One of the most famous accounts of madness, this novel stands with some queries over its level of fictionality.  However, it is a fascinating account of the terror of madness, of lead character Istina’s fears and the literal mental paralysis that ensues. The relapsing and remitting nature of mental illness is emphasised, as well as confusion, lapses in memory and discrepancies between professional’s accounts of illness behaviour and personal memory.  ECT is portrayed, as is common is fiction, as being an instrument of discipline, inducing further terror in those already disturbed. Frame also emphasises the importance of benevolent care within institutional care settings.

10 – “Until that day how can we find a path in sleep and dreams and preserve ourselves from their dangerous reality of lightning snakes traffic germs riot earthquakes blizzard and dirt when lice creep like riddles through our minds? Quick, where is the Red Cross God with the ointment and plaster the needle and thread the clean linen bandages to mummify our festering dreams? Safety First.”

“I will write about the season of peril.  I was put in hospital because a great gap opened in the ice floe between myself and the other people whom I watched, with their world, drifting away through a violet-colored sea where hammer-head sharks in tropical ease swam side by side with the seals and the polar bears.  I was alone on the ice.  A blizzard came and I grew numb and wanted to lie down and sleep and I would have done so had not the strangers arrived with scissors and cloth bags filled with lice and red-labelled bottles of poison, and other dangers which I had not realized before – mirrors, cloaks, corridors, furniture, square inches, bolted lengths of silence – plain and patterned, free samples of voices.  And the strangers, without speaking, put up circular calico tents and camped with me, surrounding me with their merchandise of peril.”

112 – “There is an aspect of madness which is seldom mentioned in fiction because it would damage the romantic popular idea of the insane as a person whose speech appeals as immediately poetic; but it is seldom the easy Opheliana recited like the pages of a seed catalog or the outpourings of Crazy Janes who provide, in fiction, an outlet for poetic abandon.  Few of the people who roamed the dayroom would have qualified as acceptable heroines, in popular taste; few were charmingly uninhibited eccentrics.  The mass provoked mostly irritation hostility and impatience.  Their behaviour affronted, caused uneasiness; they wept and moaned; they quarrelled and complained.  They were a nuisance and were treated as such.  It was forgotten that they too possessed a prized humanity which needed care and love, that a tiny poetic essence could be distilled from their overflowing squalid truth.”

168 – “But the ripple of humanity may take the forms of protest, depression, exhilaration, violence; it is easier to stun the beautiful fish with a dose of electricity than to handle it with care and transfer it to a pool where it will thrive.”

253-4 – “I looked away from them and tried not to think of them and repeated to myself what one of the nurses had told me, ‘when you leave hospital you must forget all you have ever seen, put it out of your mind completely as if it never happened, and go and live a normal life in the outside world.’

And by what I have written in this document you will see, won’t you, that I have obeyed her?”