An excerpt from The Special Patient, Auckland writer Aimee Inomata’s true story of how her partner was found not guilty of murder by reason of insanity and sentenced to seven years in a mental health unit. What happens, she asks, if your psychosis is substance-induced, a temporary insanity, and you have to live out your life as a sane person in the kingdom of the insane? Aimee’s excerpt takes up the story two months after Holden (not his real name) killed his father.

It was around the seventh or eighth week that the delusions that had protected Holden began to dissipate and he began to understand what had really happened and exactly what he had done.

Clarity returned and with it the unavoidable discernment of what he had done to his own life and to the lives of those he loved. It was like being buried alive – except that being buried alive carried with it the possibility that you just might be able to dig your way out, might yet be able to save yourself. There was no such possibility for Holden. There was simply no hope.

Even the most pessimistic of us acknowledges the small lambent light that directs us onwards and forwards, that wakes us each day. The dying of that light while is the ugliest of spectacles; the soul observing itself shrivel, the roots of meaning to wither and fail, for what meaning could there be in the world after what Holden had done?

They told him it was depression, watched as he grew smaller and smaller, as he spoke less and less. They took away his clothing and in its place gave him what are variously referred to as strip gowns, at-risk gowns, stitch gowns or stitch nighties. These are issued to patients and prisoners deemed to be at risk of self-harm and are generally made of heavily stitched layers of canvas that thwart any attempts at ripping or tearing in the pursuit of fashioning a noose. His bed-clothes were also removed and replaced with stitch blankets which offered no comfort and lay over the top of his body like sheets of cardboard.

He began to have regular appointments with the psychologist; appointments at which he would sit saying little or nothing while the psychologist talked to him, at him – a flowing patter intended perhaps to be soothing. Later, the moment that he would always remember from these sessions was the psychologist telling him as he sat immersed in his despair that this was all going to pass, would be a mere blip in his life, that though it was overwhelming and all-consuming now, he would look back in years to come and see that it had indeed been just a blip in the grand scheme of his days.

But a blip was crashing your car or accidentally setting fire to your kitchen or a divorce. Killing your own father because you believed he had killed his father was not a blip; it was a Greek tragedy.

He was certain of only one thing and that was that this was not a blip. When he learnt that much earlier in 1996 his father had appointed Holden executor of his will should his wife not survive him – not, as traditionally, Holden’s older brother, but Holden himself – he did not know whether he could, in fact, continue living.

At night, locked in his room, clothed only in the stitch nightie and with the nurses shining a torch onto him every five minutes to check he was still in bed and alive, he recognised that he could not sink any lower than this, that he had reached the bottom of a place so dark he could distinguish nothing, not even himself. There was only one thought that temporarily mitigated the pain and almost brought with it a sense of comfort and that was the knowledge that he could end this, could simply remove himself from the world. He kept remembering a quote from Nietzsche: “The thought of suicide is a powerful solace: by means of it one gets through many a bad night.”

He thought about this often but there is a reason that the verb most associated with suicide is “commit” because that is what it takes, that is what one has to do – commit, promise, pledge to oneself to undertake the act. But Holden never did. He kept the idea tucked closely to his chest but he did not make a plan of action, never made the leap from thought to deed. When they asked him if he had thoughts of harming himself, he said yes, he did. He did not tell them that the reason he would not do so was because of the added burden it would lay upon his children.

They increased his medication and decided to place him on an anti-depressant – Citalopram – and told him it would take a few weeks before he began to feel the effects, before he would begin to feel better. But he never did. He waited to feel better but he did not, could not; perhaps because there is no pill in existence that can change the past, no tablet to treat remorse or shame, no way to skirt around sorrow. To do so is to inch into freezing cold water when perhaps it is always better to just dive; at some point it will always feel as though it is closing over your head – then you must decide whether you are willing to make the effort to reach the surface again.

An investigation into New Zealand’s mental health system, as well as a love story about a university academic who never imagined that the man of her dreams would be a Nietzsche-quoting ex-mental patient, The Special Patient by Aimee Inomata (Createspace Independent Publishing, $44) is available in selected bookstores, and Amazon and The Book Depository. Please see http://thespecialpatient.co.nz/ for further information or contact aimee@thespecialpatient.co.nz