The file on Dr. Rajesh Patel's desk was labeled CASE #17 — SPECIES DYSPHORIA (AVIAN). The patient believed she was a bird.
Not metaphorically. The patient, a thirty-one-year-old software developer from Pune, believed — calmly, intelligently, with full awareness that the belief was unusual — that she was a Brahminy kite inhabiting a human body. She could describe the feeling of thermal updrafts beneath wings she did not have. She could describe the view of the Mula-Mutha River from an altitude of two hundred meters.
Dr. Patel did not dismiss her. He had learned, over sixteen previous cases, that the distance between pathology and truth was often shorter than the medical literature admitted.
Case #1 had been a man who believed he was a river. The belief had made him better at his job. Case #9 had been a child in Lisbon who believed she was two people. Her letter said: "Most people who are multiplied don't know it either." Case #14 had been an alien from Prague who called himself Kev and wanted to discuss "species dysphoria in a reincarnation context."
He did not have an answer. He had chai, which his secretary brought at four o'clock regardless of what was being discussed, milky and cardamom-heavy, placed between the file on species dysphoria and a photograph of his daughter's wedding.
The hospital board had written to him, recommending he refer cases #1 through #16 to colleagues with more conventional methods. Dr. Patel filed the letter in a drawer he kept for documents that were technically correct and fundamentally wrong. The drawer was full.
He opened Case #17. He picked up his pen.
"Tell me about the thermals," he said.
The patient closed her eyes. She said nothing. The room was quiet — the particular quiet of a consulting room in Mumbai in the late afternoon, when the traffic has achieved its maximum volume and has therefore become a kind of silence.
Dr. Patel put down his pen. His hands were still. Then she spoke, and her voice was different — lighter, higher, as if it were coming from above:
"When the thermal catches you, you don't decide to rise. The rising decides. Your wings — my wings — they know the shape of the air the way your lungs know the shape of breath. You don't think about it. You inhabit it. The river is below and it is full of silver and the sun is on your back and you are not flying. You are being flown. The sky is using you to know what it feels like to be occupied."
She opened her eyes. They were wet.
"I miss it," she said. "Every day in this body, I miss the thermals. Not the freedom. Everyone thinks it's about freedom. It's not. It's about being held. The air holds you. This — " She gestured at herself, at the chair, at the room. "This doesn't hold. This just contains."
Dr. Patel wrote in his notes, carefully: "Patient distinguishes between being held and being contained. Notes that the former is the experience of flight; the latter is the experience of having a body."
Then, below the clinical note, in smaller handwriting: "She is not delusional. She is homesick. The question is: for where?"
He looked up. The patient was watching a bird through the window — a Brahminy kite, circling in a thermal above the river.
Neither of them spoke. The bird rose.