This is session 89 with GW, a 68-year-old widow who suffers from paranoid delusions.

“Hello, Dr. Hale.”

“Please have a seat, Gail.”

“Oh. Yes. Of course. I’m sorry.”

“Don’t apologize. I want you to be comfortable when we’re talking.”

“Yes. I know. I just… I feel like…”

“Are you okay? You seem especially anxious today. Your hands are shaking.”

“I just…”

“Are you taking the medications I prescribed?”

“No. I’m afraid not.”

“How come?”

“Well, I… I know you’re going to tell me I’m being paranoid if I tell you this.”

“Tell me.”

“I… I think my pharmacist is trying to kill me.”

“Gail…”

“I know. You think I’m crazy. You think I’m paranoid. But this time, it’s true. I mean, he’s a pharmacist. It would be so easy for him to do it. He could just swap out my pills for something else.”

“Why would you think he wants to kill you?”

“It’s the way he looks at me. I can’t describe it. And after he handed me the bag with my pills in it, he winked at me.”

“So…?”

“Don’t you see, Dr. Hale? He was winking at me because he knew there was something bad in the pill bottles.”

“Maybe he was just being friendly? Or even flirting?”

“No. Definitely not.”

“Why would he want to kill you?”

“Who knows? Because he’s a psychopath. You know, people are walking around out there who are just crazy. They don’t need a reason to kill you. They just do it because they’re crazy!”

“Gail, I need you to take your medications.”

“But I can’t! Don’t you see what I’m saying? If I take those pills, I’m going to die!”

“Do you remember when you thought the mailman was trying to kill you?”

“Um…”

“Gail? Was he actually trying to kill you?”

“I’m still not sure. I mean, it’s possible. He was always outside my house at the same time. Right outside my door. Peeking in.”

“He was delivering your mail, Gail.”

“There was something funny about it.”

“The mailman was not trying to kill you. And your pharmacist is not trying to kill you. You really need to take the medications that I prescribed.”

“That’s what my son says too.”

“So there you go. You should listen to him.”

“But think about it, Dr. Hale. If I were to die, my son would get a big insurance payoff. So he doesn’t mind if the pharmacist kills me.”

“Gail, listen. You have to try to recognize that this… this…”

“Yes?”

“Hold on. I just… My phone buzzed. I have to make sure it’s not an emergency with one of my patients. It’s…”

“Dr. Hale?”

“Hang on.”

“Dr. Hale? Is everything okay? What does your text message say?”

“I’m sorry, Gail. I’m afraid we’re going to have to reschedule our appointment. An emergency has come up.”

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