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Sanity's Only Skin Deep

h2=. Sanity’s Only Skin Deep

Adam Aust

Copyright © 2017 Adam Aust


All rights reserved.


“The mind is everything. What you think, you become.”


- Anonymous







Sample Chapter from A Glitch in the System


About the Author



I am forever indebted to Maggie Astolfi, who supports me unconditionally, even when I indulge in lunacy. Special thanks also to Matthew Sullivan; your plot feedback has been pure gold.




Sarah Evans closed the bathroom stall door, lowered her skirt, and rolled her leggings and underwear down below her knees. As she sat, she saw it—the new gash on her inner-right thigh. It was bigger and felt deeper than usual, and it must have been at least a week old, judging by the scab’s raised edges and the shiny pink skin outlining it. Dammit, she thought, tracing it with her index finger. I’d better not be doing this at work.

After finishing up in the ladies room, she strode down the hall to her office. Her frosted-glass door shut with a metallic clack behind her as she snatched her phone’s handset off the cradle and started dialing.

“Maury? It’s Sarah. I’d like to come in for a session as soon as possible. I’ve apparently been at it again.” Obligatory question about whether I’ve been going to my meetings in three, two, one . . . “No, I’ve been too busy. I promise I’ll start going again after trial. But for now, I just haven’t had the time. Can you see me this week?” She waited as he checked his schedule. “Tomorrow night at seven works. I appreciate it. See you then.”

She replaced the handset and exhaled through slack lips.

Sliding open her top drawer, she withdrew her scissors, splitting the blades and holding them up to the light. The tips looked a little rusty, but she had to squint to even see that. That could be blood. Wouldn’t there be more, though?

Just then, she heard two knocks and her door abruptly opened. David Marshall, the senior partner at her firm, was standing inside. “Sarah, got a minute?”


David’s eyes jumped from Sarah’s face to her hands. She snapped the scissors closed and dropped them to her lap. “Of course,” she said, hoping she didn’t sound as guilty as she felt. “What’s up?”

“I’m afraid I have some bad news about your role on the Omnicron case. . . .”




Sarah pushed the buzzer labeled “Dr. Maurice Wexler” outside the quaint apartment complex in Manhattan’s East Village. She’d been nervous at first about seeing a therapist here; this place seemed so . . . unprofessional. Day or night, you might rub elbows outside with heroin-addicted skateboard punks, schizophrenic garbage-can scavengers, or hippy-era folk-musician types, ambling about in various states of sobriety, pontificating about bizarre political views. Once she got to know Maury, though, she understood the draw: this place fed his fascination with the human psyche in the same way the internet fed her tendency to procrastinate. He was meant to live in the East Village, and that was nothing to worry about. It just took some getting used to.

Now, three years in, she stood fidgeting on his front landing oblivious to her surroundings, poring over yesterday’s events.

Just after she’d discovered yet another mysterious flesh wound, David Marshall, head of the litigation department and lead counsel on the Omnicron case—her biggest assignment since being hired as an associate attorney at Paulson LLP—had slinked into her office unannounced as she was scrutinizing the rusty (bloody?) tips of her firm-issued scissors. He’d then sat and unceremoniously relieved her of her most important duties on the Omnicron case, sending her headlong into an unrelenting, introspective hell that robbed her of all but three hours of sleep in the ensuing twenty four. She’d been counting the seconds until she could see Maury and get her head back together.

A loud buzz yanked her back to the present as the front door of Maury’s complex clicked open. She pushed her way through the unlocked portal and ascended to the third floor, where Maury was waiting.

He stood holding the apartment door open, with the gentle overhead light reflecting off his high forehead. He was average height and thin-limbed, though he had an old-man’s paunch that Sarah could see through his green woolen sweater. He greeted her with a smile and a hug. And after she removed her shoes—one of his house rules—she followed him to the den, fixing her gaze on his tight gray ponytail as they walked. Faint traces of nutmeg and cinnamon incense hung in the air, which reminded Sarah of the holidays.

“Tell me why you called,” he said, sitting on his faded-navy couch with his left side pressed against the backrest.

“I did it again,” she said, settling into the brown leather recliner she’d occupy for the next hour. It was shabby and worn, but it felt amazing—it didn’t just support her weight, it molded to her, welcoming her gently and whole-heartedly, like an old friend eager to catch up. She’d never before or since experienced chair so comfortable. “And, yet again,” she said, “I have no memory of cutting myself. It’s freaking me out.”

“Have you had any extra stress lately?”

“I’m about to go to trial on the biggest case of my career. Shit, the biggest case my firm has handled in the past decade. So, yeah, I’ve had some stress. I also just found out that I’ve been demoted on that case. They want me behind the scenes now, overseeing the junior associates’ grunt work. I was supposed to question a witness in open court, in front of the jury. It was a big deal. Obviously, they don’t think I’m ready for that yet.”

Maury looked at her pensively. He waited to see if Sarah would add more, and, when it was clear she wouldn’t, he said in a calm, even voice, “While I can’t say for certain what your superiors were thinking, I’ve had enough lawyer patients to know that performance anxiety and client nerves often lead to strange last-minute decisions just before trial. You shouldn’t assume they pulled you off the witness because of your competence.”

“There’s nothing else to assume,” she said shrilly, raising her hands palms-up. “I had been preparing that witness for months.”

“Did they hand the witness off to another associate?”

“No, to a partner. He’s much more senior.”

“That’s exactly what I mean.”

Sarah bunched her eyebrows and rolled her head to face Maury. Even though she disagreed with him, she found herself savoring the deep, woodwind vibrations of his voice. And her body felt like wax melting into a puddle in that chair. She could always relax here, which is probably why she could always find the time for her sessions with Maury, even though she struggled to make her weekly support group meetings.

“You said yourself this was the firm’s biggest case in a decade,” he continued, still calm and measured. “Firm management might have insisted that the most experienced attorney available take that witness. Put yourself in their shoes. On a case of that magnitude, would you want your courtroom attorneys to be high-potential, but unproven practitioners, or battle-tested partners with a track record of success?”

Sarah rolled her head back and stared at the ceiling again.

“And while we’re discussing the trial team,” Maury continued, “let’s not forget they chose you for this team. Give yourself credit for that. You’re still a fairly junior attorney, Sarah. Your opportunities will come. Just be patient.”

Sarah looked over at Maury through the corners of her eyes.

“Any other sources of stress?” he said.

“Isn’t that enough?”

He tittered. “You know, Sarah, you could probably avoid some of these more serious incidents if you would just attend your group meetings regularly. They really seem to help. I don’t understand your reluctance to go.”

I’m surprised it took him this long to bring it up. “You know, Maury, if those meetings weren’t free, I would think you had a financial stake in how well attended they were.” She looked over, and they exchanged warm smiles. “Besides you can’t get rid of me that easily.”




Trial went as expected—ten sleepless nights of corralling evidence and coordinating legal research with nerve-wracked junior attorneys in a cramped back room. It was never clear from her vantage point how well the case was going, but the fact that every one of her tasks seemed to be an emergency didn’t bode well. Just finding time to eat had been a struggle.

Despite the tight schedule, she’d apparently managed to gore herself twice during trial. Again, she couldn’t remember when or how she did it.

Back home, her sister Molly had surprised her with an unannounced visit. Thinking she was doing Sarah a favor, Molly had run a load of laundry for her, discovering by accident several of Sarah’s bloodstained garments. She confronted Sarah about the source of those stains, and in the ensuing, awkward conversation, Sarah, greatly embarrassed, conceded that she’d been cutting herself since as early as high school, and confessed that their parents had secretly chauffeured her to therapy for years. Molly’s “how could you do that to yourself?” look had been soul-flattening. Shock, concern, disgust, and disappointment seemed waft off her, thickening the air between them, despite Sarah’s insistence that she had things under control. The mood had lightened only slightly when Molly hugged Sarah goodbye and said, “I’ll check in on you.”

Alone again, Sarah stared frequently at the two slashes on right side of her rear end, poking at the blood-encrusted marks, shaking her head, and thinking, You’re becoming quite the fucking head case, aren’t you?

With Molly gone, though, Sarah could at least refocus on work, which she did, attacking her assignments with monk-like dedication. No blogs, news websites, or online shopping. For four straight days—including Saturday and Sunday—she ate every meal at her desk, rising only infrequently to use the restroom.

Booting up her computer the Tuesday after Molly left, Sarah saw her cell phone light up—Molly was calling. Sarah ignored her. Molly called again. Sarah ignored her again. Jesus, Molly, she thought, shaking her head, it’s the beginning of the work day. Undeterred, Molly left text messages: “Need to talk”; “You lied to me.”

Sarah silenced her phone and flipped it over, just as David Marshall shoved his way into her office. “Sarah? Got a second?”

“Of course,” she said, doing her best to look happy and eager—and to block from her thoughts what happened the last time David stopped by for a “quick chat.”

He grabbed the stack of papers on Sarah’s visitors’ chair, scanned her desk for an empty spot to put it, and, unable to find one, dropped the stack on a covered banker’s box near the wall, and sat.

I really need to get this place organized, she thought.

“I know it was tough having that witness taken away from you just before the Omnicron trial,” he said soberly, peering straight at her, almost through her, “but it was just business. The client was getting nervous about having an associate stand up in front of the jury on such a big case.” He paused here for an uncomfortably long time and trained his eyes on hers, seemingly trying to prompt a response. The silence lingered, feeding her fears, but she knew better than to fill the space with nervous chatter. I must have fucked something else up. Must have . . .

“Anyway,” David continued, in a conciliatory tone, “you handled it like a professional, and you did great work orchestrating things behind the scenes at trial.”

Sarah forced the corners of her mouth upwards as she waited for David to say “but . . . ,” but it never came.

“I was impressed,” he went on. “How would you like to work on a matter with me directly? It would be a much smaller case—nowhere near the magnitude of the Omnicron trial—but it’s probably more important to the company involved, Sonalux Labs. They asked me to put together a team of my best attorneys, and I want you on that team. In fact, I want you to manage it day-to-day. Think you can handle it?”

Sarah’s blood warmed in her veins. “Absolutely.” She fought the urge to fist pump. “Thank you!”

“You earned it.” His smile widened. Sarah could feel her cheeks flush. “There are a few preliminary things you can get started on right—”

Sarah’s office line rang. The caller ID read “Molly Evans.” David stopped, glanced at the phone, then back at Sarah, whose hands were instinctively reaching for the “ignore” button or whatever the equivalent was on her overly complicated, firm-issued Cisco phone. But she couldn’t find it. Her back stiffened. As a mid-level associate, she’d never had the luxury of being able to ignore a call at work. She sat, helplessly gawking at the phone as if it were a fire she couldn’t extinguish, while it proclaimed, with each jarring ring, just how technically incompetent she was.

“You know there’s—” David began.

Sarah snatched the receiver off the cradle and slammed it back in place, startling David and cutting him off. “Sorry,” she offered, “I’m really bad with these phones. What were you saying?”

He squinted at her and paused for a moment before continuing: “I was just saying that there’s a do not dist—”

The phone rang again.

“Do you need to get that?” he asked.

“It’s just my sister. I can call her back.” Sarah waived a hand dismissively.

The phone kept ringing. Sarah tried to find the “do not disturb” button, which seemed just as elusive as the “ignore” button.

“Sarah,” David said, “it’s your sister. What if it’s an emergency? I insist.” He looked stern now, his voice tightening. “Answer the phone.”

She swallowed hard and turned away from David, lifting the handset and whispering into the receiver: “Molly, unless this is an emergency, it’s a really bad time.”

“Sarah, what the hell? Why do you keep ignoring me? And why did you lie to me?” Molly began.

“What? I—”

“I spoke to Mom and Dad about your . . . affliction.”

Does she keep anything to herself?

“Well,” she continued, “they were completely shocked.”

“I guess so. They didn’t know this was ongoing. They thought it ended years ago.” She glanced over her shoulder at David. “I’m sure they’ll now expect a thorough explanation next time I’m home—”

“Sarah, I don’t think you understand. They had no idea you had ever cut yourself.”

“What? Yes they did. That’s—”

“No, they didn’t. They’re obviously worried, but I asked them not to call you. I told them it might just be a misunderstanding and that I would talk to you and figure it out. I’m really worried about you. Why would you lie to me about this?”

“Molly,” she said as evenly as possible, “I didn’t lie to you. I’m just . . .” She felt the blood drain from her cheeks. She looked back at David, who was getting noticeably impatient. How could they not remember taking me to therapy in high school? “Look, Moll, I can’t talk about this right now. I’ll figure things out and call you back, OK? Gotta go. Love you.” She hung up and turned to face David again, fighting the sinking feeling in the pit of her stomach and struggling to maintain a neutral expression. “I’m so sorry about that,” she said to David.

“Family’s important, Sarah.” David’s tone had changed. He was scolding her now; a father relaying a life lesson to his recalcitrant daughter. “My advice to you is don’t take that for granted. I lost my first wife because I focused too much on this job. You don’t want to end up in that position. Trust me.”

She stared straight through him. He said something. You have to respond. “Yes. . . . Thank you.”

“Now, let me show you how to set your phone to ‘do not disturb’ so we can actually discuss this case that you will be running.”




“Don’t ever do that again,” Sarah said to Molly that evening, bypassing a greeting altogether. It was late, but Sarah was still at the office. She spoke in a hushed voice that made her sound more menacing than she’d intended. “I was in a meeting with the most senior partner in my department—the one person who basically controls my future—when you decided we had to talk at that very moment.”

“It was bad timing,” Molly said. “I’m sorry. I was just really worried and I wanted to figure out what’s going on.” She paused for a reaction from Sarah, but Sarah gave none. “Have you thought any more about what we talked about?”

“Yes, in fact. I spoke to my therapist about it over the phone today, and it turns out that a small percentage of patients with my particular condition suffer from minor memory alterations, and I’m apparently in that minority. I was misremembering the distant past. It freaked me out a little that I could misremember something so vividly, but it’s apparently nothing to worry about. Totally normal for this to happen.”

“You’re telling me your memories are changing and you’re OK with that? I mean, how do you even know your therapist is right about this?”

“I knew you would ask me that, so I even reached out to Dawn Hamilton and Rachel Moore—two of the other women in my support group—and both of them have had the same memory issues.” Molly was silent on the other end. “There’s no point in turning this into an episode of ER, Moll. There’s no dramatic twist to be uncovered here.”

“Sarah, something is messing with your mind. That’s not OK. What if you’re misremembering other, more important things and don’t know it?”

Sarah rolled her eyes. Always so melodramatic. “I’m not, Moll. The memory problems are minimal. And like I said, it’s part of my condition. So unless you’ve figured out a way to cure me, we should probably drop this.”

“Shouldn’t you at least get a second opinion? You owe yourself—and your family—that much.”

“Molly, I’m fine. Therapy and group sessions are really helping, and I am not changing my approach just because you’re overreacting. I appreciate your concern, but it’s time to let it go. I have to get back to work now. Bye.” Sarah hung up, turned off her cell phone, set her work phone to “do not disturb,” and shook her mouse to reanimate her monitor.




Leaving work that night, Sarah sighed as she listened to her latest voicemail: “Sarah, sweetie, it’s Dad. I’m sure you know what this is about, so I won’t belabor the point.” Molly had now enlisted their parents in her crusade. Great. “I want to respect your privacy, sweetie, but if your cognition is in question, then someone else has to step in to make sure things are OK. Anyway, I just wanted to pass along the name of a very well-regarded psychiatrist in New York that a friend recommended. His name is Dr. Robert Margolis, and he sees patients at NYU Langone. As of right now you have an appointment with him at 8 a.m. Monday morning. As a favor to me—your father who loves you very, very much—please at least go and speak to the man. It’ll be an hour out of your day, and it would be a great weight off my mind. I’m sure your therapist is wonderful, but even the best doctors can be wrong sometimes. Please, for your father, get this second opinion. Love you, sweetie. Talk soon.”

She saved the message and lowered her phone from her ear, staring at it as the screen went black and reflected her face back at her. She bit her lip and looked skyward, exhaling noisily. “Fine,” she said aloud. Fishing her work phone out of her bag, she clicked into her calendar and blocked out 8-9 a.m. next Monday morning.




“Hi—Sarah?” Dr. Robert Margolis stepped toward her in the sterile examination room and extended his hand. With his white lab coat, delicate wireframe glasses, salt-and-pepper beard and combover, he seemed like an idealized-prototype psychiatrist sent from some Hollywood casting agency.

“Yes,” she said, gripping his palm. “Nice to meet you.”

“Sorry about the room. I normally hold consultations in my office, but I understand part of why you’re here is to determine when your condition began. Since that requires a medical exam, it was just easier to meet here. Want to tell me a little more about why you wanted to meet?”

I didn’t want to meet. I’m doing this as a favor to my meddling, paranoid family. “I have self-harm disorder, and I can remember cutting myself and seeing counselors about it since I was in high school. But my parents and sister don’t remember any of that. In fact, it was total news to them that I cut myself at all. My therapist said that a small percentage of his patients experience minor memory revisions and that may be what happened to me. He also said that’s normal and nothing to worry about. My family isn’t convinced, though. What do you think?”

Tissue paper crinkled under Sarah’s backside as she adjusted herself on the examination table. The patient gown she’d been asked to wear was starting to untie in the back.

Dr. Margolis drew a slow breath, his gaze fixed on Sarah’s face. “I’m skeptical that your long-term memory alterations are related to your condition. And, with all due respect to your therapist, I wouldn’t consider them to be minor.”

Sarah’s face tensed. “What do you mean?”

“Just that I don’t think we should assume your memory alterations are a benign side effect. In my view they deserve closer scrutiny.”

Of course you would say that. And I bet this “closer scrutiny” will involve a battery of expensive tests that my insurance conveniently won’t cover, too . . .

“Where do you normally cut yourself?” he continued.

“On my legs and . . . my rear,” she said nodding backwards over her left shoulder and looking at him quizzically.

“I’d like to see the scar tissue in the affected areas. It may give me a sense for how long this has been happening. Please stand on the floor with your legs spread shoulder width apart.”

She stood and did as he asked, facing him when she finished, bare soles pressed against the cold linoleum. He donned purple latex gloves, which gave her a strange sense of déjà vu. He sat on a wheeled stool, clicked on a small pen light from the breast pocket of his lab coat, and wheeled behind her to begin his examination.

“How do you normally cut yourself, Sarah?” he said into the back of her left thigh.

“What do you mean?”

“Do you use specific instruments? Is there a particular time of day you prefer? Are you usually at home? Any information along those lines would be helpful.” He had moved to her right thigh now.

“I . . . don’t know.”

He wheeled in front of her, and, prodding something on her upper right thigh, said, “What do you mean you don’t know?”

“I usually don’t remember doing it. It just kind of happens and I discover it later.”

He flicked off the pen light and wheeled back a foot or so, looking up at her as if he were wrestling with his thoughts. He said, “Why don’t you have a seat on the examination table?”

She did as he asked. He wheeled his stool in front of her.

“Do you own any medical instruments? Scalpel, surgical knives, anything like that?”

Her brow furrowed. “No, why?”

“Normally what we see with self-harm patients are either puncture wounds—from a pin, a pocket knife, or something along those lines—or irregular slicing lacerations made with kitchen knives, razors, scissors, and the like. The scars on your legs and backside look more like the latter, except you seem to go so far as to remove chunks of yourself. That’s very atypical. It’s also why your legs are pocked the way they are.”

Chunks? Pocked? My legs aren’t pocked.

“The other unique thing I’m seeing here is the precision of your scars. Usually, when an emotionally distraught patient cuts herself, the wounds are inflicted quickly and violently, leaving rough, erratic scarring. Your incisions, by contrast, appear to have been made smoothly and dexterously, and the shapes that were removed look like regular polygons—squares and rectangles and the like. They’re very . . . exact, which is not what we normally see.”

Her head swam and she felt defensive. Half pleading, she said, “What are you talking about? My legs aren’t pocked.”

For a moment, Dr. Margolis sat motionless, still looking up at her over the rims of his glasses. Then he said, “I thought you might say that. Do you always wear dark leggings, or pants, Sarah, or something covering your legs?”

A jolt of anger radiated from her core. “Most of the time I do, but so do most women. Not everyone has great skin. Sometimes we ladies need a little help.”

He paused again, for longer than the last time. “Hold out your arm, please,” he said neutrally.

Sarah did, and Dr. Margolis pressed a gloved hand into the skin of her inner bicep and slid it slowly toward her wrist. “What do you feel?”

“Your hand moving down my arm.”

“Nothing out of the ordinary, right? No vibrations from my hand rubbing over bumps or scar tissue or anything like that?”

“Right. It just felt smooth.”

“And the sound as my hand ran down your arm was continuous, right? Smooth?”

“Yes.” This guy is wasting my time.

“Now I want you to sit at the edge of the examination table. Dangle your left leg over the side, but keep your right leg extended along the table’s edge.” She complied.

He pressed his gloved hand into the soft flesh on the inside of her upper-right thigh—high enough that she felt uncomfortable about it—and he slid his hand down toward her knee. Her skin stretched and then released in quick jolts beneath the latex, accompanied by irregular vibrations, as his gloved hand slid down her leg. “What did you notice about my hand sliding down your leg?”

She stared at her limb, breathing heavier. It was the same leg—exactly the same—but something about it was terribly wrong now.


She glanced at Dr. Margolis and looked back down. The skin on the inside of her leg from her right hip to her knee now resembled a huge burn scar—there were pink splotches and blanched areas, and the skin was alternately sunken and raised. Was that there before? What the hell? Looking closer, she saw geometrical skin indentations—square, rectangular, like Dr. Margolis said. Her left inner-thigh bore the same disfigurations. She reached back and felt the left side of her rear end. Same texture. Oh my god!

She was hyperventilating. She pressed her head into her palms, leaning over her extended limb.

“Sorry about the shock,” Dr. Margolis said, putting a hand on Sarah’s shoulder. “Some patients create complex mental blocks to avoid dealing with the damage they’ve caused themselves. It’s a form of cognitive dissonance. The phenomenon is similar to, but more intense than, what people experience when they realize they’ve been misperceiving an optical illusion—the observer first sees only the distorted image that the illusionist intended to convey, but later, when someone familiar with the illusion reveals the ruse, the observer realizes there is much more he or she is missing. Depending on how long that person has held the misinformed belief, it can be very difficult for her to see the truth when it’s finally presented.”

“I don’t believe this,” Sarah said, shaking her head and pressing her palms into her eye sockets. “I can’t believe this.”

Dr. Margolis took a deep breath and said, “There’s one more thing you should know, Sarah.”

She stopped, pulled her left hand away from her face, and trained one eye on Dr. Margolis. Her chest rose and fell in strained, heavy motions.

“Almost all of your scars are recent,” he said. “There’s very little chance you’ve been doing this since high school, maybe not even since college.”

Her field of vision pulsed as her heart pounded the inside of her ribs. A pressure built behind her eyes. She thrust her palms back into her face.

“I’d like to bring you back in soon for further testing. Given the severity of your wounds and your having no memory of inflicting them, there’s a chance you’re suffering from multiple personality disorder or something similar. If it’s that serious, we want to make sure we get you the right treatment sooner rather than later.”

She looked up at Dr. Margolis and tried to stand. Then everything went black and she collapsed.




Sarah left NYU Langone and walked north up First Avenue. Cars slipped noisily past, though traffic was light relative to what she would see when she turned west toward Park Avenue and her Midtown office. Not that she’d noticed. Slogging forward, head down, she was mesmerized by her boots clacking one past the other on the grimy urban sidewalk as she tried to process the news she’d just received. With each step, she could feel her skirt rub her disfigured backside and her leggings abrade her scarred inner thighs. I wonder if I’ll get a rash now that I can feel it. She resisted the urge to scratch herself and adjust her clothing. Some illusions have their uses, I suppose.

She still felt some residual dizziness, but Dr. Margolis assured her she’d be OK to walk back to the office.

At 55th Street she paused for an instant, then turned east instead of west and walked one block over to the city’s edge, where she ascended a staircase and crossed a small courtyard wedged between two residential buildings. She sat at a bench overlooking the East River, staring past the metal railing that separated her from the water. A barge with a rusty hull made its way upriver against the current, blasting its foghorn.

Sitting by the waterway, at once noticing everything and nothing around her, Sarah erupted into tears. Multiple personality disorder? That’s what bona fide lunatics have. People who are actually fucking crazy! Not eccentric, not unique, but lock-‘em-up-and-throw-away-the-key batshit crazy! If this guy’s right . . .

She inhaled deeply and exhaled noisily. She looked over her shoulder to make sure she was still alone. Get your shit together, she thought. You don’t know anything yet. No reason to panic yet. . . . Can’t wait to see how Dad and Moll react to this, though.

She opened her cell phone’s call log and clicked on the missed call from her dad from several days earlier. Nose running, lips trembling, her thumb hovered over the green “call” icon next to her father’s number. But she couldn’t speak to him yet. Not until she had more information. Instead, she stowed her phone and retrieved her work device, which showed that she’d already missed seventeen emails, some from David Marshall. Get your shit together and get back to work. Standing, she wiped her cheeks dry, straightened her skirt, checked her mascara in the screen of her work phone, and turned west to make the 20-minute walk to the office, pulling out her cell phone again.

I have to see what Maury says about this. I’ll talk to him first, then I’ll tell my family.




“Thanks for seeing me on such short notice,” she said the next evening as she wrapped her arms around Maury and squeezed.

“Of course, of course,” he said with a gentle drawl, holding her by the elbows at arm’s length, searching her face. “Come on back and let’s chat.” He encouraged her forward with his hand on the small of her back after she kicked off her shoes.

Maury took his usual position on the couch, but Sarah sat erect on the edge of the brown recliner, speaking directly at him instead of floating her thoughts aimlessly into the ether like usual. “I think I might be losing it,” she said. “I’m scared out of my mind and I don’t know what to do, but I think I have to try something different.”

“Please slow down, Sarah. I know you have a lot on your mind, but let’s take things one at a time. It will be easier that way.”

His voice trickled gently into her mind, already starting to soothe her. He was such a calming presence. I really hope I don’t have to stop coming to him. “OK,” she said, and took a deep breath before she continued. “After we talked over the phone about my memory issues, I wasn’t worried about them anymore. But my family still was. My father in particular. He arranged for me to see another psychiatrist so I could get a second opinion.” She paused, scanning Maury’s face, worried he might be offended. But when she saw no reaction, she continued: “And when I went to this doc, I saw all these scars on my legs for the first time. I mean, I saw them before, I guess, but I didn’t register them for what they were. This doc made me really see. It was fucking terrifying.”

“What you’re describing,” Maury offered, “is more or less a form of cognitive dissonance. Not uncommon, but it’s interesting that you would have it, since you seem to be very aware of your cutting behavior after the fact. Now that I know about it, though, we can start addressing in our sessions.”

Sarah sighed, folding her hands in her lap. “The doctor also told me that my memory issues were not a small side effect; they could be more serious. I might even have multiple personality disorder. And, based on the appearance of my scars, he thinks my cutting only began three years ago or so.” She paused again, to see if Maury would react, but she saw no reflexive response. She let the silence linger, hoping to draw information from him, but she grew impatient and went on: “That means I just started cutting myself recently. Maybe even after I started coming to you. I have no memory of that. And I have no memory of how or why I even started coming to you in the first place. My memory must be worse than I thought, and I have no idea how to fix it, or how to even figure out what memories are . . . off.” Warm liquid flooded her eyes. “I’m losing my grip on reality, Maury. I don’t know what to do.” Tears spilled over her eyelids onto her cheeks. She bowed her head and sobbed.

Maury slid to the end of the couch nearest Sarah and caressed her shoulder, handing her a clean handkerchief. “I remember that you were referred to me by a friend, if that helps. Though I can’t remember her name offhand. Someone you met through a roommate. And you came to me because you were cutting yourself and you were afraid. So, we know your issues started before you came to me.” She looked up with red-splotched cheeks and trickles of clear mucus peeking out of both nostrils, which she swatted away with the cloth.

“OK,” he said, leaning back into the couch, re-crossing his legs and refolding his hands. “I need you to at least relax for me, so we can have a more productive conversation.”

“Not sure that’s an option right now.”

“You could start by laying back in the chair, putting your feet up, and trying to get your breathing under control,” he said slowly, raising his eyebrows.

Sighing again, she looked behind her, pulled the lever for the footrest, and fell back into the welcoming leather, her weight redistributing across the cushions. Thank god he’s so understanding. She was still sniffling and breathing erratically.

“Close your eyes for a second and focus on your breath,” Maury said. “In through your nose, out through your mouth. Nice and easy. In and out. Give it a minute or so.”

She felt herself relaxing, her roiling mind beginning to calm. Hearing Maury’s voice was a comfort of its own, a beacon of peace amidst the turmoil of her thoughts. It felt good just to listen.

“Starting to feel better now?” he asked. She nodded, not wanting to open her mouth and ruin the feeling. “Good,” he continued. “Just give it another minute. Breathe in and out. Feel the tension float away as you exhale. Let yourself relax.”

He was right. This was helping. Her thoughts were clearer. She knew exactly what she wanted to say, what she was worried about, what she wanted to ask. It would be much easier this way. He was always right.

“Feel the cushions hug your body, the headrest cradle your head. As you relax, your thoughts will line up, organized and ready to volunteer for discussion.”

Being ensconced in the chair felt amazing. Why didn’t she buy one of these for her apartment? Or her office? If only she could bring Maury with her everywhere, too. Her mind hadn’t been this clear in days.

Thirty seconds, maybe a minute later, her breathing was normal, rhythmic. Concentrating on its regular pattern and feeling her chest gently rise and fall was helping, too. She would be ready to talk soon. Just another minute or so.

“Looks like you’re getting there. Good. Now just follow my voice the rest of the way down . . .”

A worried thought skipped across a distant part of her mind, a glimmer in the darkness. But it was fleeting, and faint, and far too weak to distract her from the moment. Maury was right. This was the solution. This is what would make her feel better. He was right. He was always right. She knew she should listen to him, whatever he said.

“When I snap my fingers you will be totally relaxed . . .”

Everything would be perfect soon. After the snap she’d be there, in that peaceful, frictionless expanse of subconsciousness. Maury would figure everything out while she was there. He always did.

She could feel her emotions slip away like a silk robe sliding off her shoulders.


Maury stared for a moment, scrutinizing his patient, ensuring the hypnosis had worked. “Sarah, I need you to tell me exactly what you told your sister and father and this other psychiatrist about our sessions together and about your condition. Start from the beginning, from the first time you remember telling anyone about me. Don’t leave out any detail.”

With a flat, monotone delivery, Sarah reported everything she had retained. Maury listened intently. “Sarah, do you think you could keep coming to me, but keep it a secret from your family?”


“Good. I’d like that very much. We’ll need to do something about this Dr. Margolis, though, to keep him from investigating too deeply. I don’t want anything interfering with our arrangement. Things have worked out so well for both of us, wouldn’t you say? You don’t want to lose the feeling you get from coming to me, do you, Sarah?”


“I don’t want you to lose that either. And I certainly don’t want to lose a patient of your . . . quality. Why don’t we head to the back room, and I’ll come up with a plan for how to proceed.”

Sarah rose and walked out of the den and down the hall to a closed door next to the bathroom. She stood in front of it, waiting for Maury to hand her the key for the exterior padlock.

Key in hand, Sarah popped the lock, swung the door open, and flicked on the overhead fluorescent tubes. The floor was covered in a waterproof, black plastic material that had the consistency of a bathmat. An industrial-looking, stainless-steel table was pressed against the far wall next to a white, floor-mounted dentist’s light. To the right, against the adjacent wall, was a smaller stainless-steel table with a small autoclave, surgical instruments, and disinfectants neatly organized on top of it. Next to that was a small, black refrigerator.

“Prepare the table, Sarah.”

She grabbed a roll of black plastic material from a shelf under the big table, cut a large swath of it, and covered the table, securing the plastic to the table’s four corners with steel clips. She then grabbed a spray bottle of disinfectant from the smaller table and spritzed the plastic covering, replacing the bottle where she’d found it when she finished.

Slowly and deliberately, she removed and folded her clothes, and placed them on a shelf built into the underside of the large table. She lay supine on the disinfected surface and waited for Maury.

He slid his hands into a pair of purple latex gloves and said, “Please lay on your right side, Sarah.” She rolled over as commanded, and Maury smeared her left glute and the back of her left thigh with a viscous disinfectant. He then removed a metal basket of sterilized surgical tools from the autoclave and placed it and a small clear-plastic food container next to Sarah on the table. With a black magic marker, he wrote the initials “S.E.” on the container.

After swinging the dentist’s light over Sarah’s body, Maury admired and caressed her exposed, meaty flesh, then squeezed a handful of her backside in his gloved hand. “I’m going to need a little more than normal today, Sarah, since it will probably be a while before we see each other again.” He leaned down next to her ear and whispered, “I want you to know that I’ve never had a patient as perfect as you. There’s a sweetness to you I couldn’t possibly describe. Something subtle and complex. God is it complex. I stay up nights thinking about it sometimes, craving your taste. That’s how incredible you are.”

He kissed her nape, rose, and retrieved a scalpel from the basket. He traced the flat side of the knife gently over the curve of her rump, settling the blade on the outer and lower part of her glute and turning it upright. Blood trickled out as he started to cut; it flowed silently over her backside, down the cleft between her legs, and onto the table as he completed the perimeter of a two-inch-by-three-inch rectangle. He was salivating copiously. “You’re doing great, Sarah. You don’t feel anything. Just a little pinch of the skin. But it will be worth it for how you will feel later. Just like always.”

He blotted the incisions, and made sure they connected at the corners, then pinched and secured one side of the bloody polygon with forceps from the basket. He sliced under the skin toward the wound’s center with smooth strokes of the scalpel, folding the slab back incrementally as it separated from her body. Sarah didn’t flinch, her ribs lifted and fell in normal cadence, as if she were laid out on her couch watching the news. Her blood flowed steadily onto the table.

As he pulled the forceps away, he admired the excised patch of her backside—mostly skin and fat, but also a thin steak of marbled flesh, all of which, when rinsed and chilled, would resemble a section of raw pork belly—then placed it gingerly in the clear plastic container. He carefully washed and dressed her wound, then cut another section from the back of her left thigh. “Just one more, Sarah, to make sure I don’t forget you while you’re gone. I am already so excited for you to come back. Not as excited as I am to sample what you’ve just given me,” he said, smiling a warm, thankful smile as he considered the ways he could prepare and consume this morsel, “but excited all the same.”

When he finished dressing the second wound, Maury had Sarah clean herself and the table and then get dressed while he wiped his instruments and put them in the autoclave to be sterilized again. Maury also put the plastic container with Sarah’s flesh in it in the fridge next to two similar receptacles labeled “D.H.” and “R.M.”

“Let’s go back to the den now,” Maury said, “where we can finish our conversation, and I can make sure you’re floating by the time you leave here. Fair’s fair, isn’t it my sweetness?”


In the den, Sarah settled back into the brown recliner, positioning herself just as she had been when she descended into her trance. Maury took his usual spot on the couch. “You’re feeling very comfortable now, Sarah. Much better than when you first arrived. That chair is the most comfortable thing you’ve ever experienced.” Her mouth curved upward and she exhaled in bliss. The leather was impossibly soft, her muscles carried no tension at all, and her mind was finally at ease, like she had been lounging on a tropical beach for weeks, far from the stresses of life.

“When you leave here today, you will continue to feel relaxed and in control. You will associate this feeling with our sessions, which you will miss terribly after you decide to discontinue them today. You won’t notice today’s wounds for two weeks—just before the next appointment you will set with Dr. Margolis, who you’ll decide to start seeing in my stead. He won’t find any evidence that you have multiple personality disorder because you don’t have it, Sarah. But while you’re seeing him, you will cut yourself twice per week—just crude slashes, I wouldn’t want you doing anything more serious outside the proper environment—but you will cut yourself at work, which will worry you greatly.

“After a few counseling sessions with the good doctor, you’ll decide his conventional therapy isn’t working. In fact, you’ll realize that your cutting has gotten worse and has started interfering with your livelihood, which you won’t allow to continue.

“You’ll remember that you were making great strides in our sessions, and that when you were coming to me, you were performing the best you ever had at work. I’ll have Dawn and Rachel remind you of this, too—you should continue to communicate with them, by the way.

“So, you’ll stop seeing Dr. Margolis and come back to me. You won’t tell your family that you’ve come back, though. You’ll tell them you’re seeing my colleague Martin Stanwick at Columbia. He has the reputation and credentials to impress your family and stop them from questioning any diagnoses you tell them about.

“Now, when I snap my fingers, you will gradually wake from your trance, feeling fantastic yet somewhat guilty that you have to tell me you can’t see me anymore. You’ll remember an hour-long conversation we just had about how you should proceed. I will understand that you need to stop seeing me, and I will wish you well. You’ll remember how understanding and gentle I was with you, and you’ll shed a few tears as we hug and part ways. But as you leave, you’ll realize you’ve made the right choice, both for you and your family. And by the time your taxi pulls away, you’ll feel a firm resolve that you did the right thing, and that although the future is uncertain, you know you can handle it if you take things one step at a time. Rome wasn’t built in a day, after all.

“Did you get all that?”


“Good.” He paused to take a breath, then looked at her. “See you soon, Sarah. I’ll be thinking of you.” He lifted his right hand, and snapped his fingers, leaving his hand raised for an extended moment before letting it fall gently to his lap.

Sarah opened her eyes and let out a long, moaning breath, as if she’d just awakened from an especially restful nap. Her head rolled to the right and she caught sight of Maury, plain-faced as always. “Sorry,” she said. “I totally lost my train of thought. What were you saying?”

“I was just noting that our time’s about up, and I was wondering what you’ve decided to do.”

She sat up, digging her heels into the footrest to push it back into the chair. She hated to do it, especially with how good she felt now, but there was no other choice. This would be best for her and her family. “I have to stop seeing you, Maury. I owe it to myself to try something different. I’m sorry.”

“I’m disappointed, obviously. You’ve been such a great patient. But I understand.” He stood and held an open hand toward the entryway of the den, and Sarah walked out toward the front.

She slipped into her shoes and looked back up at her now-former counselor, who regarded her with that warm, grandfatherly countenance of his. I don’t think I’ll ever meet anyone as gentle and understanding as Maury, she thought, tears forming at the corners of her eyes. She extended her arms for a final hug and he reciprocated, leaning forward to embrace her one last time. “Thanks for everything, Maury. I mean it,” she said.

“Just doing my job,” he said, winking. “Take care, Sarah. I’ll miss you.”

“Miss you, too, Maury. Goodbye.”

Stepping out onto 10th Street, Sarah wiped the last tears from her eyes and saw a taxi headed toward First Avenue. She marched into the street and threw her hand up to hail it. She still had a lot to work on, she knew, but today was a key first step.

The cab stopped in front of her and she opened the door, pausing to look back at the building that had given her so many fond memories. That chair, that soothing voice, that feeling I get leaving this place. I’ll miss you, Maury. She jumped in the backseat and drew the door shut, announcing the cross streets of her apartment for the driver. As the taxi pulled away and Maury faded into her past, Sarah rolled down her window and stared into the unwritten openness of the future. A confidence overtook her as the breeze flowed through her hair. For the first time in a long time, she knew she’d done the right thing. Things will get better in time, she thought. Rome wasn’t built in a day.


Like what you read? Please consider leaving a review wherever you picked up your copy of Sanity’s Only Skin Deep. Honest reviews help potential readers decide whether a book is right for them. The more honest commentary there is about Sanity’s Only Skin Deep, the better it is for the book’s potential readers. Just a sentence or two (or even just a star rating) from each reader can be enormously helpful.

Read on for an excerpt from Adam Aust’s A Glitch in the System, available now at your favorite ebook retailer.





Angela awoke sprawled face down on the floor. Her head thumped, her eyelids were heavy. She rolled onto her right side slowly and, when she completed the motion, lifted her left palm off the linoleum. It was slick and sticky. There was a palm imprint where she had pressed against the ground. Rubbing her fingertips against the meat of her hand she registered the substance—blood.

She jerked to attention and scanned her torso for wounds. Nothing there. She glanced toward her extended right arm and saw, just beyond it, a bloody cooking blade. Beyond that, a drooping, middle-aged man’s body was mounted in a stockade. He wasn’t moving—or breathing—and there was a deep laceration on the inside of his upper-right thigh. Dried blood covered his leg below the wound and viscous blood spread across the floor beneath it.

Her heart fluttered in her throat.

“Hello,” she said aloud, her voice hoarse and tired. No response from her limp companion.

Oliver Knox. His name is Oliver Knox.

“Oliver?” Still nothing. Did I kill him?

She remembered holding her phone and reaching for the knife. And then the sharp, stabbing pain.

Was someone else here?

She sat up and surveyed the room. She was alone aside from Knox. She felt her neck—nothing there. Maybe a small bump.

There’s blood everywhere.

She reached for her phone, which was next to her against the wall, smeared with blood. She wiped it clean and checked for videos. But there weren’t any. There was a 23-minute-old message from Nicole, though, asking about Samara.


It came back to her: Samara and Mark had been hours away from release; Angela had to film one last series of videos with Oliver and send them to Samara’s kidnapper; she had to get the videos to him in time or she and Mark would die.

Where are the videos of Oliver I took? How long was I out?

She had no messages from the kidnapper yet. Maybe there was still time. Did he know?

She marinated on the thought.

Was I set up to fail? Does that mean Samara and Mark are . . . ?

She couldn’t text the kidnapper—he had been very clear that he would kill Samara if Angela asked any more questions. So if she wasn’t dead already, she would be then. Detective Linares had made no progress finding Samara and Mark’s captor, so he was useless, too. He probably thinks I’m involved anyway after that bullshit with Trickett and McElroy. They do, for sure.

I could just . . . go . . . . But where? Mexico? “He’d kill them for sure then,” she mumbled aloud. If they’re even alive.

What if I got rid of him myself? She looked over at Oliver’s blanched body, the fleshy gash in his leg, the syrupy blood that had drained from it—and quickly turned away, covering her mouth and chewing back vomit. Brilliant idea. I can’t even look at it without puking. They’d figure out Oliver came here before disappearing anyway, and I’d still be fucked.

Maybe I should just . . . call Linares . . . . She scanned her bloody back room and her bloody clothes, the blood-encrusted knife and her blood-smeared phone. There is no way he would believe me . . .

A blaring shriek pierced the room, a shrill, ear-rending, two-note blast she wasn’t sure if she felt or heard first. In microseconds her pulse surged to the brink of cardiac arrest. Before she could consciously process the intrusion, she’d realized the source of the threat—her phone, sitting on the ground next to her, still set with all the notifications at maximum volume. Detective Linares had just sent her a text, a response to a message apparently sent from her phone just before she received Nicole’s text. He was on his way, he said. He would be there shortly.

What the fuck?!

Angela shot to her feet. The room would be impossible to clean before Detective Linares arrived. She could only close the door and hope he didn’t go back there. She needed to rinse herself, though, and she had to make the trek to the bathroom without getting blood elsewhere in the house.

Leave everything except the phone. Get to the shower.

She tiptoed to the bathroom, tore off her clothes, tossed them in the tub—anything leather would be ruined, but she had to flush away the blood—then she stepped in and turned on the shower. Trying to process what was happening, she scrubbed her skin violently with a loofa. There was no denying that a message was sent from her phone to Detective Linares. But she had no memory of sending it. It had to have been someone else. But who? And what the hell am I going to tell Linares? There is no time!

Arms bent at a 90-degree angle, hands and elbows raised to shoulder level, she looked down to scrutinize herself. The front of her body seemed clean. She jumped out of the shower with the water still running and inspected her back in the mirror. I think I’m OK. She ripped a gray towel off the wall to blot her hair and tie it off, stanching the dripping. Using a second towel snatched off the hook behind the door she swept her arms, legs, and body, and wrapped herself tight. Dry enough. She turned off the water.

Charging into her bedroom she slipped into a pair of yoga pants and a t-shirt, then grabbed paper towels and a bottle of bleach cleanser from the kitchen. If there were traces of blood on her phone, she didn’t want Detective Linares to see them.

He’ll be here any second.

She had sanitized her phone, but now she had a fistful of bloody rags to dispose of.

Was that a knock at the front door?

The wastebasket under the kitchen sink would have to do for now.

In the front entryway Detective Linares greeted her with an unexpected apology: “Hello ma’am. Before you say anything I just wanted to say sorry for the West L.A. detectives the other night. They have this old-school way of doing things and sometimes they get out of line. That’s the kind of stuff that gives cops a bad name. I should have said something to them—I take more pride in my work than that. Anyway, I apologize. It won’t happen again.”

She opened her mouth to speak, but the words caught in her throat. Her bottom lip jerked into her top one as she sniffed back a suddenly runny nose. He was studying her, confused.

She was confused, too, when the first saline droplet slid down her face. A pressure built around her eyes and in her sinuses. Her diaphragm began to spasm, portending an ugly disgorgement. Then she erupted into tears.

“Ma’am?” was all Detective Linares could muster.

Forfeiting speech for the moment, she stepped aside and gestured for him to enter. There was no hiding the truth now, no plausible cover story that could save her.

“Wanna tell me what’s going on?”

“I—” she gasped, her shoulders lurching back to accommodate her lungs—“don’t know what’s happening to me.”

“Ma’am, I am going to need you to get a hold of yourself and tell me what’s going on. Nice and slow, OK?”

“The kidnapper knew, Detective. He knew.”

“What kidnapper?”

“The person that took Samara and Mark. He knew that I shared text messages with you. He knew that you came here with the other detectives.”

“Please slow down. How do you know Ms. Ryland and Mr. Newsome were kidnapped?”

Angela described the text messages she received after Trickett and McElroy’s visit. She explained that the kidnapper threatened to kill Samara if she shared further information with the police. And she told Detective Linares about the box she received in the mail.

“Someone mailed you Ms. Ryland’s finger?” He was beyond skeptical.

“It’s in the freezer.”

“Show me.”

Angela pointed him to the appliance, and he opened it. He reached in, shuffled some items, and then turned back to her. “Where?”

She stepped to his left and began lifting her hand to indicate the box, but it was gone. “Of course,” she said, exhaling emphatically.


“There’s more I need to tell you, Detective.” She indicated the kitchen table. “Please sit.”

“The kidnapper told me to freeze the finger until further notice. That same day, he instructed me to make films of my clients and send them to him, or he would kill Samara. His demands were specific. I had to make a certain number of videos, each a certain length. Once I sent them to him, I had to delete them and all his texts.”

“So you have no evidence of these ‘demands’ or the videos?” Detective Linares seemed both irritated and incredulous.

“No.” Anticipating her next revelation, her heart started thumping, a battering ram pounding the inside of her ribcage. With a deep breath she continued: “It gets worse, Detective.”

“Go on.”

“He made me cut my clients. Little slices at first, but they got bigger over time. I was filming the last set of videos this afternoon. I was almost done—just about to start the final video—when my phone shut off. I went to reboot it, but I felt a stabbing pain in my neck and then passed out. I think I was drugged.

“I was out for a while, but when I came to, my client was dead—murdered—in the stockade in the back room I use for sessions. And the videos from today were wiped from my phone. Just gone. He probably took the finger back while I was unconscious, too.”

“Ms. Gianni”—his face was stern and sober; he spoke deliberately—“are you telling me that there is a dead body in your back room?”


“I need you to get up very slowly and walk me back there.” He took a deep breath.

In her mind his gun was already drawn, though for the moment it stayed fastened in his shoulder holster. She walked calmly and carefully three steps ahead of him; she eased the door open and stepped aside.

He winced, possibly choking back vomit. He radioed Angela’s address to dispatch, noting the body and that this “was an apparent homicide.” He requested detectives and a battery of specialists.


As a litigator in New York City and Washington D.C., and as a neurogenetics and neuropyschiatrics researcher earlier in his career, Adam Aust had more fodder for stories than he could reasonably keep to himself. So, he started writing. A Glitch in the System and Sanity’s Only Skin Deep are the first of his efforts, but other works are on the way. Be the first to experience them by connecting with Adam directly.


Website: adamaust.com

Email: [email protected]

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Sanity's Only Skin Deep

After years of therapy, promising New York City attorney Sarah Evans thought she had everything under control. But when a startling discovery reveals that her self-cutting problem is much worse than imagined, things unravel quickly as she struggles to reconcile her past with something even more fundamental—her grip on reality.

  • ISBN: 9781370752386
  • Author: Adam Aust
  • Published: 2017-04-10 02:50:12
  • Words: 10347
Sanity's Only Skin Deep Sanity's Only Skin Deep