It all started after we got back from a family trip around Eastern Europe.

We have family in some of the countries, but my mother and father really love the history and architecture of the region.

Everything went normally during the trip. We ate good food, saw cool sights, and spent time with distant relatives. I acted like I wanted to go home the whole time, but truth be told, I had fun.

My younger sister turned 14 on the trip. We had a big party for her. She was really into make-up and stuff, so my parents got her a bunch of foreign brands that are popular, I guess.

As far as I know, it only started once we got back home. My sister started complaining about an itch. She said there was a weird tickling sensation constantly on her back. She’d always ask anyone (and I mean anyone, even strangers) around to scratch it for her, but was never satisfied. It was as though we just couldn’t get the right spot. It seemed very frustrating for her.

My mother thought it may be a rash, or an adverse reaction to some of the products she got for her birthday. She saw the doctor, who said there was no sign of any problem with the skin, aside from irritation where she’d obviously been trying to scratch it herself with various objects.

She went to see specialists. First a dermatologist, then an immunologist, even naturopaths. My sister, and the rest of us at that point, were getting desperate.

About two months after we’d returned, it went from an itch, to an obsession.

She was always scratching, all over her body. She said she could feel the tickle underneath the skin. As if “thousands of tiny bugs were crawling around her insides,” as she would put it.

The closest thing we got to an answer was from a neurologist. He said that there could be problems with her nerves backfiring like crazy. He told us that there were certain medications she could be put on, but they’d have serious, and adverse effects. My parents were understandably hesitant, but she was in agony. We all agreed as a family, we had no other option.

I watched her, getting worse with every day. The medication barely helped, and it left her in a severe mental fog. She had a hard time communicating and paying attention. The only thing she could do properly was scratch her skin.

As her brother, watching her go through this was heartbreaking. I was helpless. I was supposed to look out for her, to defend her and take care of her. I was at my wits end trying to think of what the hell I could do. But if even the doctors have no idea, how the hell could I know?

She stopped taking the medication, she said it was giving her uncomfortable side effects. She could “hear” the itching. She said it was better to deal with the irritating sensation, rather than the disquieting hallucinations. We all understood, we wanted it to be as much her choice as possible, with how to handle things.

It was winter at this point, she’d been going for counseling and therapy. My father believed that this was some kind of psychological thing. That a psychologist would be able to help her “deconstruct the root of the issue.”

It’s a good thing too, because if the psychologist hadn’t noticed, I don’t know if any of us would have.

She’d been wearing heavy clothing all the time. We assumed it was due to the cold. As it turned out, her body was covered in lacerations. She’d been slowly trying to skin herself.

She explained to my parents when the psychologist told them, “You don’t understand! Whatever it is, it’s inside of me! I have to let it out!”

My parents were mortified. I was too. But I couldn’t help but wonder how she was able to hide it from us so well. I shared a bathroom with her, and I never found traces of blood that couldn’t be easily explained away.

In the hospital, she was manic. Screaming, and flailing. Refusing to hold still, to let the nurse bandage her.

“That's just going to keep it in!” she howled, desperately trying to rip through her clothing, to tear at her flesh.

It was more than my parents could handle.

She was sent to an institution, where they could keep an eye on her around the clock. She’d have no access to tools with which to harm herself, and she was forced to wear clothing that inhibited her from scratching.

That was a week ago.

Today we heard from the hospital. She’s dead.

The doctors said they weren’t sure exactly how it happened, but at some point when she and some other patients were taken for a walk, she’d managed to impale herself on a fence post, through the throat.

My mother hasn’t spoken a word since we heard the news. My father is furious. He demands to know how this could happen, when it’s supposed to be a “secure facility”.

Me? I’m torn. As I sit here writing this, I’m devastated from the loss of my dear sister, but I’m distracted.

I’m terrified, and I have no idea what to do now. I haven’t told anyone, especially not my family, but something has happened.

A few days ago, I felt an itch. An itch I just can’t scratch…

By: Taylor, aka Tewahway