From the Fiction Issue – Case Study 2: Recognition of the Self, by Sarah Hall
Illustrations by Klone Yourself
REFERRAL AND INITIAL PRESENTATION
Christopher [surname unknown]
Born 02.22.2004
When Christopher arrived for his first assessment he was not like a normal eight-year-old boy. There were elements of wildness to him—long unstyled hair, signs of tooth decay, brown patches on his skin from ringworm. He oscillated between stony emotional blankness and moments of high energy when he prowled around the room, picking objects up and examining them with almost forensic scrutiny—he seemed especially drawn to the collection of ammonites and geological specimens I kept on the shelf. Nor was he age appropriate with respect to his behavior, having no concept of basic social restrictions and rules—for example, he found the shoes he was wearing uncomfortable, so he took them off and began to chew at one of his heels. When he spoke he used a fascinating and unorthodox mode of verbal communication, lacking the personal pronoun, and transposing “I” with “we.” “We want to go back to Lea,” he told me. Christopher was referred for treatment after hospitalization due to extreme weight loss. He was at that stage living in temporary foster care, after removal from his home—a mountain commune called Brant Lea, near K-town (an isolated, fellside settlement in northern England).
Christopher had been discovered wandering the upland moors by a hiker, disoriented and suffering from mild hypothermia, and was admitted to the pediatric ward of the local hospital. He was 18 kg (80 percent of his expected body weight) and alarmingly cachexic—staff described him as “looking like a kid from a concentration camp.” He also had lice and fungal nail infections. He displayed a highly restrictive eating pattern, and when questioned, he described his diet as comprising produce grown or gathered—legumes, lettuce, wild snails, rabbit, and crayfish. There were no immunization or dental records. The site was 11 miles from K-town, an old, part-ruined farm property on common land where the group had squatted and taken over. Christopher had spent all his life to date there. After a program of inpatient weight restoration (sedation and nasogastric tube were unnecessary) Christopher began to eat moderate portions of food. He was discharged and placed in foster care while Social Services assessed the case. After four weeks his foster carer took him to see the family physician, concerned about repeated weight loss. She suspected that Christopher had been using food-avoidance tricks, like hiding bits of meat in his clothing and under his bed. There were also boundary issues—he kept walking in on her while she was in the bathroom, even after instructions not to, and he did not respect her personal property.