Successful Psychiatry



Hannibal builds his person suit, chemical by chemical.


I was minding my own business when suddenly my mouth, without input from my brain, decided to blurt out "what if Hannibal was on drugs the entire time?" This is my brain attempting to make sense of that statement.

Successful Psychiatry

Hannibal Lecter is six years old. He stands in the forest, watches blood splatter on pure white snow, and breathes deep.

He had asked his father, once, what hunting felt like. Moose, deer, wild boar, mouflons-- they all inhabit the forests surrounding the castle, and Count had often joined hunting parties. He'd smiled at his son, and said, "Exciting. The way your heart races when you read of adventure in a book, but it's all around you."

Hannibal had wondered what that felt like. His heart had never raced while reading a book. Nor while doing anything else, so far as he can remember.

Later, in yet more books, he would figure out why. Autonomic arousal is a key component in human emotional experience. When an individual experiences a significant stressor, the nervous system releases stress hormones which cause an increased heart rate. Individuals who experience more physical reactivity to stressors require less stimulation and are less excitement-seeking, and individuals who experience less physical reactivity to stressors require more input to acheive a sensation of excitement. Thus, low autonomic arousal might be a factor in traits such as aggression and even a predictor of psychopathy.

Psychopath. The label neither soothed nor chafed at him. It simply was.

But now, with Mischa gone and the feeling of rending flesh still singing through his veins, Hannibal feels excited. It's an entirely new feeling. The idea that other people might get this feeling all the time, even from something so simple as reading a book, is both fascinating and enraging. He wants to rip it from their hands, and now he can.

Hannibal builds a fire. He cooks the meat crudely, nearly burning it to a crisp over the open flame, and devours it anyway. Then he turns to face the world, ravenous.


When he is sixteen, Hannibal realizes that his approach may require some adjustment.

Paris is big. It's smaller than his previous hunting grounds in physical size, but exponentially bigger in population and complexity. For years, he had known at a glance exactly who wouldn't be missed if they disappeared. His fellow orphans, of course, especially those who asked for special treatment or were slow to pick up on the Soviet propaganda that made up the majority of their curriculum. The thin scraps of humanity on the street who sometimes looked at him with their wide eyes, wondering how a boy in such a tattered school uniform looked so well-fed. And as he understood more and more about the world around him, a new source of excitement presented itself: one advantage of living in a political state where dissidents regularly disappeared without a trace was that people tended to not ask too many questions of sudden absences. By the time Hannibal was scooped up by his uncle, only a portion of the deliberately unremarked-upon disappearances in the city of Vilnius were, in fact, truly the responsibility of the Committee for State Security.

In Paris, for the first time in his life, Hannibal feels... overwhelmed. It's a nice feeling. He basks in it, and as a result manages to stay under the radar for long enough to not be kicked out of his new home the moment he arrives.

It can't last, of course. The social structures of bustling, capitalistic, freewheeling Paris are more complex than what he grew up with, but he's a quick study. It's only so long until he knows he needs to return to the one thing that keeps him real, makes him feel as alive as everyone else seems to feel all the time.

And he wants to. He's done more reading about himself and people like him, since arriving in the big city. He knows that psychopaths feel strongly motivated by the promise of reward, and lack the usual sense of deterrence by the threat of punishment. It's not that Hannibal is afraid of being caught. But there are the tendrils of other excitements. They are thin and pale compared to the feeling of bones crunching and blood flowing, but he feels them wrapping around him gently, as if asking permission to be let into his heart: art, music, literature, medicine. They will never be enough for him, he knows. But perhaps they can inform his aesthetic sense in the arena of blood and breath where he finds his truest self. If, and only if, he can find a way to not allow his hunger to overwhelm all other awarenesses in his life.


He finds the solution by accident. Medical school is a logical step for him; he's perfectly capable academically, and it affords him access to plenty of cadavers to refine his technique. Psychopathy is even held to be an advantage in many specialties, and when Hannibal tells his fellow students that he wants to be a trauma surgeon, they nod and say that he'll be a good one.

It's in the bathroom of the library one night, coming up upon three in the morning. The young man spreading white powder over the countertop is not someone Hannibal would have willingly chosen to talk to; he regards the Baltic- and Russian-tinged accent of Hannibal's French as unspeakably crass, and avoided speaking with him directly until he realized that Hannibal was likely to be near the top of the class, and thus potentially a valuable ally.

Hannibal has already planned to kill this man after graduation. All thoughts of that flee his mind, though, when the student hands him a short section of plastic straw and says "Want some? We can study together afterwards."

Hannibal has no desire to study together, but he accepts the straw and positions himself over the line of cocaine anyway. "Slowly," says the other man. "Just imagine you're gently coating the inside of your nose. Not like they do it in the movies."

Hannibal has never seen the movies to which he is referring, so he breathes in the powder and forces down his wince at the burning feeling. His nose starts running immediately, and he is suddenly sniffling in a way he really wishes whoever the fuck this guy is didn't have to see.

And then Hannibal no longer cares what it says in movies or what his nose feels like, because his mind and body are alight, and nothing else matters.

He wants this. This is what was missing, this is the only thing on Earth that could ever convince him not to answer the itch under his fingers for blood.

All of his kills flash through his mind, trying to find a parallel, but it isn't quite the same thing. Even as gobsmacked as he is, he can recognize that this doesn't feel the same as killing does; it's all in his mind, too disconnected from physical reality. Still, it's the closest thing he's ever found.

Hannibal had never even asked himself if it was possible to bottle the chemicals in his mind during a kill and be able to reproduce them later; it would have seemed a crude, almost ridiculous question. He had never had any interest in chemical alterations for his admittedly strange and probably defective mind, because he had assumed that none were possible, and convinced himself he wouldn't want them anyway.

He strides out of the library bathroom, packs up his books, and heads home. He wants to listen to music while he studies. He wants scrap paper, so that he can make sketches of his anatomy lessons instead of just picturing the insides of the bodies in his head. He wants to go to Italy, and isn't entirely sure where that thought came from but files it away for after graduation.

One kill a week until he's finished with his studies and can travel outside of France, he decides. It's a civilized, rational number, which won't interfere with school or draw undue suspicion. He can be civilized, now, without burying his true self. This is his true self, Hannibal is sure of it. The bloodthirsty and the refined, kept in perfect balance by--

--well. He doesn't need to spend too much thought on the necessary conditions to keep the two sides in check. He will find more cocaine from somewhere, and he will make this work. After all, if the idiot in the bathroom managed to buy it, surely he won't have any problems.


Hannibal doesn't have problems. Not exactly.

At least not ones he can't manage. There is cocaine for school days, and xanax for a good night's sleep. MDMA heightens the effect of music and art, and amphetamines keeps him at his desk sketching for hours. The regulation of his mind is just chemistry, and he's studied plenty of that. Whoever he wants to be, however he wants to perceive and be perceived, he can come up with the correct equation for it.

He stays sober on kill days. There's no high that could match that, and he wouldn't want to try.

It's not like he's the only student staying on track via a careful regulation of illicit substances. He's irritatingly normal in that sense, actually, so he sets about ensuring that he is extraordinary in all other ways. He builds a harpsichord in the tiny living space of his rental unit, slotting together the wood and strings and keys like a murder in reverse: putting something together, rather than taking it apart. He shows his anatomical drawings to his professors, and they marvel that work of such beauty and accuracy could be produced from the shrivelled, formaldehyde-filled specimens provided in class. One suggests that, should he choose to apply for a residency abroad, he include his drawings in his application package.

It turns out, though, that it's actually not actually possible to kill, dismember and dispose of even one person a week while working as a resident and preparing for your final thesis defence. Hannibal's skin itches every time he comes near a patient-- vulnerable, trusting, frightened, and all too often insufferably rude as a result of their suffering. He forces himself not to touch them, and adjusts his own doses instead, every time he's convinced he can't spend another day holding such weak, pathetic sway over human life or death.

Italy, he reminds himself grimly nine hours into his final night shift before his scheduled defence for his specialized diploma in emergency surgery. A vacation. Utter luxury; art, culture, agency. Humanity at my fingertips.

He doesn't think too hard about the fact that no kill days means no sober days. He doesn't think about what he would say to a patient asking about drug dependency. He has better, higher things to be thinking about.


Hannibal arrives in Florence, newly qualified as a trauma surgeon, eyes nearly bugging out of his head with some combination of relief, detox, and pure lust.

He doesn't need the drugs here; that is what he has planned, anyway. He doesn't need them because there is nothing to temper, no reason to keep himself in check or provide his mind with alternatives to what he really craves. And anyway, he is different now. The knowledge of the human body and the human mind, his keen eye for art and ear for music, is a part of him now. He wants only to unite the previously separate, if balanced, halves of himself. Art must now inform his Art. Like any artist, he needs room to experiment, to make mistakes.

Hannibal is determined to give himself what he needs.

And he does. There are many more victims, of course, than those that make the news; the ones that come to light are either sloppy enough that he couldn't prevent them from being discovered, or beautiful enough that he wanted them known. He is surprised and rather pleased to discover that he loves the feeling of being discovered, piece by piece. He loves having someone see even a tiny fraction of him, and have them try to uncover more. He knows abstractly that it is dangerous, this new interest in being seen and known, but he doesn't care. He is high all the time now, not on drugs but on blood and lust and the knowledge that he is going to bring into reality every deranged image that enters his mind.

Rinaldo Pazzi is fun, at first. More than fun: he takes on Il Mostro as a personal challenge, and soon enough begins to see each new body as a personal affront. Watching him adjust the direction of his life and career according to Hannibal's actions feels a little bit like what he imagines falling in love must feel like. It's the closest he'll ever get, Hannibal assumes: this lopsided dance of Pazzi allowing Hannibal to direct him, and Hannibal allowing Pazzi to see him.

He draws it out as long as he can; probably too long, if he were a cautious man, but it turns out that he isn't, particularly. So he doesn't set aside the mantle of the Monster of Florence because he's afraid of getting caught; he does so because he can feel himself outgrowing it.

He takes up the needle again; only one of several users, he's relatively sure, in the emergency room where he finds work. The drug feels like coming back to an old friend, warm and satisfying. It slakes his thirst enough to cut back on his other habits, and there are no more murders publicly attributed to Il Mostro.

Without the familiar dance between him and Pazzi, however, Hannibal finds himself in need of something that, before Florence, he hadn't even realized he desired so deeply: recognition. He wants the thrill of knowing that someone is looking at him, could see his true self at any moment.

His first dinner party is not a success. The guests are colleagues and friends from the hospital, doctors and nurses in about equal proportion. They're down-to-earth people, not overly wealthy or fastidious, and they smile and don't mention anything about the meat being tough and bitter. The conversation flows well enough but sticks mostly to work, safe and easy topics. They leave at a respectable hour, nobody having consumed enough alcohol to linger.

Hannibal curses himself; he'd known, or ought to have known, that using meat from a victim who'd been terrorized and in pain before death would have an effect on the taste that the cooking process couldn't remove. He can change his methods to suit his recipes, he thinks; kill them nicely, quickly. Or he could change his recipes to suit his methods. The stress hormones flooding his victims' bodies at death will have no effect on organ meat.

His next dinner goes much better.


He does include his sketches in an application for a residency abroad, though only after having lived in Baltimore for almost five years. He had moved, initially, to see if a change of scenery was perhaps all that was required to redeem his feelings about his chosen specialty. To test whether his ennui was merely restlessness, or if the thrill of putting his hands inside other human bodies had truly worn off, and the realization set in of how little control he really has over the people he tries to save.

The asymmetry of it chafes at him. When he kills, Hannibal has perfect confidence in his ability to take a living, breathing human body and turn it into something else entirely-- inanimate, just a piece of meat. A thorough enough transformation that he can present the final product at dinner, and nobody will be the wiser.

Perhaps he should be content with that power: to be able to take something whole, and break it down to components more valuable than the original. He isn't, though. He wants to be able to complete the process, to but back together what he already knows he can take apart. The first time he stands in his kitchen and deliberately smashes a teacup on the floor, he ends up with a pile of broken ceramic and the feeling of having behaved very foolishly indeed. His mind draws him back to that moment, though. As long as a teacup cannot knit itself back together, perhaps anything that Hannibal can do to a human body in an emergency room is just as futile.

Hannibal finds that the substances that get him through his second residency are different from the first. His first specialty training had been high-pressure, late nights, and unending studying-- perfect for cocaine and amphetamines. In the absence of the ability to interact with patients unsupervised for longer periods of time, psychiatry is merely vaguely irritating. Opioids bring him down to the level of his patients sufficiently to get through the day, and he saves the stimulants for off-hours.

He goes into private practice as soon as he can, and finds there are certain patients whose presence is not so tedious as to require chemical assistance. Certain patients that give him the same thrill as killing does, whom he can transform into this visions he sees inside of them. It's not exactly the same as a teacup gathering itself back together, but it's close.

Kill days, as always, are sober. He acquires a new nickname, and is even beginning to wonder if he might build a facsimile of the rewarding relationship he had with Rinaldo Pazzi with the FBI's Jack Crawford.

Then he is in Jack Crawford's office, and he has had a little bit of coke but not enough to be able to entirely bury his glee at the entire situation, and there is a sweaty, twitchy man sitting opposite him, and Hannibal is gone.


"Don't give me that," says Hannibal. He is lying in the narrow bunk of the boat, nearly senseless with pain and love and relief, and Will is approaching him with a syringe.

Will pauses. He is covered in blood, his own and Hannibal's and Dolarhyde's, that he hasn't bothered to wash off. He is more concerned about Hannibal than himself, at the moment, and he narrows his eyes at the refusal. "I can give an injection just fine, I promise. But okay, sure, you can do it." He reaches over, intending to hand the syringe to Hannibal.

Hannibal doesn't take it. He feels like time might have stopped entirely, and he is acutely aware that a great deal of the rest of his life rests on the next few minutes.

Slowly, trying not to feel the scream of the bullet wound that thankfully seems to have missed his intestine, Hannibal pushes himself to sitting so that he can look Will in the eyes. "You know that I haven't had any drugs for three years," he says. It's half a statement and half a question, because he knows Will must know, but they've never talked about this before. "I could have convinced Alana that some sort of medication would improve my case, of course. I chose not to."

Hannibal winces as even the gently movement of Will sitting down on the bed jostles through his abdomen almost unbearably. Will looks appraising. He doesn't feel pity for Hannibal, just curiosity. Hannibal would breathe a sigh of relief, if that wouldn't just hurt more.

"You've always used them as a civilizing influence," says Will slowly, and Hannibal flushes with pleasure at the familiar feeling of Will's extraordinary mind probing inside him. "Psychopaths seek out strong emotions, as a general rule, because they are less reactive to the things that emotionally affect normal people. Violence is one thing that can connect. So are drugs."

Hannibal tries his best to shrug. "I find that I am able to find pleasure in... milder situations, when I have the capacity to adjust my own brain chemistry."

Will's mouth twists in an aborted smile. "Drugs temper you. Make you a bit more sane."

"That is not how I would prefer to characterize it."

"It's how I would. A serial killer kills with slightly less maniacal compulsion when he's on drugs. That's perilously close to being actual successful psychiatry, Dr. Lecter. "

Hannibal swallows, looks down. Will is right, as usual, and it feels like exposing something dirty and ugly inside of Hannibal. Which is nonsensical considering what they've just done together, and what they both already know about each other. Will sounds contemplative when he says, "Dinner parties and concerts, instead of... this." He gestures vaguely between them, and Hannibal hears something like sending a madman after my family before tearing him apart with your bare hands and allowing me to try to kill you just to see what would happen.

Hannibal has nothing left to offer but the truth, so he does. "If I accept opiate-based medication for my current state," he says, "I doubt I will be able to cease drug use voluntarily. And I doubt you will be able to stop me." He forces his eyes to return to Will's face. "It's up to you. Which version of me you wish to have."

Will's eyes glint in the moonlight filtering in through the cabin window. He holds up the syringe, considering it, and then hands it to Hannibal. Hannibal takes it, and tries to pretend that he isn't disappointed. That the person suit contained in the liquid is one he'll put back on willingly.

"I want all versions of you," says Will. "I want your Becoming, same as you wanted mine. So if you're not going to use this, I sure will." He holds out his arm.

Hannibal has given thousands of injections, probably tens of thousands, both to himself and others. There is no earthly reason for it to feel entirely new, revelatory, as he takes Will's elbow in one hand and slips the needle into his vein.

Will watches him for a moment, and then his mouth opens a little in surprise and pleasure as the drug coursing through his veins takes effect. Hannibal can't help smiling, watching Will's entire body relax and a hazy look soften his face.

He gathers Will into his arms, and it hurts, every part of Hannibal's body hurts, but it's the best he's felt in years. Possibly ever. "Enjoy, širdelė," he whispers. "We have so much more to feel together."


End Notes

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