Agent Johnson

A tall, well-groomed 30-year-old African American man walked into the emergency room of a
large urban hospital, registered under the name Harry Backman, and asked to be admitted to
Ward Three of the psychiatric division. He claimed that, despite the fact that all of his
identification cards bore the name Harry Backman, his real name was Johnson. "And your first
name?" asked the resident psychiatrist. "We're not allowed to divulge our first names," he
confided. He went on to explain that in fact he was Agent Johnson, an FBI agent on a mission
to find Harry Backman, who had last been seen in Pittsburgh several years earlier. He claimed
to have followed Harry from city to city, often posing as a patient in the psychiatric hospitals
where Harry had been treated in order to obtain information about him. Harry had a seizure
disorder for which he took phenytoin and primidone, and he had also taken trifluoperazine in
the past. Agent Johnson did not take any medications. Communicating with his superiors at the
FBI via a high-frequency radio stashed in his bag, Agent Johnson had come to this hospital in
order to be admitted to the very ward on which Harry Backman had been treated as a 10-yearold boy, in order to seek clues about Harry's whereabouts. The patient confided his fear that
the "real" Harry was, in fact, dead, and that an impostor might be posing as Harry in order to
collect his welfare checks.
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During the interview, the patient was generally cooperative and engaging. His affect ranged
from serious to jocular, and when his story was challenged, he became defensive and hostile.
There was no evidence of disorganized speech, cognitive impairment, or hallucinations.
Results of a physical examination, including a thorough neurological examination, and all
laboratory tests were normal.
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A call to the shelter where Agent Johnson lived confirmed that his name was Harry Backman,
that he carried diagnoses of chronic Schizophrenia and seizure disorder, and that he was
maintained on trifluoperazine, phenytoin, and primidone. These medications were
subsequently prescribed by the emergency room physician. In addition, a social worker at the
shelter said that Harry had been wandering the streets in the past few days, frequently not
returning to the shelter at night. She had not witnessed any seizures, and she did not know
anything about Agent Johnson.
On the following day, the patient had a generalized tonic-clonic seizure, lasting approximately 2
minutes, during which he hit his head on the floor. He was treated in the medical emergency
room; all tests, including a computed tomography scan, were normal. After a brief period of
postictal confusion, the patient woke up. He responded to the name Harry and acknowledged
that he had had a seizure. The confused resident scratched her head and said, "But I thought
Harry had the seizure disorder!""I AM Harry!" said the patient with a smile. "I've found him!"