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The Beginning

by Brian Duke

I figured if I went to enough psychiatrists eventually one of them would say something I wanted.

But this psychiatrist, like all the others, has the same office, the same stench of hand sanitizer and the same presentation of perfect sanity. This one, however, says it more viciously than the others, with more vigor.

He says, “Since I’m the third psychiatrist to say schizophrenia maybe you should start listening.”

The past three weeks my condition had worsened. There were no hallucinations, no voices, at least not yet, but my paranoia had grown to a near paralysis. I was moving through the days and weeks like a murderer, like a man who has broken his neck looking over his shoulder.

I oblige and pay attention. I listen to what the psychiatrist says, to everything he says, but most importantly, try to listen to what he doesn’t say, the silences of convenience between his utterances. Most often what psychiatrists don’t say is the closest to the truth I can get.

He says he has some questions for me. I nod.

“Do you have a family history of schizophrenia?”

“No.”

“Have you had trouble holding down a job because of your schizophrenia?”

“No.”

“Have you ever had any hallucinations because of your schizophrenia?”

“How am I supposed to know?”

The psychiatrist puts down his clipboard. “Do you have any questions for me?”

“Just two,” I tell him.

“The first?”

“Could you not say that word so much?”

The psychiatrist’s face reddens like some caught child. “And the second?”

“What’s going to happen to me?”

The psychiatrist thinks the answer I’m looking for involves the medication he’s going to give me so that’s what he tells me about. An answer never comes. The entire time I don’t hear anything but the word and the blanks between. Schizophrenia this, schizophrenia that. He keeps using the word. A hundred times it seems he uses the word, as if the sound of it rolling off his tongue establishes his professional prowess in a way no other word can.

It dawns on me how much, in my previous life, in my life before the disease, I used the word. Here and there. To describe a tough day at work. When the weather couldn’t decide between sunshine or rain.

I never minded the word until I knew the word meant me.

“Don’t worry about the term,” the psychiatrist says. “It’s a rough approximation, a general blanket. A starting point for treatment. Nobody really knows all that much about the term. Like I said, it’s a beginning.”

My wife leans over. “We’ll get through this,” she whispers to me. “Together.”

On our way out I hold her hand and nod, doing my best to be the tough, strong husband she knows I’m not. We pass the others in the psychiatrist’s office, a man saluting ghosts and a woman deathly gripping a dozen plastic bags filled with more plastic bags, and I can’t help but wonder if that is going to be me. If one day I will be sitting here as helpless as they. If this word will envelop me as it has them, if it will devour me as it has them.

We drive home in a downpour, nothing but the sound of drops beating the roof and windows to accompany the conversation we don’t have.

I tell myself it’s just a word. I tell myself, like the doctor said, that it’s a beginning, though I know what a beginning feels like and this doesn’t feel like a beginning.

This feels like, well, the end.


Brian Duke is an educator living with his wife and dog in Berlin, Germany. He has published fictional pieces before, in Boston Literary Magazine, Monkeybicycle, The Saturnalian, decomP Magazine and others.

I love the way the story partially (for me) hinges upon the binary of beginning/ending. Talk, if you would be so kind, about other binaries, if any, you see at work in this piece, either as it was being written (process) or as it appears here (product).

There are a lot of binaries occurring in “The Beginning,” from the severing of conception between the title and the actual realization on the part of the narrator that this ‘beginning” feels much more like an “end,” to the discrepancy between the term “schizophrenia” and the narrator’s mental status to the dual relationship the narrator has with his wife and doctor. But the biggest binary operating in “The Beginning” is the dichotomy between health/sickness. The narrator, facing the fact that he has been diagnosed with a serious illness, is not sure how to continue on his existence. The entire foundation of the story relies on the tension created by this binary. Indeed, how does one make the transition from being “healthy” to being “sick”? What does that exactly involve? What price is paid?

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