The Smiling Patient
Dr. Adrian Wells considered himself a man of logic. Years of practice had taught him that every mind, no matter how fractured, followed a pattern. Even the most delusional patients had roots in reality—fears and traumas that could be unraveled like tangled threads. That belief had never failed him.
Until he met Elliot Graves.
Elliot sat in his office, hands folded neatly in their lap, an unsettling smile stretched across their face. It wasn’t a natural smile. It was too wide, too forced—as though something invisible was pulling at the corners of their lips. Their eyes, dull and hollow, fixed on Adrian without blinking.
“Do you believe in puppets, Dr. Wells?” Elliot’s voice was soft, almost amused.
Adrian shifted in his chair, glancing at his notes. Elliot Graves, 27. Symptoms resembling paranoid schizophrenia. Reports of dissociation, hallucinations, and an inability to control their own body.
“Metaphorically speaking, we all feel controlled at times,” Adrian said, choosing his words carefully. “But you believe this is literal?”
Elliot let out a chuckle. “Oh, it’s very literal.”
They tilted their head, the smile never faltering.
“There’s something else inside me. A Puppeteer. It moves me, makes me speak, makes me smile. I try to fight it, but…” Their fingers twitched, spasming before stilling. “I’m just a marionette.”
Adrian suppressed a sigh. He had dealt with delusions of possession before. Most cases stemmed from trauma, a deep disconnect between the mind and body. He leaned forward slightly.
“Elliot, when did this begin?”
Elliot blinked slowly as if the question amused them.
“I don’t remember.” A pause. “Or maybe I was never in control to begin with.”
Something about their tone sent a chill down Adrian’s spine. He reminded himself this was just another case. Another mind to untangle.
“We’ll work through this,” he said, offering a reassuring nod. “Together.”
Elliot finally broke their stare, glancing toward the window.
“I hope so,” they murmured. Then, almost too quietly to hear—“Before it finds you, too.”
Adrian frowned. “Before what finds me?”
Elliot turned back to him, their smile stretching impossibly wider.
“You’ll see.”
Adrian felt an uneasy weight settle in his chest, but he maintained his composed expression. He had encountered patients with unsettling mannerisms before—those who spoke in riddles, those whose paranoia made them cryptic. This was no different.
He tapped his pen against his notepad, grounding himself in the familiar act of taking notes. “Elliot, when you say ‘it’ controls you, can you describe what that feels like?”
Elliot’s smile twitched as if they found the question amusing. “Like I’m watching myself from behind glass. I can scream, but no one hears me. I can struggle, but my body doesn’t listen. I am… performed.”
Adrian’s pen hesitated on the page. The phrasing was peculiar. Most cases of dissociation or possession delusions followed a pattern, but Elliot’s descriptions were too precise. As if they truly knew what it felt like to be controlled.
“And this Puppeteer—have you ever seen it?”
Elliot’s expression finally changed. Their grin faded slightly, their hands tightening on their lap. For a moment, they looked… afraid.
“Not with my eyes.” Their voice had dropped to a whisper. “But I feel it. Watching. Waiting. And when it moves me, I know it’s smiling.”
A shiver ran down Adrian’s spine, but he kept his voice steady. “Elliot, I know this must be frightening. But I promise, we’ll work through it together.”
Elliot let out a soft chuckle, but there was no humor in it. “You keep saying that, Doctor. But I told you already…”
Their gaze met his, and for the first time, their eyes looked almost pitying.
“It’s already watching you, too.”
The office suddenly felt colder.
Adrian exhaled, forcing a small, professional smile. He closed his notepad, pushing aside the creeping unease curling in his gut. “That’s enough for today. We’ll continue next session.”
Elliot nodded, their strange, eerie grin returning. As they stood to leave, they hesitated by the door.
“Doctor?”
Adrian looked up.
“Check your reflection tonight.”
And with that, they stepped out into the hall, leaving Adrian alone with a silence that felt heavier than before.
Adrian exhaled slowly, rolling his shoulders to shake off the tension. It was just another patient. Another case. Elliot’s words lingered in his mind, but he forced himself to file them away as symptoms rather than warnings.
Still, as he packed up his notes for the evening, he couldn’t ignore the way the air in his office felt… heavier. The faintest whisper of something he couldn’t name.
He shook his head and stood, switching off the desk lamp. The shadows stretched as the warm glow faded, and for a brief moment, he swore the darkness behind him moved.
He turned sharply, heart thudding.
Nothing.
Adrian let out a soft chuckle, rubbing his temples. He was letting Elliot’s theatrics get to him. It was late. He was tired. That was all.
Grabbing his coat, he made his way out of the office, locking the door behind him. The hallways of the clinic were quiet at this hour, the air thick with the scent of coffee and old paper. He nodded a polite goodnight to the receptionist and stepped out into the cool night air.
The walk to his apartment was uneventful—just the distant hum of cars and the occasional chatter of passersby. He welcomed the normalcy. The routine. It helped push away the lingering unease of Elliot’s words.
By the time he reached his apartment, exhaustion had settled deep in his bones. He tossed his coat over the back of a chair, loosened his tie, and made his way to the bathroom. A hot shower, then bed. That was all he needed.
He turned on the faucet, letting the sink fill as he ran a hand through his hair. His gaze lifted to the mirror.
And then—he froze.
His reflection was smiling.
Not a small, unconscious twitch of the lips. Not a half-dazed smirk from exhaustion.
No—his face was grinning at him. Wide. Too wide.
His breath hitched. His body wasn’t smiling. He could feel the neutral set of his lips. He wasn’t moving.
But the reflection was.
It tilted its head, just slightly, its grin stretching wider.
Adrian stumbled back, nearly knocking over the towel rack. He turned his head left, then right—his reflection did not.
The bathroom felt suffocatingly small.
His pulse thundered in his ears. This wasn’t real. This was stress, exhaustion, the result of a long day and an unnerving patient. He squeezed his eyes shut, taking a deep breath. It’s not real. It’s not real.
When he opened them again, his reflection was normal.
Expressionless. Still. Just a tired man staring back at himself.
Adrian let out a shaky laugh, running a hand over his face.
“Check your reflection tonight.”
Elliot’s voice echoed in his mind.
With a muttered curse, he turned off the sink and left the bathroom, flicking the light off as he went.
Behind him, in the darkened mirror—
His reflection stayed, smiling.
Adrian didn’t sleep well that night.
Every time he closed his eyes, he saw glimpses of something unnatural—his face, stretched into that impossible grin, watching him from behind the mirror. He would jolt awake, heart hammering, only to find himself alone in the dark.
By the time his alarm blared at 6 AM, he felt like he hadn’t slept at all.
He groaned, rubbing his temples as he forced himself out of bed. Just stress. Just exhaustion. That was all. He had let Elliot’s words get into his head, and now his mind was playing tricks on him.
Determined to shake off the unease, he went about his morning routine as usual—coffee, news on low volume, checking his emails. He avoided looking at the bathroom mirror entirely.
By the time he arrived at the clinic, the familiar scent of disinfectant and old books grounded him back in reality. The world here was logical. Structured. Whatever happened last night was just a trick of the mind.
He settled into his office, organizing his notes for the day. It wasn’t until he reached Elliot’s file that something made him pause.
He frowned, flipping through the pages. Something was… off.
The date. The intake date.
According to his notes, Elliot Graves had been a patient at this clinic for over a year. Their sessions were documented in neat, precise detail—his handwriting listing every meeting, every conversation.
But that was impossible.
He had only met Elliot yesterday.
His breath hitched as he scanned the pages. His own words stared back at him, an undeniable record of something he couldn’t remember. Pages and pages of notes—dozens of sessions, spanning months.
He flipped to the last page. His most recent entry.
His hands trembled as he read the final note, scrawled in his handwriting.
“The Puppeteer is watching. And I think I’m already smiling.”
The pen slipped from his fingers.
A cold breath of air brushed the back of his neck.
And from the reflection in the darkened window—
He saw himself. Grinning.
Adrian’s breath caught in his throat.
His reflection was smiling. That same eerie, stretched grin from last night—wide, unnatural, too many teeth. But his face remained still. His lips weren’t curved. He wasn’t smiling.
Yet the man in the window was.
A creeping chill coiled around his spine. Slowly, he turned in his chair, heart hammering against his ribs. The office was empty. Just the soft hum of the overhead lights, the quiet ticking of the wall clock.
You’re imagining things. You didn’t sleep well. Your mind is playing tricks on you.
He forced himself to breathe, to look away from the window. He needed to focus on something real—his notes, the files in front of him. His fingers hovered over the pages again, over the months of documented sessions that shouldn’t exist.
He hadn’t written these. Had he?
His handwriting stared back at him, a cold and undeniable truth.
Swallowing hard, he flipped further back, searching for the first recorded session with Elliot. If these notes were real, if somehow he had just forgotten—then maybe there would be an explanation. A mistake. A rational answer.
He found the entry dated one year ago. His very first session with Elliot.
The patient exhibits extreme dissociation, claiming to be controlled by an external force. Reports feelings of detachment from their own body. They describe a persistent presence they call ‘The Puppeteer’—an entity that moves them against their will.
Adrian’s fingers tightened on the paper.
He read further.
The patient warns that the Puppeteer does not just control them. It ‘finds’ others. Draws them in. Makes them part of the performance. The patient expressed concern for me, stating that I should stop looking too closely. That it will notice.
Adrian swallowed. His pulse thundered in his ears.
His notes continued, becoming more erratic as the months went on. His handwriting grew sloppier, more frantic.
Then, near the bottom of the page, his final entry from that day:
I asked Elliot how they knew they were being controlled.
They smiled at me.
And they said—
A knock at his office door made him jolt.
He slammed the notebook shut, shoving it aside as his heart pounded against his ribs. Calm down. Breathe. It’s just another patient.
He forced his voice to stay steady. “Come in.”
The door creaks open.
And Elliot stepped inside, smiling.
TO BE CONTINUED.....