Patient File #107

Found this on Reddit and thought I’d share. Therapists have a lot on their plate on a daily basis and they have to work in a broken system that doesn’t understand the need to address the underlying problems and provide proper methods of helping and curing instead of masking. Those at the level where the struggle really happens and where the first line of defense lies, face the ever easy task of getting blamed for the failures of the other layers of the system and this case is a good example of that, other will only go so far before they throw their arms up in the air and give up leaving the burden on someone else…

But last night, the police informed me that they had completed their investigation and found nothing of concern.

Of course they didn’t. Alex knew I’d report him, so he hid everything. Shit.

It reminds of the story – Whose Job Is It, Anyway?

This is a story about four people named Everybody, Somebody, Anybody and Nobody.

There was an important job to be done and Everybody was sure that Somebody would do it.

Anybody could have done it, but Nobody did it.

Somebody got angry about that, because it was Everybody’s job.

Everybody thought Anybody could do it, but Nobody realized that Everybody wouldn’t do it.

It ended up that Everybody blamed Somebody when Nobody did what Anybody could have.

by Dr Harper

I was so relieved to find this subreddit. I haven’t been able to sleep for weeks and I need to get this off my chest.

I’ve been treating Alex for almost a year now, but the vague threats started around Thanksgiving.

He’d fallen in love with a girl named Emma, and she didn’t feel the same way. Typical high school heartbreak. The problem was, he wouldn’t back off. He kept asking her out, and she kept rejecting him.

He ranted about her every week — she didn’t appreciate him, she led him on, her friends mocked him, etc.

I gently suggested that he give her some space, and he burst into a grandiose tirade about how all women are sluts.

This wasn’t the first time he’s gotten angry. That’s why his mom sent him to me in the first place. He had a history of outbursts and antisocial behavior, which led to other students alienating him.

But this was the first time I felt afraid of Alex. There was a frenzied look in his eyes, like he wasn’t really in control anymore. And it wasn’t just anger. It was elation.

When he came back the next week, he seemed much calmer, but that only made me more uncomfortable. I tried to casually comment that he seemed happier this week, and he told me that he had “figured it all out“.

I asked him what that meant, and his only response was a slight smirk.

You know that feeling in your gut, when you know something is terribly wrong, but you don’t want to believe it? That’s the feeling that keeps me up at night.

A few months ago, Alex was just an agitated teenager who struggled with making friends. He carried a lot of rage about his dad abandoning his family, but people can work through that stuff. That’s what I’m here for.

But now we’re in a whole different realm.

In last Wednesday’s session, I did something I’m not proud of. Something that could cost me my job. I asked the school receptionist to interrupt our session and bring Alex outside for a phone call.

The moment he left, I reached for his backpack and started digging. Regular stuff, like notebooks and binders. I flipped through the pages and found nothing but doodles and notes.

What was I doing?

I stuck my hand deeper into the bag and felt something. It was one of those old TI graphic calculators. I slid off the cover and tried my hardest to remember my Algebra days from high school.

PRGRM. That’s where we used to goof around.

The first program was called EMMA. I opened it up, heart pounding:

1. WHO



I pressed (1).

Emma, Christine, Sara, Chris. After that, as many as possible.
Need 20+ for top 10.


Probably chemistry. Maybe the library, when she's on her free
period with the other bitches.


December 17. Right before Christmas, like Newtown.
Ruins the holiday for everyone.

Hands sweating, I reached for my phone to take a photo. And that’s when the door opened.

What are you doing?” Alex lunged forward and grabbed the calculator.

Alex, we need to–

You can’t go through my stuff,” he mumbled. Then he packed his bag and stormed out of the room.

Shit. I thought to myself. Shit, shit, shit.

I called the police first. They came over to interview me and said they’d take the report very seriously. They asked if I took photos of the calculator. Nope. Five more seconds would have made all the difference.

Then I talked with the school. They said they’d work with the police to investigate.

But last night, the police informed me that they had completed their investigation and found nothing of concern.

Of course they didn’t. Alex knew I’d report him, so he hid everything. Shit.

We have our next session tomorrow — the last one before December 17.

He still hasn’t canceled.

What would you do if someone told you about 9/11 the day before it happened? Or Newtown? Or Vegas?

How would you stop it, without sounding like a raving lunatic?

Some of you suggested contacting Alex’s mom. I tried, and she told me to back off or she’d get a restraining order.

Some of you suggested I’m terrible at my job, and that I should refer him to someone else. I don’t blame you. Just wait until you hear about my other patients.

Some of you suggested a 5150 (involuntary hospitalization). Probably the best idea, but I’m a control freak, and I think I know more about Alex than anyone could learn in 72 hours. Involuntary anything would only worsen his state.

Some of you suggested I kill him. I’ll be honest, it crossed my mind. Not my proudest moment.

Some of you suggested I stay home today, but I couldn’t do it. I couldn’t be the next therapist or neighbor or friend in the news, reminiscing about all the warning signs, and how the tragedy could have been prevented.

Not when kids were in danger.

To the school’s credit, they hired two armed resource officers, and both of them stood outside my office while Alex and I sat down for our session.

Given the circumstances, I actually couldn’t have felt more relaxed. They already patted him down and took his bag. Plus, every second that Alex spent in here meant he wasn’t out there.

Alex,” I began. “We need to talk about what happened last week.

His head was down and he didn’t speak.

You didn’t cancel our session,” I said. “Your mom didn’t even want you here, but you still came. I have to assume that means you’re having second thoughts?

Alex looked up, but didn’t make eye contact. “I’m not saying anything about last week,” he said. “I know you probably set up cameras.

My stomach turned. He wasn’t wrong.

Okay,” I said. “What if we talk about something else then?

Like what?

I bit my lip and decided to go for it. “Your dad.

Finally, his eyes met mine. They were bloodshot, wide, and exhausted.

What about him?

He left a long time ago, Alex,” I said. “But I think the pain still lives inside you.

I don’t have any pain,” he spat. “I’m glad the asshole’s gone.

What about Emma?” I asked. “When she rejected you, it caused you so much pain. I saw it all month. You were hurting, Alex.

I don’t have pain!” he gripped his chair. “She’s just some dumb bitch. I don’t give a fuck what she thinks.

Anger is a totally normal reaction to pain,” I said. “Especially recurring pain.

Would you shut the fuck up about pain!” He stood up. “I’m a million times better than Emma and my dad — and fucking you.

I took a deep breath and remained seated. “What about the emptiness? The boredom? The loneliness?

What?” He was still standing, but he looked like a caged animal. “What are you talking about?

“Every day, you feel empty,” I said. “Disconnected from the world and people around you. Like there’s no point to it all. What if we could change that?

His face went pink and he finally lowered his voice a bit. “We can’t.

Of course we can,” I said. “Countless people before you have suffered from these wounds, and countless people have healed them.

Hallmark bullshit.

I bit my lip again. Shit, why did I do that? Therapists shouldn’t have nervous tics.

Even if this whole world was pointless and fake, how would harming others help?

They deserve it,” he said. “They’re bullies. They treat me like I’m nobody.

Sometimes, when we’re carrying around abandonment and rejection, we just keep finding more of it,” I said. “But Emma isn’t a bully for not wanting a relationship. So what could you gain from hurting her and her friends?

He thought for a moment and said, “I’d be their God for a day.

But that’s no way to gain power and fame,” I said. “I mean, no one even remembers the names of the shooters after Parkland. We’re numb to it by this point.

He frowned and moved his mouth slightly. I could tell he was trying to prove me wrong, but he couldn’t.

All I’m asking is that you give my way a chance.” I leaned forward. “We can turn that emptiness into wholeness. The disconnection into connection. What do you have to lose?

He paced around the room without speaking for what felt like an eternity.

Finally he came to a stop, and I heard him mumble, “Okay.”

My heart flooded with relief. I had just shoehorned his yearlong treatment plan into a 5-minute session, but at least we were getting somewhere.

Then he added, “But–

No buts. Please. “Alex, I’m fully committed to helping you get to that point,” I interrupted before he could change his mind. “But a quick session like this isn’t enough to resolve lifelong damage. Maybe you’re feeling hopeful now, but that could change tonight, or tomorrow, or next week.

What are you saying?

I looked him in the eyes. “I need you under 24×7 supervision,” I said. “Would you be willing to agree to voluntary hospitalization? I’ll take time away from school to spend every second with you. To help you feel good again.

He glanced at the ground, and then the door. “It won’t make any difference.

Of course it will,” I said. “We’ll–

No, I mean… I’m not the one you need to lock up anymore.”

I frowned. “What do you mean?

Obviously I wasn’t going to get guns inside the school with the guards tailing me,” he said. “So we changed the plan after you found the calculator.

What?” I shook my head. “Alex, who’s ‘we’? What plan?

I’m just supposed to distract you and keep all the guards on this side of the building.”

Distract?” I repeated, heart pounding. “From what?

Until he gets to the library.”

Before the words came out of his mouth, I bolted up and ran for the fire alarm.

But the sirens were already singing.

A few weeks later, once they moved the bodies and resumed classes, I started clearing out my desk.

Yeah, I got fired.

They always fire the therapist when stuff like this happens. “Should have seen it coming,” they say. “All the signs were there.”

No kidding.

But it’s the school’s reason for termination that still burns in my mind: “Reckless behavior resulted in needless tragedy.”

It almost sounded like the whole thing was my fault.

Maybe I was reckless, I don’t know. Sure, it was the opposite of what you’re supposed to do in an active shooter situation. But at least I tried.

If you really want to know what happened after the fire alarm went off, I’ve shared my version of events below. But as you’re already quite aware, it’s not a happy ending.

* * *

Call him,” I said.

What?” Alex raised his eyebrows.

If you really want to stop this, take out your phone and call him.”

He looked hesitant, but he took out his phone. “What am I supposed to say?

Tell him you escaped with one of the officer’s guns, and you want him to wait for you — to join in the fun.

The last part made me sick to say, but this had to sound real.

That’s crazy–

NOW, Alex.

Just as he held up the phone to his ear, one of the resource officers burst into the room. I hurried over to him and whispered, “It’s not Alex.


There’s a second shooter,” I said, as Alex mumbled into his phone. “You need to be quiet and let him make this call.

No, I — I can’t do that.” He stepped forward, but he looked terrified. “We need to wait for the police.”

I moved in his way. “Listen. At best, the library is a sixty second sprint from here. How many unarmed students can a gunman kill in one minute?

He looked around the room nervously.

Alex is just buying time,” I said. “Every second counts. You need to trust me. I know him.”

He took a deep breath and gave me a small nod. I think he was actually relieved that I was taking charge, so he didn’t have to. I could tell it was taking every ounce of courage he had not to run away.

I glanced at his badge and said, “Dave, I want you to listen to me, okay? Everything is going to be okay.

He nodded again.

Dave, where is the other officer?

I don’t– ” he trembled. “I don’t know.

Jesus,” I muttered under my breath. “You’ve called 911, right?

Yes,” he said. “They’re three minutes away.”

I shook my head. “That’s too long.”

I turned back to Alex and he was already off the phone. I missed the whole conversation. Shit.

Did he believe you?” I asked.

I think so,” said Alex. “He said he’s holding twelve in the library.”

I closed my eyes for a moment and turned to the officer. “I need you to give me your gun.”

What?” He shook his head. “No way. What if the kid gets it?

Take out the magazine and give me the gun,” I repeated.

N–No. We need to wait for the police and hostage negotiators.”

For fuck’s sake, this isn’t a hostage situation,” I snapped. “It’s a massacre, waiting for Player 2 to enter the stage. The second he thinks Alex isn’t coming, he’ll kill them all.”


Jesus, do you want to be the next Parkland guard, like your missing buddy? World famous for letting innocent kids die?

His face went white.

Finally. Something resonated with him. It’s hard to manipulate people you’ve never met, but that one seemed to hit the mark.

He shook his head, removed the magazine, and handed over the gun.

Thank you,” I said.

I took the gun and shoved it in Alex’s hands.

What the fuck?” Alex and the guard spoke at the same time.

We’re going to the library,” I said.


Alex, right now, you’re the only thing keeping those kids alive. As long as he believes you’re coming, he won’t hurt them. So he has to believe you got the gun.

He swallowed and accepted the gun.

Good,” I said. “Now let’s go.

We hurried past the guard, who didn’t move or speak another word. It was probably for the best. An officer would only provoke this guy — whoever he was.

As we broke into a run, I said: “Alex, point the gun to my head.”

What? You’re nuts.”

Do it,” I said. “If he’s watching the security feed, this has to look real.”

He did as I said. We ran through the hallway as the alarm blared: Active shooter… This is not a drill… Take cover…

Now, I had just sixty seconds to figure out two things:

Who was the other kid? And what did I need to know about him in order to manipulate him?

Did Alex really want to stop this, or was he still playing me? He was clearly capable of fooling me, but I really felt like his breakthrough earlier was genuine. Or maybe that was all just part of the distraction. But he told me about the distraction before the alarm went off.

Alex, I need you to tell me everything you can about this kid,” I said. “Who is he? What’s his name? How did you meet him?

Uh– His name is Ian. I met him on a forum a month ago.

You were there to talk about Emma?

Yeah.” He was already out of breath. “And Ian understood me. He went through the same thing.

Does he go to this school?

No,” he said. “He’s older. 24 I think.

And he wanted to help you plan this?

It was his idea,” said Alex. “He said it would make everything right.

It explained so much… Alex’s rapid descent into darkness last month. The sudden calm. And the ancient graphing calculator, which students never used anymore. I had to admit, it was a clever way to communicate without leaving a technical trace.

Alex, I need you to tell me the truth.” I tried to catch my breath. “Do you really want to help stop this, or are you still messing with me?

He didn’t answer immediately. “I guess I want to help.”

That wasn’t convincing.

I got the sense that Alex didn’t even know what he wanted to do yet. And that scared the hell out of me.

Because all the stuff I said in my office, it’s true. You can feel better. I promise.” Then I added, “You know Ian’s exploiting you, right? He’s just using you to play out his own fantasies.”

I felt like a lawyer, trying to make my case, to convince the jury to take my side.

Alex nodded, and that was it. Our sixty seconds were up.

We turned the corner and slowed down in front of the library doors. I peered through the glass and saw a group of students huddled by the reference desk. Ian towered over them, pointing his gun.

Walk me in there, and keep the gun at my head,” I whispered. “Tell him you want me to watch them die, so I can see what a failure I am.

What the fuck is wrong with you?” Alex whispered back.

Just do it,” I hissed. Then I pushed open the doors and we walked inside.

Ian quickly turned his gun to us.

Why’s the shrink here?

To fuck with our heads,” said Alex, lowering his gun. “Like I said on the phone, don’t listen to a goddamn word the snake says. Now give me something loaded.

What the hell, Alex?

Alex and Ian gave each other big smiles, then walked toward one another and embraced.

The Glock 19, right?


Ian handed Alex the gun and turned his attention back to the group of students. I quickly scanned the group, and that’s when I saw Emma.

My heart sank. Why was she here? I called her father last night to warn him. Who would send their kid to school after that? He, of all people, should have known better.

It was easy to see why Alex fell for Emma. She was beautiful, but in more of an innocent, unassuming kind of way. She cowered with the other students, tears streaming down her cheeks.

The cops are going to be here any minute,” said Alex. “Let’s do this.

The students whimpered. Emma let out a loud sob.

Shut up, bitch!” Ian shouted.

She cried again and buried her face in her hands.

For just a second, Alex actually looked upset.

And that’s when I realized that Emma being here was actually a good thing. I wasn’t the one who needed to manipulate anyone.

Alex, she needs you,” I said gently.

He spun around and pointed the gun at me. “Enough out of you. You’re going to watch us kill every single one of them. Maybe that’ll finally shut that fucking mouth up.”

Look at her,” I continued. “She’s in distress, and you’re the only one who can save her.

He lunged forward and hit me in the face with his gun.

Shut. The. Fuck. Up.”

But even from the ground, I persisted. “You can save her, Alex. You can be her hero.”

I looked at Emma and raised my eyebrows, trying to imply that she should play along with me.

She gave me a pained look and closed her eyes.

Please save me, Alex.”


Finally, I saw it. The softening of Alex’s face. Just like in my office before.

Dude, just kill the whore,” said Ian. “Don’t you remember what she did to you?

Please save me, Alex,” repeated Emma through tears. “I need you.”

Are you fucking kidding me with this shit?” Ian laughed and pointed his gun at Emma. “Here, I’ll get us started.”

Emma screamed.

Then there was a gunshot.

And before I could piece together what happened, Ian was laying on the ground next to me, a pool of blood forming around his head.

I looked up and saw Alex standing over us, white as a sheet.

You did it,” I whispered. “You did it, Alex. You saved her.”

His eyes brimmed with tears, but I knew he wouldn’t cry.

Alex, you’re her hero. You rescued Emma.”

His face stayed soft, exactly the state we needed to keep him in until the police got here.

I knew I’d be in huge trouble, but in my book, one dead murderer was better than twelve innocent students.

Call it reckless if you want, but as the sirens closed in around us, I knew I’d sleep soundly tonight.

If it wasn’t for that next fucking gunshot.

Before I knew it, Alex had fallen on top of me, and I felt something warm spilling all over my chest.

What the–

I looked up and saw Emma standing above us.

He’s not my fucking savior!” she screamed.

Emma, I need you to calm–

He’s a stalker and a psycho!” she sobbed. “He made me afraid to come to school.

I understand,” I said, still on the ground with Alex bleeding out on top of me. “Can you drop the gun, so we can make sure no one else gets hurt?

I’m not dropping it.” She shook her head. “When you called last night, my dad gave me his gun and told me to use it if anything happened. You should have stopped this. You shouldn’t have used me like a pawn. I don’t trust you. I don’t trust anyone.

Her dad was in the military. He must have taken the threat seriously after all.

You’re safe now, Emma,” I said calmly. “I promise.

She wiped her eyes. “I don’t even know what ‘safe’ feels like anymore.”

I just want to make sure the police don’t hurt you when they see a gun in your hands,” I said. “Can you slide it over to the other side of the library?

She sniffled and considered it for a few seconds. She finally nodded and pushed the gun away.

I let out a deep breath as the police burst through the doors.

There was shouting and crying, but I didn’t pay much attention.

Instead, I looked into Alex’s eyes, which were mere inches from my face. I saw sadness, but I also saw pride. I saw the face of a young man who felt he had redeemed himself.

I ran my hand through his hair and whispered, “I’m sorry.

* * *

So, you see, the truth is complicated.

Reckless? Probably. But I’m convinced that phone call saved twelve lives, even if it cost the life of my patient.

Maybe you think I should have just let the hostage negotiators do their jobs. I guess we’ll never know.

Maybe you think I was being manipulative and controlling, but I only do that stuff because I don’t believe people can be trusted to do the right thing.

Maybe you think this will scare me away from therapy forever, but I’ve seen it all… A woman who kept her ex locked up as a sex slave. A patient with PTSD who gave me nightmares. A husband and wife who accused each other of abuse, and only one of them was telling the truth. A pedo-ring conspiracy theorist who was actually onto something. And who could forget, the choir boy who claimed he was being molested — not by a priest — but by God Himself.

The problem is, my patients have a habit of dying. Alex isn’t the first, and I’m worried he won’t be the last. Sometimes I wonder if I’m the common denominator. Or maybe that’s just the cost of taking on exceptionally broken clients.

I picked up my crate of belongings and took one last look around the office. I would miss this place and the people, but I would find another home soon enough.

I’ll never stop trying to help.

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