‘In this form of speech, he reaches conclusions that don’t follow logically, or his thoughts might have no conclusion at all. Sometimes the individual words are correct, but the manner they’re put together is wrong, resulting in what some clinicians call word salad. Sounds rather than meanings govern the connection between words – a clang association. He might also repeat a word over and over, or echo other people’s speech.’

‘That confusion in his speech was already evident a few days ago.’

‘Really?’ Sinclair frowned. ‘It varies with the individual patient, of course. But perhaps he had stopped taking the medication earlier than we thought.’

‘Will this get worse?’

‘Yes, as his condition deteriorates, he might become incoherent, using inappropriate words or mispronouncing them, or making up new words altogether.’

‘Hunting for whores. No – for babies.’

Sinclair shrugged. ‘It’s impossible to interpret his real meaning without having Mr Lowther here for a proper interview.’

Cooper bristled. ‘A what?’

‘My apologies. I meant a properly structured clinical interview.’

Cooper watched Sinclair gather up his notes, plucking up the courage to say what was on his mind.

‘Doctor, you said that many people who have psychotic episodes find them a positive experience.’

‘Yes. Many of them are non-clinical individuals, of course.’

‘Non-clinical?’

‘Individuals who have hallucinations but aren’t troubled by them, so they don’t seek treatment.’

‘But if they have psychiatric problems, they should be receiving treatment, shouldn’t they?’

‘Unless it’s a troubling experience, it wouldn’t be what we term a psychiatric problem.’

‘I don’t understand.’

Sinclair leaned back in his chair and looked at Cooper. ‘Do you believe in the supernatural?’

‘Well, I’m not sure –’

‘No, of course not. Many of us aren’t sure. But, you see, from a neurological point of view, people with a tendency to psychotic experiences show increased activation in the right hemisphere of the brain. The same increase has been found in perfectly healthy people with high levels of paranormal belief, or mystical experiences. Even creative individuals can show a similar pattern.’

Cooper opened his mouth to ask whether that meant people who believed in the paranormal were mad, but Sinclair shook his head.

‘No, supernatural experiences aren’t themselves a symptom of mental illness. But people with different views of reality or unusual opinions have always held a rather complex role in society. Some are considered mad, while others are treated as prophets and visionaries. At the end of the day, the difference comes down to a question of contemporary social attitudes.’

‘You seem to be suggesting that almost anyone might suffer from psychosis of some kind.’