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Literature / The Patient

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"I write this because as of this now, I am not sure if I am privy to a terrible secret or if I myself am insane."

The Patient is a 2020 novel by Jasper De Witt. Starting originally on Reddit's No Sleep board under the title "The Patient That Nearly Drove Me Out of Medicine," the story was later optioned by Ryan Reynolds and then published as a standalone novel by Houghton Mifflin Harcourt. One of the few Reddit works to successfully make the jump to traditional publishing, with Pen Pal being the other big example.

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The year is 2008, and Dr. Parker H——- (all the characters have their last names blanked out this way to protect anonymity) has just started work at the Connecticut State Asylum. On the day of his first interview, he witnessed an orderly being wheeled out of a room, tied down to a gurney, screaming about one particular patient. Parker soon discovers that this patient, known only among staff as "Joe" and rarely discussed due to his fearful reputation, has been kept in the hospital for 30 years with no diagnosis. Everyone who's tried has, apparently, gone insane and/or killed themselves before they could figure "Joe" out. Parker, being convinced that his Ivy League pedigree and mental toughness from witnessing his own mother's violent mental illness at a young age will shield him from a similar fate, decides that he should try his own hand at figuring out the mysterious "Patient." What could go wrong?

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As it turns out, quite a lot.


The Patient provides examples of:

  • Admiring the Abomination: Parker, sort of. He certainly has a healthy respect for Joe's species by the time the novel's over.
  • Adults Are Useless: Joe's parents, and also Dr. A———.
  • Affably Evil: Joe wants Parker to think Dr. G——- is this. In reality, Joe is much closer though still not so much "affable."
  • All in the Eyes: Parker describes Joe's expression in his hospital photo as a "feral, wide-eyed stare."
  • Ambiguous Gender: Depending on what you think happened to Parker's wife, Joe's species may have this.
  • And I Must Scream: The real Joe's fate. Suffocating to death in your own wall while the monster that's tormented you for over a year takes your form and persuades everyone it is you.
  • Ax-Crazy: The general consensus on what Joe is. It's so much worse.
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  • Demonic Possession: One of the theories about what's wrong with Joe. It's wrong.
  • Driven to Madness: Lampshaded by Parker as something that might have happened to him in the process of treating Joe. It's hard to tell how much of the story is real or a delusion of his.
  • Evil Smells Bad: When Joe escapes the hospital, he does so in the form of a torrent of what is implied to be (or at least smells like) piss and blood.
  • Humanoid Abomination: Joe’s true nature, being a bizarre, sadistic shapeshifter that pulled a Kill and Replace on the real Joe before going on to commit terrible crimes in his name.
  • I Know What You Fear: The thing that calls itself Joe plays on people's fears or insecurities, to the extent that it's kept in solitary confinement after traumatizing several patients.
  • Unreliable Narrator: Parker, and possibly every account of Joe's treatment.
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