Patient Name: Theodore Azrael
DOB: [REDACTED]
Date of Admission: [REDACTED]
Facility: Mirevale Psychiatric Institute – High Security Wing
File No.: 2847-AZ
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Presenting Problem:
Admitted following court order after conviction for two homicides. Displays signs of psychosis, emotional detachment, and potential delusional thinking.
Diagnosis (DSM-5-TR):
- Dissociative Identity Disorder (F44.81)
- Schizoaffective Disorder, Bipolar Type (F25.0)
- Antisocial Personality Disorder (F60.2)
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The room was silent except for the faint hum of the overhead lights and the distant, hollow ticking of a wall clock.
Dr. Elira Voss stood with her clipboard in hand, posture straight, eyes keen, and the taste of stale coffee still lingering on her tongue. Her breath was calm, rehearsed, controlled- just like her expression. She had read the file three times before this meeting. Still, nothing prepared her for seeing him in person.
Across from her stood Theodore Azrael.
Black hair framed his face like ink spilled with intent, and his eyes- black, not dark brown, not hazel or charcoal, but black- met hers without wavering. There was nothing inherently menacing in his gaze. On the contrary, it was the stillness in him that disturbed her. He looked at her the way a cat watches a flame- curious yet detached.
He was tall, lean, draped in a hospital gown that hung slightly crooked on his left shoulder, revealing a sliver of collarbone. He had no restraints. He didn't twitch. He didn't fidget nervously like the other patients she had. He simply stood there, head tilted slightly as if waiting for a cue.
"Good morning, Mr. Azrael," she began, stepping into the space between him and the door, "I'm Dr. Elira Loftenheim. I'll be handling your case for the next few months."
"Theodore will do," he said with a smile, warm and polite. His voice was smooth, and exuded charisma. "Titles always make things feel more… distant."
She made a note of the remark, though her face didn't show it.
"Alright, Theodore. Let's begin with something simple. How are you feeling today?"
He blinked once, slowly. "A little bored, I think. The walls here don't change much. Neither do the people."
"This is your first time in psychiatric care," she said gently. "Prior to this, you've had no institutional history, no records of long-term therapy. Is that correct?"
"Yes," he said. "This place is new to me. The system too."
"And yet, you don't seem shaken."
He shrugged. "What good would that do?"
"You're composed," she noted, watching him closely. "Polite. Self-aware. But you're also here because a judge deemed you mentally unfit for a standard prison sentence. That's not a small ruling."
He didn't respond immediately. When he did, his voice was quiet, almost thoughtful. "I'm aware."
"Do you remember the ruling?"
"I was there."
"That's not what I asked."
He turned to look at her more directly now. His expression wasn't cold- just still. "Yes, I remember it. Word for word."
She nodded slowly.
"And what do you think about that outcome?"
He paused. "It was… unexpected."
"Why?"
"Because I don't feel unstable."
"Do you feel remorse?"
There was no shift in his face. "No."
"And that doesn't concern you?"
"No."
Elira's pen didn't move. She didn't write that down. She just folded her hands in her lap and kept her voice light.
"The file mentions mild dissociative identity disorder, bipolar traits, and sociopathic tendencies," she said. "But I don't want to treat you like a list of diagnoses. I want to understand the person sitting in front of me."
He smiled small and tight-lipped at her. "You make this sound so personal."
"It is," she said without flinching. "Whether you like it or not."
A beat passed between them. Then he said, "You don't treat me like the others have."
"That's because I'm not afraid of you."
His head tilted again. Again with that same odd, feline motion.
"Should you be?"
"You haven't given me a reason to be," she replied gently.
"I could be lying."
"You could," she agreed. "But if I assumed you were, we wouldn't get very far."
He leaned forward, resting his elbows lightly on his knees. He looked at her curiously, then at the file, then back at her.
"Tell me something, Doctor. Do you enjoy this?"
"Enjoy what, Theodore?"
"Talking."
"Talking to you?" she asked. "Yes, actually. I find people fascinating."
"Even people like me?"
"Especially people like you."
He blinked. Not in surprise, but perhaps in amusement. "Then I suppose we'll get along just fine."
Elira tapped her pen once against the clipboard. "Let's start simple, Theodore. Why don't you tell me about that day."
For the first time since she'd entered, his gaze drifted away from her. Out the window. Toward nothing.
"I don't think I can tell it the way you want to hear it," he murmured.
She didn't push. Instead, she said quietly, "Then just tell it your way."
He looked back at her, and for the briefest moment, something flickered behind his eyes. Not sorrow. Not fear. Something unplaceable. Like a shadow slipping past a crack in a door.
And then he smiled again, soft and pleasant, as if they were two friends having a casual morning chat.
"Would you like to hear something from my past?" he asked.
"I would," Elira said gently. "If you're comfortable."
"I am not uncomfortable. It is simply a sequence of events," he said. "I will tell it now."
She nodded once.
"My mother is alive," he said. "But she does not speak. She does not move. She does not respond to light or sound. Her body breathes. That is all."
Elira's eyes softened. "She's in a vegetative state?"
"Yes."
There was no change in his tone, like she was merely talking to a programmed robot
"She became that way when I was sixteen," he continued. "Because my father took money. A large sum. From a man named Count Saul. After he failed to return it, men came to our house."
Elira waited.
"They entered while I was gone. My mother was there. She was preparing food. They broke the door. They broke her body. When I came home, she was on the ground. Bleeding. Unconscious. Her limbs twisted in ways they shouldn't move."
He blinked once. No emotion. No pause.
"My father disappeared. He has not returned."
Elira's voice stayed soft. "Did you try to find him?"
"No. I did not want to. I took care of my mother for two years. I fed her. I turned her body. I spoke, though she never answered. I waited, though she never woke."
He blinked once. "But something started to change. Inside me."
"What do you mean?" she asked, carefully.
"I began to feel something," he said. "Not an emotion. Not anything I could name. An urge. Like a pressure in my hands. A sensation in my arms."
His long fingers twitched faintly, and he raised them.
"And then one day, I did this-" He brought both hands up and mimicked wrapping them around something, or someone. "I placed them here. Around her neck. My mother's."
Elira didn't speak.
"She didn't resist. Couldn't. I squeezed until her face turned blue. Her eyes shifted in her skull. I stopped before she died. Her breathing was shallow afterward. I made sure she was okay. I fed her later that day."
"Why?" Elira asked softly. "What made you stop?"
"I didn't want her dead," he replied. "She was the only one who never hurt me. But… in that moment, I felt something."
He paused, looking at his hands. "It was the first time I felt… alive."
Elira swallowed.
"So I did it again," he said. "Every day, I would try. Just a little. I'd stop before it went too far. She was fragile, but I learned the limits. Her body would tense. Her mouth would twitch. And then I'd let go."
"And you felt something?" Elira asked.
"Yes."
"What did it feel like?"
"Like warmth in my chest. Something pleasant. Not joy. Not happiness. Just… something."
He looked up at her.
"I didn't want to kill her. So I looked for alternatives. I found odd jobs in a nearby town. Cleaning, lifting, replacing broken things. One day, someone offered me money. End someone's life. It paid more than anything else. So I said yes."
Elira's throat tightened. "And did you do it?"
"Of course."
He blinked slowly.
"There was blood. But it wasn't messy. It was quiet. She was asleep when I came in. I covered her mouth and held her down until she stopped moving."
"And… did you feel it again?"
"Yes. Stronger. I could feel it in my chest. Like a heartbeat I didn't know I had."
Elira's hand gripped the arm of her chair, just lightly. Despite being a psychiatrist for over five years in Mirevale, it still made her feel nauseous whenever she listens to her patients from the high risk security wing.
"I became good at it," he continued. "Simple jobs. No one looked twice. I didn't care about the money. I only cared about the feeling."
He sat back slightly.
"Then I saw him," he said. "My father. He was walking in the marketplace. With a woman. Younger than my mother. He called her his wife."
He tilted his head slightly.
"I followed them. They lived in a stone house at the edge of the village. Nice garden. She hung laundry outside while he drank tea."
There was a pause.
"I waited until dark. I climbed through the back window. She was reading. I stood behind her. Then I placed my hands here again-" He repeated the gesture. "And I squeezed."
His voice did not rise. His breathing stayed calm.
"She made a sound. A short one. Then her eyes rolled back. I held on longer this time. Until she was gone."
Elira couldn't stop herself. "And your father?"
"I waited in the dark. He came into the room. He saw her. He screamed. He tried to hit me with a chair." Theodore's head tilted a little more. "It didn't work."
He looked at her now, directly.
"I killed him."
Silence.
Elira sat very still. Her heart beat fast behind her ribs. But her face stayed composed.
"Do you feel regret?" she asked gently.
"No."
"Guilt?"
"No."
"Anger?"
"No."
"Anything at all?"
He looked thoughtful for a moment.
"Only the feeling. The warmth. It comes when it happens. It stays for a while. Then it fades. So I chase it again."
Elira felt her pen cold in her hand.
She gave a slow nod, and her voice, when she spoke, was quiet. "Thank you for telling me that, Theodore."
He nodded once in return and smiled sweetly at her.
"You're welcome, Doctor."