But one patient in particular drew my attention. "Peter" was a bright, highly educated but extremely ill man. Living with schizophrenia for more than a decade, he had already been robbed of his career potential and was extremely isolated. The cognitive decline was profound. Where there should have been the brilliant, inspired ideas of an educated professional, there were, instead, cluttered, incomplete thoughts and incessant voices whispering half-truths and misperceptions. His lack of insight into his illness was striking. He came from a family with significant genetic predisposition for mental illness. His sister also had schizophrenia. Unlike Peter, however, she recognized her illness and embraced treatment, finding relief in clozapine. Indeed, she had been able to live independently and maintain meaningful employment as long as she remained on her medication. Peter clung desperately to the belief that he was not ill. His years of refusal to take clozapine seemed to confirm the denial. He would take any other medication offered, even though he did not agree that he needed it, but accepting this one drug would mean he had given in to the enemy. It would mean he, like his sister, was ill.