Perceptual Delusional Bicephaly

 

Brad Pitt and Edward Norton, Fight Club

The following is the next installment in a series of posts which began with the piece, Half Guilty.

One afternoon in October 1980, a 39 year-old man entered the Royal Melbourne Hospital suffering from a self-inflicted gunshot wound to the head. Doctors were able to extract .22 caliber bullet fragments from the man’s left frontal lobe and evacuate a intracerebral blood cot, saving the man’s life. Over the next few days, the man’s condition improved and doctor’s were able to interview him. Doctor’s would later diagnose the man with schizophrenia. It was signficant that two years prior, the man’s wife died in a car accident in which he was the driver.

The man described having a second head on his shoulder that would antagonize him at night. He believed the head belonged to his wife’s gynecologist, who, he suspected, his wife was having an affair with prior to her death. He claimed the head belonging to the gynecologist was trying to take over his body by dominating his normal head. Additionally, he said that he could hear the voices of Jesus and Abraham conversing with each other. These voices were confirming that he did indeed have two heads, while the gynecologist’s head had been telling him that it was the “king pin” and that it was going to take his wife away from him.

After three weeks of nightly torment from his phantom head,  the man decided to do something about it. He first considered removing the second phantom head with an axe. But with the proximity of his own head to a swinging axe blade, he chose a different tact. The man fired six shots in total, the first at the phantom head. The man thought the first bullet nearly took the second head off, leaving it hanging by a thread. He fired the second bullet through the roof of his own mouth. He then fired four more shots, one of which appears to have gone through the roof of his mouth and three of which missed. He said that he felt good at that stage, and that he could not feel the other head any more. He then passed out.

During his interview with doctors the man explained his motivations for his unorthodox behavior:

“The other head kept trying to dominate my normal head, and I would not let it. It kept trying to say to me I would lose, and I said bull-shit. ‘I am the king pin here,’ it said and it kept going on like that for about three weeks and finally I got jack of it, and I decided to shoot my other head off.”

Years later, the man was admitted to the hospital again, suffering from seizures as a result of alcohol abuse. Doctors interviewed him about his previous psychological delusions:
Q. Could you see the other head?
A. Yes.
Q. You felt it, or you could see it?
A. I could see it.
Q. And the voices were coming from the other head?
A. From that head and my own head too.
Q. Whose voice was it?
A. It was the voice of my wife’s doctor.
Q. What was he saying to you?
A. He had an affair with my wife and he reckoned he was going to take her off me and all that kind of talk and I got antagonistic towards him and I decided to do something about it and I shot myself.
Q. Since that episode have you had anything like that?
A. Not really. I have not heard any voices for about two years, ever since I shot myself and I haven’t had any ideas that I have two heads again. When I shot myself it fixed it up.

Via David Ames, Self Shooting of a Phantom Head, British Journal of Psychiatry 145:193-194 (1984).

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