The fellow laughed aggressively and said, “Wadaya want, Rabbi? You trying to save his soul?”

My new patient Yonasan Goldberg, an adult male with treatment-resistant chronic schizophrenia, believes that I’m Eliyahu Hanavi. He spends his days at the local aquarium talking to the cuttlefish, yet he feels threatened by an alleged neighbor he’s convinced is wicked King Achav — Eliyahu Hanavi’s nemesis. With Yonasan so clearly and totally delusional, it’s hard to decipher the parts of his life that are real. Actually, it’s often a fine line for all of us. PART II

I was considering various therapy protocols for Yonasan, wondering if he’d respond to any of them,  when he swept into my office and handed me a business card. It said “Yonasan Wilkes Sleuth: Gumshoe and First-Rate Mensch.”

“I thought you would want proof that it’s me,” he said. “It’s not like I’m in the witness protection program or anything like that.”

I was having a hard time following his train of thought, but hey, as long as he wasn’t dangerous….”

“It’s just a really good name. Goldberg is boring, and Yonasan Wilkes Sleuth sounds like John Wilkes Booth, you know, the guy who assassinated Abraham Lincoln. Besides, all the other good names were taken.”

“Yonasan Goldberg was available,” I offered.

“You’re right, I guess it is again now that I’m not him anymore,” he said as he handed me another card to prove his point.

“Why ‘Sleuth’ instead of ‘Booth’?”

“Because I’m not an assassin, Dr. Eliyahu. I’m just a humble first-rate mensch.”

“And a gumshoe?” I asked.

“Well, I am a bit of a detective. I like to help people find stuff that they’ve lost. That’s why I can’t figure out why wicked King Achav hates me so much — he’s always telling me that I should just kill myself,” Yonasan let me know.

This was a bit concerning, as I still wasn’t sure if “wicked King Achav” was a real person or some sort of delusional exaggeration, or a hallucinatory misperception. I was pretty sure I’d never know what was true and what was fantasy with my patient.

“That must feel terrible, Yonasan,” I replied empathically.

“Not just terrible, Dr. Eliyahu,” he said. “He makes me feel like a ferklemptomaniac — that’s a word I made up. You like it? It means that he’s stealing away all of my life force…. Hey, oh my gosh! I think I hear him right outside the window in your office — that terrible wicked King Achav! Ferklempt! I can’t even come to my appointment with Dr. Eliyahu without him tracking me here to torture me!”

And with that, Yonasan sprinted through the waiting room without even a thought to shut the door behind him.

I had heard the workers outside of my office window schmoozing with each other but didn’t find it as threatening a stimuli as Yonasan must have. I had no idea what to make of the situation, but it was clear I needed to follow him outside to at least help to avoid a confrontation.

By the time I ran out of the main door and caught up with him, I was too late. Yonasan was in the process of being berated by a middle-aged fellow with a shaved head. The man was covered in tattoos, drinking a cup of coffee and smoking a cigarette on a work break — while laughing at Yonasan.

“It’s not nice what you do to me, telling me the cuttlefish are all angry at me — you know I love the aquarium and you’re ruining it for me!” my patient yelled at the muscular fellow who flicked a lit cigarette that hit Yonasan in the shoe and scared the daylights out of him.

“Wicked, wicked King Achav!” Yonasan yelled back and started crying as the man pretended to strike him.

Yonasan fell to the floor. The nasty fellow was laughing as he watched my patient curl into a ball on the sidewalk, then he picked up his drill and went back to work fixing the gutters on my building.

I helped Yonasan up and sat him on the bench outside.

“Don’t waste your time, that guy is totally crazy,” I heard the voice over my shoulder.

“You know him?” I asked as I turned around.

“Of course I do. He’s my crazy neighbor who goes to the aquarium all day long. I tell him to just kill himself already but he never listens to me.” The fellow laughed.

The fellow looked menacing and I wondered if I should be concerned about my own safety. But then I stood up a bit taller, and in seconds it was clear that while the fellow looked tough, he wasn’t so young anymore, and was a bit flabby.

“You shouldn’t say those things to this fellow, he’s a pure soul,” I tried to reason. “Just let him be.”

The fellow laughed aggressively and said, “Wadaya want, Rabbi? You trying to save his soul?”

Yonasan stood up from the bench and yelled feebly, “He’s not a rabbi!  He’s my doctor!”

The man stood a bit taller himself and, eyes wide, said to me, “You must be a terrible doctor if this retard is your patient. And you must be crazy yourself if you think you can tell me what to do.”

He began to roll up his sleeves and there it was, in big letters on his arm: “Achav.”  Yonasan was right, this was a wicked man.

“Look, no one needs to hurt anyone,” I said calmly, noticing his balled fists and bulging biceps. Luckily, I had my licensed weapon on me. Sometimes, just seeing it is a deterrent.

“You gonna shoot me, Doc?” Achav questioned, noticing that I was armed. I hadn’t made any moves suggesting I would ever think of using my firearm, but Achav was obviously a man of conflict and used to noticing who was carrying what.

Achav stared at me silently, but drawing my gun on another Jew was something that had never crossed my mind or would never even joke about.

I’m not even sure where the next words came from — probably the most ridiculous thing I’ve ever said to another person: “You don’t want to mess with Eliyahu Hanavi, because I’m capable of things that go far beyond the laws of nature.”

Achav looked at me, looked at Yonasan, and then thought for a moment before deciding I was the craziest person out of the three of us.

He backed away, muttering to himself, “Bunch of maniacs — they’re not even worth my time.”

Achav gathered up his tools and returned to fixing the gutter.

“Don’t you ever even look at him again, Achav,” I growled as I took Yonasan by the hand and walked back into my office.

“I knew you were Eliyahu Hanavi! I knew it!” he cheered as he closed the door behind us.

I certainly wasn’t Eliyahu Hanavi, but the Achav outside was definitely a wicked fellow.

“Can you get a taxi to take me to the aquarium, Dr. Eliyahu? I want to tell the cuttlefish that you conquered wicked King Achav!”

At this point I didn’t know what was real and what was fantasy, delusion, or hallucination. But sending Yonasan off to the aquarium sounded like a good idea in the meantime.

to be continued…

Identifying details have been changed to protect the privacy of patients, their families, and all other parties.

Jacob L. Freedman is a psychiatrist and business consultant based in Israel. When he’s not busy with his patients, Dr. Freedman, whose new book Off the Couch has just been released in collaboration with Menucha Publishers, can be found learning Torah in the Old City or hiking the hills around Jerusalem. Dr. Freedman can be reached most easily through his website www.drjacoblfreedman.com

(Originally featured in Mishpacha, Issue 870)