A man appears from nowhere, with no discernible past or history, and collapses at a hospital. He has no recollection of his past and he seems consumed by some kind of guilt that he won't speak about, although he isn't exactly dangerous as such. The setting isn't super important but for ease it'll be either in the UK or USA - probably the UK due to our public health care. I'm assuming that he'd be referred to some kind of mental trauma unit? Would he be kept in a ward or just given intermittent therapy? And once he appeared to have recovered (still no memory, but functioning normally & healthily) what would happen to him? Where would he live/go? I assume they'd provide accommodation but where/what would it be like? Shared accommodation? A flat? I'll tweak reality if I have to but obviously I want it to seem realistic.
Why would he be rendered to a mental health ward? He has collapsed. There's something physiological going on. An ER would begin a battery of tests to determine why he has just passed out. He would have a full examination. Are his pupils equal and reactive? Do they dilate or constrict appropriately? Is there evidence of a head injury, closed or open? Does one side of him seem to slack to one side or no? What are his oxygen levels? COuld he be hypoxic and simply passed out due to lack of oxygen or on the flip side hyperventilated and passed out as a result? Does his heart beat regularly? Is he bradycardic or tachy? Does an EKG show an issue that caused his syncope? They will draw blood to determine if he is hypoglycemic. They will run tests to see if he has a blood infection. There is a gamut of issues to address physically before this would ever be considered a psychosomatic situation. John Doe's are taken into ERs all the time. They are treated until they are stable. A mental health ward is never warranted unless they prove a danger to themselves or others.
That's still helpful, but to be honest I'm kind of glossing over those issues in the book, seeing as he ends up recovering from whatever physical issues he had and basically collapses due to exhaustion, dehydration and maybe mild hypothermia, having been out in the pouring rain and cold, walking and walking with nothing to eat or drink. Maybe he didn't collapse at the hospital, maybe someone brought him there. It's not hugely important to the story why he collapses (Sorry, I probably should've made that clear), but him ending up at the hospital seems the easiest way for me to make the authorities aware of him (maybe he could've committed a crime but a legal process would only get in the way of the story and he would probably be given therapy at least anyway, to try and find out who he is?) The reason I was wondering about the ward was because he doesn't know who he is. He's forgotten everything (except for one thing, but he keeps it to himself). Surely that would warrant investigation? I mean, he was wandering around the city in the freezing cold and pouring rain, and he doesn't know why. That must be cause for a lot of therapy, at the very least. Plus he has nowhere to go anyway, so where would they keep him until accommodation could be found? Also some kind of hospital ward is a good place for him to do some of the thinking he needs to do to come to terms with who he is and come to function normally.
But that is a physiological reason. People don't medically collapse out of exhaustion. They collapse because as you said...nothing to eat or drink. He's dehydrated and malnourished. More than likely hypoglcemic. Amnesia would not warrant a mental ward neccessarily. If he was afraid and prone to violence due to unfamiliaririty of his envronment (brought on by amnesia) he could be in the mental ward. But wards are only used for those who are a danger to themselves or others. Other forms of mental illness are generally dealt with on an outpatient basis. As to where they would keep him? They would probably keep him a few days to insure his glucose levels didn't drop again and to rehydrate him. They would consider him homeless and would contact hospital social services to arrange for housing. Normally in a homeless shelter. They would probably set up therapy sessions as well and assist him in getting transportation back and forth. If you want him institutionalized, he has to do something worthy of institutionalization (a.k.a. violent outburst). I'm speaking for U.S. hospitals of course, considering this is where I live. I have no experience with hospital services elsewhere. I have worked enough with in mental health and hospital settings to understand this is the general approach to these types of situations. My current hospital just had to allow a homeless person to sign out against medical advice on a night that was 20 degrees farenheit outside. There was nothing they could do to hold them, and the fact that they left meant that medical assistance would not foot the bill either. My hospital just ate tens of thousands of dollars for patients that would prefer to live on the streets than receive help for their brain injury.
As for his amnesia...this sounds more like post traumatic stress disorder. Check that out as well. I'm sure a good flash back or two to the event he is berating himself over will be sufficient enough for an outburst worthy of hospitalization for a few days longer.
That seems like it could work... the one event he remembers is the brutal murder of his wife (he didn't actually do it but at this stage he thinks he did; it seems real), he experiences several flashbacks of a sort but I hadn't intended them to be violent as such, more like him remembering things about it than suddenly being transported back there. Being in hospital for just another couple of days might be helpful but I don't want him institutionalized for any serious length of time so the time it takes them to bring him back to full health is probably enough. And then afterwards, a homeless shelter? That should work just fine. It's also interesting that they had to just let him go, as about 1/3 of the way into the book he runs away from all that anyway. Okay, so that seems OK. What would happen in the way of him "becoming a person", if you will? I.e. going on official records, having a name and identity and american citizenship etc. I need him to leave for South America at some point but I imagine it's pretty easy to do so (to get in, at least) without any of that.
Well, that may be tricky with the whole amnesia. He would need a passport to leave the country and depending on which country he goes to a VISA. If it's like Bourne Identity, he could find a bunch of when he wandered somewhere familiar, otherwise, he is stuck being smart enough to sequester illegal documentation. Perhaps "who" he is comes back as well as some of his past, but the events leading up to his wife's murder can still be obscure. The human mind is excellent at repressing traumatic events at times. It would make sense that he would regain who he is without the event in question for quite some time. It could be something he works on in therapy. It could be another side plot as he tries to put back the pieces. Obviously he was employed before. He could make contact with that job. Try to get his old job back in spite of being MIA for a while. There's any number of situations to revolve around the idea of regaining who you are without the actual event. It would also fit in well with PTSD. Good luck.
Currently that doesn't really work out because the basis of his existence is that he was created as an "experiment", if you will. Literally, brought into being by the story's God a couple days before the start of the story, which is why he knows how to operate in society (he was given that much knowledge) and why he remembers the murder (it's the whole point of his existence) but nothing else. I'm reluctant to have had him exist beforehand because it raises all sorts of questions about whether he actually murdered her, and, if so, why are the police not after him and how did he escape. If he'd had a life and family beforehand he'd be on records etc.
Ooooh. Well, if the society is advanced enough to make people or wipe out memories to make new people...they are advanced enough to have DNA tests. Perhaps his DNA is close enough to another's that it causes the police to chase him. Perhaps not, and that's why they aren't after him. So it's possible he didn't kill this "wife". It's possible she isn't even his wife...but only you know that. If he does know how to operate in society then he can obtain a fake passport. He may also search out this non existent history to no avail as a way of character development. I guess the reason for his creation will determine the direction you take it. But this new fangled "amnesia" that isn't amnesia could provide for interesting therapy sessions no?
Yeah actually, the therapist's lack of ability to help him understand who he is could be a contributing factor in his running away. And there's no reason why he couldn't find some kind of employment before leaving the US, nothing major but a simple job to allow him to get some money together etc. I think it's easier to assume that he lived in the homeless shelter and saved his money, then used it to purchase a fake passport, than for him to go through the whole time and process needed for him to become an american citizen and legally obtain a passport.
The best place for someone like that would be neurological rehabilitation facility, but in the UK we are pretty lacking in this department, due to funding shortages. Presuming a person presented to the A&E department, he would initially be admitted for blood test, CT scans etc, trying to establish if there is an organic cause for his memory loss. At some point he would also be assessed by a psychiatrist, to establish whether he is danger to himself or others. If he isn't then, I am afraid, our system would be rather lacking. As a first point of call, the police would take over the case, try to find out who he was, they might release his picture to the media appealing for anyone who might recognise him to come forward. He would be able to stay in the hospital for a while (on the ward) but eventually, if nobody comes forward, he would be referred to Social Services who would try to sort him out with some social security benefit and accommodation. He might accept referral to counselling, such as with MIND. Otherwise, it would be a very unusual situation, nobody has protocols for this, so they'd do the best they can, considering tight resources. Accommodation wise, there are half-way houses, residential accommodation, but if his function was otherwise unimpaired, he would probably not be able to stay there for very long. Something would be sorted out for him, but what, it is anyone's guess, so you can be creative here all you want.
My first thought on reading the OP was Of Andreas Grassl- remember that chap who was found wandering around in a soaking wet suit, who couldn't speak but could play the piano? It seems until he started talking (it all turned out to be some sort of hoax/PR thing) he was kept in a secure mental health unit despit not being obviously dangerous, so it might be worth looking his story up to check how he was treated.
Aaah, I was about to mention that - I got all the way down to the bottom of the thread and there it was. Ha ha.
I knew a person who had totally lost his memory due to EST. This was in the US, about 20 years ago. He was in the residential mental health facility to help him cope with his new situation - having no memory is a traumatic experience in and of itself, after all. He couldn't cope with living with his family (whom he no longer knew), simply wasn't prepared to live on his own, and there was really no other place where he could stay and get the intense support needed. He was there for a little over a month, as I recall, and then moved into an assisted living situation while continuing therapy. He received assistance also from social services in terms of eventually finding a place to stay, a job, etc etc.
The key here is - he wasn't talking. When a person who is to be assessed psychiatrically doesn't talk (or otherwise effectively communicate in some way), it is impossible to validate the assumption that he is not dangerous or in danger (of harming himself, or neglecting himself, or being vulnerable due to lack of comprehension etc). This is why in that situation it is legally not only possible but mandatory to commit someone, for their safety, for observation and treatment. If the person is talking and it is possible to reliably assess their mental state, and they appear to be of sound mind and good judgement, committal to a mental health facility is not appropriate, legally or ethically speaking.
there's another major thread on this very subject here... i suggest you do a search for it... or maybe someone posting here will know how to find it...
