Patient X

David Peace

August 31, 2018 
The following is from David Peace's book, Patient X. The book explores the life of 20th-century Japanese writer Ryūnosuke Akutagawa, whose short story "In The Grove" inspired Akira Kurosawa's film Rashōmon. David Peace was named one of Granta‘s Best Young British Novelists of 2003. He has won the James Tait Black Memorial Prize, the German Crime Fiction Award, and the Grand Prix du Roman Noir for Best Foreign Novel.

Alone now, Yasukichi lit a cigarette and began roaming the office.
True, he taught English, but that was not his real profession.
Not to his mind, at least.
His life’s work was the creation of literature.

–“The Writer’s Craft,” Ryūnosuke Akutagawa, 1924


It was the Age of Winter, the autumn after the death of Sensei, and the ninth of the month. Ryūnosuke had finished teaching at the Academy early that day, had caught the train from Yokosuka to Tokyo, crossed the city, bought flowers and come to the northern entrance to the Zōshigaya cemetery. From the dawn, the clouds had threatened rain and Ryūnosuke was wearing a raincoat over the Western clothes in which he taught, carrying a Western umbrella along with the flowers. He entered the cemetery and walked down an avenue lined on each side with Maple and Zelkova trees, their leaves yet to turn. There was nobody else in the cemetery, nobody living. Ryūnosuke turned off the thoroughfare, went down the paths, between the stones, the paths to the dead, the stones for the dead, over roots and moss already damp in anticipation of night and rain, the branches of the trees bowing listlessly, welcoming the approach of twilight, the coming of Ryūnosuke to the grave.

Ryūnosuke leant his umbrella against the low hedge fence which enclosed the plot, stepped inside and stood before the grave. It was a temporary grave, the name of Sensei descending in black characters down the pale wood of a tall sotoba, towering beside the smaller marker to his daughter. Ryūnosuke knelt down before the rough mound of earth at the feet of the two markers. There were two vases and narrow incense holders standing in the dirt. Ryūnosuke removed the withered flowers from the vases, laid them to one side. He divided the fresh flowers he had brought into two. He placed them in the two vases. He took a box of incense sticks and his matches from the pocket of his raincoat. He removed nine sticks of incense, put the box back inside his coat, struck a match, lit the sticks and stood them in one of the holders in the mound. He stood up, he bowed his head before the grave of Natsume Sōseki and he closed his eyes . . .

“Are you working hard? Are you writing something? I am watching your future. I want you to be great. But don’t get too impatient. I want you to go forward boldly like an ox; we have got to be oxen. So often we try to be horses, but it’s very hard indeed to be thoroughly oxen. So please don’t be impatient; don’t wrack your brain. March forward untiringly. The world knows how to bow to perseverance, but seldom remembers momentary flares. Push right on to the death. That alone matters. Don’t seek out rivals and try to beat them. Then there will be no end to your rivals; they will keep coming one after another and annoying you. Oxen do push on and on, always aloof. If you ask me what to push, I will say: push the man within, but not the artist.”

Ryūnosuke put his palms together. He bowed once more, then opened his eyes. He bent down, picked up the old flowers from the ground and stepped back from the grave. He smiled and said goodbye to Sensei, then turned and walked away from the grave, back down the paths, between the stones, onto the wider avenue.

Ryūnosuke turned off the thoroughfare, went down the paths, between the stones, the paths to the dead, the stones for the dead, over roots and moss already damp in anticipation of night and rain, the branches of the trees bowing listlessly, welcoming the approach of twilight, the coming of Ryūnosuke to the grave.”

Two crows were nosily tracing a circle across the thoroughfare, swooping ever lower and lower, arguing ka-ah, ka-ah. Ryūnosuke smiled up at them as he walked, naming them Kanzan and Jittoku, watching them disappear into the leaves of a great Hinoki cypress tree up ahead. Under its branches, Ryūnosuke could see the dim figure of a man. The face and features of the figure were hidden in shadow and twilight, but he seemed to be dressed almost identically in a raincoat, holding a Western umbrella. Ryūnosuke sighed, looked down at the dead flowers in his hand, shook his head and turned back towards the grave; he had forgotten his umbrella. But when Ryūnosuke had retraced his steps to the low hedge which surrounded the grave, he found his umbrella was gone.

Ryūnosuke quickly turned and headed back towards the Hinoki tree. Perhaps somehow—though Ryūnosuke could not think how—that man under the tree had picked up his umbrella and had been waiting to return it to him. But now, as he approached the tree, Ryūnosuke could see the man was gone, too. Only Kanzan and Jittoku remained, hopping back and forth under the branches, laughing at his misfortune—A-hō! A-hō!—knowing full well what was coming next for Ryūnosuke—A hard, cold rain on the man without an umbrella.


Monday morning, Yasukichi Horikawa opened the door to the teachers’ lounge. He was not in the best of tempers; he had had a most unpleasant and unproductive weekend, full of cold, sleeping fitfully, unable to finish the story he had foolishly promised an editor. Typically, the only other teacher in the room was his elder colleague K, the German instructor who had seemingly taken a dislike to Yasukichi on first sight. As always, K was standing with his back to the fire, stealing the heat from the room.

“Good morning,” said Yasukichi, as cheerfully as he could, taking out the notes for his first class from his briefcase.

K raised an eyebrow and said, “Well, if it isn’t the fashionable young writer who says good morning but not good evening.”

“Excuse me,” said Yasukichi. “If I have offended you, I’m sorry.” “Not offended me, nor even surprised me, just amused me,” said K. “Obviously you do not care to introduce your teaching colleagues to your literary acquaintances, particularly if your ‘acquaintance’ should happen to be an attractive older lady.”

“Really,” said Yasukichi. “I have no idea what you could mean.” K snorted, winked and said, “On Saturday? At the cinema?” “This past Saturday,” asked Yasukichi. “I was not at the cinema.”

“Really,” laughed K, approaching Yasukichi. “Then that is most strange indeed. And then quite a coincidence, too.”

“How can it be a coincidence?”

“Well, on Saturday evening, I could have sworn I saw you there—at the Denki-kan in Asakusa—in the company of an older lady. I was so convinced that I called out to you as we were leaving, but you just stared blankly through me and walked past without a word.”

“But I wasn’t there,” said Yasukichi. “It wasn’t me, so please don’t say ‘you,’ or that it was a coincidence.”

“But it really is a coincidence,” said K. “Because the film was the revival of Der Student von Prag. You know the film. . . ?”

“Yes,” snapped Yasukichi. “I know the film, of course.”

“Of course,” smiled K. “So then of course you now understand why I say it is quite a coincidence, me watching a film about a doppelgänger, me then seeing you, but it not being you, and so we then can only conclude that I must have seen your doppelgänger.”

“Or that you were too easily influenced by the film.”

K was now at the table, very close to Yasukichi. He stared at Yasukichi, smiled again and said, “Or maybe you were simply embarrassed to be seen in the company of a woman who was very obviously not your fiancée.”

Yasukichi regretted having let his irritation get the better of him. As calmly as he could, he said, “I’m sorry. I wasn’t there, it wasn’t me. Now if you’ll excuse me, I’m going to be late for class.”

K looked down at the notes in Yasukichi’s hand, and then smiled again: “Well, well, well, if it isn’t Edgar Allan Poe today.”

“Now that is a coincidence,” said Yasukichi with a smile.

“Perhaps,” said K. “Then again, we all know they seem to let you teach whatever you want. But only you, of course.”


In his room in the lodging house in Shioiri, Yokosuka, Ryūnosuke threw down his pen and cursed. He had planned to write a story in a single sitting that night; “planned” because he had no choice if he was to meet the deadline. But it was already gone midnight and all he had scribbled was a dismal, ramshackle chain of words with neither beauty nor point. He lit another cigarette. His mind wandered, searching for targets to blame for his inability to write the story; if only he did not have to teach in the morning, then he could write through the night. But not only had he lessons to teach, there were always so many other demands and requests between the classes: a funeral oration for some captain or other, a revision of a lecture in English for a colleague, a translation of an article from a foreign newspaper, and how could he forget the textbook he was supposed to be putting together. There was also an ever-rising pile of letters from friends and editors which he needed to answer. And then there was his wedding; the endless appointments, discussions and formalities! He cursed again. Then cursed himself; blaming others would solve nothing. He put out his cigarette. He picked up his pen, tried to get it moving again. But still he could not write a single line of worth. He put down his pen again. He needed help, he needed inspiration. And not another cigarette. He picked up a book from the desk. He got up from the desk. He walked over to the bedding already laid out on the floor. He stretched out on the futon to read the book. The book was a collection of stories by Edgar Allan Poe. He began to reread one of the stories, attentive more than ever to the inspiration behind the work, the way in which Poe had adapted his original source. This particular story was based on a brief article by Washington Irving. Ryūnosuke was familiar with that article. He recalled the protagonist was a young man who finds himself followed and thwarted at every turn by a masked figure. Finally, the young man stabs the figure with his sword. But when the young man looks behind the mask, he finds only “his own image—the spectre of himself.” Ryūnosuke had even copied out that line by Irving into one of his own notebooks, along with so many other lines and passages from Poe. But now as he reread Poe’s retelling, he began to feel ill. In all of Poe’s tales, Ryūnosuke felt the fragility of the mind, so easily, easily fragmented and torn, shattered and ripped into so many, many pieces. And yet Poe wrote with such craftsmanship, with such clarity and with such realism, yet with such lyricism; the alchemy of his analytical intellect and his poetic temperament, harnessing and sculpting the truth, the verisimilitude of his dreams, his dreams within dreams, real and yet unreal, in words, in writing, in poetry and prose, tales and stories, so beautiful and so terrifying, and so much greater, so much, much greater than Ryūnosuke could ever, ever hope to even, even attempt. He hurled the book into the corner of the room—

“You have conquered, and I yield!”

He had planned to write a story in a single sitting that night; “planned” because he had no choice if he was to meet the deadline. But it was already gone midnight and all he had scribbled was a dismal, ramshackle chain of words with neither beauty nor point.”

Ryūnosuke collapsed back onto the bedding. He stared up at the ceiling, his Night Thoughts reading patterns and signs in the shadows and the stains. And he closed his eyes—

Ryūnosuke was sitting in a box seat at the theatre, a woman by his side, a woman he did not recognise. In the darkness, she was squeezing his arm, resting her cheek on his shoulder. On the screen, an old man in a top hat tore up a sheet of paper, scattered the pieces over the body of a young man lying dead on the floor. The scene then changed, the double of the young man sitting on his grave under a willow tree. Beside Ryūnosuke, the woman was squeezing his arm tighter and tighter, the warmth of her blood burning through her clothes and into his, her mouth to his ear whispering, “Where you go, I’ll always be, even to the last of your days. Look, look. . .”

Now Ryūnosuke saw himself up on the screen, in a garden. A garden which looked like the garden of his family home in Tabata. Ryūnosuke was sitting on the steps to the veranda. He was wearing a large-brimmed sunhat, smoking a cigarette, blowing smoke directly into the camera. He seemed much older, his face gaunt, his hair long beneath the hat. Two children, two boys were playing around him in the garden. They seemed to be his children, his sons. Suddenly, this Ryūnosuke sprang up and started to climb the large crepe myrtle tree beside the veranda. Higher and higher he climbed, his underwear visible, swinging from branch to branch until he reached the eaves of the house. He climbed out onto a limb and perched there, staring out at the audience. A caption flashed up on the screen: “Quack, quack! Pleased to meet you. I am a Kappa. My name is Tock.”

The children ran screaming into the house, this house which looked like his family house. Ryūnosuke followed them inside the house. The children disappeared down a corridor. Ryūnosuke followed after them, but lost them. Still searching for them, he turned into a room. A man in a Chinese-patterned yukata was lying on a futon on the floor. His eyes closed, a Holy Bible open on his chest, the man looked like Ryūnosuke, his exact double. Now the eldest child came into the room. He shook the man, he woke the man. The man sat up, and the man said, “I have been having such an odd dream. I dreamt we were playing in the garden. But you and your brother ran into the house. I followed you, but I lost you. And when I came into this room, I saw myself lying senseless, lifeless on the floor, like an old discarded raincoat.”

Ryūnosuke could not contain himself. He cried out to the man on the bed, “I came searching for you, and here you are!”

The man rose from the futon, came towards Ryūnosuke and embraced him. “So you are Ryūnosuke, too. It was not a dream. . .”

“No,” cried Ryūnosuke. “It was more true than truth itself.”

But hardly had Ryūnosuke finished speaking when the younger child came to the door, looked inside, then turned and ran, crying, “Ma-ma, Ma-ma! Please come to Ryū-chan’s room at once . . .”

Now the man rushed from the room as Ryūnosuke called after him, “Please don’t go, Ryūnosuke! Please don’t leave me . . .”

The older boy looked at Ryūnosuke, stared at him and laughed. “Where is this Ryūnosuke you are calling to, Ryū-chan?”

Ryūnosuke pointed at the door. “He has just gone out.”

“Why, you are still dreaming,” said the boy. “Don’t you know who you are talking to? It is your own reflection in the mirror.”

Suddenly, the film jumped, appeared to snap in two. The lights in the theatre went up. The woman beside Ryūnosuke dug her nails into his arm, bit his ear and said, “So that is how it ends.”


Yasukichi Horikawa was in the Paulista café in Ginza, chatting with the editor of another literary magazine to which he sometimes contributed articles and stories. No sooner had he met one deadline for one story for one editor than Yasukichi would agree to another deadline for another story for another editor. This editor was eating a second baked apple and talking about the works of Edgar Allan Poe. Yasukichi interrupted him: “Actually, I feel I am becoming trapped inside a tale by Poe. Just the other day, at an end-of-year party, I bumped into that one-legged German translator. He said he had seen me in a tobacco shop near here and was offended when I ignored him. But I was in Yokosuka at the time, teaching as usual. But when he described what had occurred, I realised this ‘second-self’ of mine had been wearing exactly what I had been wearing that day: a raincoat. And this is the second time this has happened to me recently.”

“So you are a believer in what the Germans call a doppelgänger,” asked the editor. “They do say we live in the Age of the Double.”

Yasukichi sighed. He squeezed the bridge of his nose between two of his fingers and said, “I don’t know. But if it’s not my so-called ‘second-self,’ then what if someone is deliberately impersonating me, and with some ill intention? I am afraid neither explanation is very welcome.”

“Then you also believe the doppelgänger to be a harbinger of bad luck,” asked the editor. “Even death?”

Yasukichi sighed again. “I don’t know. But either way, I do feel as though I am being stalked by something or somebody.”

“If that is what you truly believe,” said the editor, “then you should see someone. Someone who might be able to help you.”

Yasukichi smiled and said, “Like who? A doctor?”

“A private detective,” said the editor.

Yasukichi shook his head. “I detest detectives, I hate detectives. Detectives cannot even pass for human beings. They are machines.”

“But detectives and writers surely have much in common,” said the editor, smiling. “In different ways, both search for the truth. . .”

Yasukichi snorted. “Nonsense. It is extremely rude to compare a writer and a detective. Theirs is a profession whose essence is to search for the truth in the most vulgar of senses. And if there are writers who only profess truth and do not care what happens to other ideals such as beauty and morality, then such writers must be people with a defect. Perhaps not as individuals, but certainly as writers. And I would say they are unhealthy. Akin to pickpockets and thieves.”

“On what unfortunate personal experience are you basing such a rant,” laughed the editor. “Have you had trouble with a detective?”

Yasukichi shook his head and said, “No. Luckily, I have never had the misfortune to ever meet a detective.”

“So these are simply your observations, then?”

Yasukichi smiled and said, “Not simply my observations, no. Simply my observations would make me no better than a detective, too. These are my opinions; my opinions based on my knowledge, my knowledge formed by my observations.”

“But you have had no personal experience with detectives,” said the editor. “You have never even met one.”

Yasukichi shook his head again. “As far as I know. But more than likely, I have been tailed. In fact, I am certain I have been followed by a detective. And that probably explains my feeling of being stalked. As have you, no doubt. Such is modern life in the modern city.”

“But then perhaps you should meet a detective,” said the editor with a grin. He took out his wallet, then a name-card from the wallet. He placed the name-card on the table before Yasukichi—

“Know-your-enemy,  so-to-speak,” he laughed.

Yasukichi looked down at the name-card on the table, then back up at the room. The mirrors set in the café walls reflected him in endless doubles. Coldly, menacingly mocking him.

“At the very least, you’ll surely get a story out of it,” said the editor.

Yasukichi sighed. “You mean, you will.”


From Patient X: The Casebook of Ryūnosuke Akutagawa. Used with permission of Knopf. Copyright © 2018 by David Peace.

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