So I lied. I'm a wimp. I just felt weird asking Peter for the full amount of my services when he is paying the freight by himself. It's one thing to bill the HMO, and quite another to bill a person in distress. So I'm billing Peter $20 per "session." What a way to get rich--e-mail therapy! I tried to bait Peter a bit by questioning whether certain metaphysical statements were actually suicidal longings and by urging him to consider checking into a mental hospital. In some ways, a voluntary "involuntary" commitment makes sense for Peter. It would free him from the influence of Serena, and he would have a plausible way to end the relationship without blame. The rest of my letter was primarily an attempt to continually challenge Peter to think logically about his situation. I feel that the best I can do with Peter through e-mail is to keep challenging him to stay rational. So I am much more confrontational and abrasive in writing than I would be with a patient who I was seeing in person.
Friday, May 2, 1997	I received an e-mail from Peter Hossfeld. Peter is so caught up with psychic phenomenon that he hasn't recognized a genuine scientifically unexplainable phenomenon that has struck him like a lightening bolt. Peter has experienced "Love at First Sight." I've seen it happen before, and it always floors me. Here, it hit him rather hard and seems to have affected Eliza in much the same way. Peter is trying to explain it by believing Eliza to be the sorceress which fulfills Serena's prophecy, but to tell the truth, I was always expecting the sorceress to turn out to be Serena herself (surprise, surprise), although I believe that Serena, too, will be in for a surprise when Peter tells her that he's located the sorceress in the person of Eliza. I suspect that Serena will dispute Eliza's claim to the throne. Peter has undergone a fairly remarkable transformation in just a few short hours due to his new surge of interest in this life--and Eliza. Love is making him strong. I think that she can do a world of good for him in ways that I have failed. If anyone is going to free Peter from the bondage that he's experiencing with Serena, it's Eliza. Even if the relationship doesn't work out between Eliza and Peter in the long run, in the short run it may win Peter his freedom and his health, if he can get some genuine medical treatment. Somehow, I don't see Eliza as supportive of artificially inducing epileptic seizures. When their relationship becomes more intimate and they tell each other of their therapists, I am sure they'll be surprised to discover that they are both seeing me. I'll have to be careful to keep a wall between things I've learned from Peter and things I've learned from Eliza when talking to each of them. Basically, I have an ethical problem, but now is not the time to try to resolve it.
Monday, May 12, 1997	I sent an e-mail response to Peter Hossfeld. I'm trying to counter his magical thinking and get him to challenge his basic mystical assumptions--that every positive aspect of his life derives from supernatural origins. When Peter first came to me, he complained of feeling spiritually unfulfilled. He suffered from a generalized malaise and had tried to find fulfillment in a number of new age philosophies and treatments. In my earliest notes on Peter, I wrote: "My job, I suspect, will have less to do with diagnosis and treatment of his underlying complaint and more to do with exploring his feelings of personal inadequacy and helping him cope with his obsessive need for outside systems designed to remake himself." Now, Peter achieved his goal, in part. Rather than being an ordinary programmer without spiritual depth, he is the reincarnated spirit of a Babylonian priest of Marduk with a tragic love story, a quest--the curse which must be lifted by the passion of a beautiful maiden. Perhaps I'm overstating it a bit, but Peter is trying to live a Harlequin romance. And what am I offering in its place? Treatment for epilepsy and a return to being like everybody else.
Friday, May 16, 1997	I received an e-mail from Peter Hossfeld. Peter describes meeting Eliza and then walking back to her house. After leaving Eliza with a passionate kiss, he ran into Luke, who was obviously spying on them. Luke said that Eliza and he were going through a rough spot in their relationship, and that Peter was to stay away from Eliza or Luke would do Peter bodily injury. As if Luke wasn't enough of a threat to Eliza, Peter also said that Serena, motivated by jealousy, triumphantly removed one of Eliza's hairs from Peter's coat and disappeared into her inner sanctum, where she was obviously casting magical spells intended to do Eliza harm. While Peter is concerned about the magic that Serena wields, he didn't seem concerned enough to either confront Serena about it or try to stop her. Frankly, I was a bit surprised. Peter seemed weak. But then, he said he's been eating nothing but brown rice and wheat grass juice in an attempt to purge his system of "toxics."
Friday, May 23, 1997	I sent an e-mail response to Peter Hossfeld. Mostly more of the same, with my trying to distance Peter from his magical constructs, although I was particularly concerned about Serena's attempt to use voodoo on Eliza. I told Peter that I believed that he had communicated something about Serena's attempt to Eliza and that Eliza's recent pains might be attributed to her belief that Serena is trying to cause her harm. Unfortunately, they are both magical thinkers and Eliza's problems will probably have to be confronted by using some form of magical remedy. If she was a devout catholic, I'd say use an exorcism. But as a Wiccan priestess, we'll have to find some other appropriate magical methods. Perhaps Peter can help Eliza on that level rather than by confronting Serena directly, which he seems loath to do. I can hope that Peter will try to play the knight in shining armour for Eliza and the prospect of Serena causing her harm will actually give him some backbone and inspire him to stand up to her.
Monday, May 26, 1997	10:30 pm. I visited Eliza in the hospital (related to Peter Hossfeld). I got a call from a Slavic sounding man who identified himself as Eliza's father and told me that she was in the hospital asking for me. I hurried down to the CPMC Cherry Street campus, and found Eliza in the cardiac ward. Apparently, she had been complaining of sharp, undifferentiated pains in various parts of her body and someone thought she might be having a heart attack when she was admitted. She wasn't. This evening, she was having a party at her mother's mansion mostly for the purpose of allowing her to introduce her new friend, Christina Herald, to Peter Hossfeld. Well, seeing Peter at the house must have been too much for Luke, who burst in and started to bodily threaten Eliza. Peter intervened and got Luke away from Eliza, and Luke assaulted Peter. Malcolm happened to arrive in what must have been either an extremely provident coincidence, or Christina is dating Malcolm again. Anyway, his martial arts skills came in handy to immobilize Luke until the police arrived. So Eliza has her restraining order, after all. Eliza wasn't hospitalized as a result of the assault by Luke, although her pains might have been triggered by the assault. I talked to the attending physician, a Dr. Culter whom I didn't know. He said that Eliza's pains were probably a reaction to the shock she experienced. He planned to hold her overnight and then release her in the morning.
Tuesday, May 27, 1997	12 pm. Thirteenth Session with Eliza Raven relating to Peter Hossfeld. Eliza was released from the hospital and came to our session at her usual time. Eliza described in a bit more detail the events at her Memorial Day soirée yesterday. It turns out that Malcolm was there through a romantic effort by Anders to reunite Christina with Malcolm. Eliza doesn't think it likely that Christina will take Malcolm back--both Christina and Eliza feel angry that they were lied to by Malcolm, although Eliza feels grateful that Malcolm saved Peter yesterday. Eliza talked about the possibility that she was the victim of Serena's voodoo. While Eliza discounted the possibility, she also said that the Wiccan Law of Three would ravage Serena if she was, in fact, using her magic to harm Eliza. Essentially, the Law of Three says that the doer of bad deeds receives the same harm back, but magnified thrice. It seems that Eliza is also marshaling her allies on the astral plane to rally to her assistance and is taking steps to strengthen her aura. I'm not sure what all this means in mystical terms, but Eliza is clearly fortifying herself for the battle she apparently must wage with Serena for Peter's soul. Eliza feels like she is being smothered in the emotional problems of others. She became quite emotional over the prospect of being alone--she thinks of herself that way, even despite her blossoming romance with Peter.
Thursday, May 29, 1997	12 pm. Eleventh Session with Christina Herald relating to Peter Hossfeld. Christina came in sporting an impressive black eye. Although I already knew the story from Eliza, I had to pretend that I did not. Luke hit Christina while she was at Eliza's house to meet Peter. Luke burst in and assaulted the people there--especially Peter, whose injuries I haven't heard about yet.
Monday, June 9, 1997	I got an e-mail from Peter Hossfeld. Peter surprised me by giving a fairly accurate description of how he might appear to someone who didn't share his belief in higher realms--he stated that sometimes he feels that way himself--like someone who is distorting everything to fit his assumptions. But Peter has another perspective--soaring aloft over the low petty concerns of humanity, viewing us all as burrowing like ants in the dirt. And he still has Serena to thank, even if she requires such a pittance as his body, his soul, his time, and his money. He gave me a clue, I think, with one line in his e-mail. When I said that Peter should give reality a chance, Peter responded: "Right, back to boring old reality, where i'm a pathetic fool who can't do anything about the mess he's made of his life." Serena makes Peter important in a way that he could never be by himself. But Eliza gives Peter a reason to trade-in what Serena offers for something a bit more emotionally satisfying and tangible. Peter described the scene at Eliza's house where Luke assaulted Eliza and him. He saw Malcolm not as a person but as a karmic force--overwhelming Luke with a blur of motion. He said that he never saw anybody hit in so many places so fast. Malcolm must really be good. Peter, in contrast, thinks of himself as a spineless wimp. My guess is that he is really in love with Eliza. She is definitely the key to bringing Peter back from the brink.
Tuesday, June 17, 1997	12 pm. Fourteenth Session with Eliza Raven relating to Peter Hossfeld. Eliza came in with bandages around her slashed wrists and the heels of her hands. She apparently tried to commit suicide by hacking at her wrists with an x-acto knife. Eliza said that the reason that she stopped herself was that she thought of Peter, crying at her grave site. It's awkward with both Eliza and Peter as my patients, but I think it might be appropriate for me to contact Peter and let him know that it would not be amiss for him to contact Eliza. But that will have to wait. I thought it was my clear obligation to hospitalize Eliza--I think she is at risk for another attempt.
Monday, June 23, 1997	I wrote an e-mail response to Peter. It was the normal attempt to try to bring him back to earth and interest him in human concerns. But I also went quite near the edge in terms of breaching Eliza's confidences--I did suggest to Peter that Eliza needed him right now, and that he should wake up and take a look at what her needs were.
Wednesday, July 2, 1997	10 am. Fifteenth Session with Eliza Raven relating to Peter Hossfeld. I had my first session with Eliza since her release from the in-patient mental health facility at the California Pacific Medical Center. When she was in the hospital, she apparently saw Peter there as well, which could explain why I haven't heard from him for so long. Eliza told me before that she stopped herself from committing suicide after imagining Peter weeping at her grave. Seeing him reinforced that sense of guilt and responsibility. I should stop by and see Peter in the hospital as soon as I can.
Thursday, July 3, 1997	11 am. Visit with Peter Hossfeld at the California Pacific Medical Center. I tracked down Peter at CPMC and went to visit him. I spoke with the resident, Dr. Victor Tessler, who I didn't know. He said that Peter had come in badly undernourished and suffering from repeated complex partial seizures, approximately once every five hours or so. They were concerned that he was heading towards status epilepticus, which can be fatal. Neurologist Susanne Gallagher was brought onto his team. She performed an EEG and did a cardiological work-up and gave a tentative diagnosis of temporal lobe epilepsy. She noted that the seizures were not tonic-clonic. She prescribed Dilantin as an anticonvulsive, 100 mg. (2 tabs) three times daily. But Peter's physical health was also quite poor. He showed considerable bruising near his upper left abdomen just under his ribs. The internist suggested that his spleen may have been involved, especially after a blood test revealed that Peter was suffering from anemia, and Peter told them that he had been assaulted. The initial concern was that he may have ruptured his spleen and was suffering from internal bleeding. But an ultrasound revealed that his spleen was intact, although enlarged. Frankly, I was shocked by how poorly Peter looked, even after a week of hospitalization. I guess even with everything that he had been telling me, I still had an image of Peter in my mind as I last saw him. His complexion is grayish and his cheeks are sunken. When he shook my hand, he displayed an obvious weakness. I detected a bit of tremor in his hands as well. I'm amazed that he was able to actually function at work in such a condition. I had the distinct pleasure of meeting Serena too. She came in and forced the end of my visit. She announced that she is pregnant with Peter's child before rudely forcing me from the room. Serena is about 40 years old. She was wearing a skirt and a t-shirt. She was about five feet tall and pudgy, with very wide hips and legs like hairy little tree trunks. Surprisingly, her arms seemed quite thin. She had some unusual markings on her wrists which might have been tattoos or that Indian henna technique. Her hair was long, bushy, and frizzled--shot through with gray. If in body, Serena was unintimidating, her eyes were something else altogether. They were black, sharp and penetrating, darting around the room. It really felt like she was stabbing at me with her gaze--quite formidable, actually. Her method of announcing her pregnancy was all about manipulation and confrontation--it seemed to be used for an effect, trying to shock Peter and me at the same time, rather than as an attempt to share any joy she felt with Peter. I felt like she was using the pregnancy to tie Peter to her even more closely. With her one announcement, she seemed to accomplish many goals: to destroy any nascent relationship that Peter might have with Eliza, to thwart any efforts that I might be making to get Peter back into therapy, to accuse Peter of plotting against her, to accuse Peter of not doing enough for her, and to remind Peter just how deeply he was in her debt. I felt that it was very calculated. It is conceivable that the pregnancy is a fiction--she is at least forty years old, and Peter told me that he has infrequent sexual relations with her, and when he does, he simulates emission. And her pregnancy was awfully convenient. If she is shamming, her body shape will give her plenty of time to either really get pregnant or to claim that she has suffered a miscarriage--probably in response to some claimed misdeed of Peter's. It was also illuminating that when Peter asked her how she knew about her pregnancy, she didn't mention any pregnancy test or doctor visit. She said that she knew because, as a woman, she was able to recognize the signs. I'm not sure how I can manage to get to Peter through the formidable barricades that Serena has placed in my path.
Tuesday, July 8, 1997	12 pm. Sixteenth Session with Eliza Raven relating to Peter Hossfeld Eliza believes that she may be in love with Peter Hossfeld. They got together at Peter's house--which I imagine was a considerable act of bravery for him--when Serena wasn't there. Eliza was shocked at Peter's physical condition--she described him as skeletal--until she found out that Serena is possibly poisoning Peter by having him drink belladonna and datura. I have no idea what the effects of these poisonous plants would be if ingested, although I seem to recall that belladonna has hallucinogenic properties. Peter was suggestible under the best of circumstances. Serena may be tightening her grasp by fiddling with Peter's wits. If Peter would sign out a complaint, or if Eliza could prove that Serena was actually poisoning Peter against his will, then the police could get involved. Eliza said that she would research that avenue. But she is clearly prepared to go to war with Serena.
Tuesday, July 15, 1997	1 pm. Eighth Session with Peter Hossfeld. Peter gave me a call yesterday and asked for an appointment. He came in wearing a bandage around his right hand. He told me that he had invited Eliza to visit him at his apartment when Serena wasn't there--very much the way that Eliza told it to me. Eliza came there at his invitation and discovered Serena's penchant for growing poisonous plants and keeping them in jars in the kitchen. Eliza apparently found foxglove, henbane, and jimson weed growing in Serena's pleasant little garden. And she also identified the poisons in the kitchen that Serena has probably been making into tea for Peter's consumption. Eliza destroyed much of Serena's garden and dumped her "teas" into the garbage. When Serena came home, well after Eliza had left, she was none too pleased at what she found. Eliza had left some sort of a sign in the garden, made out of sticks and rocks, that caused Serena some considerable consternation. Serena hit herself in her supposedly pregnant belly and said, among other things, "She did it all!" Peter tried to soothe her, but she grabbed his right hand and bit into it hard, breaking the skin. When I saw his hand, it was clearly infected and probably septic. I judged that Peter's hand was in need of treatment without delay. I was able to get hold of Doug Halsey, and he squeezed Peter in for an immediate appointment. After biting his hand, Serena disappeared. Peter hasn't heard from her in about a week--she hasn't even returned to retrieve her belongings. Peter also disclosed several other interesting items: he's taking Dilantin that was prescribed by his neurologist, but Peter believes that he is suffering some cognitive side effects--he said that he feels "fuzzy" including having a fuzzy taste in his throat and being fuzzy minded. He seemed to demonstrate some slight inability to differentiate between dream and waking states. And he's apparently raised the concerns of his supervisors at work, although apparently they are cutting him some slack because of his epilepsy and hope that he'll rebound soon.
Monday, August 4, 1997	1 pm. Ninth Session with Peter Hossfeld. Peter has been fired from his job at SII. While Peter admits that his performance has not been up to par during the period following the beginning of his epileptic seizures, he said that he had been making a special effort during the last couple of weeks to try to focus on his work. However, he believes that someone higher up in the organization had already decided to fire him, and he was particularly unhappy that they gave him a series of reasons for his termination which he believes were bullshit. They said that he wasn't meeting productivity goals and that his termination was the result of a standard cut back--they even held out the possibility that he might be rehired. Yet the project that Peter had been focusing on was the Millennium Bug which, as Peter points out, is unrelated to the normal ebbs and flows of the Company fortunes. Peter's termination has affected him far more than he ever imagined it would. He finds that he thinks about it continually and that the unpleasant thoughts and emotions caused by the termination recur unbidden even while he's meditating. The termination is especially unfortunate because Peter has been making an effort to reestablish contact with his physical life. Now that life is falling apart, making it more likely that Peter will retreat back into a spiritual world fantasy life. Complicating Peter's return to the here and now is that apparently Eliza and he had a fight. Peter said that he finally had an opportunity to see Eliza free of Serena's influence--they had a date. But Peter describes his personal reactions to the evening as completely detached--as if he was watching a robot body go through the motions with Eliza while he remained aloof. He even described the event in the third person. From what Peter told me, it sounded like Eliza was really hurt by Peter's reaction during their date--she left in tears. I wonder if this incident has something to do with why I haven't heard from Eliza in the last couple of weeks. The particular dissassociative reaction that Peter described together with certain cognitive deficits that he's noticed, could be caused either by a drug side effect or, less probably, a drug interaction. In addition to the anti-convulsants, Peter is also taking antibiotics to treat the vicious bite on his hand inflicted by Serena. I told Peter that I would check the literature and see if I found a drug interaction. Peter is clearly in need of substantial help to complete the transition back to reality. I hope that we can establish regular sessions once again.
Tuesday, August 12, 1997	12 pm. Eighteenth Session with Eliza Raven relating to Peter Hossfeld. Eliza sought Peter's company. Peter already described to me how disastrous that "date" really was. Eliza said that, instead of comforting her following her mother's actions, Peter blamed her for ruining his aspirations of becoming a higher-being. When Eliza tried to make it up to him by showing him signs of her physical affection, Peter turned cold. Eliza began to cry. She jumped up and ran out of the house, and Peter, of course, never followed. Eliza believes that Peter hates her and that she ruined his life.
Monday, August 25, 1997	3 pm. Tenth Session with Peter Hossfeld. Peter is clearly depressed, although given his termination from his employment, it is likely caused by external circumstances. He claims not to be interested in going to job interviews because he doesn't feel that he has the right mental attitude. He believes that he is experiencing a "natural low" akin to "hibernation" and believes that it is another rite of passage. He has also become enmeshed in the Internet which he claims to be a substitute for a social life. Although Peter's current withdrawal could be considered a normal transition, I am particularly concerned because of a recurrent dream that Peter told me about: he is an animal, with his right paw caught in a trap, and he finds that he has to chew his arm off. Peter didn't make the connection, but the dream seems to me clearly related to the bite that Serena gave him on his right hand and which still causes him pain. Although he was a bit reluctant to admit it, Peter told me that he believes it possible that the bite has somehow cursed or enslaved him, like the bite of a vampire or a werewolf. He asked me, as his therapist, if I was prepared to drive a wooden stake through his heart. He got back together with Eliza for one date punctuated with apologies and tentative emotional gropings towards one another. They've both been scarred by Peter's "Robot" persona and both of them are taking the renewal of their relationship in slow steps. Peter told me that he was taking aspirin simultaneously with the phenytoin and it's possible that the interaction caused the sense of dislocation which Peter experienced previously.
Friday, October 3, 1997	5 pm. Eleventh Session with Peter Hossfeld. Peter is experiencing a recurring psychotic episode coinciding with the phases of the moon. He believes that he has become possessed by an evil and malevolent entity which wishes to take over his form and commit violent acts. The closest I can come to describing his psychosis is that Peter believes that he is a werewolf, without any of the lupine transformation normally associated with that legend. But as the moon goes to full, Peter feels himself losing control in his continual battle against the monster within. He is beset by auditory hallucinations as an evil voice tells him to commit acts of mayhem against children he passes on the street, or to sexually assault Eliza. To this point, Peter has not actually committed any of these acts, but he feels himself weakening. I diagnose Peter as suffering from a Brief Psychotic Disorder, but with a "culturally relevant" stressor of the phases of the moon. It is culturally relevant only within Peter's peculiar mind-set, particularly his belief in the particular form of Serena's curse. After talking with Peter, I became convinced that he required hospitalization, and he agreed to a voluntary commitment. So I asked him to wait in my reception area while I made the arrangements. I called the Mental Health In-Patient facility at the California Pacific Medical Center and arranged for his admission, but when I went out to get Peter, he had vanished. I've tried calling his home several times since, but with no results. I can't call the police, because I can't honestly say that I believe Peter is an imminent threat to himself or others, although that thought has certainly crossed my mind and I am clearly concerned. I tried to contact Eliza to let her know that I thought it was a good idea that she stay away from Peter for the time being, but I was unable to reach her either. I'll keep trying at both numbers.
Monday, October 20, 1997	11 am. Telephone Call with Sgt. Tracy Keefe of the SFPD respecting Mr. Peter Hossfeld. I got a call from Sgt. Tracy Keefe of the San Francisco Police Department. Apparently, Peter went into the police station on the night of the full moon and confessed to a crime involving murdering a woman by savaging her with teeth and claws. He asked to be locked up before he murdered again. The police complied and tested him for blood stains, but there were none. When no body turned up, they started to doubt Peter's story. The department psychiatrist is apparently booked a week in advance, so when they found out that Peter had been under a psychiatrist's care, they called me. The detective was looking for my assurance that Peter wasn't a societal risk, which I couldn't give, although I did express my opinion that the "murder" was probably just a fantasy. I did request an opportunity to see Peter and the detective said he would comply. In fact, he was quite happy to hear that Peter had private insurance and liked the thought that I might be able to talk Peter into a voluntary commitment at a private mental health facility. If Peter resists a voluntary commitment, I think I now have enough to insist on an involuntary commitment if necessary. I'll await the detective's call.
Monday, October 27, 1997	10 am. Telephone Conversation with Sgt. Tracy Keefe respecting Peter Hossfeld. They just let him go. I finally got hold of Keefe and he told me that they released Peter on Wednesday. Keefe even told Peter that I intended to have him committed. I'm not surprised now that Peter hasn't contacted me. I guess I have little to do but just wait. The authorities are clearly not interested in trying to ward off a crime that hasn't yet occurred--Peter had turned himself in voluntarily, and they never even got him looked at by a psychiatrist. I feel a responsibility to warn Eliza of Peter's current condition, and I'll do so. But if Peter has really turned towards violence, there's little I can do to stop him unless he contacts me.
Saturday, November 15, 1997	10 pm. A Chance Encounter with Peter Hossfeld. I attended an event at the Spectrum Gallery on Harrison Street, which is quite near an entrance to the Bay Bridge. I was walking to my car, which I'd left parked in a vacant lot, when I was nearly knocked down by a group of feral dogs, obviously ownerless mongrels of various sizes, colors, and degrees of reversion to ancestral type. I was startled again when I noticed Peter Hossfeld in the middle of the pack. I haven't seen Peter in quite a long time and I've been worried about him, ever since he was released by the police after falsely confessing to a murder. Recovering from the shock of my encounter with the dogs and him, I shouted his name and brought him up short. His appearance differed from the passable but indifferent style I'd been used to in him, often typical of computer programmers. Now he looked like he hadn't washed or changed his clothes in a month, his hair was snarled and stood up in peaks. His feet were bare and filthy, with long untrimmed toenails; he wore a light patchy beard; and his face was heavily sunburned, interspersed with areas of open scabby wounds which might have been impetigo. In short, Peter resembled many longtime denizens of the city streets, with the addition of a distinctly canine pong which became evident as he moved upwind. During our conversation, Peter sang the praises of living in a dog pack. He's given up on human society and is reveling in the more direct canine interaction that he's found. I thought it was remarkable, actually, how he had been accepted into their society. They waited for him to finish his conversation with me, even though he clearly wasn't leading their group. That honor fell to a large beige dog that might have been a German Sheppard & Labrador mix. Peter told me that he was named Belshazzar and that he was the reincarnation of a king in Babylon. Although I suggested it, Peter refused voluntary commitment--he called it wrapping himself in a drug cocoon--and although I'm most distressed by the turn of Peter's life, I can't say that he must be involuntarily committed. He was not obviously delusional and he was not an imminent threat to others. Peter said if I wanted to find him again, the vacant lot was as good a place as any. As Peter and the dogs left, I noticed that each male dog, in its turn, paused to urinate on certain trees, posts, and fire hydrants. After they were done, Peter followed their example, rather acrobatically lifting his leg as he did so. As I turned to go, I could see him in the distance, carefully sniffing under one of their tails.
Monday, March 23, 1998	3 pm. I received a letter from SII's Legal Department. Apparently, Peter is suing SII for wrongful termination and is citing the American's with Disability Act as his authority. I know that it can't really be Peter. Unless he's gone through a dramatic reversal, in his current state, he couldn't possibly be pursuing a lawsuit. But he could have hired an attorney when he was terminated and these things have a way of grinding on by themselves. Clarence Livingston, associate general counsel for SII, wants me to testify that there was nothing wrong with Peter. I can't do that, but I don't think SII was in the wrong for terminating Peter. I would have preferred that they gave him disability leave, or something, but it seems to me that they were within their rights. Peter was clearly incapable of doing his job. So I'll write back and let Clarence know that I'll testify that he was very sick and that SII probably had cause to terminate him.
Tuesday, March 24, 1998	9 am. I wrote a letter to SII's Legal Department respecting Peter Hossfeld.

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Peter Hossfeld's Patient File
Charles Balis' Notes by Patient



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