His head is a little bit too big for his frame and he often squints his eyes as if he is going to cry. Evan never has facial hair, nor does he ever have bad breath. After finishing his cereal, Evan brushes his teeth and rinses his mouth out with mouthwash. (Again, he yells and stomps if Jim is still in the bathroom.) He then proceeds to the second floor of the residence to take his medication.

Evan lives in a treatment program for people with major mental illnesses on the Upper West Side of New York. There are 18 other “members,” in the residence, most of them living with schizophrenia.

“LelandLelandLeland,” he usually yells while walking down the stairs. “Where are you? Where is you?”

When he walks in the door, I greet him. “Evan, how many times have I asked you not to yell people’s names throughout the building?”

“I need my medication,” he says, biting his lip.

“I know. If you’re looking for somebody, quietly come down the stairs.”

“But what if you’re not here? What if I never get my medication?”

“Evan, there’s staff here 24 hours a day.”

“What if I never leave this place? It’s times like these that I want to go back to King Solomon’s Manor.”

“Evan…”

“You’re making me go into a tizzy, a quandary, and a conundrum!” he says, accidentally spitting on me.

By this time, Evan is whipping his hand either with a thick rubber band or the band of a wristwatch, both of which he carries in his coat pocket. In his pockets are also a half-dozen pens, a small notepad, and various papers and appointment slips. He then approaches me–perhaps only a few inches away–biting his lower lip.

“Back up, Evan, and please lower your voice.”

He backs up. “I know I should lower my voice,” he mutters, glancing at me. I hand him a coin envelope in which his AM dosage of medication is stored. Each week, I sit down with Evan and package a week’s worth of medication with him. Evan writes the names, dosages, and time of day on the coin envelopes. He takes Zyprexa, an atypical anti-psychotic, Kemadrin, for side effects such as akathesia, and Colace, a stool softener. I have to remind him to write clearly since his penmanship is nearly illegible. Evanshuffles over to the counter to take his medication.

“I know I should lower my voice,” he mutters again. “You didn’t have to tell me.”

Evan then takes his medication. He always brings his own cup so he can mix a glass of Metamucil. I have to remind him to periodically wash the cup. He claims he does.

Evan has recently acquired a one-day a week job placement through the day program that he attends. The goal for many members of this program is to try to live as independently as possible. Often, they try to get jobs or re-enter school. Most of the members also go to the main clubhouse, a day program in Midtown that members and staff run together. There are no formal groups there, but “units” in which staff and members work together to get things done. There’s a clerical unit, an education unit, and so on.

Evan once asked me: “Why is that when I’m at the job I don’t have thoughts that intrude in my brain? You see, I free associate, but there I’m able to control my impulses, but when I get back here at the residence or at the day program I feel like I’m in hell.”

Evan gulps down the Metamucil and the pills. He signs his initials on a sheet that lists each of the medications he takes. Each of the residents has a sheet that they and the staff must sign after they take their medication. “I’m sorry,” he mutters like a child while looking at the ground. “I’m sorry for what I said.”

“It’s OK, Evan. Have a good day at program,” I say.

He leaves the room, pushes the button for the elevator, and walks back into the staff office. “I’m sorry for what I said. I’m sorry.”

“I accept your apology. Have a good day at program.”

He begins to walk out of the room. “I’ll be back after 10 PM. I’ll be back after 10 PM.” He shuffles toward the elevator. He says, “Leland, I’m sorry for what I said. I’ll be back after 10 PM.” He walks back into the doorway.

“Leland, I’ll be back after 10 PM.”

“Evan…”

He walks toward the elevator. I wait in the staff office, not sure if he’ll come back and repeat himself. “I’ll be back after 10 PM. I’ll be back after 10 PM,” I hear him say from the hallway.

He walks into the elevator and the door closes.

It’s the Waiting Room. Institutional seat cushions, easily cleaned in case of vomit, spit, coffee, or feces.

I pretend to read.

The woman’s tongue stabs the air. She has no teeth.

“It’s 11:30,” she insists, speaking to the receptionist. “Where’s Dr. Forrester?”

She’s told the doctor will be right out.

She sits for about a minute and asks again. Her tongue is long and pink. It reminds me of a sea creature.

A young doctor comes to get her. I imagine he’s been dreading her all afternoon.

Back on the job. I enter the psychiatric ward. I must visit Virgil. We sit in the day room. Old, squawking people line the institutional couches.

“Can I open your mail for you?” I ask Virgil.

He giggles. He’s incoherent. A middle-aged man. Overweight. He has three teeth. He looks at the Reader’s Digest I brought him, along with his bills and a newsletter. He rips the Reader’s Digest in half.

“I have a red rabbit,” he tells me. His eyes are drunk. He laughs and laughs. “I have a red rabbit that eats corn.”

Home. One of our cats has been missing for several days. He must’ve jumped from our balcony. We live on the twentieth floor. I checked the closets, under the bed, and the kitchen cabinets. He had from six to seven toes on each paw. He must’ve jumped, right? Where else could he have gone?

Going back to the Waiting Room today. It’s damp outside. The middle of spring. A man in a motorcycle jacket stares at me the whole way up on the elevator. He wears a poorly chosen brown tie. These are dangerous times.

At work again, Virgil has been released back to the residence. Having spent nearly four months in the psychiatric ward, life should be much better for him, but it’s not. He has resumed shuffling around in his bare feet. I can hear his dry skin rake against the linoleum. His ankles are badly swollen

I have begun working full time. I do the graveyard shift again. Nights at the residence are usually quiet, stifling, and long.

So now I must make my rounds. A place like this turns you philosophical. Couches made so they can be spray-cleaned, a kitchen with a lock, keys attached to a wooden block. Everyone is asleep. Or, at least I’d like to think they are. Perhaps they’re all watching me, listening each time I pace around the office, aware of my thoughts. When the fan swivels its head, papers on the bulletin board waft upward. There’s the notion that someone is at the doorway peeking in. Will it be tonight that something happens?

In a million years, will sadness have evolved away?

Grown men here shit and piss their pants. It’s our job to care. We must. We must. But reciprocity is never a given.

Virgil, a man older than his 50-something years, almost weeping every minute. People love him because he is nearly a lamb. But he’s deeply sad. So sad, he is old. He’s happiest when totally nuts: his eyes full of life. At those times, whole new words burst from his three-toothed mouth as he boils freakish soups of onion, mustard, and oatmeal. But he must come down. Elation is poison for his body.

They think caregivers don’t weep.

And no, sadness won’t evolve away. It’s here forever. It’ll out last us. It’ll out last everything.

In 1980, Mark David Chapman stood here with a gun and waited for John Lennon. He watched as Lennon and Yoko Ono pulled up in a car, and then shot the ex-Beatle. .

A double-decker tour bus glides past the building. The tourists turn their heads toward the Dakota. One lone guard stands in front of the driveway. He wears a black uniform, police style cap, and lets his hands hang at his sides. .

Some have claimed that houses are metaphors for the mind; each of the rooms like partitions we erect to protect ourselves. .

“I’m sure the large part of me is Holden Caulfield, who is the main person in the book,” Mark Chapman said to the police. “The small part of me must be the Devil.” He had bought The Catcher in the Rye the morning of the shooting. .

Mark Chapman worked as a camp counselor. .

He helped Vietnamese refugees. .

He attempted suicide, and was later hired by the hospital for his ability to cheer people up. .

On the other side of the park, north of 72nd Street, is another fortress. The architecture is unremarkable. A blue awning covers the sidewalk with the name of the hospital emblazoned in white. There are two wards for the emotionally infirm. .

On the door to one of the wards is a sign scrawled in red: No cell phone use inside. .

Elderly men and women in gowns line the sides of the day room. A blind woman screams, “I want to go to my room!” She tries to stand up. A staff person tells her to sit down because she may fall. “I want to go to my room,” she says again. The staff person tells her lunch will begin soon. She sits and mumbles to a man next to her. He is snoring. .

“I won 8 million dollars,” Virgil says. He has anger in his eyes. He had put his gown on backward, exposing his stomach. He mumbles and laughs to himself. “You told me you received your PhD from the University of Wisconsin? What do you have to say about that?” He claims to have been visited by his dead mother. A man sits next to Virgil. “This is my father,” he says. The man smiles and says nothing. .

Someone screams in the adjacent room. “My name is Virgil and my counselor is here!” he screams. .

Virgil has been at the hospital for more than three months with no end in sight to his psychosis. .

After several minutes of incoherent mumbling, he says, “Death is a dreamº”.

“To dream about death can have many meanings,” a psychologist once said. “Jung believed there is a personal and collective meaning. There was a patient that dreamt of being confronted by two cannibal apes in the front yard of his childhood home. One was male and one female. He felt he was in imminent danger. Anima and Animus? Some archetypal self?” .

Back on the Westside, the guard in front of the Dakota is blowing a whistle. He waves his gloved hand. Three young tourists rush toward the driveway. One of them is armed with a camera. A yellow cab screeches in front of the building. It has begun to rain. A woman emerges from the driveway holding an umbrella. She scans the streetæher head swiveling back and forthæand slowly approaches the taxi. .

The three tourists snap pictures of whatever lies beyond the threshold. If you want to ask John Lennon death, you can. The John Lennon Artificial Intelligence Project claims to have programmed a computer with his words. After giving him your name, you may ask him a question. “John? What do you think about death?” .

“Fuckin hell.. It doesn’t matter what I think about death,” John will say. “Live your own life, man. Wouldn’t you rather talk about peace or Revolution or something or how Jesus is more popular than Elvis or something?” .

She was suddenly awake. Her pupils were pinpoints.

“Ariel, are you OK?”

She stood up and scanned her environment as if she were about to be attacked.

“Sit down, sweetie,” I said. “You just had a seizure.” She stormed out of the lobby area and into the kitchen.

“Ariel!” we screamed.

The police knocked at the front door. Another patient let them in.

“What’s the problem?” one of them asked.

“She just had a seizure,” I said pointing toward the kitchen.

Ariel was pacing around. “Ariel,” one of the police officers said. “Hey, please have a seat.”

She sat down and stared at a bucket of butter spread. She took out a cigarette.

“Don’t smoke, Ariel,” an officer said.

Her hands were shaking. She glared at me. She dipped the cigarette into the butter spread and ate it.

“Ariel!” I said reaching into her mouth.

“Hey,” an officer said to me. “She may bite you.”

I retracted my hand.

“Holy shit, is she always like this?”

The paramedics arrived. A medic with dreadlocks injected her with something. As the fluid went into her veins, she started to talk. “What happened?” she asked.

“Did you take drugs?” the medic with the dreadlocks asked.

“No.”

He eyed me. “We’re going to take her to St. Luke’s.” He pulled me aside. “We think she took some opiates because she came out of it when we gave her that medication. That blocks the drugs from working.”

They helped her into the ambulance. “You coming?” they asked me.

I sat next to her.

I had been sitting there for hours. Ariel was dressed in a gown. An IV was hooked to her arm. She slept. She had wanted some coffee, but I didn’t know if that was appropriate. I sipped my coffee, hoping she wouldn’t awaken and see me drinking it. The nurse had asked me if she takes any medication. I told them I gave a copy of her meds to the medic. “She lives in a home for people with schizophrenia,” I told the nurse.

Ariel seemed to have a crush on me. She always asked me, “Do you have a girlfriend?” I told her that I did. “You know,” she said to me once. “I lived in Michigan and we passed through a town called Leland. I remember going to a restaurant in Leland that served French Fries and stuff.”

The nurses brought in an elderly woman next to us. “She can’t seem to make a bowel movement,” a middle-aged woman said to the nurse.

“Hello,” the nurse said loudly to the elderly woman. “When was the last time you had a bowel movement?”

The woman grumbled something. She was small and fragile. She sounded as if she might have been from the Caribbean. A lacy shawl was draped over her head.

“She’s an author, you know,” the middle-aged woman said.

“Oh! What’s the name of a book you’ve written?” the nurse asked.

The woman moaned. “Shanghai Princess,” she said.

I was bored. I wanted out of there and out of this job. I felt depleted, broke, spent. I was outside smoking a cigarette. It was at least my fifth since I had been there with Ariel. Inside the waiting room, the security guard stared out the window, into the distance. A teenager in baggy pants was talking on his cell phone. I had seen him earlier in the waiting room. I was contemplating my next move. In the last few months, I had called 911 several times. An obese woman who always listened to Kiss on her headphones had lit her canvas bag on fire that summer. She ended up taking off on a Greyhound bus for Nevada. Jonathan, a chess master who had defeated Bobby Fisher once in the 1960’s, had erupted into a tirade about another patient. “I’m gonna kill the bastard!” he screamed. He wouldn’t talk to me after I called the police on him. When Ariel went into convulsions, I pictured the fat CPR trainer going through the steps of care. I thanked god that she didn’t stop breathing.

As I finished my cigarette, the kid with cell phone shook hands with a passerby, exchanging something into the guy’s hand. The passerby walked away, checking the small plastic bag.

A man across the street carried a camcorder. He was dressed in a plaid sports coat and blue slacks. He was talking to himself. Three young latinas walked past me on my side of the street. The man with the camera zoomed in on them. “Hey, girls!” he screamed at them. “You could be models on TV! Hey!” They continued down the sidewalk, chuckling. The man screamed, “And that’s a wrap!”

“How are you doing?” I asked Ariel. She was lying on the cot, her legs curled into a ball near her chest.

“OK, “ she said.

The elderly woman moaned. The woman turned toward the nurse. “Please,” she said in a raspy voice. “Don’t torture me.”

The nurse laughed. “Honey,” she said to the woman. “We don’t torture people here. Those are writer’s thoughts.” She turned toward the sheet that partitioned the room. “At least not on my shift,” she muttered.