Patient Name: Harold Pike
Age: 7
Place of Birth: Blackreed Cemetery, MA (born to grounds keeper's daughter)
Next of Kin: Mother (deceased); no paternal record found

PRESENTING SYMPTOMS:

• Found attempting to sleep in shallow grave behind sanitarium; stated, “It's softer there.”

• Repeated pattern of digging into mattresses, floors, and walls — searching for "earth"

• Sleeps only during daytime hours; walks extensively at night

• Chronic nail damage; observed chewing dirt, small stones

• Refers to deceased children by name, with knowledge of their final treatments and locations

NOTES FROM DR. HORACE FELL:

“The boy is polite. Quiet. Cooperative—so long as he’s allowed to sleep with soil nearby. He identifies patients we have never introduced him to, including several who passed years before his admission. When asked how he knows these names, he replied: ‘They told me. From underneath.’”

“He is often seen speaking into the ground. Last week, he offered me a folded note written in charcoal: ‘There’s still one child left below. She sings.’ I have since ordered the east cellar sealed.”

TREATMENTS ADMINISTERED:

• Removed dirt from room – patient tore open floorboards to create earthen pit

• Mild sedatives – ineffective; patient buries tablets and mutters prayers in reverse

• Bathing regimen – results in violent panic attacks; screams “I’ll drown like them”

• Observation in sleep – no REM patterns detected; patient occasionally grins in sleep and whispers: “They’re colder now.”

STATUS:

Current Location: East Garden Annex, Room 0
Special Containment: Earthen “nest” allowed under supervision
Incident Note: On July 30th, night staff discovered Harold had dug a shallow grave in the hospital garden. When questioned, he said:

“She asked for a bed beside me. Said her stitches itch.”