When I first met Billy, he was sitting motionless in a wheelchair, gnawing on a bedsheet dangling from the side of his mouth. He did not reply to questions. When I asked him something, he would just stare at me with an ear-to-ear smile, as if he knew something no one else did. His muscles were stiff. Occasionally he would glance from side to side, chew on the sheet or pick at his arms with his fingernails.
Two weeks ago, Billy went to the emergency department of another hospital with wet shoes on the wrong feet, saying, “I need to talk … about brain damage.” Now he was in a state of catatonia, immobile and stuporous. How could a perfectly healthy guy become like this in just a handful of days?
With silky black hair, a winning smile and a cocky, sarcastic edge to his humor, Billy typically had enough charm to fill any room and made friends easily. He was in his early 30s, had a master’s degree in chemistry and worked for years in a commercial laboratory. He was moving up in his career and had a steady girlfriend.
But suddenly things changed. He became distant from his friends and family. He was laid off from his job and broke up with his girlfriend. He lost the ability to pay his bills, maintain his car and apartment, and feed himself. When his mother went to look for him in his apartment, she discovered towering stacks of empty pizza boxes. Full, untouched containers of home-cooked food she’d made for him lay all over the house, spoiled. Billy’s car was found abandoned in a distant public park. No one was sure how he found his way to a hospital. The answers would have to come from Billy, but he was mute.
