Last time on the Summoning, we met the other inmates.

Did we wash the guys’ underwear, too? I really hoped not.

You could worry about that, I suppose. I’d be more worried about them messing with my clothes when it’s their turn, given the relative thieving tendencies, unless the laundry is a girls only job, which only raises new issues.

Suddenly, she hears a voice calling to her, but she refuses to pay attention to it, instead checking out Tori’s lace thong.

…Tori is in ninth grade, and the fact she’s here suggests that she’s far from emotionally mature for her age. Why were her parents letting her buy clothes like this?

Chloe just starts thinking about how her own panties are just regular ones and how she’ll need to buy new ones before anyone washes them. Uh. Well, it’s not slut shaming, I think, so there’s that… But it’s more acting like this sort of thing is just normal, like it’s calculated to make its even younger target audience think this is expected.

The voice tells her there’s a closed door. Ooh, now we’re getting somewhere.

I looked at the closed door. The one I’d noticed earlier, which was proof that the voice was really just my overactive imagination.

If she actually wanted proof, there’s a number of ways she could try it. I designed a related experiment while discussing proof of god, as I admitted that yes, just God talking in my head wouldn’t convince me it was God and not me going nuts. What you could do to find out if the voices were external was ask them about something you can’t see, then check it out. Granted, if you’re also suffering from visual hallucinations that isn’t completely foolproof either, but those usually don’t also have a tactile component.

So in this case, I would tell the ghost I believe it’s a hallucination, and that if it wants me to treat it otherwise, I need it to tell me something I didn’t see. If it can’t think of anything or something, I’d do something like grab a piece of clothing without looking, then ask what color it was. It is, of course, possible I’d get it right by chance, so this wouldn’t prove it in the first test, but that’s not the goal, the goal is just getting it wrong to prove I can safely ignore the hallucinations, and it’s pretty likely I would.

Ha! Now there was a classic movie scene: Just come look behind the closed door, little girl. I laughed, but the sound quavered, squeaking at the end.

Chloe, instead of my plan of how I’d disprove the ghost, then decides to prove it isn’t real by trying to open the door. Now, it’s perhaps unfair to say this is a sign Chloe has an IQ more commonly found among algae. See, one symptom of schizophrenia is disordered thinking. That might be the reason why, when the possibilities are either real ghost who’s lurking behind a door or hallucination lurking behind the door that she won’t be able to distinguish from a real ghost because that’s kind of how hallucinating works, she thinks the solution is to open the door.

Anyway, it turns out the door’s locked. The ghost just tells her to find a key, and she says nope, “The door is locked and I’m going upstairs,” which is reasonable if we assume her main issue here is laziness and not any concern about how her brain is malfunctioning.

She turns to go and she walks into Derek. Derek is surprisingly good at sneaking around for someone built like a brick shithouse. He wants to know who she was talking to.

She says herself, which he naturally doesn’t believe. So he’s read the script too.

It’s not that unusual for people to talk out loud when they’re stressed. People don’t start off talking to themselves most of the time, and they don’t usually do so idly, but what Chloe’s doing here is exactly what I’d expect from someone stressed out in an empty room, narrating what she’s doing. Her sentence isn’t addressed to anyone. There isn’t even the implication of a conversation, like there would be if she’d said, “See, the door is locked.” or “I’m going upstairs now.”, both of which would still be within reason for people to say to themselves.

If Derek is supposed to be able to tell she was talking to someone, here are some better options: “I’m sorry, I can’t.” “You’re not even real.” “I’m not stealing the key because you told me to.” “Leave me alone.” and anything along the lines of “Shut up.” Those are all things you say to other people.

Speaking of leaving, that’s what Chloe tries to do, but Derek gets in her way. Derek has read the script, so he’s sure she’s talking to ghosts down there and he asks what they look like and if they talk to her. Chloe snarks about the ghosts wearing sheets and Derek lets her go.

Then it’s therapy time, finally.

Dr. Gill was a small woman with a long rodent nose and bulging rat-like eyes that studied me as if I were the rat

It’s a change from fat, at least.

We find out Chloe’s gone to therapists before, two in fact, to deal with her mom’s death. (She didn’t like the first one and complained so they got her another one.) Despite that, she acts like a kid without any experience with them, because she just lies and says everything’s fine and she understands that she’s crazy and belongs here so she can get better.

Then finally, we get her official diagnosis.

“Y-you think I’m schizo?”
Her mouth tightened. “We don’t use that word, Chloe. In fact, we prefer not to use labels at all. But a diagnosis is a necessary part of the process. A patient must know her condition, understand and accept it before we can begin treatment.”
“B-but I just got here. How c-can you know already—”
“Do you remember at the hospital? The doctors you spoke to? The tests they ran?”
“They found schizophrenia?”
She shook her head. “While scientists are working on a way to definitively diagnose schizophrenia, we don’t have anything conclusive yet. Those tests, though, ruled out other possibilities, such as tumors or drug use. Taking those results and combining them with your symptoms, the most likely diagnosis is schizophrenia.”

This is actually total bullshit.

In order to diagnose someone with schizophrenia, at least two major symptoms need to be present for at least a month. Chloe has one symptom which has been present one day. In addition, they need to display a major problem in daily functioning. And there need to be signs of either of those two things for a minimum of six months. Upon examination, schizophrenics will almost always have general cognitive issues preceding the full blown symptoms, and the disorder usually develops slowly. Incidentally, this disorder is also far more common in men than women.

Chloe’s symptoms seem to best match brief psychotic disorder. The symptoms of that are the sudden onset of one or more symptoms for a period as short as a single day, and ending within a month. This disorder is far more common in women than men. Treatment is hospitalization for safety reasons, because the negative symptoms appear rapidly. Tranquilizers are used in the event of panic, and as a last resort, antipsychotics can be used if their symptoms are debilitating, but should never be used for more than a month.

There are also a number of other psychotic disorders which include hallucinations,. Chloe isn’t showing the other symptoms for most of those, true, but neither is she showing the other symptoms for schizophrenia.

Gill wants to know if Chloe has any idea what that is, which is dumb because she’s doing the usual horrified gaping people do at the idea of having it. But then Chloe proves her right by saying “I’ve seen A Beautiful Mind.” and then saying it’s based on a true story, because a film student would really think that “based on a true story” means “a documentary, but with movie stars”.

Dr. Gill continued. “What you are experiencing is what we’d call undifferentiated schizophrenia, meaning you’re displaying a limited number of the primary symptoms—in your case, seeing visions and hearing voices. Visual and auditory hallucinations.”

Hallucinations only count as one symptom and you need two. The exception is if the voices are constantly present or arguing with each other, neither of which apply here.

It’s like catching a disease in its early stages, when we have the best chance to minimize its progression.”

And honestly, the success rate with schizophrenia is pretty awful. There’s some evidence the anti-psychotic medications, which work very well at first, end up actually causing the relapses later, because people in developing countries without access to them seem more likely to show eventual improvement. That’s without the fact that the drugs have nasty and sometimes fatal side affects. Also, they haven’t gotten it in the early stages, she’s already showing a full blown psychotic symptom that they seem to think are going to be her only one.

“And get rid of it.”
A moment of silence as she fingered a long corded necklace. “Schizophrenia … is not like the flu, Chloe. It is permanent.”

In addition to the brief psychotic disorder that fits her perfectly so far, there’s schizophreniform disorder, where the disorder is present for between one and six months. Like BPD and unlike schizophrenia, it also has a relatively fast onset.

So no, there’s no reason to think this is permanent.

Gill disagrees with me and starts saying it’s like asthma. With lifestyle changes and medication, it can be controlled and you can lead an otherwise normal life, to the point where no one will realize you have it unless you choose to tell them.” Well, unless you’re in the 40% of people who relapse despite following their drug regimen perfectly. Or start off in the large group of people who find the drug can only reduce their symptoms, not suppress them entirely. Or you develop a bad reaction and have to go off them. Or…

I had more questions. Did it usually happen this fast, with no warning? One day you’re walking around, totally normal, and the next you’re hallucinating and running screaming through the halls? Then, bang, you get told you have schizophrenia, case closed?

So in short: no. This goes well beyond gross incompetence into malice. Chloe needs to get out and report them to the authorities.

Gill does at least explain the medication, and yes, they’re antipsychotics. They gave her antipsychotic medication before bothering to tell her what her disorder was, after telling her father that this was just a brief stay. Bear in mind antispychotics can take two to eight weeks to even start working, yet she and her father were repeatedly reassured that this was only a two week evaluation.

Once they had the dose adjusted, there shouldn’t be any significant side effects, but at first I might experience partial hallucinations, depression, and paranoia

…those are not actually the side effects of giving it to a schizophrenic. Those are the side effects to giving it to someone who isn’t.

The actual side effects tend to be muscle related, such as spasms or rigidity.

Chloe asks about group therapy. Nope.

at Lyle House, we believe that privacy is critical. You need to fully accept your condition before you’ll be comfortable sharing it with others.
…
“And that leads to our final topic for today. Privacy. As I’m sure you’ve guessed, all the residents here are coping with mental issues. But that is all anyone needs to know

…so there’s no shame in the disorder but let’s not talk about it. Why are they even keeping kids together (and enforcing interaction on top of that) if they’re so concerned with privacy?

Anyway, Chloe says it’s too late for that, they already know. Just. . . someone knew about me seeing things. Ghosts. Which I never said. To anyone.”

So, confirmation that characters are peeking at the script.

I have a good idea who it was. She must have been eavesdropping when we were discussing your hallucinations and jumped to her own conclusions about …” A dismissive wave of her hands. “Ghosts.

…that isn’t actually a real explanation. There’s no reason hearing about Chloe’s hallucinations should have led to Tori thinking ghosts and not hallucinations. Seeing stuff that isn’t there is already a perfectly good attack.

Chloe doesn’t mention the fact the large scary boy keeps sneaking up on her, either.

Dr. Gill said it was just a matter of taking my meds and learning to cope. If it was that easy, why were there people wandering the streets talking to themselves? Crazy-eyed homeless people shouting at thin air?

I’m glad you asked that, Chloe. What it really comes down to is the deregulation of mental health services in the country. See, unlike you, they don’t have rich parents to send them to the weird kid summer camp for diagnosis and medication, and if they can’t afford it, they don’t get it. Blame Reagan. It’s actually a very serious issue and you’re not even listening to me in favor of wallowing in your own misery.

Since bed is off limits for wallowing, she picks the media room. Simon prances in.

He looked happy.
How could he be happy here? Comfortable, maybe. But happy?

Well this is just a thought, but he is taking medication, so that could be it.

He notices her and warns her that she shouldn’t sit around sulking, they don’t like it. It’s best if she hangs out with the rest of the kids and talks to them. Chloe wants to tell him about her new diagnosis, but…

his gaze had already shunted to the door. Sure, he thought I should hang out . . . with someone else. He was just giving advice to the new girl.

Well, it’s not like she was giving any sign she wanted company, and anyway, he’s not obligated to hang out every second. She does not, of course, manage to say she wants to talk. Simon then asks Chloe if she wants to go outside with them, but Chloe knows he doesn’t mean it because he doesn’t stick around to wait for her answer. God she’s whiny.

Derek stands around for a while staring at her, and Chloe’s sure it’s because he thinks she’s a dumb freak.

Chloe leaves and mommy nurse sends her off to do more chores, peeling potatoes this time. It’s like they’re disappointed at her lack of stabbing initiative and are giving her a second chance.

Before I started, she gave me another pill. I wanted to ask when I could expect them to start working, but if I did, then I’d have to admit I was still hearing voices.

First, she doesn’t have to admit it, she can just ask in general, because they have no idea how often her hallucinations are happening yet because they inexplicably rushed the diagnosis. Second, they’re already convinced she’s crazy and needs to be medicated, admitting she’s crazy and needs to be medicated isn’t going to change their opinion. Third, since she’s decided to go for the faking it option, she needs to know when the medication is supposed to kick in so she can start pretending then, because if she acts cured immediately when the drugs take longer to work they’ll know she’s pretending.

Suddenly, a scream! It’s not from a state inspector seeing Chloe holding a sharp object. Chloe pokes her head out to see Liz rushing off sobbing.

“Enjoying the show?”
I jumped and caught Tori’s glower before she hurried after her friend.

I really do think Tori’s not that bad of a person.

The teacher is shouting. (EEEEEEEEEEEVIL nurse continues to be pretty sane and competent seeming and is trying to get her to calm down.)

“I expect some behavioral problems tutoring in a place like this, but that girl needs professional help.”

So, I take it we have confirmation that this place is not actually a valid hospital, private or not, because professional help is exactly what Liz should be getting already.

“She threw a pencil at me. Whipped it. Like a weapon. Another half inch and she’d have taken my eye out. She broke the skin. Blood. From a pencil! All because I dared to suggest that a tenth grade student should be able to understand basic algebra.”

…the very, very unqualified teacher, from the sounds of it. That last line would be pretty assholish in a normal setting. With already stressed kids, ones you’ve been working one on one with for some time and should know their limitations, it’s coming off outright abusive.

And from the sounds of it, Liz wasn’t premeditating any of this and is currently crying, so at a guess, the teacher was ignoring all the warning signs that she was being pushed way, way too far. I did say earlier that a problem is that mentally ill people can overreact or not give clear signals, but anyone hired to work with them should know to be more attentive because of that. I’d expect someone with just basic special ed training to know this.

If Liz has problems with outbursts, she should be allowed to leave whenever she’s getting overly stressed, instead of feeling like she has to attack another person to get away.

As he looked down at me, I expected some sarcastic comment about eavesdropping, but he only muttered, “Welcome to the madhouse,” then brushed past me into the kitchen to swipe an extra snack.

You know, the adults and Simon claim the kids are friendly, but I’m really not seeing it.n