This is based on a bizarre feeling I felt last week, while watching a movie. I began, inexplicably, to feel light headed, nauseous, and my heartbeat rose. I didn’t know what was causing it, and then I was reminded of a story my grandfather told me once, about a man who thought he had a snake in his belly and had died two days later despite having nothing wrong with him physically. What if it’s all in my mind, I thought? Rather than comforting me, it only made everything worse, because I, of all people, know what horrors my mind can imagine. If those horrors had any power, any impact on reality… Well, I was done for. Anyway, nothing came of it, obviously, but it was enough to get me to send my hobo of a muse on another trek.




By Ben Pienaar


As I write this, I crouch huddled in the corner of my spotless kitchen. I’m wearing gloves over hands that I’ve washed nearly twenty times today, and it’s only ten in the morning. By this point, it hardly matters. I can see my reflection in the tiles as clear as in a mirror. I look drawn, old. Most of all, I look very, very sick.

The truth is, I shouldn’t continue to write this, shouldn’t have even started it. I want people to understand what’s happened to me, and that I’m not crazy… I think.

A month ago, I was a doctor, and about as far from a ‘germ freak’ you could be: I’d had every bodily fluid imaginable on me, blood, excrement, urine, pus, vomit, you get the picture. I worked in intensive care, and so there was no shortage of horror. At first, everyone’s a little squeamish, but you have to learn to concentrate on the patient, and after a while it’s all just background stuff. Eventually you don’t think about it at all.

Recently, I turned forty, and decided I needed to relax, separate myself from the stress of work a little bit, so I opened my own clinic and started to treat patients in my own hours. A big change from the chaos of the hospital, and it was definitely a relief not to be called up at three in the morning after a twenty hour shift. I was enjoying it. Until, that is, I treated a woman named Ellen Ngona.

She entered my little white office at the back of the clinic, looking out of place and panicked. She was shivering, and had broken out into a cold sweat. I stood up immediately and told her to lie down on the bed, but she only shook her head. She was almost as tall as me, and lanky, so that it looked like she was on the brink of falling over all the time.

‘Doctor. I am a cursed woman,’ she told me.

I stood awkwardly in front of my desk and waited for her to go on.

‘In Africa, two weeks ago now, I saw my son talking to a man. This man, he was a witchdoctor, and he was going to take my son away. So I took him back, I screamed for help and my boyfriend came and helped me. The witchdoctor, he cursed us.’ She put a special emphasis on ‘cursed’, making it sound like ‘Kessed.’

‘I see,’ I said. From what I could tell, she had a fever of some sort, maybe gastro.

‘He said secret words to us, and the next day my boyfriend died straight away. The day after that, my son fell over and broke his skull, and then he died. I went to the witchdoctor, to ask him to bring them back, but he said no. He told me, “for you I put a snake in your belly, so it will take even longer for you to die.” And he… laughed.’ Here she put a hand up to her face and I was quite dismayed to see her in tears. Of course, if what she said was true it was entirely understandable. Murder, I could believe – curses, I could not, and so I vowed then and there to cure this poor woman’s illness as quickly as I could.

I put a hand on her shoulder and gave her my most reassuring expression. ‘I believe I can cure you, Ellen, and no curse of any kind has every stopped me before.’

The look of gratitude was instantaneous, tears forgotten. ‘Yes!’ she cried. ‘That is why I came to this country. In Africa, the hospitals are horrible, and if I wait too long there it will be too late. Here, I know, you have the machines, you can cut the snake out of my belly.’

I smiled uncertainly. I’ve treated the unstable and the superstitious before, many times. In my experience it’s always best to humour them. ‘Yes… We will do that but first we’ll have to run some tests to… make sure of exactly what to do.’

And that was what I did. I ran test after test on Ellen Ngona, first checking for the things I thought it was, then for the things I thought it wasn’t, and then anything at all. None of her symptoms seemed to fit with anything, really. Actually, there was a curious physical lack of symptoms, aside from the pains she claimed to have. After I’d gone through half a dozen different examinations, I found her to be completely healthy. Her temperature and blood pressure were both slightly higher than normal, but not by any serious stretch. Her heart rate was also up – from fear I suppose – and I couldn’t for the life of me determine the cause of the stomach pains she was having. In the end I gave her some mild pain killers, which she protested frantically.

‘You must cut the snake out!’ she said. In the end, she only left when I assured her that the pills were poison that would kill the snake. Luckily I hadn’t given her enough to overdose.

Two nights later, I got a call from a good friend of mine, Michael McHolland, who still worked in intensive care. I’d met with him for lunch the day before, as was our weekly custom, and mentioned Ellen, so he’d recognized her name when she was rushed into his operating room.

‘Nothing wrong with her, physically, you were right about that,’ he said over the phone. ‘She came to us because someone saw her staggering down the street with her entrails hanging out. She was practically tripping over them, trying to wrench them out at the same time. When they rolled her into the hospital, she was screaming “get it out, get it out”, over and over. Incredible, isn’t it? It’s the first time I’ve ever heard of an unwilling suicide, personally.’ He chuckled. Mike has always had a despicable sense of humour.

‘So she’s dead, then?’ I said, incredulous.

‘Yes. Sliced her belly open from hip to hip. Pierced the stomach and both large and small intestines. Not easy to come back from that sort of thing, you know.’

‘Yes,’ I said, feeling completely dazed. It was then that he said the thing that really drove it home to me. It was his simple observation that lay the seeds for my own horror. It is why, even now, my right hand writes while my left is scratching frantically, and why I’m trying to keep the damned paper away from my body so I don’t get any damned blood on it.

‘It’s incredible how the mind alone can destroy a person, isn’t it?’ he said. ‘I heard a story once, about a man who sincerely believed he was going to be struck down on his birthday, for who knows what reason, and when the day came, down he went. Heart attack. Truly incredible.’

I sat in deep thought for a long time after I put down the phone. It really was amazing, the way that worked, I thought. The way the mind had such power over the body, could make it strong or sabotage it, to the extent of death. I shook out of it after a few minutes and got back to work, and a patient or two later I’d stopped thinking of it. Notice, I didn’t say I’d forgotten it. I stopped thinking of it, yes, but it was there, in the back of my mind, burrowing and laying seeds.

A few days later, I treated an old man and found two melanomas on his back. I recommended he have them cut out as soon as possible, though they weren’t serious. The following night, I noticed something odd on my forearm. A freckle I’d had there my entire life had suddenly become darker, and a bit misshapen around the edges. I didn’t think much of it then. Paranoia, was all it was – a result of seeing the old man and worrying about myself.

When I woke the next morning, it was larger. There was a spot of red in the middle that hadn’t been there. The second I saw it I realised that it was a melanoma, and that it was growing faster than any that I’d ever heard of: usually it takes months even to notice the changes.

I skipped work and went straight to St. Andrew’s, where I’d worked the ICU, and as it happened it was Michael who was assigned the operation. After he cut it out, I told him, for the sake of his professional interest, how quickly it had come about.

‘Overnight, you say?’ he said, with a smile on his face. ‘You sure about that? You know that’s unheard of.’

I rolled my eyes. ‘You think I wouldn’t have noticed it, right there on my forearm?’

He seemed to think it was only bad luck, but the seeds were growing and I knew better. I’d caught it from the old man. I know, I know, and it’s true: melanomas are not contagious. But ideas are. The parasites of the mind are the worst kind. Trust me, I know.

After that, things began to accelerate. Now, I suppose I’d explain it by saying that, after Ellen, my ‘mental immune system’ broke down. It’s a ridiculous thought, of course, but that’s how I think of it. On Friday I treated a man complaining of fatigue and endless thirst; on Monday I had all the symptoms of diabetes. Luckily I have access to insulin. On Tuesday I treated a boy with a stomach bug and spent the remainder of that week struggling with the same thing, but in the end my immune system took care of it, barely.

After a while, I started to stall my patients. I’d let one leave and then just sit in the office, sweating and afraid, not wanting to let the next person in. What if they have something serious, I’d think. What if I get it, too? A woman would come in complaining of anxiety and my heart rate would double. A girl with a fever made me break out into a cold sweat (as soon as she left I checked my temperature and found it to be two degrees above normal). These things did not go away, unless I took the correct medications and treated myself the way I would if I actually had the diseases.

At last, I couldn’t deal with it any longer and I closed down the clinic. I wasn’t short on money, I told myself, and besides, I was more than deserving of a vacation.

I didn’t go on a holiday, though. Instead I stayed in my house, venturing out only to go to the shops or meet Michael for lunch. I told him about my worries, but of course he didn’t understand. ‘You’re telling me you’re sick, right now?’ he said.

‘No, not now. I was. I’ve been ok for a few days now, but I have diabetes.’

‘That’s why the water today?’

‘Yes. It acts up when I… well when I think about it. Which is usually when I eat food that diabetics shouldn’t eat.’ I knew I sounded mad already, but I needed a rational mind desperately – I no longer trusted my own.

‘You need to see a psychiatrist, John.’

‘I was looking for a second medical opinion, actually,’ I said.

He cut a fresh slice of his steak and put it into his mouth. Mike had always loved his steak rare and the blood was pouring out of it. Some of the veins twisting through the fat were still purple. I thought, salmonella, and then shut my eyes tight in a grimace because I realised that in that instant I’d just contracted it.

‘A medical opinion? You want me to look you over?’ he said, his mouth full of meat.

I shook my head. ‘No need for that. I’ve done the tests myself. I know when I’m sick. I just wanted to know if… If you had any ideas.’ What I really wanted, to be honest, was for him to prescribe me a placebo. Just sugar pills or something, and tell me that it cured what I had. I couldn’t actually ask him for that, however, because if I knew they weren’t real medications they wouldn’t work.

‘I don’t really have any,’ he said apologetically. ‘I’m sorry, but I really think it’s a mind thing. You need a psychiatrist, my friend.’ He spoke with his usual light heartedness, but I sensed the concern in his voice.

I considered it, but very soon after that day I was in no position to see anybody. I had salmonella, for one thing, as well as half a dozen other horrific things I’d accidentally thought of. At this stage it was taking everything I had to keep my mind on anything that wasn’t medicine. I spent all my time ridding my house of everything that might be harmful. The first things to go were my medical journals. If I even glanced the name of a disease I was sure to get it in a matter of hours, and I couldn’t take the risk.

After I started showing symptoms of several allergies, I began to cleanse my entire house from top to bottom. I threw out huge volumes of things I deemed too dirty. I dusted everything, had the place fumigated, shined, and I polished every surface.

It wasn’t enough. My body was vulnerable. If I touched anything at all, my mind would start listing possible allergic reactions, or infections, and if I didn’t wash my hands or shower immediately I’d begin to suffer the very things I feared.

It’s a peculiar thing, this hypochondria. You know it’s all in your mind, but you also know that your mind is capable of making your fears a reality. So you think to yourself: my heart’s beating a bit faster than usual, I’m sure I don’t have anything serious, but what if, by thinking about it now, my mind is making it beat faster. If I don’t stop panicking now, I might faint, I might blow blood vessels in my brain. You get scared, and your pulse rises evermore, and you think, damn!, it’s happening. My mind is making it worse. I have to stop thinking about it now! Only you can’t, and that’s the horror of it. And it worsens, and the next thing you know you’re having a heart attack.

I cleared most of my illnesses a week ago. I waited them out, I took the right medications, and I meditated the thoughts out of my head as best I could. (And that is no mean feat, believe me). The place was spotless, furniture covered by plastic and every surface disinfected a hundred times, including my own skin. Hospitals look like sewers compared to this sterile place.

I might have taken to drinking, but I was afraid: my diabetes might worsen, or I might become an instant alcoholic, or the first sip might cause alcohol poisoning. Any of these things could happen, because they were in my mind.

I made my visit to the psychiatrist three days ago. He was a highly regarded man, so Mike told me, and when I walked into his office, I admit he looked respectable. There were plenty of certificates and awards on the walls, and he had a professional, minimalist setup, complete with the soft couch in one corner. He was a friendly looking man with fuzzy grey hair and a wide smile. He came around the desk to shake my hand. ‘Dr. Vandenberg, nice to meet you. Why don’t you take a seat?’ he said.

I sat, and then, before he asked, I told him everything. I’d contracted at least four different diseases on the way to his office, and I was damned well going to make the most of my time. If he helped, I might never have to treat the osteoporosis now eating its way through my wrists and ankles, or the cirrhosis that would soon overcome my liver. A long silence followed the conclusion of my story, in which he sat in his chair, notebook in his lap, both hands steepled in front of his face.

After a pause, he said slowly: ‘It is a very interesting story, if you don’t mind me saying so, Mr. Collins. In these sorts of… phobia related cases, hypochondria and suchlike, I lean towards a shock therapy approach. For phobias especially, I like to expose the patient to steadily more and more of whatever they’re afraid of. That doesn’t quite fit your case, however, and I think you’re especially sensitive.’ He paused, considering. ‘This is what I suggest. Take your mind off it. Go easy on whatever medications you’re taking, as well. What interests you? Besides medicine, of course.’

‘Travel,’ I said, truthfully. ‘Biology.’

‘Alright then. Read up on them, do some hobby research, if you like. Or start something new. Immerse yourself in a distraction. I think that when you’ve done that for a day or two you’ll realise that you’ve forgotten your “symptoms” and as a result they’ll fade away. I hope that will give you the strength to throw this thing for good.’

He wasn’t wrong, I’ll say that much for the man. I have a bookshelf full of National Geographics, travel novels and similar things, and when I came home from his office I began to read. I sat in my spotless study and scanned page after page until I had a splitting headache (I thought migraine, and it happened a minute later. Thank God I’ve been able to resist that thought since.)

When it faded, though, I realised several of my other symptoms had receded also, and I dove back into the literature before they could return.

Today, I began reading a long chapter on Amazonian insects, of all things. I was finding it fascinating, until I realised that at some point the chapter on insects had become one about parasites, and then the real hell began.

There is a parasite, you see, which lives in the rivers of the amazon, and has been known to infect people. It gets under the skin and multiplies, and travels, and multiplies some more. It is fatal, but not because of any of the usual reasons. It doesn’t cause deadly infections, or wounds, or serious physical damage. It’s the itch. The people who have been contaminated with this evil worm tend to die by suicide. Because the itching of the worms beneath their skin is constant and all encompassing, and there is no cure.

I dropped the book the moment I read that and stood up. My heart, already pumping from my new nervous disorder, pumped harder. I came straight to the kitchen to make myself a hot cup of tea and think of something else, forget what I’d just read as quickly as possible. I seized the nearest thriller novel and read the first ten pages in a frenzy. I can’t for the life of me remember what any of it was about, because that was when I felt the itch.

I settled down on the floor, my back against the refrigerator, and continued to read, focusing every ounce of my concentration on that book, and never have I concentrated so hard on a piece of paper in my life. Fiction, I thought, why the bloody hell hadn’t I been reading fiction the whole time?

It did not save me, then. As I read, I saw the letters on the page begin to move. The es uncurled and the ts uncrossed. They all turned into slippery, slithering esses, and they wormed their way down the page and into my fingers before I could drop the book. Most of them made it into me, by slithering under my nails and into the skin.

I screamed and stood up, tearing at my clothes and hair and skin, but it was no use. They were in me, now. The itch I’d felt a moment before had been only a premonition – this was the real thing.

No, this is the real thing. It’s not the worst it can be, yet, but it’s getting there. If I look closely, I can see the tiny letters squirming over and under the little veins in my arm. I can feel them in the space between my skin and my bones and GOD, it ITCHES. They haven’t even reached my waist, or my neck, yet, but Jesus. I want to peel myself like an apple and tear the wiggling worms from my exposed meat, just for the blessed relief it would bring. The only thing keeping my hands from scratching every inch of skin off my body is writing on this page. I won’t be able to bear it for long. though. When they reach the place behind my eyes – when I can literally see them crawl across my vision, then I think I’ll go mad. That’s when I’ll lose control for good.

In one sense, the good doctor was right: I’m not thinking of all those other diseases any more. They’re nothing compared to this, they don’t exist to me anymore. All I can think of is this godforsaken itch. ITCH ITCH ITCH ITCH! I must keep typing or else I’ll die, I’ll fall apart.

I’m thinking of the knives in my kitchen drawer, how good it would feel to scratch with them. It would feel amazing. Maybe I could even use them to pry out some of the worms. Maybe if I was careful, and I’m a doctor after all, I could pry out each and every one of the bastards, keep the wounds clean, get rid of all of them and stomp them into the tiles. I could live, still, suicide won’t be the answer for me! ITCH JESUS!

They’ve reached the bottoms of my legs now and I feel them in my NECK!

It’s all in my mind, all in my mind. I must keep writing or I’ll THEY’RE IN MY CHEEKS, CRAWLING. No, they’re gone. I have to focus.

I’ll scratch the skin off my face and then where will they go? Anywhere else but my face. I just saw two of them slime across my eyeballs. Black squiggly shadows crawling right across my vision. There’s more. I think I’m going blind. If I do, I won’t be able to see what I’m writing. I wont’ be able to concentrate. I’ll hav3 to start scratching, and scratching.

God please I hope no one reads this and gets what I have. I hope no one ever see sthis. They’re Under smy skIN HELP ME I CANT I CNT KEEP WROTPNG THEYRE IN MY BRAIN ITCH ITCH ITHC ITCH IT

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