CASE HISTORIES 7 



study be then?") I don't know, but I'm patiently satisfied. 

 (Then with a gleam of pleasure) : It is dramatic!" 



In conversation his voice constantly tended to fade to a 

 whisper. He now began to mutter to himself, but always stopped 

 before anyone could get close enough to hear what he was saying. 

 Another habit developed, of hawking and spitting. He would 

 stand in the toilet doing this for an hour at a time. There 

 seemed to be no phlegm, only saliva. Questioning about it 

 irritated him greatly; it was the only subject that made him 

 angry. "I'm sure I don't know why I do it. ("Think!") I 

 don't think. ("You get nothing up, why do it?") For fun, I 

 suppose. ("Do you think you have any disease?") I'm sure 

 I don't know. You will have to ask the doctor." 



Once I asked what he would do if he were discharged. " I'd 

 shift for myself. I should have to readjust, buck up against the 

 world. ("Would you rather stay here and be patiently satisfied 

 or go out and buck the world?" He hemmed and hawed, evi- 

 dently thinking he ought to say buck the world. "You really 

 don't like to answer that question, do you?") No, I don't like to 

 answer." 



Occupational therapy: He consented to begin without urging 

 and chose basket weaving, which he did beautifully. He 

 wouldn't bother to learn any other kind of work, and subsequently 

 admitted he had learned to weave baskets in another hospital. He 

 became so expert that he could continue his fantasying as he 

 worked. If lie ran out of material or got stuck, he made no sign 

 but sat thinking until the instructor noticed his idleness. 



After a few weeks he lost what interest he had and began to 

 beg off, saying he'd rather think or he didn't feel well. 



He was very shy with the instructor, refusing to enter her 

 small store closet with her. Only after she had come out would 

 he go in. Once he wished to return a tool when she had both 

 hands full, and when she told him to drop it into her apron 

 pocket he became much embarrassed and laid it on the window 

 sill. 



Physical examination: Short in stature. Skin dry and 

 covered with fine flaky scales. Beard very heavy. Hair, male 



