Before my life fell to pieces, I was a psychiatrist. A damn good psychiatrist. It’s tough to say what made me a good psychiatrist, I don't really even know how I became good at what I did. I always just happened to help people. I'm not saying I just turned people from suicidal tendencies to happy people at the snap of a finger; but whether it was just luck, or a hidden talent, I fixed people. My life could be considered very fortunate. I started in my field knowing no one, and one patient recommended me, then another, and pretty soon I had more patients than I could handle. I earned a certain sense of respect in my community and pretty soon I’d see patients recommended to me from all over the country. The influx of patients led to me becoming a psychiatrist for higher-tier members of society. I became very wealthy.

I'm not sure how the Bowman family found me, I assume they were just recommended by a satisfied client. I had two phone calls before I arranged a preliminary meeting with Mary Bowman. She was not my client, but rather the mother of the man I’d be seeing the following day. My secretary had her fill out a general health form before I saw her. The health form can be used as reference in diagnosing genetically transferred illnesses. The form aided me in more ways than one, however. For example. One of the questions asks for a current weight, and a weight six months before the patient first recognized any symptoms. This can be useful in isolating any illnesses that directly affect weight, and it saves me time. The health form, which I looked over before speaking to her face to face presented a woman in a perfect picture of health. Mrs. Bowman did not look at all how I imagined her to be. No history of any illness, and at a perfect weight for her age. I did not expect to see a woman only fifty years old with dry and scraggly snow-white hair, and paper thin skin that stretched tightly around her hands but sagged and wrinkled around her face. She tearfully begged me to see her son, a cocaine and heroin addict that has been passed around from unsuccessful psychiatrists all over the country. Although I normally don't take clients where addiction is the primary issue, as I am not a rehab clinic, I accepted. She was paying three times my hourly rate.

I met Andrew on a Monday morning. Normally addiction therapy is easy as they usually don't show up; but Andrew was fifteen minutes early. He certainly looked like a drug addict, and his height didn't help him in this case. He was about six feet tall, so the weight loss was especially noticeable on him. His skin was tight around his face, and I could notice every muscle move when he talked. His clothes were loose and draped around his body. I would've mistaken him for a corpse if not for the fact that I witnessed him walk in and sit down on the plush reclining chair parallel to my desk. He sat, but would not lean into the chair, or even consider laying down. I dropped the matter nonchalantly. For my own privacy, I am Doctor A.

“So Andrew,” I began. “I’m Doctor A. Why don't we start by you telling me a little bit about yourself, and why you're here today.”
He was silent for a moment, I considered repeating myself when suddenly he broke his silence.
“Okay. So this is my eighth or ninth time doing this. My mom told you I was a drug user, and she's right. I use heroin, and cocaine, when I can get my hands on it.”
I opened my mouth to explain to him the dangers of using both at the same time but he beat be me to.
“No. I do them separately. I'm not an idiot.”
“I don't think you're an idiot.” An obvious lie, but being a psychiatrist I'm accustomed to telling lies. “I've seen plenty of users in my day..” I drifted off as I became aware of his staring. Then came the obvious question. “So, why do you use?”

“I use cocaine when I don't want to sleep, and heroin when I don't want to dream.” He had averted his piercing stare to the floor; he started to pick at his hands, which were covered in scars and scabs.
“I'm sorry. Just to make this clear, the nights you don't want to dream you use heroin-”
“And the nights I don't want to sleep I use cocaine.” Andrew interrupts.

“Why don't you want to sleep, Andrew?” I asked.
“Because of the Amca” Andrew shifted his gaze to measure my reaction, but my face betrayed nothing.
“I'm sorry, who is Amca?”
“No, not Amca, the Amca. The Amca is a monster that terrorizes me in my dreams.”
“And how does this... Amca... Control your dreams?”
“Well I don't know how the f*** he does it but I know the things I dream of no normal person would want to think of.” He stopped picking at his hands and balled his fists up, I noticed blood was dripping onto his pants; so I offered him a tissue that he refused to accept.

This was starting to get interesting, so I decided to venture deeper down the rabbit hole. “And what does the Amca force you to dream of?”

Then he snapped at me. “Look, I'm not crazy. Before all this happened I was a star athlete and poised to be valedictorian of my class.” He was getting more and more angry.

“Andrew, I don't think you're crazy,” I lied again. “I've seen a lot of crazy people in my line of work and I generally don't waste my time on them.” That answer seemed to satisfy him. “I can't diagnose you until I learn every possible detail. Please continue.”

“Well, the Amca forces me to watch horrible things... Things that happen to the people that I love. One time it put me in a cage in my basement, and showed me men in masks raping and beating my mother.”

This startled me, and he noticed. I masked my shock with intrigue. “Please continue.”

“My mother would cry and call out to me, and then a man would hit her. No matter what happened she would keep calling for me, and they'd keep hitting her and violating her.”

It is important to understand that no normal person would dream these things. Only in the cases of the most extreme psychopaths would these dreams be normal. I was beginning to understand the severity of Andrew’s affliction.

“How do you know it is the Amca that controls your dreams?”

“Sometimes he says his name, sometimes I see him.”

I have Andrew a notepad, and a pencil.
“Would you mind drawing the Amca for me?” He accepts, and starts the sketch the monster. I don't really need to see the sketch, I was just distracting him so I could look through a couple of my books. There has never been a diagnosis of bad dreams manifested in a reoccurring being before, especially not a case as bad as this. I was either dealing with a time bomb that would become one of history's most prolific psychopaths, a Ted Bundy or Son of Sam; or I could be the one to diagnose a new disorder. I decided the reward heavily outweighs the risk of having him attached to my name, so I cleared my calendar.

“Doctor A? I finished.”
He returns my notebook and I set it on my desk, face down. “Now Andrew-”
“Doc aren't you going to look at my sketch.”
“Well, I was just getting to that, but yes. I can look now.”

I flipped the notebook over and pretended to look intently at his drawing. The Amca had the insect-like exoskeleton of a wasp, with wings vastly disproportionate to its body, which was fat and shiny. The Amca had six limbs, all human-like arms, except they had multiple joints. The arms hung limp, and six sets of fingers lightly touched the ground. The creature’s face resembled an anteater, it was hairy, with a long snout that also drug on the ground. The snout had a tongue that slightly protruded. Amca’s eyes were vertical ovals that looked to be completely devoid of a pupil, and shiny black.

“Excellent drawing Andrew. I think I have a diagnosis for you, you've been lu-”

“Lucid dreaming? No. I haven't been lucid dreaming. I told you I wasn't an idiot. I did my research; opioids suppress dreaming, that's why I shoot heroin. The thing is the harder I fought the harder he fought back. That's why I had to start using cocaine, if I stayed awake I didn't have to see him. There's a problem though, it's called micro-sleep. The longer I stay awake the more likely it was that I would be susceptible to him while I was awake. The more tired I got, the easier it was for him to mess with my reality even though I wasn't even asleep.” Andrews voice had been slowly rising as he gave his speech. “That's the problem Doc. I see horrible things all the time. And there's nothing ANYONE can do about it.”

I didn't know what to say to this. Either Andrew was so far gone he could never be helped, or he was so unbelievably intelligent that his subconscious had incubated his own madness.

“When did you first see Amca?”

“After my older brother died. I was fourteen. He killed himself, just like my dad. The first night after his funeral I dreamt of the grave. I was standing on top of the dirt, and I could hear him screaming all the way down in his coffin. I wasn't able to move no matter how hard I tried, and that's when I heard it. Then I woke up. It's been six years.”

Andrew and I looked at each other for a long time. It's not uncommon for a child to link a traumatic event to some imaginary antagonist to help them comprehend what has happened. It's a form of PTSD that can be treatable.

“Andrew I think I can help you. There's an antibiotic that isn't an opioid but has a side effect of suppressing dreams. Specifically nightmares.” I lied about the nightmares bit, but maybe it would have a placebo effect. “I'm going to write you a strong prescription for it. It should help with your Post Traumatic Stress Disorder.”

“But it's not PTSD,” Andrew butt in, “It's Amca.”

“I know Andrew,” I lied to him for the last time. “But it should help all the same. Now I'll give your mother a number for a good rehab clinic, check yourself in there, and don't forget to take the antibiotic, okay.”

“Okay doc.” Andrew practically jumped to his feet to shake my hand, it was the first and only time I saw him smile. He exited my office, and I smiled to myself. I really was good at what I did.

Next week Andrew didn't show up. If he were anyone else I would breathe a sigh of relief, and tell my secretary I’m going down the street to get a cup of coffee; but this was Andrew, so I had to check on him. I drove across town to his apartment; in my hand I had his bill, which had his address. He lived in a complex his mother owned. I slipped through the door as someone was leaving and looked his name up in the directory. After an arduous walk I got to his room, it was at the end of a long hallway with filthy carpet on the 6th floor.

I knocked on the door, nothing. I stood there for a couple minutes listening for movement. Still nothing coming out of the room, so I knock harder and wait longer. I realize that with him being a drug addict I can't just assume he's not at home. Slowly I move my hand to the door knob and jiggle it. It's unlocked. I reflect on how this could look; a patient’s Doctor breaking into his apartment, and I walked into the room. Andrew’s apartment was immaculate. Despite being a drug user it was nicely decorated, and there was not a spot of dust on any surface. The bathroom door was open and I peaked inside. There was no vomit or used needles, no sign of an overdose. That was a good sign. I searched his apartment, no sign that anyone ever lived there at all. There was one door left, and that's where I found him. Andrew was in the corner, a handgun and half his skull lay in his lap. Upon seeing him I immediately turned around and tried to shout for help, but I cut myself off when I promptly fell to my knees and threw up. A concerned neighbor heard me and came into the hall. I shouted “call the police” between coughing up bile, and the neighbor left.

The police came, and took Andrew away. I sat on the curb for awhile and watched it all. His mother was there too. She was held back by the police and just kept screaming “my baby! Someone let me see my baby!” After they had all gone, I went home, and did not dream.

The day after I found Andrew I cancelled all my appointments for the next month, I could afford it. Ms. Bowman called, and I let it go to the answering machine. She asked me if I could be there for his funeral tomorrow. I spent the rest of the day alone, which isn't hard since I live alone. I distracted myself with wine and reading. The day passed slowly. As I readied myself for bed I decided I would make an appearance at the funeral, but I would not stay for very long.

The funeral was at St.Thomas’. It was a poor parish that could only seat about fifty people,but still the church was not packed; it occurred to me that Andrew’s family was very wealthy but they still decided to attend a church that had no air conditioning. I arrived early, as I am always early, and left as soon as he was being lowered into the ground. I did not socialize or stay for a reception in the church basement. On my drive home my mind started to wander on the subject of Andrew’s condition. Should I leave him in the past, or study what little I know on what could be an undiagnosed illness? Suddenly I saw a flash of light in the sky, like the sun reflecting off water. I looked away from the road for a second.my car drifted to the right and suddenly I hit something, my car’s wheels spun on something wet and I slid off the road. I got out of my car unhurt, and my blood ran cold when I heard someone crying softly. The sidewalk was covered in blood and matter. On the ground was the body of an old woman. Her face was caved in and grotesquely distorted by my tire tracks. Kneeling over her was her husband. He held his face in his wrinkled hands and sobbed. I approached the body in shock and he looked up. His face flashed from grief to bitter rage. “It was your fault you f***ing idiot! Don't you know how to drive?!” I stuttered and felt myself going lightheaded, “I-I’ll call an ambulance.” I said weakly. “What's the f***ing point?! She's dead! She's dead and you killed her! What the f*** have you done?!” I felt time go slower and slower, I felt my stomach turn and felt bile in my throat. The man kept getting more and more angry until he was stamping his feet in the blood of his wife and grunting incoherently. Suddenly he reached into his pocket and pulled out a snub nose revolver. I shielded my face with my arms and cried for mercy when I was showered in his blood. His body fell like a sack of rags and I saw into the inside of his  head. That's when I heard it.

It was at that moment that I woke up in a cold sweat. I looked at my clock and felt all my strength leave me. It was the morning before Andrew’s funeral.