By Tim Stevens

Doctor Otto Octavius is an adult male who presents as suffering from significant physical deterioration. According to the consensus of the client’s doctors, his organs are largely unable to function without the assistance of machine and, even then, his remaining time is limited.

Oddly, however, Octavius seemed almost jocular. This did not seem to be the kind of relaxation that may result in one accepting that their imminent death is inevitable or the relief one with a critical illness may experience in regards to a final end to their pain. Instead, he presented as almost giddy, which is particularly at odds with his reputation even pre-chronic disease.

This writer had been invited in to assess the client in part because of this sudden dramatic shift in temperament, and in part because he had requested he be allowed to change his will and hospital administrators wanted assurances that Octavius was of sound enough mind to make such choices. The client readily agreed to the session without hesitation and commented that it would “be nice to talk to someone who isn’t a real doctor for a change,” presumably as both a reference to the numerous physicians that have been involved in the client’s case since his hospitalization and as a putdown of this writer and, most likely, the field of psychology as a whole.

Unfortunately, the writer feels uncomfortable making a declaration either way. On the one hand, Octavius’ current presentation is undeniably at odds with everything that this writer has read, seen, or heard about the client and would be unusual for nearly anyone in his state. Additionally, the client repeatedly evaded attempts to explore his state of mind, offering vague answers about change or abstract summaries of complex equations.

That said, he also was coherent enough to be evasive and seemed to actively delight in the numerous ways he could find to avoid answering my questions in a straightforward, honest manner. This would seem to indicate that his mind remains very present and nimble and that signs of mental illness are in fact willful choices on his part.

Given this, it is not surprising that Octavius was thoroughly rejecting and noncompliant when it came to the other purpose of the session, end of life counseling. Once again though, it was very difficult to discern if he was avoiding the topic because he was simply unwilling to face that he will die soon or because he is delusional enough to believe that he will survive.

In order to best answer the hospitals questions about the client, this writer has determined it would be best for him to see another team. With this in mind, Doctor Otto Octavius’s next appointment is scheduled with Doctors Dan Slott and Humberto Ramos on December 26. For further information, please consult the AMAZING SPIDER-MAN #700 chart on that day.

Psy D. Candidate Tim Stevens, MA is a Dialectical Behavior Therapy Consultant and Practicum Trainee who currently provides therapy and outreach at a state university.