LET THE DAY PERISH.

Mornings we stood barefoot on the gray carpet, our hair disheveled and our faces imprinted with fine red creases from our bedsheets, wearing the rumpled shorts and T-shirts we had slept in, yawning and rubbing our eyes as we waited for the nurse to record our weight and blood pressure. She was short and cheerful and wished us a good morning as she adjusted the weights on the exam room’s scale. We said nothing to her, nor did we speak to each other. It was six-thirty, and the first minutes after waking were usually the worst. Each morning was a reacquaintance with the confines of my body: its heavy bowels and full bladder, its aches from sleeping in unaccustomed positions, the pulse of its little blind heart.

After recording our vitals, the nurse handed out our daily medication. We took the pills from their small paper cups and swallowed them with a mouthful of water from the drinking fountain. We returned to our rooms to shower, then walked to the Hospital cafeteria, clean and pink, our hair damp. The hallways were bright and colorless, lined with soft-toned paintings of harmless and familiar subjects: mountains, fruit. The ceiling lights reflected in their framing glass. Small tables held potted plants that were either fake or so carefully tended as to look fake. Our meals were served buffet -style; breakfast was cereal and fruit, supplemented with vitamin pills and small containers of juice. Claire-Sophie, the staff member whom we liked, usually ate with us. She was Haitian and plump and sweet-natured, with a steel bar running through her septum, and she would offer encouragement to anyone who left their food untouched.

“Got to eat here too,” she would say, “just like anywhere else. Look how thin you are.”

I swallowed just enough to avoid attracting her attention. The act of eating was like operating a complicated piece of machinery. I ground the food with my molars until it was mush, then used my tongue to push it into my throat. My body, not knowing any better, would interweave the food’s fibers with its own.

After breakfast came group therapy. This was led by Mike, the staff member whom we disliked, in a small windowless room. Our chairs were Hospital issue, with thin gray cushions mounted on metal frames, and because there were too many to comfortably fit we crammed alongside the walls. We slumped in our seats, staring at the floor or at the clock above Mike’s head. It was the same model-plastic and round, with a thin red second hand-that I remembered from elementary school.

“I want you all to think,” said Mike, “of one reason why the world would be a worse place if you were dead.”

We thought.

“Okay?” said Mike. “Have you thought of something? Daniel?”

“If I was dead,” said Daniel, “my stepdad wouldn’t have no one to yell at.”

Mike took this in stride; he was used to such responses. Today he wanted to talk about values, which he explained were the things that we found important, the things that made us who we were. “Let’s open this up,” he said. “Do any of you have ideas of what your values are?”

We looked at the carpet. We looked at the clock.

“Billy?”

“Well,” Billy said slowly, “my family-”

“Good, good.”

“-um, staying healthy-”

Mike nodded. “Go on.”

“-big tits-”

We laughed. Anna rolled her eyes. Mike frowned and sat up straighter, waving us silent.

“All right, all right,” he said. “What about you, Anna? Can you think of some values?”

“Well,” Anna said in a mocking tone. “My family-”

There were two ways to respond to group therapy: you could stay quiet, giving minimal answers only when prompted, or you could fight it. I had no real experience fighting anything, but Billy seemed used to struggle. He was fourteen and had been dealing meth since age twelve. A short blond mane flapped over his neck whenever he moved, and he was always moving-drumming his hands on his knees, giggling nervously, the sinews twitching in his slight arms. He had only two T-shirts, which he wore on alternate days: one depicted a blond Jesus with sad blue eyes under a crown of thorns, the other a cartoon Saddam Hussein fleeing cartoon bombs.

“You going to try to escape?” he asked me when I first arrived. “Try to kill yourself again?”

“Here?” I said. The thought hadn’t occurred to me. “I don’t know.”

“Be careful,” said Billy. “They’ll catch you. They’ll strap you down.”

Later I found out that he was referring to the Time Out room down the hall, where the orderlies strapped unruly patients to a padded table until they became calm. This was no concern of mine. My first days in the Hospital were motionless days. The processes of the place, its meals and medications and therapy, occurred around me, but they could not move me. Even when we walked the hallways it seemed that only the hallways were moving, sliding beneath my feet like a motorized sidewalk, while I hovered above them, as still as death.

We were in the juvenile section of the Acute ward. Patients stayed here for a week or so, after which their disposition would be decided: either release, or transfer to an indefinite stay in the Chronic ward. The third possibility, for nearly everyone but me, was juvenile hall.

Throughout the week we were on display. Even during our free periods, when we sat and talked at the day room’s plastic table, Mike or Claire-Sophie would be in the corner pretending not to monitor us. They could watch us even when occupied at the reception desk; one wall of the day room was a giant observation window reinforced with a screen of wire mesh in case of sudden violence. Another, opposite window opened onto a courtyard of landscaped cactus and gravel. This courtyard was our only reminder that Arizona was still out there, seething in June, and through the glass it seemed more like an image televised from somewhere impossibly distant. The Hospital’s interior, air-conditioned and lit in flat white, was as placeless as an airport.

Daniel was my roommate. He was sixteen and much taller than me, with flaky red gashes lining the insides of his long arms. He spoke seldom but his eyes were always wide and alert, gentle and deeply sad. On our first night together he explained quietly, with a heavy Latino accent, that we had to leave our bedroom door open because he was on a stringent suicide watch.

“They took my shoes,” he said. “So I can’t hang myself with the laces.”

“Oh,” I said.

“I have to leave the bathroom door open too, even when I’m taking a shit. Just so you know.”

Our room held two single beds, two small closets, and nothing else. We undressed in silence; then Daniel switched off the light and we climbed into bed. The open doorway cast a pale strip of light over the carpet. I settled into the sheets and spent a couple of minutes breathing, watching the dark ceiling. Then I heard Daniel shift in his bed.

“I got my girlfriend pregnant,” he whispered.

I didn’t know how to respond, and so I said nothing. After a few seconds Daniel began to whisper again. He wanted an abortion, he said, but the idea frightened her and neither of them knew where the money would come from. They fought, and kept fighting, and he felt himself falling out of love. He grew afraid of her, he said, afraid of what was growing inside her.

“So what happened?” I asked, after a few seconds.

“You seen my arms, man.”

All kinds of questions seemed to bloom in the following silence. I was afraid that Daniel would ask for my story, a story I wasn’t ready to tell anyone. A sound from the hall grew perceptible: soft footsteps over carpet. A shadow passed over the illuminated strip of our doorway and hung there for a moment. Then it moved on, and we were silent.

The next day we spent our free period at the day room table with Billy, who told stories about his former life. He talked about having guns pulled on him, about cooking drug cocktails in his mother’s microwave. He claimed that he had scored drugs at Disneyland last year, while on a family trip. “I saw a guy by the teacup ride,” he said, “with tracks all along his arms, so I pulled him over and said”-here he affected a conspiratorial voice-“hey man, looks like you got something for me.” He had tried to hang himself a week earlier, but the ceiling was weak and he had fallen in a rain of plaster. I didn’t believe everything he said: for instance, he thought our vitamin pills were really antiaphrodisiacs. He explained this with a story about a couple who had started going at it in the bathroom, one time, before the staff found them.

Daniel countered with a story of his own. He had been high on crystal meth when he first discovered that his girlfriend was pregnant, and he had physically attacked her. “I didn’t know what I was doing,” he said softly. “It wasn’t me.”

“Shit no,” said Billy. He drummed his hands on the table. “You never know what you’re doing. One time I was high and I hotwired a Corvette and I didn’t even remember it. I just woke up and looked out the window and thought, shit, I stoled a car.”

“She made me quit after that,” said Daniel. “I stayed off, too.”

“But it’s so easy going back,” said Billy.

Another day they passed the time by comparing gang signs. They were shocked to learn that I didn’t know any.

“What part of town you from?” asked Billy.

“Northwest,” I said.

“There’s all kinds of gangs up there,” said Billy. “Who’s up there?”

“Mano Negra,” said Daniel.

“Mano Negra,” said Billy.

“Farther outside town,” I said. “The Foothills.”

“Oh,” said Billy. “You never done drugs neither?”

“No.”

“Shit, man,” said Billy. “You don’t got problems. Why you want to kill yourself?”

During these conversations Anna sat apart, slumped in the corner beanbag chair, and wrote in a large black binder filled with looseleaf paper. Her pen seemed to possess its own motive force as it jerked her hand across the page; she glared at it through the thick black frames of her glasses and pushed errant strands of dark hair behind her ear. When Billy grew bored with conversation he would stalk her, pacing around her in circles, hovering over her and jerking away, his mane flapping.

“Leave me the fuck alone, will you?” she said.

“Anna,” said Mike. “Watch the language.”

“Yeah yeah,” said Anna. “Sorry.”

“You been wearing that shirt three days,” said Billy. He giggled. “It smells awful.”

Anna squinted at him. “I’ve only got so many shirts,” she said. “They won’t let me have my suitcase. It’s behind the front desk.”

“They took my suitcase away too,” said Daniel.

“And they took away my bras,” said Anna. “They think I’ll hang myself with those. And I didn’t even try to kill myself.”

Later, in confidence, Billy told me that six months ago she had attacked her mother with a kitchen knife. She wouldn’t say why. She had spent the intervening time in jail.

“She’s freaky as shit,” Billy said. “You know she don’t shave her armpits.”

On my first morning in the Hospital, Claire-Sophie accompanied me to the psychiatrist’s office. She led me past the hallway paintings and plants and told me about dreams.

“They’re spirits trying to connect with you,” she said. “They’ll predict the future for you, if you let them. Tell me what you dreamed last night.”

I had dreamed about everyone I knew: my parents, my friends, everyone I would have shattered by killing myself. In the dream they had come to visit me in the Hospital. They stood around my bed quietly, like mourners, with gentle faces.

“That’s easy,” said Claire-Sophie. “It means they’re all thinking of you on the outside. It means they care about you, and they want you to come home safe.”

I nodded and thanked her, but I didn’t believe it. I had read Freud and knew about the principle of wish fulfillment; it was merely embarrassing that my sleeping mind would so baldly disclose its needs. After a year of therapy I imagined that I understood the psychiatric process better than the psychiatrists themselves. There was no surprise cure awaiting me.

The psychiatrist’s office was another gray room, this one with soft chairs and photographs of desert plants. The psychiatrist was a small woman with a navy blue skirt and a clipboard. Her name was Dr. Mills. She asked how I felt.

“Fine,” I said.

“Fine isn’t a feeling,” she told me.

Claire-Sophie left, saying she would be back in an hour, and Dr. Mills squinted at her clipboard.

“Paul,” she said after a moment. “You’re fifteen years old.”

“Yes.”

“You attend Foothills High School.”

“Yes.”

“And you’re taking one hundred milligrams per day of Zoloft.”

“Yes.”

“All right, Paul,” she said gently. “Now why do you want to die?”

I tried to explain. I had been trying for years. There was pain—I could say that much—but I was powerless to communicate its particulars.

“Hasn’t your family been supportive?” she asked me.

“Sure,” I said. In fact they had inundated me with sympathy, far more sympathy than I knew what to do with, but they could not assuage the pain any more than I could express it.

“Have you thought,” she asked, “of what it would do to your family if you were to kill yourself?” And I knew, I knew; the guilt only worsened the pain. The usual explanations for the suicidal impulse did not apply. It was not a cry for help, not an expression of some grudge against life. It was a last bid to escape a malady that had been a part of me for so long that it had come to define me. I held it against my heart, and it gnawed there; it grew to fill my world. There was only me and it, and the two were not really separate entities.

“You’re going to cry,” said Dr. Mills.

I shook my head.

“Tell me how it happened,” she said.

It was afternoon. I made a telephone call to the house of a friend, who I knew wouldn’t be home for hours, and left a brief message on his machine. It seemed the easiest way. To write a note for my parents, addressing them directly, would have been an effort beyond imagination.

I left my bedroom and walked the hall to the bathroom. My father was in the office at the far end of the house, working on one of his engineering projects. My mother had left the house years ago. I locked the bathroom door behind me and took a loose razor blade from the drawer where I had been keeping it. I sat on the bathtub rim and studied the skin of my wrists. There were fading pink scars from older, experimental cuts I had made; the veins beneath were sinuous and blue, entwining my tendons like vines. I traced their course with my fingertips. This would hurt, yes, but it would not last long. I placed the blade against my wrist.

The split occurred then. I could not truly grasp what I was doing. I had dreamed of this scenario so often that I seemed to have entered the dream. The tiled floor and plaster walls of the bathroom were bright and flat, like imagined objects; nothing in the scene appeared as real. A calmness settled over me, as if I were dead already, and with that calmness came a release from my physical form. It was not me pressing the blade against my skin, feeling the slight discomfort in my wrist; my body was doing this on its own, impelled by the same blind mechanism that led it to digest or to breathe. I was formless. I was elsewhere. A knock came at the door.

“Paul, are you in there?” called my father’s voice.

My body obediently stood and replaced the blade in the drawer. I watched it move, walking across the bathroom tile, opening the door to see my parents standing in the hall. They knew—it was obvious they knew—though at the time I didn’t realize that someone else must have intercepted my message. I imagined that the suicidal act itself had somehow alerted them, summoning my father from his office and my mother from her house on the other side of town. The mechanics of the Hospital had been set in motion.

In the car my mother turned to watch me at every stoplight in case I tried to leap into the street, but I was unable to move. I stared through my window at the summer afternoon: red-faced pedestrians on the sidewalks, barrel cactus on the median strips, sunlit cars and houses. Even after we left the car its window seemed still to be in front of me, screening my vision and placing everything at a remove. The parking lot simmered, half-molten; the hot asphalt sank under my heels; and we passed through sliding doors of tinted glass into the air-conditioned Hospital lobby. A friendly man with a huge wad of curly hair checked me in, smiled at me and my parents, clasped my limp hand, cracked little jokes, pulled a Polaroid camera from nowhere and flashed it in my face. I stared back. It was like watching a cartoon. We walked a cool hallway to the Acute ward’s reception window, where an older nurse gave me photocopied sheets: our daily itinerary, a numbered list of Patients’ Rights. I read them with one hand on the suitcase my mother had packed, with my parents looking over either shoulder. My father pointed to Patients’ Right number 25.

“Hey,” he said. “At least they can’t perform medical experiments on you.”

The “hey” meant that he was making a joke. I didn’t laugh. Surely he didn’t expect me to. The patients’ rights concerned food and mail and medical insurance, and other things related to living. I wasn’t interested. The receptionist handed me a plastic cup.

“If I could ask you to urinate into this,” she said.

In the bathroom I was once more alone with my body. The heart was pulsing, the skin warm and unbroken-though much later, I would tell people that I really did slice my wrists open that afternoon. It made a better story, I thought, if blood were really spilt. I didn’t know how to explain that what mattered was the decision itself, that even if the hot froth in the plastic cup proved I was not biologically dead, neither was I fully alive. I watched myself hand the cup back to the receptionist and felt only a twinge of shame that my parents, following me with gentle and frightened gazes, could see my urine.

In the following days I clung to the idea that I had actually died that afternoon at my father’s house, that anything to come would be merely a strange and inconsequential epilogue. The wire screen in the day room’s observation window dimmed my reflection to the point that I could barely discern its outlines, and I came to think of that shadowy double as my ghost, my dead self looking with pity on its living counterpart. It was the only way to avoid thinking about the future, because either possible future-transfer or release-terrified me. And it was not so hard to imagine myself as dead inside the Hospital. The environment was so strange and yet so banal-the flat gray of the walls, the flat hours of our routine-that I could easily consider it a sort of limbo, a waystation on the path from life to nonexistence.

I kept guard over my feelings. I would not laugh at Billy’s jokes or cry during my meetings with Dr. Mills. I would not admit that I was attracted to Anna. Such an attraction was ludicrous; she was from a darker world that I knew nothing about, that would surely eat me alive, and in any case I had forsworn the emotions of life. But some current in me ran deeper than these arguments, and more and more often I found myself studying the grip of her thin fingers on her pen, the angry intelligence of her glare. After a couple of days I asked Claire-Sophie for a notebook.

I began to write during the free periods, while Billy and Daniel played cards at the table or argued about which radio station to tune in. At first Anna glared at me from across the room, as if she thought I was mocking her, but as I wrote more her reaction became less important. Between my scribblings I had conceived a project: I would fashion a perfect suicide note. There was no practical aim in this; it was merely an extension of that imaginary fate where I had already died in the bathroom, leaving behind a pure and eloquent explanation of why the world and I could coexist no longer. I took the note through several drafts, rearranging paragraphs, using organizational methods I had learned in English class. In the third or fourth draft I hit on the device of writing in the third person, and that seemed a stroke of brilliance-the only way to truly indict myself would be to describe myself from this distance, coldly and without passion, sentencing myself to death in the clinical language of a case study. I became enamored of the very word suicide: its harsh sibilance, its clean final vowel. Even the sound suggested a razor slicing crosswise into flesh. I had grown so engrossed with the project that it was an honest surprise when, after a couple days of writing, I felt a weight in the air behind me and someone’s head cast a faint gray shadow over the open page of my notebook.

“All right,” said Anna, “let’s see it.”

I turned and looked up at her. She was standing near enough that I could smell her: a thick odor, like burnt wood. “What?” I asked. “The notebook?”

“Yeah, the notebook.” She slid her body into the chair beside mine and held out her hand. Her nails were bitten, the skin beneath raw. “Give it.”

I placed it in her hand. She leaned back in her chair, resting her knees against the edge of the table, and spread it in her lap. For a couple of minutes she turned the pages, her thin eyebrows furrowed, her free hand tapping the frame of her glasses. “I don’t know what half these words mean,” she finally said. “What’s a elegy?”

“Like a poem,” I said. “For someone who’s dead.”

“Huh. You’re writing one for yourself?”

“Well.” Explained out loud, it was suddenly embarrassing and juvenile. “I guess.”

She squinted. “But you hate yourself.”

“Yeah. That’s what I wrote.”

“Okay,” she said, closing the notebook. “You’re depressed, you’re smart, whatever. They teach you that shit in the Foothills?”

An uncomfortable heat rose in my ears, but I was saved a response by Billy’s arrival. He bounded through the day room door, clapping his hands, and after a couple of leaps he came to rest behind Anna’s chair. “Psy-chi­-atrist,” he sang, leaning over her. “Just saw the psy-chi-atrist. You’re next. You got is-sues.”

“Fuck off,” she said.

“We ought to mosh,” he said. “What do you think they’d do if I started moshing in here, just by myself? Tossing chairs and shit around.”

Claire-Sophie appeared in the hallway, past the observation window, and opened the door. “Anna,” she called, “it’s time for your psychiatrist.”

Anna sat up, rolling her eyes, and Billy’s gaze flickered to the notebook in her lap. “What’s that?” he asked.

“Nothing,” I said.

Anna tossed the notebook at me. “Fuck this too,” she said. “All you suicide people need a good kick in the ass.” She stood, straightening her glasses, and walked toward the door.

“An-na,” Billy called after her. “Anna In-san-na.”

That afternoon I asked the receptionist if I could shave, and she retrieved the razor from my suitcase and accompanied me to the bathroom. She stood behind me and watched in the mirror as I scraped my face clean. When I returned to the day room Anna said “Smooth shave,” in the voice of a television announcer, and though there was mockery in her tone I appreciated the attention. I began to sit beside her at mealtimes. I knew that I was reenacting the awkward courtship rituals of junior high; it should have been ridiculous, but at times the Hospital could seem less like a hospital than a summer camp. We were so young. And they made such an effort to keep us entertained. There were board games, card games, watercolor paints. Daniel and Billy and I sat around the day room table and played Uno.

“Show me your cards,” Daniel said at one point, after we had played a few rounds. Billy and I looked at each other.

“Come on, show me.” We lowered our hands slightly, and Daniel craned his head to peek. “See, that’s what I thought. You,” he said, pointing at me, “got the best cards, you,” pointing at Billy, “got some OK cards, and I don’t got shit!”

We all laughed. I laughed mostly at the realization that I could laugh, that the joke held no malice. The Hospital had eased distinctions of race and class; we were all patients together. Daniel tried speaking to me in Spanish and though his speech was slurred and riddled with slang, completely different from the classroom Spanish I knew, I nodded and followed along as best I could.

“Bueno,” Daniel said after a bit, “dime algo.”

“No me gusta este hospital,” I said.

Daniel and Billy cracked up, as though it was the funniest thing they had ever heard. “Este hospital,” Billy repeated, snickering. Mike squinted at us suspiciously from the corner. Anna continued to scribble in her binder, head down, giving no sign that she had heard.

Claire-Sophie taught us a simple lie detector. We held our arms above our heads and she pressed down on our hands. She claimed that we could keep them upright only if we told the truth.

“You going to stay off drugs when you get out of here?” she asked Billy.

“Yes,” said Billy, and Claire-Sophie immediately pushed his arms down to the height of his shoulders. We laughed.

“Wait wait wait,” said Billy, jumping back, his hair flapping. “Ask me if I’m going to try to stay off drugs.”

“All right,” said Claire-Sophie, and took his arms. “You going to try to stay off drugs?”

“Yes, ma’am.” This time his arms held firm. He laughed and ran around the room in a victory dance, pushing chairs aside and making boxing jabs with his fists.

We had a copy of the board game Taboo, where we gave one another hints to guess words from printed cards. “Um, these are my people,” said Daniel.

“Mexican,” said Billy.

“Latino,” I said.

“No, no,” said Daniel. “Like from before, like the Indians.”

“Aztec,” I said.

“Shit,” said Billy, “you can’t kill yourself. You’re too smart.”

I laughed with everyone else, but after laughing I always felt guilty. Laughter seemed to invalidate my reasons for being in the Hospital; it suggested that the pain was a conscious choice, that I was enduring this routine not because of an incurable malady but from my own free will. Though at other times it seemed clear that I had no choice. My parents’ visits, for instance, were always horrible.

They came every evening, which was as often as they were allowed. They looked at me with mournful eyes, held my thin arms, asked whether I needed anything. Dr. Mills had suggested that my depression might be merely a means of getting their attention, and I did take some pleasure in seeing them so suddenly concerned: but it was a shameful thing. As soon as I caught myself enjoying the attention—my father’s serious gaze, my mother’s wide-eyed pity—my heart would curdle with remorse.

“Are they treating you well?” my mother asked.

“Oh yeah,” I said. “They’re fine.”

“What do you do all day?” she asked, though surely she knew.

“We talk,” I said. “We eat. We have therapy. Today it was art therapy. We painted pictures of our safe place.”

“What was your safe place?”

“It was green,” I said, starting to feel interrogated, an edge sharpening in my voice. “And it was empty.”

My father said little during these visits. He sat cross-legged, with one hand cradling his chin, and nodded as my mother and I spoke. He may have feared that his emotions would get the better of him. He had been especially guarded around my mother since the divorce.

“So what do you think?” he asked me. “Are you going to come home next week?”

“I don’t know,” I said. “The staff decides it.”

“No,” he said, controlling his voice with effort, “you decide. Do you want to stay alive or not?”

At the end of one visit he left me a typed letter, which I read before going to sleep that night. The letter made a distinction between emotions, which one could not necessarily alter, and attitude, which one could. It offered sympathy, but also exhorted me to work on my attitude. He handed me the letter without saying anything, self-consciously scratching his temple. On my parents’ way out, my mother asked Claire-Sophie’s permission to bring pizza the next day.

“Sure,” said Claire-Sophie. “Only we ask that you bring some for everyone.”

My mother kissed my cheek. “I’ll see you soon,” she said. She and my father walked off as always, their gaits slow, their heads bowed. Often it seemed that they would like to touch each other, but of course they didn’t. The next evening they brought a hot and sweet-smelling cardboard box, and after their visit we had a pizza party in the day room.

“Paul’s family is the bomb,” Billy said through a mouthful of melted cheese. “The fucking bomb.”

I tried to eat a slice, but halfway through my second bite I conceived the horrible idea that the warm food secretly embodied the taste of love, all fifteen years’ worth of love that I had consumed while giving nothing in return, and my throat seized up. I had to spit my half-chewed food into a napkin. In group therapy the next morning, Mike brought up self-mutilation.

“Anna,” he said, “you’ve mentioned that you give yourself eraser burns.”

“Yeah.”

“Why do you do that?”

“I don’t know. It feels good.”

“It feels good to hurt yourself?”

“Yeah.”

“How do you feel about that, Billy?”

“I don’t feel nothing about that,” Billy said, giggling. “Anna’s a bitch.”

Mike frowned and turned to me. “What about you, Paul?” he asked. “You have a history of self-mutilation.”

“Not much,” I said, keeping the insides of my wrists concealed. “Some razor scars.” In front of the others, I was embarrassed at the pettiness of my gestures.

“Well, what was your motivation?” asked Mike.

“I was angry.”

“About what?”

I shrugged. “About everything.”

“So you hurt yourself?”

“Well, I couldn’t hurt anyone else,” I said.

“Yeah, that’s it,” said Anna. “That’s why.”

Mike turned to her and blinked. I don’t remember what he went on to say—probably something about finding a more positive outlet. What I remember is the half-smirk that Anna gave me, just for a moment, before her face sank back into indifference. It was the first smile I had seen from her. That afternoon, in the day room, she asked whether I wanted to see her binder.

“What?” I asked, surprised by the offer. “I mean, sure.”

“You don’t have to look,” she said.

“No,” I said quickly, “I want to.”

Her writing was mostly unrhymed poetry in short lines. The pronoun “I” was everywhere, usually in unhappy contexts: I want… I fear… I am alone. Her script was like a child’s, large and bulbous. In the margins she had drawn crude landscapes populated by stick figures. Ugly scribbles, apparently signifying night, choked the skies. As I read she sat quietly, looking over my shoulder, her face betraying none of the self-consciousness that I would have expected. After a few pages I came to a short poem sitting alone on its page, with no accompanying sketch. As I sit beside you tonight, it read, I feel such happiness… I feel peace when we are together… I know nothing will ever separate us. I looked up at her, surprised. Her face was blank.

“I wrote that for my old boyfriend,” she said.

I looked back at the poem. “What happened to him?”

“He… I don’t know.” She shrugged. “Got tired, or something.”

“So the poem didn’t come true.”

She glared at me and reached over to slam the binder shut in my lap. “I meant it when I wrote it.”

“Sorry,” I said quickly.

Her hand remained on the binder’s blank cover. She stared at it, not answering.

“I like it, though,” I said cautiously.

“Yeah?” she said, not looking up.

“I like that there’s hope in it.” It was a trite sentiment, as trite as the poem itself, but I wanted to tell her something. She raised her eyes to me without moving her head, her pupils clear and dark behind her glasses, and then she lifted her hand from the binder to grasp my own. Her grip was strong, her skin surprisingly hot. Not knowing what else to do, I squeezed back. A thin film of sweat prickled between our palms.

“Hope,” she said, with an intonation that could have meant anything at all.

The next day our dispersal began. Billy’s announcement came first; he had been sentenced to three years of juvenile hall for possession and sale of narcotics. He surprised us all by bursting into tears and falling into Claire-Sophie’s arms. She held him to her, murmuring, stroking his head like a mother. Daniel was released to his family, Anna sent to the Chronic ward. There were no elaborate goodbyes: handshakes, brief well-wishes, nothing more. We came into one another’s lives by accident, and our departures were equally incidental.

I got my news a day later, during my last meeting with Dr. Mills. As a preamble she suggested that I might consider staying alive as a sort of punishment.

“If you hate yourself so much,” she said, “you could think of your life as a penance, for a time. That you aren’t permitted to die.”

I didn’t realize that she had been reading my notebook until she made the offhand, bizarre remark that my suicide note was well written, subject matter aside. “I only mention this,” she said, “because your parents are coming to pick you up this afternoon. You’ll have to figure these things out for yourself now.”

“Oh,” I said.

“How do you feel about that?”

I suppose I should have felt violated that someone had been combing through my words, but in fact I felt a slight warmth. Surely—I thought at the time—this was due only to the news of release. Surely it couldn’t be that all this time I had only wanted an audience.

“I feel fine,” I said.

She frowned. “Fine isn’t a feeling.”

Returning from her office, walking through the cafeteria with Claire-Sophie, I saw Anna for the last time. Since her transfer to the Chronic ward she had been kept in isolation even for meals. A tray of salad and noodles lay on the table before her and she chewed grimly, without expression, seated between two Hospital orderlies. When she saw me her eyes widened and she raised her hand, hurriedly swallowing her mouthful.

“Hi, Paul,” she said, and from her tone I understood that this was not a greeting but an act of defiance. She wasn’t supposed to speak to me. All the same, I waved back and said hello. The orderlies glanced at each other.

“Come on,” said Claire-Sophie, “let’s keep moving,” and she ushered me out of the cafeteria. “You don’t need to talk to her now,” she told me as we neared the Acute ward. “You don’t need to worry about her.”

“No,” I said. “It’s fine.”

“Poor child,” said Claire-Sophie, but it wasn’t clear which of us she meant.

The afternoon before, after Anna had said “hope,” she would not let go of my hand. Her grip tightened, with more strength than I would have expected from her slight figure, and her eyes did not leave mine. I didn’t know what to think: maybe in revealing her poem she had also revealed some deep vulnerability. Maybe she was clinging to me out of need. Ridiculous ideas flashed through my mind; I remembered Billy’s story about the couple in the bathroom, wondered whether such a thing was actually possible here. My fingers began to ache.

“Hey,” I said, trying to pull my hand away. “Easy.”

“You are so full of shit,” she told me. She yanked my arm toward her, pulling the joints taut in my elbow and shoulder, and then sprang from her chair and came at me. My chair tipped backward; the carpeted floor sprang up and hit the back of my head. Anna was above me, holding down my arm with one hand and striking at my face with the other. I tried to push her away with my free arm, but I had never been in fights and didn’t know how to go about it. My arm seemed to contact only loose cloth and hair. I couldn’t see anything. She was making a hiccupping noise, and even in the midst of the fight I thought how strange that was; but it wasn’t until the weight of her body suddenly eased off me, until I saw her rise above me, twisting, with Mike and Claire-Sophie gripping her arms, that I realized she was laughing. Her eyes were closed, her mouth wide open, and my view of her exposed tongue and teeth was weirdly intimate; it seemed those things should have remained private. She kept laughing as they pulled her out of the day room, and even after its door closed I could see her through the observation window, her mouth still open as they dragged her down the hall. Claire-Sophie pulled open the door of the Time Out room and they disappeared inside; Mike pulled the door shut behind him, and then everything was very quiet. Billy and Daniel stared at me from the corner, cards in their frozen hands.

“You all right?” asked Billy.

I pushed myself from the floor with one hand and ran the other over my battered face. The imprints of her blows were real, gently throbbing under my skin. For a moment everything was real. The gray tint of the walls and floor, the shapes of the plastic furniture, the carpet’s rough bristle under my palm were painful in their sudden precision. And Billy and Daniel, sitting wide-eyed at the table, seemed to be the truest people that I had ever encountered.

“I’m all right,” I told them. I didn’t know it, but I was.

Iowa City, April 2002