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Alex nodded. “How’s she doing?”

The man shrugged his rounded shoulders. “Same.”

“Has she caused you any trouble?”

The man arched an eyebrow. “She tried to stab me to death with a plastic spoon a few days back. Yesterday she jumped a nurse and would have beaten her senseless if another orderly wouldn’t have been ten steps away at the time.”

Alex shook his head. “I’m sorry, Henry.”

The man shrugged again. “Part of the job.”

“I wish I could make her stop.”

Henry held the door open with one hand. “You can’t, Alex. Don’t beat yourself up over it. It’s not her fault; she’s sick.”

The hall’s grayish linoleum floor was struck through with darker gray swirls and green speckles, presumably meant to add a little bit of interest. It was as ugly as anything Alex could imagine. Light from the sunroom up ahead reflected off the ripply floor, making it look almost liquid. The evenly spaced rooms to each side had varnished oak doors with silver metal push plates. None had locks. Each room was home to someone.

Cries coming from dark rooms echoed through the hall. Angry voices and shouts were commonplace — arguments with imaginary people who bedeviled some of the patients.

The showers at the rear of the bathroom were kept locked, along with a few of the rooms, rooms where patients were placed when they became violent. Locking a patient in a room was meant to encourage them to behave and be sociable.

The sunroom, with its skylights, was a bright spot in a dark prison. Varnished oak tables were neatly spaced throughout the room. They were bolted to the floor. The flimsy plastic chairs weren’t.

Alex immediately spotted his mother sitting on a couch against the far wall. She watched him coming without recognizing him. On rare occasions she did know who he was, but he could tell by the look in her eyes that this time she didn’t. That was always the hardest thing for him — knowing that she usually didn’t have any idea who he was.

A TV bolted high on the wall was tuned to Wheel of Fortune. The gaiety and laughter from the TV struck a stupefying contrast with the somber dayroom. A few patients laughed with the TV audience without comprehending what they were laughing at. They only knew that laughter was called for and so they laughed out of a sense of social duty. Alex guessed that it was better to laugh than cry. Between the laughter, some of the younger women glared at him.

“Hi, Mom,” he said in his sunniest voice as he approached.

She wore pale green hospital-issue pajama pants and a simple flower-print top. The outfit was hideously ugly. Her hair was longer than the other residents’. Most of the women had their hair cut short and curled. Alex’s mother was protective of her sandy-colored, shoulder-length hair. She threw fits if they tried to cut it. The staff didn’t feel it was worth a battle to cut it short. Occasionally they would try, thinking she might have forgotten that she wanted it long. That was one thing she never forgot. Alex was glad that she had something that seemed to matter to her.

He sat on the couch beside her. “How are you doing?”

She stared at him a moment. “Fine.” By her tone, he knew that she didn’t have a clue as to who he was.

“I was here last week. Remember?”

She nodded as she stared at him. Alex wasn’t sure if she even understood the question. Sometimes she would say things that he knew weren’t true. She would tell him that her sister had visited. She didn’t have a sister. She would say that she had gone shopping. She was never allowed to leave the confines of the ninth floor.

He ran his hand down the side of her head. “Your hair looks pretty today.”

“I brush it every day,” she said.

An overweight male orderly wearing shiny black shoes that squeaked rolled a cart into the sunroom. “Snack time, ladies.”

The top of the cart displayed a few dozen plastic cups half filled with orange juice, or something that resembled orange juice. The shelves in the cart held baloney-and-lettuce sandwiches on wheat bread. At least, Alex assumed it would be baloney. It usually was.

“How about a sandwich, Mom? You’re looking kind of skinny.

Have you been eating?”

Without protest she rose to take a sandwich and glass from the man with the cart when he rolled it near. “Here you go, Helen,” the man said as he handed her a plastic cup of orange juice and a sandwich.

Alex followed as she shuffled to a table off in the far corner, away from the other residents.

“They always want to talk,” she said as she glared at the women clustered on the other side of the room, where they could see the television. Most of the people in the place talked to imaginary people. At least his mother never did that.

Alex folded his arms on the table. “So, what’s new?”

His mother chewed a mouthful for a moment. Without looking up she swallowed and said under her breath, “I haven’t seen any of them for a while.”

“Is that right?” he asked, playing along. “What did they want?”

It was hard to make conversation when he didn’t know what she was talking about half the time.

“What they always want. The gate.”

“What gate?” He couldn’t imagine what she imagined.

She suddenly looked up. “What are you doing here?”

Alex shrugged. “It’s my birthday, Mom. I wanted to spend it with you.”

“You shouldn’t spend your birthday in this place, Alex.”

Alex’s breath halted for an instant. He could count on the fingers of one hand the times she had called him by his name except when prompted.

“It’s my birthday. It’s what I want to do, Mom,” he said quietly.

Her mind seemed to drift away from the subject. “They look at me through the walls,” she said in an emotionless tone. Her eyes turned wild. “They look at me!” she screamed. “Why won’t they stop watching me!”

A few of the people on the other side of the room turned to look at the screaming woman. Most didn’t bother. Screaming in the institution wasn’t an uncommon occurrence and was usually treated with indifference. The orderly with the cart glanced over, appraising the situation. Alex put a hand on her arm.

“It’s all right, Mom. No one is looking at you now.”

She glanced around at the walls before finally appearing to calm down. In another moment, she went back to her sandwich as if nothing had happened.

After she took a sip of orange juice, she asked, “What birthday is it?” She put the sandwich up to her mouth.

“My twenty-seventh.”

She froze.

She took the sandwich out of her mouth and carefully set it down on the paper plate. She glanced around, then seized Alex’s shirtsleeve.

“I want to go to my room.”

Alex was a bit puzzled by her behavior, as he frequently was, but he went along. “All right, Mom. We can sit in there. It’ll be nice, just the two of us.”

She held his arm in a tight grip as they walked back down the depressing hall. Alex walked. She shuffled. She wasn’t an old woman, but her spirit always seemed broken.

It was the Thorazine and other powerful antipsychotic drugs that made her that way, and made her shuffle. Dr. Hoffmann said that Thorazine was all that kept her functioning as well as she did, and that without it she would become so violently psychopathic that she would have to be restrained twenty-four hours a day. Alex certainly didn’t want that for her.

When they went into her simple room she shut the door. The doors didn’t lock. She opened it and checked the hall three times before she seemed satisfied. Her roommate, Agnes, was older. She never spoke. She did stare, though, so Alex was glad that she had stayed in the sunroom.

The TV, bolted high on the wall, was on, but the sound was muted. He rarely saw the TV turned off. The sound was usually muted, though. He’d never seen his mother change the channel. He didn’t understand why she and Agnes wanted the TV on without the sound.