Salutations, Dr. Wilson,

I received your letter in the post this morning. How wonderful that your sister has left death’s door! May your mother also recover in due time. I hope that Tennessee is faring better this Winter. I am wistful for the sun. A storm cracked the window in my office last week; I’ve been writing patient assessments and permission forms in two coats and it’s still not enough.

Regarding your work inquiry, I must inform you that the patient you left me has, himself, left - with signed papers, not through the window and running wild through the snow. I know you were looking forward to interviewing him when you came back, but he was rather eager to leave as quickly as possible. He was far less hostile than some of our other patients, so perhaps you’ll be able to convince him to return for a talk over tea.

He is not the most scintillating conversationalist, I’ll say that much. I spoke to him regularly during the assessment period. He’s slow to respond to questions, and stutters when he has an answer. Once he lost track of the conversation entirely, going slack in his chair for minutes before he resumed talking. Still, he’s not a complete imbecile. His answers are intelligible if uninspired, he’s able to tend to his bodily and social needs without a carer (given enough time), and he’s able to retain information. I experimented with cutting his laudanum dosage in half for a week; it improved his cognition somewhat but led to insomnia and lunatic behavior on his part. Night terrors, throwing himself against doors, hiding under his bed when he sees Negroes outside his window. One night, he tore apart a Bible a previous tenant had left and pinned the Gospel of John to his wall. He reacts particularly poorly to laughter. He threw a fork at a cleaner who laughed at something in his city mystery.

He is clearly brain-damaged in some fashion, given the symptoms and the cranial scarring. I cannot determine the full extent without more information - his handlers refuse to tell me anything about what he went through besides ‘blunt trauma and asphyxiation’, except that the amount of scarring doesn’t cohere to any sort of impact I can imagine. When you return, I’d like to trade theories. I’d do it with the other doctors, but the Marshals won’t allow me to discuss it with anybody else; they’re already upset that they have to deal with me instead of you.

And yet, despite the clear damage done to his mind, it seems to have led to an overall improvement. The Marshals compiled a list of accounts from his contemporaries, which all described him as a surly, violent individual - absurdly so, even. Before his brain damage, he threw one of his fellows into a river and he nearly drowned. Now he throws a fork, and apologizes immediately after. He attributes this change in attitude to his newfound devotion to Christianity, but I suspect that the damage to his prefrontal lobe has curbed much of his aggressive tendencies. I’m afraid to say it out loud though. I know some of the younger doctors might very well start jabbing needles into patients’ brains through their noses to make them docile.

I want him to stay here. You’d want him to stay here, I’m certain. But all the Marshals are concerned about are whether he’s fit to re-enter society, and I can’t in good conscience tell them no. He’s addled and confused but in the fashion of an old man, not a madman. So long as he takes his medication, he should be fine outside these walls, and that’s all they needed to let him out. I might have been able to convince him to stay until you returned, but some friend of his sent an invitation and he’s been champing at the bit to go see him in some town in Missouri.

Take some heart. I just received an admission form for a new patient that’ll interest you. Another Bragg survivor, gone completely mad. You’ll enjoy having a poke through his mind.