The Laryngeal Switch

"Spasmodic dysphonia is a voice disorder. It causes involuntary spasms in the muscles of the voice box or larynx. This causes the voice to break and have a tight, strained or strangled sound."

Spasmodic Dysphonia, definition, courtesy of Johns Hopkins Medicine


"...I'm trembling because of you."

Translations, Brian Friel 








Content Warning:
Strong sexual content, abuse

Transcript

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The Laryngeal Switch

            Patrick P. Shaw had many letters after his name, too many to announce in one go without their utterance becoming an arcane, meaningless, and interminable string. He displayed his certificates of qualification, proudly, around the walls of his little subterranean office in Broadpig Street, and every letter after his name was accounted for with a certificate or diploma from some relatively prestigious awarding body or another. A number of disciplines lay within his hands, and within his mind- (and in his office cupboards- for those requiring intermediary tools): champissage, acupuncture, manual therapy, laryngeal massage.

            Patrick’s background was in voice: before undergoing a career change and entering the wellness world he had been in the theatre. An actor first, and then a voice tutor and vocal coach, he continued to find himself drawn to the human voice, and the beautiful mechanism responsible for producing it. Though he did not miss the theatre, nor the drama school, and less so with every passing year, he had not moved on from his deep and mysterious love affair with the human voice. Though it was his way of making a living, it was more than that too: it was his place of play and exploration, a throaty throbbing playground for his soft, curious hands: a sanctuary to which he was admitted, in tenderness. He could do more than just listen to a human voice: in his expert hands, he was permitted to enfold the bobbing tube of flesh and tissue where it originated. All the while the larynx lifted and fell, and the vocal folds contracted and relaxed, danced well or ill portraying the being of their bearer, Patrick P. Shaw could feel it all. He remained a specialist in this section of the human body, and offered laryngeal massage not only to people bound to use their voice professionally, (actors, voice artists, operatic vocalists, rockstars, science communicators, public speakers- even air traffic controllers, Samaritans operators, medics, and accident rescue staff), but also to anyone and everyone else experiencing vocal discomfort, structural disturbance, or obstruction of any kind. A great deal of the time he received into his practice clients struck with throat ailments who had been referred to him by GPs that pronounced that vaguest of Western diagnoses “Globus Pharyngeus”, the Latin for “Lump in the throat”…the average person was quite able to get that far without seven years of medical school, and so they were referred to Patrick Shaw to explore deeper possible causes for their discomfort than Western medicine was able to probe, in the hope that he would be able to offer a more nuanced means of alleviation. One or two wealthy and eccentric hypochondriacs regularly visited Patrick’s office, just one juncture along a lengthy and comprehensive weekly routine of specialist visits, but though he found their incurability and neurosis and paranoia trying, he was ever professional and treated them with the same positive regard due to any patient, any person that set foot in Patrick’s office to avail themselves of his tactile therapies. Patrick took very good care of his own voice: he was able to shout, should he so wish, to great effect, incurring no damage to his healthy folds. 

            On one overcast day, just as a thin rain was beginning to patter upon the awnings and asphalt and car rooves of Broadpig Street, Patrick said cordial goodbye to a woman with painful laryngeal nodules whom he had spent a fairly lengthy session working with. It was the second time that they had encountered one another. The first time she had been closed, impenetrable, wary: this time she had opened up about the difficult circumstances of her home life. Her voice portrayed a being long subjected to terrible stresses and strains; yet she had been adamant, there was nothing wrong in her personal life, the problem was mechanical, arbitrary. But after a while, that second time, a special moment had bloomed between them in the little office: a warm wave had risen up through her, as if from beneath her feet…frightening, at first, in its approach but healing once accepted and submitted to. While Patrick held the voice in his hands, held with great care the damaged larynx like fruit, as this wave went through her, finally her truth was granted its safe expression, as though by the unlocking of a metaphysical door. She parted from Patrick, shaken, but changed, changed for the better, and accordingly hopeful as she set off down the street, turning left at the end of Broadpig onto Cliff. The rain was wetting shirts, hair, making puddles in the cobbles. Patrick retreated to the shelter of his office and consulted the schedule. He had a new patient in half an hour; the patient had put down no name on the online booking system. This was unusual. It was the last patient of the day. 

            Patrick ate some tabouleh, and drank a cup of coffee. He tried to take a quick ten-minute nap as he was feeling sluggish but found himself unable to enter even the shallowest of sleeps. But he had hardly any time: as it turned out, the new client came about ten minutes early. A strange high voice begged admittance at the outer door, over the intercom:

            “Please could I… could I come in?” it said.

            “Come right in,” Patrick said, and electronically unlocked the door.

            “Thank you…k-kindly,” the voice said. Regardless of its electronic distortions, Patrick was able to tell that the voice was strange, unhealthy, tight, poorly modulated, stifled.

            At the end of the long corridor onto which Patrick’s office door opened, a curious figure appeared. The character, skinny, toweringly tall and ghostly pale, revealed a completely bald head beneath his quaint pork-pie hat. He carried the hat in his hands, having quickly and courteously removed it: the left of the two hands was bandaged. His spectacles were immediately distinctive, they impressed their bold black frames upon Patrick quite strikingly. Within, the lenses gradually lightened- having been turned black by the exterior natural light. The figure, stooping slightly because of his height, approached Patrick and took him by the hand.

            “Pleased to me…meet you, Patrick,” the man said, grabbing Patrick’s hand in his right hand.

            “Hello, hello! And your name is?”

            “Anonymous. I shall remain a-a….anonymous, tha-…ank you,” the man insisted, with surprising abruptness.

            Patrick had already received intimations of it over the intercom, but immediately the man’s vocal predicament told, as his voice unresoundingly sounded in the dense, dry length of the corridor. Patrick was able- with great swiftness- to name the ailment he heard in the man’s speech, a sort of cutting out every so often of the voice, a startling crunch of silence that muted his speech though the lips around it continued to move, then he’d to sharply hiccup, purposefully, in order to continue speaking. The natural sound was high tenor, and a little piercing, touched with the faintest tremor, almost like a kind of nervousness as it apprehensively awaited the major dysphonic disturbances. Spasmodic dysphonia, momentary abductory, there could be no doubt. The man’s case was not mild, nor was it terribly severe: in Patrick’s mind, he placed it somewhere on the continuum between moderate and severe. The man seemed ashamed of his dysphonia, whenever the intermittent whisper kicked in, he ceased to speak, and then continued, reclosing the vocal cords which had insubordinately opened causing the voice to cut out. 

            Patrick had encountered numerous cases of spasmodic dysphonia, both adductory and abductory, all severities, and countless gradations of tonic, fry, cry, and tremor intermixed. However, he had never received a patient who wished to remain anonymous. This struck Patrick as exceedingly strange. As the man entered, and seated his skeletally slender form upon the nearest chair to the office door without being offered it, Patrick wondered why this man would not share his name, what reason did he have for clinging on to it so tightly, refusing to give it up? Patrick looked his newest patient up and down and realised that he was clothed entirely in black: black coat, black trousers, black shoes, black socks, a black shirt, (behind which a black vest was evident through an undone top two or three buttons), and Patrick had, additionally, every reason to suspect that his client’s underwear was the same colour as the rest of him, though in his present capacity the matter of the underwear colour would have to remain a mystery; and the pork-pie hat, which the man had placed upon the floor, was black, and the transition-lens glasses upon the man’s face had frames as similarly black as the ace of spades.

            “Let me take your coat, sir,” Patrick said.

            The man shed his coat, with some difficulty, as though it were a second skin. Patrick received it gratefully and hung it upon the office coatrack.

            “That’s a…n- …ice skel-e-t-n” the man remarked, greeting the office skeleton against the wall, by the massage table.

            Patrick didn’t say anything in reply.

            “As you can…h- hear…my voice is fail- …failing me,” the man began, going on to steadily, slowly detail what exactly had brought him to Patrick’s practice. He volunteered some medical conditions and health history, and explained to Patrick what he wanted to achieve by being there at his practice, that people were struggling to hear what he was saying, and the dysphonia (what he incorrectly called stammering) was negatively affecting his professional life- dentists are vocal creatures he would go on to repeat a number of times.   

            Patrick entertained, for a while, his client’s misapprehensions and layman’s descriptions of his condition. Patrick had learnt to listen to what people have to say, learnt to allow them the space to express it: though invariably inaccurate, it might just prove instructive.

            “What do you do, may I ask?” Patrick enquired.

            “I’m a dent- dentist,” the man answered.

            “Oh, really?”

            “Yes. Sh-…show me…y-…your teeth.”

            “You want me to show you my teeth?” Patrick said, perplexed.

            “Please…” the man beseeched.

            Patrick reluctantly obliged, parting his lips in a square shape, revealing his teeth, each set, both upper and lower, brought together in a bite. The client peered at them inquisitively.

            “I lo-…love tee…teeth,” the man said.

            Patrick’s teeth withdrew from public view.

            “Please lie down on the bench, sir, facing up” Patrick said.

            The man obliged, lowering the back of his head into the cushioned dip of the headrest at the end of the bench. Longly he lay, his feet well beyond the end of the bench. Patrick saw the man into position before turning his back and gloving his hands in the regulation black gloves, tight, sensitive, non-latex. Patrick felt a small sense of unease about this man, the tiniest intimations of darkness: tiny trepidation knocked at the door. Hands now gloved, Patrick took a little massage-wax on each clothed digit from the little apricot-coloured pot on the tabletop. A second later, he became quite suddenly aware of a little snuffling sound. Patrick turned around, and he saw that his client had covered his eyes, hidden their two secret shining darknesses in his palms. Beneath the down-turned palms, he was crying, softly.

            “What’s the matter, sir?” Patrick enquired.

            But the man, supine on the table, shook his head. The wide, deliberate shake almost certainly meant Please, don’t make me speak. Patrick approached the man, and said:

            “I can tell right away listening to you speak that you’re suffering from what we call spasmodic dysphonia. Essentially, the vocal folds are opening when they are meant to be shut…they’re separating when they’re meant to be together, that’s what’s causing that block while you’re speaking, that feeling like your voice is disappearing.”

            The man had continued to cry softly while Patrick spoke but he let out a loud and painful-sounding sob just as soon as he had heard his circum-laryngeal masseur say the word “disappearing”.

            “I’m going to put my hands on your throat now, sir, is that alright?”

            Patrick looked down and registered a nod. He touched the larynx beneath him: a gulp lifted the deposited fingers and dropped them back into place again. It was almost sharp, the small prick he felt from the Adam’s apple as it bobbed with movement. Patrick left his hands in place on his client’s neck, he abandoned those hands in a sense, as though they had become tools rather than body parts. While thus engaged, they were indeed tools, those qualified hands. Lingeringly, pausing the forward progress for a short deliberate, contemplative bout, Patrick allowed for the possibility of a bond to form between toucher and touched. The man’s soft sobbing gradually died away. After a brief period of stillness, Patrick moved his hands and began to explore the man’s larynx. Then he ventured:

            “So, what I do, broadly speaking, is called Myofascial release. So, what I’m going to do is to apply some pressure to the larynx, what we might call a Myofascial “hug”. You’ll feel some pressure on your larynx; it’s perfectly safe but please tell me if it hurts, okay?”

            Once he had received the nod, Patrick laterally displaced the larynx with his left hand. It shifted within its vertical, fleshy tube of residence. Patrick then carefully manipulated the larynx as he purposed, before reaching, with primed fore and middle fingers on his right hand, quite eagerly- almost hungrily, into the thick taut throatiness, seeking the very beautifully named Arytenoid cartilages that he wished to palpate. That was when he discovered something astounding…

            …The feeling of what Patrick became quickly certain was a switch, just like a plug socket switch or a light switch or a lamp switch or the switch with which the house hoover might be summoned into action, was so singular and so startling in such a place as the middle of a man’s larynx that Patrick gasped aloud.

            “What the fuck…?” he muttered.

            “Hm?” his client grunted.

            “There’s a…what is this? …give me a moment,”

            Softly, Patrick felt it again on his fingers. He was so confused that he removed his gloves and went in again, unsheathed. In clement curiosity, he located it again, beyond any doubt: a switch.

            “You appear to have a switch on your larynx?”

            “A sw…itch?” the client replied: Patrick couldn’t tell whether he was learning of this affliction for the first time or simply taking issue with the word “switch”.

            “Like a light switch, a button…”

            “Oh, yes,” the man on the massage table said after an incredulous silence. “Do not touch that.”

            “Oh, so you know about it already then?” Patrick enquired.

            “Yes.”

            Patrick knew better than to ask, but he couldn’t resist, under such peculiar circumstances.

            “What happens if you press it?”

            The man with this laryngeal switch contemplated his switch for a moment. Perhaps it wasn’t an affliction; perhaps it was a power, Patrick thought…

            “It’s a secret. It’s a secret inside me, a secret that’s part of me” the man replied, enigmatically. “Only very few know that it’s there, only a very small number of people know of its existence”. Miraculously, not a single whisper interposed, as if his vocal folds respected that he had something important to share.

            “But what does it do?” Patrick further enquired.

            “That’s a very personal question indeed,” the man answered. “I don’t think I can share that information with you.”

            “You don’t trust me?”

            “Not yet.”

            Patrick felt deflated. He felt a great sense of rejection enter and span his entire being. With the downward pooling and dropping of this sensation, down as deep as the souls of his feet, he felt utterly bleak within his soul.

            “But…” Patrick protested. “I’ve got…I’ve got so many letters after my name.”

            “Do not press the switch,” the man said. “Do NOT press it, alright?”

            Patrick always respected a patient’s stipulations, boundaries, feedback.

            “Of course,” he said.

            He palpated and manipulated the man’s larynx, he moved it one way and then the other, held it in a position of some stress and then released it back into its natural state. The man hardly let up a single syllable of complaint. Patrick continually prepared his patient for what he was about to do to his larynx, and continually listened to the man’s response to each move. The reply was always tepid but unflustered, and unconcerned. Patrick listened to a few long vowel tones that he got the man to produce in order to monitor the voice’s response to his manual manoeuvres. Still the voice was regularly stifled by its intermittent whisper. And yet Patrick could hardly detect any trauma at all in his hands.

Underneath it all, all the while the session went on, Patrick felt bothered. He concealed his complaint well beneath the polish of his professionalism’s several layers, but he could not dispel the overwhelming feeling of rejection that he felt. First this dysphonic patient’s name withheld, and now this, the purpose of this switch on his larynx. Suddenly, quite without warning, Patrick went in and pressed the switch. His curiosity overcame him, and the suddenness of the overcoming took both Patrick and his patient by surprise.

            “Ow!” the man said, reacting to the sudden stab. The switch had been a little difficult to press, as though it were bunged up with flakes of dirt, stiff with unuse. But it was well and truly flicked, there could be no doubt.

            Patrick stepped back, already admonishing himself inwardly for his breach of contract, this sudden lapse in professionalism, purely out of a curiosity to which he had been unable to refrain from succumbing. Mystified by what was occurring inside of him, though it seemed as though he recognised the sensations even while he was mystified by them, a few seconds after saying “Ow” the man’s eyes shut and his whole body solidified. The spell was indeed one of solidification, but it wasn’t yet concluded. Quite suddenly, and by a large and identifiably betraying bulge in the crotch of the man’s black trousers, Patrick was able to recognise that his anonymous patient with a switch on his larynx was fully erect. Did this laryngeal switch switch on the man’s sexual function, call it into being while making the rest of him static and comatose? Patrick was quite intrigued. He removed his gloves.

            …Would this opportunity ever arise again? the opportunity to have, at his disposal, a patient, alive, and yet senseless; not a patient: a subject. Yes, a subject. Patrick knew that he should press the switch again, return the man to his prior state, and he took it to be the case that, like any lamp, he might alternate between the man’s two states with considerable ease: On, off, on, off. But the rareness of this opportunity enthused him. The man was quite dead, responseless. All that he could do to the man’s uvular orifice, the store of fruit-like parts in the red cavern of his throat, his entire outer body, he had done before to patients under far more normal conditions of life than this. What he had at his disposal, supine and comatose, seemingly mindless, perfectly anesthetised upon his massage table- this wonderful foamy gurney by which he earned his bread-, was a chance to know someone more privately than he was usually able, more intimately, unhindered by consent, consent was a fence that no longer surrounded the only softly throbbing fleshy reality of this man. If only it were a woman: somewhere, Patrick consoled himself, was a woman with a switch on her larynx that shut her down but turned on her sexual function. Why should two states of being be so disparate? Why should sexual function only be permitted within this sedative unconsciousness? Patrick lifted the man’s eyelids, which stubbornly resisted opening: he looked like he was in perfect oblivion. Could Patrick transpose his massage table to an operating one? Look inside; cut away: see! No, he couldn’t, not a chance.

            …Patrick reached forward, intending to press the switch and reanimate the man (and presumably deflate his privy member), but he was held back from doing so by this sense that he must take advantage of this laryngeal switch or he would regret it: having pressed it, he dared and double-dared himself to take advantage of its effect. This man wasn’t as worthy, Patrick told himself, equivocated, spun, propagandised to himself, he wasn’t as worthy as some of his more distinguished clients of the same ethical consideration. Patrick looked at the pork-pie hat, redundant and unsnug upon the floor. This man was strange and unlovable: no-one could begrudge Patrick taking unethical and illicit advantage of this odd, long, unlovely man, with his black clothing and his pale pale skin, upon the massage table. Patrick offered himself one last chance to do the right thing, and let it pass him by. The switch on the man’s larynx remained pressed.

            Under the circumstances, what Patrick did next really did seem the right thing to do, the most appropriate course of action. He had never seen another man’s penis, not at such close quarters, certainly not under such a condition of focus; never anything more than a vague flash of tousled grey dangling about in some peripheral corner of a communal changing room. Patrick touched larynxes for a living- he was great at it- why should he not try his hand at the phallus? He unbuttoned his client’s jet-black trousers, and jetter underpants, and surveyed his substantial erection, the taut red rod helmeted in shining purple. Patrick had never touched any penis but his own. Up until this very moment, he had not considered such a poverty of experience an injustice. Now, in hesitant apprehension and a welling thrill he did not well comprehend, he touched this penis, with nothing more than the tip of a craning index finger at first, withdrawing swift. But then,  advancing again, he took braver, firmer hold of his client’s turgid, toothpaste-tube-sized, flesh-coloured shaft. The testicles never seemed, at any point, to become relevant.

            He felt perverse and wrong and yet intensely engaged, tremblingly alive as he handled this man’s secretest part, his vulnerability exposed and held in Patrick’s very hand. With great interest, he watched as he folded up and pulled back down the almost perfectly proportioned foreskin, revealing and concealing and re-revealing the glistening penile head. The massage table seemed sullied to Patrick, christened, (at last) and for the first time, in the squalor of the unprofessional. All the certificates around the walls of the little office, responsible for the alphabet soup of qualifying letters after his name, gazed, like weary eyes misty with disappointment, upon their straying owner, as Patrick once again went too far, went right on pumping the upstanding penis in his hand, a hand experienced upon no other penis but his own (though the larynxes of many of course).

            Although comatose, the owner of that responsive, sturdy, purposeful penis experienced a hearty ejaculation. A smile spread across his face, and his slumbering form sagged in relaxation. The penis drooped, retiring drowsily back to his previous state. Patrick looked down in some horror at his semen-stained hand. Scenting the foreignness of this man’s sex upon his hands, revulsion filled him and pushed two tears from his eyes: one pearled drop and then another joined and commingled in the white moisture upon his upturned palm. The situation was upsetting and unfamiliar. He was dizzied to consider the betrayal, the many betrayals contained within this one act: and he the committing deviant! He had betrayed his code, his professional ethic, his integrity, this man, Christine. Was this the most betraying touch he could have laid upon another human being? Judas, Judas, Patrick admonished, and poor Christine! Could he ever lay his offending hand upon her shoulders and her neck with the purity he had before? this secret would forever remain, trapped, in the deft and yet spiritually disordered digits, sullying, complicating, squalid, festering. Patrick had no notion as to what he should do. His earlier curiosity was quite satisfied, and it was far from the only thing to find itself satisfied. Now he, the satisfier, felt sordid, and quite naked- now that he was without the engulfing urgency of whatever strange spell it had been that had led him to take the course of action that he did. Sticky with his curiosity’s aftermath, he looked around the room helplessly, having quite simply no idea what he should do. For such a happy ending, he couldn’t help but notice that he felt incredibly distressed.

Patrick couldn’t bare the thought of rousing his patient with the laryngeal switch… laying a finger upon the place where he knew it to be, flicking it back into its previous position, only for this man upon the practice table, flushed post-climactically and flecked here and there upon his person in semen, to come alive, notice the heated heaviness of post-orgasm in himself and the general starchy moistness in the front pouch of his pants, and find that he had been heinously molested by someone he thought he could trust.

            Patrick decided to rectify the situation in what small ways he could: he bathed the patient’s penis and cleaned underneath and around it with a damp folded cloth. He folded away the man’s genitals and rebuttoned him. He reached down, picked up the pork-pie hat, and laid it upon the man’s face, covering up his features.

            Patrick cleansed his hands in the sink with soap and wondered if they were now forever sullied. In the sink mirror he could still glimpse the flat form of the man, the pork-pie hat over the face. He was as still as a corpse. Patrick wished with a great sigh that this anonymous man with a switch on his larynx had never set foot in his practice. He bolted over to his schedule. He was relieved to rediscover that the rest of the day was empty.

            Patrick, after struggling to locate it for about twenty terrified seconds, located his mobile phone beneath a folder. Before his wife’s mobile number was fully dialled, he was able to catch one last look at the crumpled set of stretchable gloves upon the rim of the sink. His ear to the screen, he heeded five of the usual trochaic rings as contact with his wife’s receiving device was attempted, the signal vaulting at amazing, luminous velocity across acres and tracts, across hundreds of miles of commuter distance, wires and wires, pylons and pylons, trees and streets and houses and towns, roads and traintracks, all those souls; and then his wife answered.

            “Hello, darling?” she said.

            Patrick’s voice had grown used to silence. Actions spoke louder than words in his world, and this day had been no different. The instrument of his voice had been retired for what felt like a long time, so he found it difficult to speak at first. He was surprised by the sound that came out:

            “Hello,” he croaked. He coughed away whatever clag was among his vocal cords.

            “What is it, darling?” Christine enquired, cordial but clearly a little busy.

            “Um…” Patrick didn’t know what he was asking.

            “Is everything alright, Patrick?” Christine asked, growing concerned.

            “What’s for…” Patrick’s voice sounded odd to him. “What’s for…di- nner?”

            “Um, I don’t know, Patrick…you sound dreadful, dear, is anything wrong?”

            “No, er…”

            Listening in his head to his own voice, the symptoms were harder to immediately perceive, and he was disorientated. He looked back at his client on the bench: dread clutched at his throat.

            “I’ve got a…problem…” his voice was dysphonic, a moderate to severe intermittent whisper stifled his words. But realising his ailment, with great care he carried on: “I’ve got some-thing I h…ave to…deal with. I’ll be h…ome…soon th…ough.”

            “Okay, love. You would tell me if anything was wrong, wouldn’t you, dear?”

            “Yes,” Patrick wheezed. Then, quite out of the blue, he said “Could we have….could we have…fishfingers?”

            “Fishfingers?” Christine answered incredulously. “You want me to make fishfingers for tea? Why do you want fishfingers?”

            A pause.

            “I don’t know…” Patrick squeaked, lost. His larynx rose and fell, with new heaviness.

            Christine said she was busy at work and had to return to the task she had been attending to before Patrick called. He yielded, and glumly let her go.

            Patrick tested his voice with a few held vowels. No doubt, spasmodic dysphonia, abductor. The irony made him laugh, and his laugh sounded terrible to him, like a laugh that had been subjected to a cheese-grater. Then, quite abruptly, he stopped laughing.

            Still, Patrick’s problem lay motionless, face obscured in hat, upon the massage table. He knew that he should simply press the man’s laryngeal switch, return him to his previous state, incur the mortification of having seen his sexual function to its natural culmination, and say goodbye…beg the man not to press charges. The other alternative that Patrick was giving increasingly serious consideration was to softly, unsensationally, quite professionally stop this man’s breathing, asphyxiate him with a dry cloth while he slumbered... conceal, and dispose of the body. Could he do it? He had already, that day, done other things that he thought he could never do. A box of non-woven sterile swabs continued to make to him a strange mew of appeal.

            …But the man’s condition had passed to Patrick. It unnerved Patrick. There could be no doubt.  They had switched places. Switched larynxes.

            The rain had long ceased on Broadpig Street. At last, Patrick did press the man’s laryngeal switch and return him to life, removing the pork-pie hat from his face. The man didn’t seem to notice his abuse: he had been a world away, and no time seemed to have passed since the laryngeal switch was first pressed.

            “Say Aah,” Patrick croaked.

            A beautiful clear booming and unencumbered Aaaaaaah came from the man’s mouth. He was delighted.

            “I’m so gl…ad,” Patrick whisperingly wheezed.

            Scooping up his hat and cheerfully departing the practice, lifting his coat from the coatrack and re-robing himself in it, the patient turned around in the doorframe and remarked to Patrick that he didn’t sound too well.

            Patrick purposed to say that he would be alright. I’ll be alright, his mind preparatorily said:

            “I’ll b…”

            Ee disappeared.

            “I’ll b alr…”

            Ight disappeared.

            A business card changed hands. The man chipperly beseeched Patrick to drop him a line or give him a bell if ever he had any trouble with his teeth. Patrick thanked the man and the man said he would show himself out; he thanked Patrick once again, closing the door behind him, enclosing Patrick in the small office: a little carpeted prison without bars. The office skeleton, its throat area amplified and its component parts denoted in bold red and blue foams, so familiar to Patrick that he had not even noticed it once that day, suddenly struck him. That lunar-coloured length of soulless anatomy, with its counterfeit goggle eyes, sharp and segmented and deconstructible as a jigsaw puzzle, unexpectedly tranced Patrick with a sense of strange, unhappy majesty. His diplomas, hung in plenty upon the eggshell office walls, continued to gaze like unblinking, disappointed eyes. Once, in private, while he was the soul life in the small room, he might have amused himself by speaking aloud every letter of the many after his last name. Patrick P. Shaw BA, MA, LRMB, DMA…etc… But he would not do that now. He would not dare sound out those sounds, for fear of the sound his voice would make, what it might betray.