Alma: a Successful Case Study, Pt. 1 (Poetry)

When Alma entered my office for therapy,
I was stunned by her pearl white skin,
Her hopeless, dead, dark eyes,
And her anemic, almost anorexic body
Covered in a T-shirt and sweatpants.

After our initial greetings, I said,
“With a simple look I would have suggested
To make an appointment with a doctor,
Because you must have a physical issue,
But you told my secretary that you did,
And that they found nothing wrong with you.”

Alma sighed deeply, then said,
“Yes, there seems to be no physical reason
For why I feel this way.
They said it’s all psychological,
That my anxiety and depression
Are just a result of stress from life.”

Alma’s voice was thin, slow and labored,
As if pushing the words out exhausted her.
She sounded like a robot in distress,
Who was somehow on the verge of tears.

“How long have you been suffering like this?”
“Oh, ever since I was a little kid,” she said with a sigh,
“Although I remember a couple of normal years,
Then I came down with this depression and lethargy
As if something had switched on in my genes.
Ever since, I always felt like everything inside had died.”

“How old are you now?” I asked.
“Twenty two,” she answered, “but I feel much older.”
“Do you think it could be hereditary?”
“I don’t think so, even my grandparents are full of life.
I swear, I have no idea where I must have come from.”

She told me she had no friends at all,
Or anyone who truly cared about her.
Alma’s look of exhaustion was frustratingly familiar;
I’d seen it on other patients over the years,
That haunting despondency and despair,
And the prognosis was rarely good.

“Have you done drugs? Alcohol? Other substances?”
“No, sir. I’ve been clean as a whistle,
No drugs unless you count coffee,
And I must drink four or five cups a day,
Because I often feel about to pass out from tiredness.”

“Have you tried any other treatments? Any medications?”
“Many times,” she replied,
“We went through every test imaginable:
MRI, EEG, bone density scan, X-ray.
All showed me perfectly healthy.”

Alma became more exhausted as she talked,
Like she was running on empty.
“I’ve missed apointments,” she said,
“And even worse, I fell asleep during tests,
Which made me drop out of high school.”

Alma sniffled, then had to dry a tear.
“I need help, sir,” she said in a pitiful voice,
“Because I have no idea how I will survive
Having to endure such a mortifying depression
When I barely have the energy to get out of bed.”

“What else are you experiencing?” I asked.
“Well, I always feel weak all over,
My arms and legs, and especially my throat.
I can hardly hold anything to eat,
Partly because many foods taste foul.
Sometimes I even gag and choke.
However, the doctors discarded allergies.”

“Have you ever been hospitalized?”
“Just once for a week, when I was twelve.
I was diagnosed with an eating disorder.
I was very skinny then, like a stick figure.”
“What was your diagnosis?”
“Anorexia nervosa.
My parents were horrified,
But what else could they do?”

I rubbed my chin thoughtfully.
I felt that I was missing some vital detail.
“How are you spending most days, Alma?”
“I usually stay in my childhood bedroom,
All alone, without any friends to talk to.
I mostly listen to music,
But even that fills me with dread,
Because each song is just a dirge,
A funeral march for the soul.”

Alma broke into tears.
Although I wanted to comfort her,
I admit her plight seemed hopeless.
“I know you feel weak, but have you tried exercise,
Even just taking walks around the neighborhood?”
“When I was younger, I wanted to be outside,
But the light of the sun bothers me too much.
Although afterwards I ran inside, on a treadmill,
I ended up drained after a few minutes.
I’m too tired to go anywhere, or to do anything.”

“Do you have other interests, hobbies?”
“I’m fond of movies, science fiction and fantasy,
Tales that deal with aliens and monsters.
I was a fan of Star Wars, Doctor Who and X-Files,
But now I rarely watch television or movies,
Because of what happens when I try to sleep.”

“What do you mean?” I asked.
“In my dreams I relive stressful scenes
From all that fiction I otherwise enjoyed.
For example that episode of Doctor Who
Where a monster sucks out the Doctor’s brain,
Which causes him to transform into a fiend.
I’m afraid of the monster coming for me next,
So I wake up screaming, and wanting to be dead.
Anything would be better than this awful pain!”

I shifted my weight in my chair;
I was troubled by her lifelong struggle.
“Can I ask you something personal?”
“Please do, sir. I want to figure things out.”
“Are you sexually active?”
“No, sir. I haven’t dated anyone.”
“How about masturbation?”
“Sir, I really don’t want to talk about that.”

“Alright. Is there anybody special in your life,
Someone you care deeply about?”
“Well… I’ve been attracted to some guys,
But who would want to be with me?
I’m the worst downer, and I can’t do anything.
They would need to become my caretakers.”

Alma looked at me with her desperate eyes.
“I feel like I’m not meant to be alive.
I wish I could just fall asleep and die.
I must have done something wrong in my past life,
Or I would have been born in better circumstances.”

Alma sobbed loudly, then calmed down.
“Please excuse my lack of manners.
I am ashamed that I cry so much.”
I tried to soothe her with my tone.
“Those are understandable feelings,
But I suspect we have missed a source.
You said that you lived a couple of normal years?”
“Yes, before I began having these problems.”
“Did you enjoy those times?”
“Of course! It was a wonderful time of innocence.
I had so much fun, and everyone loved me.”

“Did everything change one day?” I asked.
“Yes, one afternoon I woke up in a park.
I couldn’t remember how I got there.”
Alma took a deep breath,
And wiped away another tear.
“Somehow, that event changed me.
I started feeling strange and isolated.”

“Did anyone check you for wounds?”
“Yes, and I told the regular doctors.
Two puncture wounds on my arm,
Which disappeared after a week.
But I lacked other physical issues;
All the test came out correct,
So they said I must be mentally ill.”

I shook my head, but I was content.
“Those doctors focus on their fields of expertise,
Which makes them discard obvious conclusions.
Alma, I’m afraid I know why you are ill:
You contracted vampirism as a child.”

Alma slumped in her chair, dumbfounded,
Then only managed to say, “What.”
I gave her a calming gesture.
“I know it’s a lot to take in,
But your lethargy and weakness
Are caused because you aren’t eating,
Or at least getting the needed nourishment
That sucking someone’s blood provides.”

Alma stared at me, wide-eyed with shock.
I explained her predicament further,
“Vampires are creatures of the night
Who live on blood, and must feed regularly.
If you’re not drinking blood often,
Your body starts to atrophy and wither,
And you end up looking like a corpse.
You likely remain alive to whatever extent
Because human food is sustaining you.”

Her gaze was unfocused, she looked lost.
I filled the silence for her.
“You might have trouble believing they exist,
But there’s plenty of evidence out there.
If you read books like ‘Twilight’, ‘True Blood’,
‘Interview With the Vampire’, or ‘Dracula’,
You’ll see all kinds of proof.”

Alma nodded slowly.
“You don’t have to convince me,
I already knew they existed.”
“Really? How so?”

“On Halloween, when I was six years old,
I was walking home from trick or treating,
And saw a group of children gathered together.
One boy told them he was Dracula,
And showed his fangs to the rest.
His face was pale, and his lips were blue.
He was covered in sweat and smelled bad.
One of the girls of the group screamed,
But the rest just stood there terrified.
I ran away, hid behind a bush and cried.”

“Did you ever talk about this with anyone?”
“No, I was too ashamed to tell,” Alma said.
“You can confide in me, I won’t judge you.”
Alma sniffled. “Thank you, doctor.”

“Haven’t you suspected you were one?
Haven’t you noticed a thrill running through
Whenever you stare at a sexy, bare neck?”
She was flabbergasted, and let out a noise
As if she suddenly experienced an epiphany.
“W-well, yes, but I thought it was a sexual thing.”

“It can be both vampiric and sexual,
But that’s your cursed impulses telling you
That you should sink your teeth into that flesh,
Mainly to feed on the nutritious blood.
I guess your urges have been suppressed
By culture, religion, and maybe your parents,
Who didn’t want their daughter to be a freak.”

Alma hung her head low.
“Is there a cure for vampirism, doctor?”
“No, I’m afraid it’s like herpes.”
“How so?”
“There’s no known cure for either disease.
You’ll always be a vampire.”
Alma covered her pale face,
And let out a noise of despair.

She stared at me with sad eyes,
Then she stood up forcefully
While streams of tears ran down her face.
“I need to search around for a stake,
Or any equivalent implement,
Because I intend to kill myself tonight,
Before I lose the courage to resist.
Goodbye, doctor. Thank you for the help.”

She rushed to the door and opened it.
“Wait!” I shouted, but she left.
I caught up with her in the hall.
“Listen to me, Alma, you are a good person,
And I believe in you. Don’t give up hope.”

Alma bent over and sobbed loudly.
“I’d rather die than turn into a monster!”
I rubbed her shoulder to calm her down.
“I am here for you anytime you need me,
So please, don’t do anything rash.”

She wiped her tears and looked down.
“I guess nothing matters for me anymore.
This world has no use for vampires,
So I can’t ever date, let alone marry.”

“You said that you don’t want to turn into one,
But you’ve been a vampire since you were a child.
You don’t understand: vampires are rare beings,
Different from the rest of the undead.
You retain your human intellect,
And that means you may find someone to love,
And even build a family some day.”

Alma’s tearful gaze looked straight at me.
“I don’t know what to do, I feel so lost.
I doubt you’re right,
But for a while I guess I can try
To become used to this nightmare
As a member of the cursed undead.”

“Unfortunately, you can’t choose a reality you prefer.
You’ll suffer until you embrace that you are a vampire.”
Alma’s gaze was distant, she was lost in her thoughts.
“You referred to vampires as monsters,” I said,
“But monsters just kill indiscriminately.
Vampires need to feed on living creatures,
Which makes them more humane than murderers.

Outward appearances can be decieving.
Take Dracula, for example:
His teeth may have looked sharp,
But he also wore soft leather shoes,
And under his cape he carried a cell phone.
Furthermore, Dracula was quite smart,
Although he had a terrible temper.
He was able to use science and technology,
Like hypnotism and hypnosis machines,
And he mastered modern medical techniques.
No, he wasn’t a monster; he was a hero.
A true gentleman, and a brilliant scientist.”

“How does that prove that vampires are less evil?”
“Dracula didn’t cause harm to people.
He merely wanted to protect them,
By making them believe he wasn’t real,
And by offering them a reprieve.
Even though he drank their blood,
The victims remained healthy.
In fact, the victims became stronger,
Due to the nutrients stored in their bodies.
Dracula also helped heal many wounded soldiers
From World War One, and even went as far
As giving blood transfusions to save lives.”

Alma listened silently as I spoke.
“A vampire isn’t necessarily a villain.
Sometimes they’re kind and compassionate,
Such as Count Chocula, or Peter Pan,
Or maybe even Frankenstein’s monster.
Whether they’re good or evil depends
Upon what they’re trying to accomplish.”

I leaned on my desk and I stared intently.
“I know how hard this news may seem,
But I urge you to accept it anyway.
Why fight against your fate?
Your future lies ahead of you.
The first step to becoming healthy again
Is for you to embrace your vampiric nature.
Then you’ll start living properly,
Instead of just surviving.”

Alma looked at me with sad eyes.
“My body is weak, my mind is slow,
But if you truly believe I’ll improve,
I guess I could try for a while.
But how do I go about fulfilling that purpose?”

“First, you’ll need to drink some blood.”
“Can’t I just drink animal blood?”
“I don’t know. Probably,
But your nature urges you to bite humans,
So at least you should figure out how that goes.”

“S-so what, I’ll look for a place to hide in the dark,
And wait for a victim to come along,
Then I’ll attack and feed upon them?”
“I was thinking you could just seduce a guy.
I’m sure many would go for it.
Once you are doing the deed, bite his neck.
He may even enjoy it.”
Alma smiled. “That sounds like fun.”
She stood up from her chair.
“Let me get started right away!”

She left feeling uplifted, hopeful,
And promising she would return soon.
When she finally reappeared,
I was astonished at her sudden change.

Alma was smiling, and looked cheery
With a sparkle in her eyes.
Although she needed months of sun
To improve her extreme paleness,
She had lost those bags under her eyes,
She sat with her back straight,
And she was wearing jeans
And a flamingo pink hoodie
That exposed a bit of her midriff.

“I have a boyfriend, doctor.
Things have changed so much!”
“That’s wonderful, Alma.
So this is someone you approached to feed?”

“Yes! I was wandering around at night
And I got into a random party.
This cute guy was looking my way,
Maybe even checking me out.
We talked for a while about Doctor Who,
Then he wanted to take me out to see a concert.
Afterwards, I dared to kiss him first.
We had sex the next day, and it was then
When I plunged my teeth into his neck.
His blood tasted so sweet
That I couldn’t stop myself
From sinking my fangs deep into his flesh.
I felt like I was in heaven,
My body tingling all over.”

“I’m proud of your initiative.
So did you feel any different later?”
“I felt great! It was like an energy rush,
Like my mind suddenly became sharper,
And I had been dehydrated for months.
Afterwards I could barely believe
That I had resisted drinking blood until now.”

“Alright, what does your boyfriend think about it?”
“He says that I am crazy, no way I’m a vampire,
But I I think it feels real good for him
When I bite him while he’s inside me.”

I took a long sip from my coffee mug.
“Have you suffered from depression in the meantime?”
Alma’s smile faltered.
“Although I have way more energy,
I can tell that I have developed mental issues
From the many years I’ve been rejecting my nature.
But that’s why I come for therapy, right?”

“It may be nothing more than a placebo effect.
You’re just happy because you have a boyfriend.”
“That’s not true, I’m happier than ever before!”
Alma smiled again as if she was in love.

“I have a new outlook on life,
A new perspective,
And I don’t need to hide anymore.
I can become who I really want to be:
A happy, healthy, vampiric woman!”

“What do you suggest we do next, Alma?
Should we practice seduction techniques?”
Alma’s face lit up as she grinned.
“No, I want to return to my boyfriend.
I need to taste his blood, to feed.”

I wanted to give her a big hug,
But I had been warned about touching my patients.
“My door will always be open for you, Alma.
I will always listen to whatever you want to discuss.”

She beamed, and a giggle escaped her mouth.
“After they told me that my problems were psychological,
I was too embarrassed to discuss them with anybody,
Especially with my parents, but even with a stranger.
I didn’t want to feel like I needed to be locked up.”

She wiped one eye with her sleeve, then continued,
“But I was an idiot! I should have come for therapy sooner.
If my parents had brought me as a child
I wouldn’t deal with this chronic shame and despair,
Due to so many years suffering in silence,
Hiding my pain, pretending it wasn’t real.”

A warm sensation spread in my chest.
“Fortunately, that’s all in the past.
Now that we’ve figured out your true nature,
You can finally begin to live.”

The next time Alma showed up in my office,
She was wearing a risky crop top shirt,
With a V-neck that emphasized her small tits.
Her yoga pants were as tight as they come,
And they accentuated her slender frame.
She was wearing sunglasses indoors.
Her easy smile made me shiver.

She told me that her moods had improved,
And that she had started exercising regularly.
“More importantly, I’m getting my fill of blood,
Because I feed from a few people every night!”

“How do you achieve that?” I asked, curious.
“For new blood, I just cruise the nightlife.
I’ve become attractive enough
That I can simply suggest that I want sex,
And I can choose between different men.
I’ve gained a whole collection of people
Whom I can call whenever I’m hungry,
And they just let me into their houses
And they fuck me while I suck their blood.”

“How many people do you need
To satiate your thirst until you feel full?”
“Oh, about three, and that involves
Leaving enough blood in them,
Because otherwise they might pass out,
Or, you know, just die.”

“I see. And how is the sex?”
“It’s amazing! They’re so excited,
They cum so hard when I bite them,
But I need to control myself;
I can end up sucking them dry.
Either way, I get what I need,
By feeding off a lot of people.
My life is so much better, doctor.”

I realized I had forgotten something.
“Does your boyfriend accept you
Feeding on different people every night,
Not to mention having sex with them?”

Alma was confused for a moment.
“My boyfriend…? Ah, that guy.
No, he was just the first person
Whom I managed to fuck and feed upon.
I’m dealing with many people these days.
Even girls; if one of them ogles me,
I have no issue going somewhere with her
And biting her neck, her thighs,
Or whatever she wants sucked.”

“Well, you look fantastic, certainly,
As if you are doing really well.
What about your lethargy and depression?”
“All that’s totally gone,
I’ve felt more energetic and alert.
I’m like a completely new person.
I guess the cure was becoming myself.”

“I’m glad to hear that.
So many patients feel ashamed
When they come to my office
And discuss their issues.
You are a model patient, Alma.
I hope you continue to succeed.”

Alma smiled warmly at me.
“Thank you so much, doctor,
For patiently listening to me rant,
And for helping me this much.”

I waved my hand, but I was touched.
“Oh, please, don’t mention it.
Honestly, I just enjoy talking to young women.
My patients are usually younger than me,
And I’m fascinated by their problems.
Not many people my age treat me nicely.”

“In fact, I’d love to tell everyone
About how great it feels to be a vampire,
If only to help shed light on
This weird taboo society we live in.”
“I’m sure people will listen to you, Alma.
Your problem is just too interesting
For most people to ignore.”

Alma smirked at me, and tilted her head.
“So… do you want to feel my teeth
As they plunge into your neck, doctor?”
I felt a shiver down my spine.
“I can’t interact with patients in such a way;
Another strike and I may lose my license.”

One afternoon, as I was preparing to leave
Because I didn’t expect any patient,
My secretary called me on the interphone.
“Alma, that vampire patient of yours,
Insists on speaking to you urgently.
She’s waiting right in front of my desk.”

I hadn’t imagined Alma doing this;
She always called a week in advance.
“Alright, let her in.”
When Alma walked into my office
And then locked the door behind her,
I could tell something was wrong.
She was wearing her usual sunglasses,
But also an old hoodie and sweatpants.
Her hair was messy, barely tied up.
She smelled of sweat and possibly blood.

‘Alma: a Successful Case Study, Pt. 1’ by Jon Ureña

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