Darryl had had a virus for a few days, but was feeling better. As a
matter of fact, he felt bloody marvelous. He felt like he had been
touched by an angel. He hadn't felt that good in years. He got out of
bed with a bounce in his step and a smile on his lips. The day went by
quickly and he finished his day at work with a flourish. The only
residual symptom he was feeling from the virus was that he was pissing
more than normal. He had to stop at gas stations twice on the way home
to urinate. This wasn't a mere bladder infection though, he was
producing huge volumes of urine.
He decided to buy some flowers and candy for Brydie, his wife, on the
way home. Darryl was feeling romantic. After his daughter, his wife and
he had eaten, Darryl and Brydie retired to bed and indulged in a long
night of lovemaking. The went to sleep and made love again in the
morning before he went to work. That day went like the day before and he
repeated his previous night's performance. This went on for three days
more before he noticed that he middle-aged pot belly had disappeared. He
weighed himself on the bathroom scale and discovered he had lost
sixty-nine pounds. He had to cinch his belt in six inches when he
dressed to go to work. When he looked at himself in the bathroom mirror,
he looked years younger. "It must be all the exercise I'm getting at nig
ht," he thought with a chuckle.
He had never performed that well in his life; to be honest his
lovemaking skills were lackluster at best and his sexual endurance had
always been poor. Still, his new found sexual energy was a pleasant
surprise for Brydie who was enjoying his sudden attentions. The next
morning found him as horny as before, perhaps more so. He weighed
himself again and found he had lost an additional twelve pounds. He
urine output hadn't decreased any either, he was still pissing what
seemed like a gallon a day. Despite how good he felt, Darryl decided to
call in sick and go and see the doctor. True, the doctor had told him on
numerous occasions that he should lose weight, but eighty-one pounds was
an incredible amount to lose in one month. The constant need to urinate
was worrying him too. He called his doctor and explained he had
experienced severe weight loss and had a frequent need to urinate.
Darryl also told him that his appearance had changed too, he looked like
he had when he was nineteen. The doctor arranged an emergency
appointment that morning for him.
When he doctor saw him, he couldn't believe it was Darryl. He thought
that Darryl had talked a younger brother into impersonating him as a
joke. When Darryl finally convinced him that he really was Darryl, the
doctor became very concerned. He explained to Darryl that the rapid
weight loss he was experiencing was extremely dangerous when coupled
with the high urine output he was having. The doctor convinced Darryl
that something was very wrong. He thought that perhaps Darryl had
contracted a new form of virus and should be hospitalized until the
cause of his symptoms could be determined. He made Darryl agree not to
have any more sexual relations with Brydie until it could be determined
that he wasn't contagious. Darryl reluctantly agreed to enter the
hospital the next day.
North Central Memorial Hospital
Doctor's Progress Notes
Date: Aug. 30, 1998 Time: ~9:00 pm Patient: Darryl Burr
Diagnosis: Patient admitted to hospital with Dx of Idiopathic Somatic
Regression,
Vitals:
Pulse
61
B.P.
119/72
Resp.
14
Temp. 99.6° F
(oral)
Weight
143 lb.
[approx equal]w
-11 lb. since office visit 8/29/98
Height
69 in.
Lab: urine (~6300 ml) [normal ~1000 ml.], pO2 88, pCO2 38
Other: Dental: third molars have disappeared
General: Pt. complains that he is becoming younger. Pt. complains of
frequent urination with some weight loss, Pt. age appears to be ~17 yrs.
old, although age is known to be 41 yrs., otherwise appears to be in
good health with slightly elevated temp.
Notes: Pt. was admitted to Adolescent Unit due to lack of space in other
units.
Orders: Ordered complete isolation of Pt.; mask, gown and gloves
required for staff safety. No visitors, including Pt.'s wife, until Pt.
has been fully screened for infectious diseases. Ordered complete news
blackout on Pt. to preserve Pt.'s and family's privacy. Pt.'s
measurements are to be taken each shift; height, weight, arm and leg
length, etc.; details in Nursing Orders. Called Pt.'s Dentist for dental
records, Ordered full set of dental X-rays each day, Ordered full
photographic set by medical photographer every 24 hrs.; asked Pt.'s
family for photo album for age comparison purposes, Ordered full
radiographic set of major skeletal bones, as well as a Tanner-Whitehouse
survey to determine RUS bone age, Standard Lab values including,
Urinalysis, CBC, etc. Ordered multiple tissue cultures, antigen/antibody
tests for pathogenic organisms, DNA tests
Darryl was bored. True, the hospital room had a tv, but nothing was on
except talk shows and soaps. Darryl lay in bed and waited for the next
visit by hospital employees. The doctor had ordered that he be allowed
no visitors, including his wife, but that did not, of course, include
employees following doctor's orders. So far this morning, he had had
every inch of his body x-rayed while in his bed with a portable x-ray
machine, another x-ray tech had come in and taken a full set of dental
x-rays, a hospital photographer had had Darryl strip to the buff and
photographed him from multiple angles standing in front of a folding
cardboard grid to measure his body size, medical technicians had come up
from various departments of the laboratory and taken samples of blood,
urine, throat swab, and (ugh!) stools and finally a pair of nurses had
come in and weighed him before measuring and recording the length and
circumference of all his limbs. Then they took his temperature, pulse,
blood pressure and listened to his heart and lungs with a stethoscope.
He had suspected that a single nurse could have done the job alone, but
one of them must have wanted to see the "incredible shrinking man" for
herself. Darryl would have liked to see the employee's faces but
everyone was gowned, masked and gloved into anonymity.
Darryl lay back in the bed and sighed. He had been poked, prodded,
probed, photographed, bled, and irradiated. He was beginning to feel
like a visitor from another planet being cataloged by medical science.
The hospital personnel had been courteous but firm in their demands for
samples from his body. Darryl hadn't realized how entertaining it had
all been until they left. The employee's conversation had been formal
and job related, but at least it was conversation. Darryl wondered how
long he should wait until he tried to call Brydie again. Darryl had
never been a big reader but he decided to have Brydie bring him some
books to read to relieve the boredom. He looked at the clock on the wall
at the foot of the bed; it read eleven thirty am, they would be serving
lunch in thirty minutes according to the brochure that he had found on
the bedstand. Maybe the nurse would have time to talk to him at lunch.
He rolled over and lay on his side trying to nap. Darryl was sure they'd
wake him when lunch came.
North Central Memorial Hospital
Doctor's Progress Notes
Date: Aug. 31, 1998 Time: ~9:00 pm Patient: Darryl Burr
Diagnosis: Idiopathic Somatic Regression,
Vitals:
Pulse
65
B.P.
117/70
Resp.
17
Temp.
99. 8° F
(oral)
Weight
112.2 lb.
[approx equal]w
-21.1 lb.
Height
64 in.
Lab: urine (~9800 ml) [normal ~800 ml.], pO2 88, pCO2 38
Other:
Measurements: (normalized to values at admission), thigh 89%, calf 89%,
foot 91%, upperarm 85%, forearm 86%, hand 87%, muscle width; arm + calf
11.3 cm (reduced from 14.1 cm at admission), height 93%, weight 78%
Dental: missing two canines as well as third molars
General: Facial Alopecia of the lower maxilla and mandible
(baldness-Pt.'s mustache and beard have fallen out), Nail shedding of
both hands and feet, testes have shrunk from 21 ml. to 7.2 ml.
Notes: The Pt.'s upper layer of dead epidermis sloughed off during the
night, exposing fresh, pink skin. No lesions or dermatitis, skin normal
in appearance. The Pt.'s family album was delivered today, comparison of
pictures of the Pt. as a 14 year old boy and today's medical photograph
seems to indicate that the Pt.'s physical age is approximately 14 years.
Orders:
When Darryl woke up the next morning, he felt like he had been skinned
and dipped into an acid bath. He had dreamed that he was lying painfully
face down on a bed of thorns and the thorns had impaled themselves into
his chest. He awoke to find the pain was real. He threw back the sheet
on the bed to see what was sticking him and found hundreds of short,
stiff brown hairs lay on the sheet amid large flakes of dead skin. He
tried to brush them off the sheet and discovered that he could barely
use his hands. Darryl looked at his hands; the calluses were gone and
they were a bright pink. He had lost the entire upper layer of skin! The
ends of his fingers ached dully; he was surprised to see that he had
lost his fingernails too. He got out of bed and immediately found that
he had lost the toenails and calluses on his feet as well! He could
barely walk. Darryl hobbled over to the sink and looked in the mirror.
His face was pink and his mustache had fallen out! He groaned in dismay,
what was happening to him? His body seemed to be falling apart. When he
opened his mouth to groan he saw that he had gaps in his teeth. He
gingerly pulled back his upper lip and examined his teeth, somehow
during the night he had lost his upper canines. Suddenly he realized
that he had to urinate. He had to urinate now! He shuffled to the toilet
and sat down just before he started to go. He had almost pissed on the
floor! Darryl put his head in his hands and wept. "I can't deal with
this," he thought in confusion, "What's happening to me? My teeth are
falling out, my skin is peeling, and I've lost my fingernails. Is this a
virus? I've never heard of a virus that does anything like this. Do I
have radiation poisoning? I've heard of cases of radiation poisoning
where the victims lose their fingernails and hair, but I hadn't heard
they lose their teeth and skin too. If I have radiation poisoning, then
why don't I have diarrhea? Doesn't radiation kill the lining of the
intestine? Is this some kind of heavy metal poisoning? Why do I have to
piss all the time? Mercury poisoning will cause loosening of the teeth,
loss of fingernails and hair, and can act as a diuretic. But, if that's
it, why is my skin peeling? Mercury poisoning is famous for making
people salivate excessively. I'm not salivating and other than the fact
that I'm shrinking, I feel good. I don't feel like I've been poisoned. I
wish someone would tell me what's going on." He finished urinating and
got up from the toilet, then turned around to look at the color of his
urine. There was some kind of white plastic container that was fitted
into the top of the toilet under the seat that was being used to collect
his urine. It was a dark shade of orange against the white plastic. He
had seen that color before in his life when he was a teenager in high sc
hool football. His urine used to turn that color after summer football
practice in the sun. It looked like he was severely dehydrated. The
funny thing was, he didn't feel thirsty. Darryl limped back to bed and
called the nurse. If he could get her to come in here and see what he
looked like, perhaps she would call the doctor. Maybe this time someone
would explain what was happening!
North Central Memorial Hospital
Doctor's Progress Notes
Date: Sept. 1, 1998 Time: ~9:00 pm Patient: Darryl Burr
Diagnosis: Idiopathic Somatic Regression,
Vitals:
Pulse
67
B.P.
115/71
Resp.
23
Temp.
100.2° F
(oral)
Weight
77 lb.
[approx equal]w
-35.2 lb.
Height
56 [fl] in.
Lab: Pt. voids urine continuously (~15000 ml) [normal ~750 ml.], pO2 88,
pCO2 38
Other:
Measurements:(Normalized to values at admission), thigh 80%, calf 82%,
foot 87%, upperarm 81%, forearm 81%, hand 82%, muscle width; arm + calf
10.3 cm, height 82%, weight 54%
Dental: 20 teeth; first molars (4) [permanent], incisors (8)
[permanent], bicuspids (8) [permanent]
General: Alopecia of underarm hair, secondary sexual characteristics
have disappeared, reduced penis size, testes have shrunk considerably-
size 2.5 ml., aureole diameter halved from 1 in. to [fl] in., size of Pt.'s
voicebox has reduced; voice has become higher and more childlike,
forehead has become less pronounced, mandible has receded. Epidermal
sloughing continues.
Notes: Teeth do not disappear entirely; the roots are absorbed and the
balance of the tooth either falls out or is swallowed (crowns of teeth
were found in the bed by nurses during bed changes and by lab
technicians in stool samples)
Orders:
Darryl awoke in a puddle of urine. He was pissing in the bed! He grabbed
his penis to shut off the flow and ran to the bathroom, heedless of the
pain shooting up from the soles of his feet. He sat on the toilet and
released himself and pissed a full five minutes before he stopped. He
hobbled back to the bed when he was finished and pushed the button to
call the nurse. When the unit clerk answered, he asked her to have the
nurse change the bed. The unit clerk asked why the bed needed changing
and he explained he had had an "accident". The clerk promised him the
nurse would by there right away. He stood by the bed in shock. The sound
of his voice this morning had surprised him. He wasn't talking as much
as squeaking his requests. The nurse arrive a minute later, changed the
bed and emptied the urine collection container in the toilet. She had
explained to him yesterday morning that he needed to call her after he
urinated so she could chart his output. He ended up calling her a dozen
times a shift. Darryl dressed in the clean gown she had given him and
sat on the easy chair by the close to the bathroom door. It wasn't worth
it to go back to bed, he'd be getting up to go to the bathroom in a few
minutes. He was glad that there was never anything good on tv in the
mornings. When he had tried to watch tv at night, he had had to get up
and go to the bathroom every few minutes. He couldn't keep track of the
plots. He hoped that Brydie would bring him some books and magazines
soon, at least he could read them while sitting on the toilet. He
decided not to try and call her again. The change in his voice might
worry her. She find out soon enough about his bodily changes.
North Central Memorial Hospital
Doctor's Progress Notes
Date: Sept. 2, 1998 Time: ~9:00 pm Patient: Darryl Burr
Diagnosis: Somatic Regression,
Vitals:
Pulse
70
B.P.
112/72
Resp.
28
Temp.
99.7° F
(oral)
Weight
61.6 lb.
[approx equal]w
-17.6 lb.
Height
52 in.
Lab: urine (~8200 ml) [normal ~700 ml.], pO2 88, pCO2 38
Other:
Measurements:(normalized to values at admission), thigh 72%, calf 74%,
foot 81%, upperarm 72%, forearm 73%, hand 75%, muscle width; arm + calf
9.6 cm, testes 1.6 ml. , height 75%, weight 43%
Dental: 18 teeth; first molars (4) [permanent], incisors (8)
[permanent], bicuspids (2) [permanent], posterior molars (4) [deciduous]
General: Alopecia of pubic hair, pronounced epidermal sloughing, Pt.'s
face has become childish in appearance. Pt.'s appearance compares
favorably with photos taken at age 9
Notes: The deciduous teeth erupted very quickly; within a few hours.
X-rays of the mandible and maxilla show other deciduous tooth buds
developing and the absorption of the roots of the permanent teeth
Orders:
The next day Darryl woke feeling much the same as he had the day before.
His skin was still raw and tender. The bed sheet was covered in flakes
of dead skin, it looked like he was molting during the night. When he
got out of bed to go to the bathroom, he had almost fallen on his face.
The bed seemed to have grown in the night. He was still shrinking.
Darryl hurried to the toilet as fast as his tender feet would carry him.
He sat down and exploded urine into the collection container. He pissed
until he thought surely he must have filled the plastic bucket in the
toilet. He looked down at his penis and was shocked by it's appearance.
He had been denuded! All of his pubic hair had fallen out! His penis had
shrunk too; it was only half the size it had been the day before! Darryl
reached down and cupped his scrotum in his hand and felt his balls. His
balls had shrunk too! They had been the size of small eggs yesterday and
now they were the size of marbles; small marbles! His penis and balls
looked like a little boy's organs. "If only I knew what was happening to
me. Can't they stop this? Why won't they tell me what's wrong with me? I
could handle this a lot better if I knew what was going on." He was hit
by a renewed urge to piss again and hastily stuffed his penis between
his legs before he had an accident in his hand. Darryl began to weep in
frustration. He felt trapped. Alone. He was terrified by the thought of
what he would look like tomorrow. Would he continue to shrink? What
about the day after? And the day after that? Would he dwindle into
nothingness? Why was his hair falling out? Why wouldn't someone tell him
what was going on? Did they know what was happening to him? Darryl
finished on the toilet and went to the mirror to see what his face
looked like. He was shocked by the image the mirror returned to him. It
was his face alright. His face when he had been nine or ten. He opened
his mouth to check his teeth and saw multiple gaps in his dentition. He
wasn't just shirking, he was regressing! His body was becoming younger!
He looked closely at his gum and thought he saw a tiny tooth bud
erupting from the gum. That explained why they were taking a complete
set of dental x-rays every day. He had understood the need for regular
x-rays of his body, but the dental x-rays had baffled him. Now he
understood why the medical photographer was taking pictures of him every
day as well. They intended to use them in medical textbooks. They hadn't
explained to him what was happening because they didn't know! His
condition was totally unknown to them. That's why they took all his
measurements three times a day. They were gathering data for study! He
went back to bed and pulled the covers over his head. He was supposed to
call the nurse and tell her after he had urinated so she could chart his
urine output and empty the collection container, but it was too much
trouble. Besides, he didn't want to see anyone right now. He wanted to
be by himself. He would have to get up and piss again in a few minutes
anyway.
North Central Memorial Hospital
Doctor's Progress Notes
Date: Sept. 3, 1998 Time: ~9:00 pm Patient: Darryl Burr
Diagnosis: Somatic Regression,
Vitals:
Pulse
75
B.P.
110/70
Resp.
28
Temp.
99.4° F
(oral)
Weight
50.6 lb.
[approx equal]w
-11.6 lb.
Height
48 1/2 in.
Lab: Urine (~5650 ml/day) [normal ~650 ml.], pO2 88, pCO2 38
Other:
Measurements:(Normalized to values at admission), thigh 63%, calf 65%,
foot 73%, upperarm 66%, forearm 67%, hand 69%, muscle width; arm + calf
9.0 cm, height 70%, weight 35%
Dental: 20 teeth; first molars (4) [permanent], incisors (4)
[permanent], upper lateral incisors (2) [deciduous], lower lateral
incisors (2) [deciduous], canines (4) [deciduous], posterior molars (4)
[deciduous]
General: Nocturnal enuresis, PMI (point of maximum impulse of heart)
relocated from the 6th left intercostal space to 4th intercostal space,
just left of midclavicular line
Notes: Epidermal sloughing continues at the same pace. Pt.'s dental
records arrived today, comparison of daily dental X-rays and dental
records substantiates the hypothesis that the Pt. is physically
regressing in age. The Tanner-Whitehouse study of the radius, ulna,
metacarpels and phalanges corroborates this evidence with an error of ±2
years. The photographic evidence also supports this conclusion with a
physical age estimate of 7 years. The medical statistician has predicted
on the basis of this evidence that if the regression continues unabated,
the Pt. will be 1 year old in 4 days. The Pt. is already too small to
wear hospital gowns or b.p. cuffs in unit. The Head Nurse of Adolescent
Care and the Medical Chief of Staff have requested that the Pt. be
transferred to the Pedi Unit.
Orders: Transferred to Pedi.- Isolation Room
Darryl woke up early in the night in a puddle of urine. He had wet the
bed in his sleep. He called the nurse, who came and changed the bed
sheets and he slept the rest of the night without incident. In the
morning, Darryl got sleepily out of bed and promptly fell on his face. A
blood vessel broke and his nose started bleeding. The pain from his nose
stunned him and he sat motionless on the floor, forgetting his urgent
need to urinate. Without warning, his bladder cut loose and he peed all
over himself. This was too much, he began crying. A passing nurse heard
him and looked in the room to see what the commotion was about. When she
saw him sitting in a puddle of urine with his face covered in blood, she
rushed in to check his condition. She helped him up, removed the wet
gown and called his nurse. The bleeding stopped just as his nurse
arrived. She took over for the other nurse while the passing nurse
sopped up the puddle with the already wet cotton gown. His nurse soaked
a washcloth in cold water in the sink, wiped his face clean of blood and
told him to hold the washcloth to his nose while she got a clean gown
from the cabinet for him. As Darryl was standing there at the bedside,
he noticed that the height of the hospital bed mattress came up to his
solar plexus. The bed height was still set to the height it had been set
to when he came in and was now too tall for him. No wonder he had
fallen. His nurse came over and attempted to dress him in the fresh gown
only to find it was too large for him. When she put his arms through the
gown, the bottom of the gown dragged on the ground by a good four
inches. He had become too short to wear even the smallest adult sized
gown. She called the unit clerk on the nurse call system and asked her
to call housekeeping to mop the floor in his room while she went to
pediatrics and borrowed a gown to fit him. Darryl sat on the easy chair
and waited for her return.
She bustled in his room with a stack of disposable paper pedi gowns in
her arms and restocked the cabinet. Then she gowned him and helped him
back into bed. She put the side rails up on the bed saying, "I think we
should have these up on the bed from now on. That was quite a fall you
took. If you need to get out of bed to go to the bathroom, call me with
the nurse call button and I'll lower the side for you and help you out
of bed. Here, I'll clip the call button on your pillow so you can find
it easily." Darryl lay in bed morosely after she left. This was
humiliating! Not only had he fallen and bloodied his nose, but he had
had an accident on the floor besides. He was surprised that she didn't
lower the bed height for him to get out of bed without assistance i
nstead of raising the bed rails. Was this her way of insuring that he
would stay put in the bed until she came to get him out? His need to
urinate lately had been so urgent that he wasn't sure he could wait
until she arrived. What would they do if he started to wet the bed on a
regular basis? Catheterize him? The housekeeping maid came in and looked
at him with a disgusted expression on her face. The mask prevented
Darryl from seeing her pursed lips but he could read the angry look in
her eyes easily enough. This was the fourth time this morning she had
had to clean up a patient's "accident" on the floor. "If these people
can't control themselves," she thought, "...then why don't the nurses
put them in diapers?" Darryl turned over in bed and faced the wall while
she mopped the floor, he didn't care for the expression in the maid's
eyes as she worked.
North Central Memorial Hospital
Doctor's Progress Notes
Date: Sept. 4, 1998 Time: ~9:00 pm Patient: Darryl Burr
Diagnosis: Somatic Regress,
Vitals:
Pulse
84
B.P.
109/71
Resp.
28
Temp.
100.8° F
(rectal)
Weight
41.8 lb.
[approx equal]w
-8.8 lb.
Height
43 1/2 in.
Lab: Voids urine every 45 min-1 hr (~4200 ml/day) [normal ~600 ml.], pO2
88, pCO2 38
Other:
Measurements:(Normalized to values at admission), thigh 54%, calf 57%,
foot 66%, upperarm 57%, forearm 60%, hand 64%, muscle width; arm + calf
8.5 cm, height 63%, weight 29%
Dental: full set of baby teeth
General: Early childhood Lordosis has reappeared, Pt.'s physical age
estimated at 5 years.
Behavior: outbursts of uncontrolled temper (temper tantrums?), Pt.
unable to shower unassisted. Pt. increasingly confused & attempts to
leave bed unassisted, Pt. wets self and requires constant assistance to
toilet. Pt. cannot control tongue for oral temp., nurses took rectal
temp instead, Pt. strongly objected to use of rectal temp. probe. Pt.
has begun sucking thumb when there is no one present. Pt. has formed an
emotional attachment to one of the day shift nurses and calls for her
constantly.
Notes: DNA tests have revealed an abnormality at site p51; the gene
involved in cellular replication usually associated with carcinoma. The
study suggests that a plasmid of unknown structure and origin has
inserted itself into the site. The growth this plasmid may be causing in
the Pt. is unusual, but not a oncological type growth pattern. An
alternate possibility for this structure is a jumping gene, switched on
by unknown environmental factor(s).
Orders: Nurses requested Pt. be placed in diapers, Nurses requested use
of crib with crib top device to control night wandering, also high chair
to facilitate feeding- Ordered
If yesterday had been bad, today was terrible. He had been transferred
into the pediatric side of the floor with all the children. The nurses
had told him it was an administrative move to free up space for other
patients, but he suspected they were lying to him. He had simply become
too small to be cared for in an adult unit. Every time they had wanted
to take his blood pressure yesterday, they had had to borrow a pedi cuff
from the other unit. When they tried to take his temperature he
rebelled. The nurse had told him to drop his pants and lay down on the
bed. He had thought she was only going to examine him. When he felt the
rectal probe placed into his anus he battled the nurse fiercely. She
rang for assistance and three pairs of hands compelled him to submit to
the intrusion. Darryl was told afterwards that the unit policy was that
all the patients in the pedi unit were required to have their
temperatures taken rectally, regardless of age. He had also had problems
getting immediate assistance to go to the bathroom. He had been right in
his guess that he wouldn't be able to wait until the nurse got him out
of bed to urinate. He had wet the bed twice yesterday waiting for the
nurse and three times today. The first time it happened he exploded. He
vented and screamed his rage at the embarrassment her delay had caused
him. The second time he was climbing over the side rails and his gown
got caught in the bedframe. He was forced to balance on the rail while
he attempted to extricate his gown from the bed's lifting mechanism. The
pressure of the rail on his stomach had proven to be too strong for his
overfull bladder to tolerate and he peed helplessly while stuck on the
rail. He was forced to call his nurse to extricate him from his
ignominious predicament. When she arrived, she went ballistic. She cut
the trapped end of the gown off with a pair of bandage shears from her
pocket, lifted him up form the rail and put him back in bed. She told
him in no uncertain terms that he was not to get out of bed unassisted
and would be strapped in the bed if necessary. He had snuck out of the
bed three times after that by climbing over the foot of the bed.
Today he got caught out of the bed twice and when the nurse demanded to
know what he was doing, he was too frightened and embarrassed to explain
clearly. He had mumbled something about wanting to sit down on the easy
chair to watch tv. When the nurse reminded him that the sound from his
tv came from the pillow speaker attached to his pillow, thus making
listening from the chair impossible, he looked vague, put his thumb in
his mouth, and told her he forgot. She put him back in bed, told him she
would be watching him and left the room. The second time he had been
trying to take a shower when the nurse burst into the bathroom. He was
startled by her entry and slipped on the wet floor and landed in a heap
on the tile. He was livid! He told her that she caused his accident and
if this happened again he would sue her and the hospital. She told him
it was all his fault; he had no business being out of bed without
assistance and his accident only proved that he needed to have someone
with him in the bathroom while he showered. She helped him up and
assisted with his shower despite his demands that she leave immediately.
When he had finished, she dried him off, regowned him and helped him
into bed. She told him his accident would be reported to his doctor and
measures would be taken to keep him in bed.
The nurse left the room shaking her head. No wonder the day shift said
this patient had an attitude. She intended to talk to his doctor when he
made rounds tonight. His threats had irritated her; she had read the
nurses notes about how he had wet the bed three times today. She'd fix
it so he didn't have to leave the bed to pee. For that matter, she
intended to fix it so he wouldn't be able to get out of bed.
North Central Memorial Hospital
Doctor's Progress Notes
Date: Sept. 5, 1998 Time: ~9:00 pm Patient: Darryl Burr
Diagnosis: Somatic Regress,
Vitals:
Pulse
87
B.P.
104/70
Resp.
28
Temp.
100.8° F
(rectal)
Weight
35.2 lb.
[approx equal]w
-6.6 lb.
Height
39 in.
Lab: Urinates every 30-45 min. (~3300 ml/day) [normal ~550 ml.], pO2 88,
pCO2 38
Other:
Measurements:(Normalized to values at admission), thigh 44%, calf 47%,
foot 58%, upperarm 47%, forearm 52%, hand 56%, muscle width; arm + calf
8.0 cm, height 57%, weight 24%
Dental: full set of baby teeth [deciduous]
General: Complete childhood Lordosis, Pt now has appearance and sound of
small child of approximately 4 years
Behavior: Pt. initially resisted, but now accepts use of diapers for
urination. Pt. requests the use of the toilet for bowel movements, but
on one occasion, soiled himself before nurses could assist him to
bathroom. Pt. is becoming increasingly dependent on his nurse for
assistance in basic activities. Pt. has difficulty using knife to eat
and needs his food cut up for him. Pt. sucks thumb frequently, sometimes
in the presence of favorite nurse. Pt. appears to be regressing
emotionally to apparent age. Pt. appears frustrated by crib top device
and cries when placed in crib.
Notes:
Orders: Nurses requested that the Pt. be given sponge baths in the crib
instead of showers due to the Pt.'s size and increasing loss of motor
skills.- Ordered
Life for Darryl became more and more difficult to bear; late last night,
night nurse had come in and forcibly put him in diapers. He had screamed
and tried to fight it, but to no avail. She had left and then returned a
few minutes later with another nurse in tow and a baby board in hand.
This was a three-quarter inch thick plywood board with straps attached
to allow recalcitrant babies to be tied down and treated. Darryl fought
like the devil incarcerated in a nunnery populated by charismatic nuns,
but he was quickly overpowered. They were too strong for him. He
struggled valiantly within the straps of the board, but once he was
belted to the board, he was defeated. Frankly, he needed to wear diapers
and knew it. He just didn't want to the nurses to think he wanted to
wear them. His nurse promised him he could use the toilet to poop in if
he wanted to, he just had to wear diapers to keep him from wetting the
bed. Then the next morning the nurses had come in and replaced his bed
with a baby crib. This was not just any crib but an all steel crib with
a matching steel barred top that enclosed the entire crib. It was for
all practical purposes, a cage. He cried for hours when they first put
him in the crib. When the nurse brought in a high chair for him to eat
his breakfast in, it was anticlimactic. He had fully expected it after
they had put him in a crib. An hour before, Darryl had a serious
accident in his diaper. He had called the nurse to take him to the
bathroom, but she had been delayed. His bowels had cut loose and he had
filled his diaper while he stood at the crib rail and screamed for his
nurse. One sniff had told her what he had done in his diaper. She
dropped the rail and laid him on his back to change him. Darryl had
never felt more vulnerable in his life. Darryl whimpered in
embarrassment and frustration. He turned his head away from her and put
his thumb in his mouth without realizing it. She comforted him saying,
"There, there Darryl. It's okay. It's just a little accident. You're
clean now. I put a fresh diaper on you. Don't worry, Honey. I'm not mad
at you. Lots of our patients have accidents."
The knowledge that she was speaking as a pediatric nurse did nothing to
quiet him. He knew that the patients she was talking about were all
children. He was losing his toilet training. His whimpering changed into
distraught weeping then anguished crying. The nurse picked him up, held
him to her and patted his back as if he was an infant needing cuddling.
He continued to wail for fifteen minutes before he became quiet. From
that moment on, she began to coddle and pamper him like a small child.
At first, he found her pity humiliating, but the loneliness of his
condition made any sympathetic human contact attractive. He found
himself becoming more and more dependent on her. When his coordination
deteriorated to the point where he had problems cutting his meat with a
knife, she cut up his food for him. He began sucking his thumb in her
presence and putting his arms out to be held by her. He felt silly
sucking his thumb, but lately the urge was irresistible. He tried to
hide it, but the other nurses had caught him sucking his thumb several
times. His regular nurse hadn't said anything when she caught him, she
had only smiled understandingly and continued with her duties. He was
glad she hadn't made an issue of it, sucking his thumb made him feel
better, more secure. Now Darryl sat in his crib, sucking his thumb and
watching tv. His tastes in tv had changed since he had been in the
hospital. He had quit watching news shows and watched cartoons almost
exclusively. He knew his behavior was regressing to match his apparent
age, but he was unconcerned. There was nothing he could do about it, so
he had resolved not to worry about it. He found himself wanting to have
his nurse beside him at all times. He called her constantly on the
slightest pretext. When she asked him what he wanted he was unable to
answer; he was finding it increasingly difficult to talk in compete
sentences. Later that day he soiled his diaper again after lunch. He had
not been able to exert any control over his bowels, they had acted on
their own. Darryl was glad he was wearing diapers, the thought of
soiling his bed was unbearable.
North Central Memorial Hospital
Doctor's Progress Notes
Date: Sept. 6, 1998 Time: ~9:00 pm Patient: Darryl Burr
Diagnosis: Somatic Regress,
Vitals:
Pulse
93
B.P.
98/64
Resp.
28
Temp.
100.4° F
(rectal)
Weight
30.8 lb.
[approx equal]w
-4.4 lb.
Height
35 1/2 in.
Lab: Urinates every 30-45 min (~2300 ml) [normal every 2-3 hours ~500
ml/day], pO2 88, pCO2 38
Other:
Measurements: (Normalized to values at admission), thigh 37%, calf 42%,
foot 52%, upperarm 40%, forearm 47%, hand 54%, muscle width; arm + calf
7.6 cm, height 51%, weight 22% (Normalized to values at admission),
thigh 44%, calf 47%, foot 58%, upperarm 47%, forearm 52%, hand 56%,
muscle width; arm + calf 8.0 cm, height 57%, weight 24%
Dental: 20 teeth; lower central incisors (2) [deciduous], upper central
incisors (2) [deciduous], upper lateral incisors (2) [deciduous], lower
lateral incisors (2) [deciduous], anterior molars (4) [deciduous],
canines (4) [deciduous], posterior molars (4) [deciduous]
General: Three large bowel movements during day; after breakfast and
after supper, there was a third in the midmorning standing at the side
of the crib. Alopecia of scalp; considerable thinning of hair, but no
bald spots. Fontanelle closed, big muscles well developed, abdomen
protrudes slightly, Lordosis receding, arms and legs shortened giving
Pt. appearance of toddler 2-3 years old.
Reflexes: Plantar reflex absent, neck righting reflex absent, Babinski
sign present, Landau reflex absent, accommodation present
Behavior: Pt. has little control over bowel movements, Pt. recognizes
when he has soiled himself & asks to be changed, loss of speech; Pt.
says short sentences only, shows cooperation at being dressed, uses
spoon, uses cup hesitantly. Pt. frequently sucks thumb in the presence
of others. Pt. has emotional reactions of a toddler of 2-3 years.
Demands constant attendance of favorite nurse.
Ambulation and range of motion: Unable to balance self on either foot,
Pt. losing fine muscle coordination, although can build a high tower
with blocks and fit a peg into its proper hole, throw a ball into a box,
walks unsteadily alone, good control with a spoon, poor control with cup
Notes: Screening for infectious agents negative, if final tests return
negative, will remove Pt. from isolation status and allow Pt. wife to
visit Pt.
Orders: Nurses requested the removal of the crib top device to
facilitate Pt. care - Pt. is now unable to get out of crib without
assistance, Nurses requested the removal of the Nurse Call button from
the Pt.'s crib., also requested the use of baby bottle when Pt. can no
longer control cup- Ordered
When Darryl awoke, his diaper was sopping wet. He called the nurse
repeatedly before anyone would answer him. His muscular control had
deteriorated badly during the night; he couldn't even stand on the crib
mattress without holding on to the bars. She changed him without comment
and thirty minutes later he was wet again. His noticed his body was
changing in shape as well as proportion; when he sat in the high chair
his protruding stomach almost touched the tray where there had been an
inch of clearance the day before. Eating was becoming more difficult
too. He had to grip his spoon in his fist instead of his fingers and he
had almost lost control of his drinking cup several times. His gown had
served as a bib and caught most of his spills. He soiled his diaper
again at midmorning while standing in the crib waiting for his snack,
causing him to wail in distress. He couldn't help himself, it was
becoming impossible to control his emotions and his thinking was
becoming foggier with each passing hour. He was becoming a infant in
every sense of the word. He realized that soon he'd be unable to utter
any intelligible sounds and would be reduced to infantile babbling. He
lost interest in tv cartoons, they were too difficult to comprehend. He
sat in his crib most of the day, staring out the window and sucking his
thumb. His bladder emptied itself every hour. He quit calling the nurse
to come and change him; it was too much trouble. Besides, he was getting
used to wearing wet diapers. Sleep came more easily to him; he found h
imself napping almost three hours a day in addition to the ten to twelve
hours he was sleeping at night. When he went to sleep that night, he
said goodbye to the world he had known. He knew that tomorrow his
personality would regress into infancy, taking his reason with it.
North Central Memorial Hospital
Doctor's Progress Notes
Date: Sept. 7, 1998 Time: ~9:00 pm Patient: Darryl Burr
Diagnosis: Somatic Regress,
Vitals:
Pulse
135
B.P.
93/63
Resp.
33
Temp.
100.8° F
(rectal)
Weight
23 lb.
[approx equal]w
-7.8 lb.
Height
30 in.
Lab: Voids urine continuously (~3650 ml/day) [normal 6-8 times day ~400
ml/day], pO2 88, pCO2 33
Other: Measurements: (normalized to values at admission), thigh 33%,
calf 37%, foot 48%, upperarm 37%, forearm 45%, hand 52%, muscle width;
arm + calf 7.2 cm, height 43%, weight 16%
Dental: 6 teeth; lower central incisors (2) [deciduous], upper central
incisors (2) [deciduous], upper lateral incisors (2) [deciduous]
General: Sleeps 10-12 hours night, naps easily - 20 min. to 3 hours
daytime naps, loss of large muscle development. fontanelle open,
pronounced protuberant abdomen, Pt.'s age estimated at 1 year old.
Reflexes: Plantar reflex present, neck righting reflex absent, Babinski
sign present, Landau reflex present,
rooting reflex present, accommodation present
Behavior: gives attention to people and objects, shows fear of strangers
and strange situations, Pt. has become uncertain and fearful; cries if
left alone, demands to be picked up and held by favorite nurse. Pt.
eliminates urine & feces automatically and does not recognize when he
has wet or soiled himself. Pt. cannot speak intelligible words or say
his name, but makes sounds like da-da and ma-ma, Pt. does not appear to
understand simple sentences when spoken to, Pt. indicates wants by
crying, Pt. will not feed himself with spoon, must be fed by nurses,
demands bottle for drinking, eats some chopped foods, a very picky
eater, more negative, especially at meals and naptime, Pt. sucks thumb
continuously, if given pacifier, Pt. will suck in preference to thumb.
Ambulation and range of motion: cannot walk alone, walks a side-step
pattern along furniture, otherwise walks a wide-legged gait, but prefers
crawling, creeps like a bear; hands and soles of both feet in contact
with floor, gets to a standing position from a squat, pivot a quarter of
the way around, can sit up strongly without support, uses one hand more
than the other, fine motor coordination nearly absent; builds a tower of
two blocks and fits a peg into its proper hole with difficulty, cannot
throw a ball into a box, cannot control cup, cannot lower himself from a
standing to a sitting position without falling.
Notes: Removed Pt. from isolation status in a.m., Pt. will remain in
isolation room to insure privacy. Allowed wife to visit, but restricted
visits from other family members.
Orders:
Brydie sat gloomily in the Pediatric Waiting room looking out the
window. A fast moving storm was coming in; the black clouds boiled
angrily as the front swept over the city. The cheerful pastel designs on
the wall were muted by the room's growing darkness. Brydie waited
impatiently for the doctor to arrive, the nurses had told her that the
doctor had taken Darryl off isolation status and she could visit Darryl.
Dr. Halstead had requested that she talk to him before visiting her
husband. She waited about an hour in the Pedi waiting room becoming
increasingly frustrated. The nurses were taking care of patients and the
nurses' station was unoccupied except for the unit clerk. She decided to
take matters in her own hands and slipped into the isolation room when
the unit clerk was occupied. She entered the room quietly, expecting to
see Darryl in bed. The room smelled of disinfectant and baby powder.
There was a curtain around a bed in the center of the room. She went to
the curtain and pulled it back. All she saw was a sleepy rosy-cheeked
tot wearing a small paper patient gown standing in a crib. The crib was
stainless steel and completely surrounded the little boy; even the top
of the crib had bars. He looked like he was in a cage. He must be a
handful if they have to put him in a crib like that, she thought. She
turned to leave when Darryl's nurse came in the room with a stack of
diapers in her hand. "Oh, there you are Mrs. Burr. Is Dr. Halstead still
here? I need to talk to him."
Brydie shook her head no and demanded, "Where is my husband now? The
clerk at the nurses station told me that he was in this room, where have
you moved him?"
The nurse looked puzzled and said, "He's right here......Ohhhh...You
haven't talked to Dr. Halstead yet, Have you?"
Brydie replied testily, "No, I've been waiting a hour, but I haven't
seen him. What do you mean he's right here? There's no one here but this
baby," Brydie said turning and pointing at the crib.
She glanced at the card taped to the footboard of the crib and saw that
the patient's name had been written on the card with a black marker. It
said Darryl Burr. "This has to be some kind of horrible mistake! That's
not my husband," she said angrily.
The nurse looked at her sympathetically and said, "If you'll come with
me, I'll see if I can find Dr. Halstead."
Brydie looked at her stubbornly, determined not to move until she found
Darryl. She said, "What's going on here? Why does this crib have my
husband's name on it? Why did you say he was here? Where is he?"
"I think I'd better let Dr. Halstead answer that question," the nurse
said primly.
Brydie stood her ground and said softly, "He was getting younger when he
came into the hospital. You can't mean that this is my husband?", she
said turning back to look at the nurse.
The nurse's face was set in an expression of barely concealed sorrow and
nodded involuntarily. Brydie turned and looked at the baby again and saw
the resemblance between her husband's baby pictures and the tot in the
crib. "Darryl!', she cried. "What have they done to you?"
She ran to the crib and dropped the side. Brydie wrapped her arms around
him and hugged him tightly. She kissed him repeatedly on the face and
said, "Oh my darling, What's happened to you?"
Her hands moved lower on his body and felt the diaper. "They've put you
in diapers!", she said in a surprised tone.
She turned back to the nurse and demanded, "Why is he in diapers?"
The nurse looked embarrassed and said, "Doctor's orders, Mrs. Burr. He's
lost his toilet training."
"He's a grown man, no matter how he looks. He doesn't need diapers!",
Brydie said defiantly.
The nurse looked at her sadly and said, "He's wet right now, Mrs. Burr.
I checked his diaper a few minutes ago. I left to get some clean
diapers. That's where I was when you came in here."
The nurse sniffed and said, "And I think he just pooped too. Let me get
him in some clean diapers"
Brydie look at her in disbelief and turned to Darryl. She lifted the
gown and looked down at his diaper. It sagged low on his hips and was
obviously soaking wet. She could smell it too. The nurse was right. He
had pooped in his diaper. She hadn't noticed it in the excitement. "Oh
Darryl, Now look at what you've done!", she said in dismay.
He smiled innocently at Brydie, completely unaware of his dirty diaper.
"I'll change him," Brydie said resolutely.
The nurse nodded and handed a diaper to Brydie, who began to change
Darryl. She laid him on his back and removed the diaper tapes and pulled
the front of the diaper down between his legs. Darryl chuckled happily
and kicked his feet. "Be still, Darryl!", Brydie said and finished
changing him.
She folded the dirty diaper together and handed it to the nurse. Brydie
picked up Darryl from the crib and carried him over to the easy chair
and sat with him in her lap. Darryl looked up into Brydie's eyes and
patted her cheek affectionately with his hand. "Oh my poor darling,
what's happened to you? Speak to me!", she said.
Darryl smiled at her, then made a cooing noise. "You can't talk anymore!
Nurse, how long has he been like this?"
"About a day, Mrs. Burr. Yesterday he could say simple sentences, but
today he hasn't talked at all," said the nurse.
"I should have stayed with you the whole time you've been in the
hospital," Brydie said miserably.
"It wouldn't have changed anything, Mrs. Burr. We're doing all that can
be done," the nurse said, trying to comfort Brydie.
"Try and talk to me, Darryl. Please try and say something!", pleaded
Brydie.
Darryl's face assumed an expression of concentration and he said,
"Mmm....Ma...Ma-ma!"
"Oh my poor husband, you're talking just like a baby!", she said
pityingly. She cuddled him to her breasts and said, "It's okay, Brydie's
here honey. Brydie will take care of you. Don't worry darling,
everything will be alright."
She comforted him, murmuring sympathetic noises lovingly over him as the
nurse silently left the room. An hour later the nurse returned and
announced, "It's time for lunch, I'll be bringing his food in a few
minutes. Would you like to feed him?"
Brydie nodded and the nurse left and re-entered with a high chair. She
set it up and said, "Go ahead and put him in the high chair. Leave the
gown on him, we don't have any bibs. I'll bring him a new gown after
lunch."
She went out of the room and returned with some jars of baby food, a
feeding spoon and a small pre-packaged bottle of infant formula. "He
drinks formula from a bottle too?", Brydie asked unhappily.
The nurse nodded and handed Brydie the food and bottle. She told her she
would be back later and get the high chair after he finished lunch.
Brydie fed him mixed vegetables from the jar, followed by a chicken
dinner with macaroni. She gave him the jar of apple cobbler for dessert,
then wiped his face and hands with the gown and removed it. Brydie
folded the jars into the gown and put it in the trash can. She took him
out of the high chair and sat him in her lap on the easy chair. She
fondled his cheek gently with her fingers and smiled knowingly as she
saw his mouth make unconscious sucking movements. Darryl reminded her of
their daughter Carol when she was little. Rain started to patter on the
window as she tilted him back against her arm and put the nipple of the
bottle in his mouth. He seized the bottle with both hands, eager for his
noon bottle. She stroked his hair as he surrounded the nipple with his
mouth and suckled hungrily, murmuring in delectation while making loud
sucking noises. "He looks like his baby pictures taken when he was a
year old," she thought to herself as she watched him consume the formula
greedily.
He finished the bottle and she sat him upright on her lap. She patted
his back to bubble him and was rewarded with a loud burp. She laid him
back on her arm again and cuddled him close to her. Distant thunder
rumbled in the background as he smiled winsomely and tugged on the front
of her blouse. He thoughtlessly put his thumb in his mouth and began
sucking it. He looked like every mother's dream of a charming, cheerful
baby. "Oh my precious angel, you've regressed into infancy!", she wept,
cuddling him with both arms to her bosom.
"I'll get the best doctors for you, Honey. We'll get you in
rehabilitation so you can re-learn how to walk and talk again. You'll
have to wear diapers until they can do something about your incontinence
though. I hope they can reverse the changes in your body and make you
grow again. You look like you're a year old. Poor Darryl, I don't know
if you'll ever be normal again."
Bitter tears rolled down her face as she wept for Darryl. He reached up
and touched her cheek, bewildered by the tears. She looked back into the
baby face gazing up at her in confusion. He smiled at her hopefully and
touched her lips with his tiny fingers, trying to capture her attention.
Drool rolled down his chin as he bubbled and cooed at her. The storm
clouds outside parted momentarily and a shaft of sunlight came through
the window and illuminated his face. She looked into his eyes and saw
that behind them lay a fundamental lack of comprehension of the world
around him.
"Oh God, Darryl, your mind is gone!", she said, stunned by the sudden
realization. "What's happened to you? Can you understand me? Wave your
hands if you can understand what I'm saying! Do something Darryl! Don't
just lay there! Oh God, it's affected your mind too! You not only look
like a baby, you are a baby! You can't even understand what I'm saying!
You have the mind of a infant! No wonder they've been treating you this
way, you've become a diaper-wetting, drooling baby again," she sobbed.
He sensed her anguish and started to whimper. Brydie snuggled him
protectively against her and comforted him saying soothingly,
"Shhhhhh.....There, there, Darryl... I'm right here. ...Don't worry,
I'll take care of you! ...Don't cry baby, it'll be okay."
She rocked him silently, tears streaming down her face. He quieted and
lay his head serenely against her breast. She sat looking down at her
diaper-clad, infant husband tenderly as the last silver beads of rain
ran down the window pane and hoped the doctors could reverse this dark
miracle. He put his hand to his side and tugged on the adhesive diaper
tab, trying to take it off. Brydie took his hands away from the diaper
gently, saying, "My darling, you've lost control of your bladder and
bowels, you're going to have to wear diapers until you're potty-trained
again. When you can control your peeing and pooping, I'll let you wear
regular underwear."
He gurgled happily, blew bubbles, then grinned a gap-toothed smile while
peeing in his diaper.
"He looks so much like Carol looked when she was a baby. If Carol had
been a baby boy instead of a girl, she would have looked just like him,"
she thought.
He yawned sleepily, then stretched his small fat arms and clenched his
tiny fists. He turned his head and nestled it between her arm and her
breast. "He looks so terribly innocent. You'd never know he'd been a man
once," she told herself as she pulled the top of the diaper up over his
protruding tummy.
Her maternal instincts were aroused by the sight of her infant husband
snuggled protectively in her bosom. "Look at him. He's completely
helpless. He can't do anything for himself," she whispered to herself.
"I'll have to take care of him like he's a baby. He supported and cared
for us all these years. Now it's my turn to take care of him. He needs
me to be his mommy now," she thought.
"Would you like me to be your mommy, Honey? Do you want to be Brydie's
baby boy?"
Darryl bubbled with glee as he reached up and plucked at her breast.
"Darryl likes that idea, doesn't he? Darryl will have a mommy to tend to
him and watch over him. Darryl will never have to worry about anything
again."
She smiled down at him indulgently as he put his thumb in his mouth and
resumed sucking. Brydie tickled