Sylvia Frumkin was among the most troubled patients on her ward—and also, at times, the most entertaining. On her 36th day at Creedmoor, she wears a pair of blue jeans tied around her neck, gold sandals with high heels, socks, and a bandanna on her head with a spoon stuck in it. She paints her entire face with bright-red lipstick. She talks for an hour without stopping, delivering rambling soliloquies about various celebrities: Geraldo Rivera, Paul McCartney, Mayor Koch, Neil Diamond. Her monologues—which Sheehan captured in shorthand, then transcribes at length—are the best parts of the book, offering a glimpse straight into Sylvia Frumkin’s beautiful mind. To a fellow patient, she announces:
I’m going to marry Geraldo Rivera. I think we’re going to get married in Madison Square Garden, just like Sly Stone did. Mick Jagger wants to marry me. If I have Mick Jagger, I don’t have to covet Geraldo Rivera. Mick Jagger is St. Nicholas and the Maharishi is Santa Claus. I want to form a gospel rock group called Thorn Oil, but Geraldo wants me to be the music critic on Eyewitness News, so what can I do? Got to listen to my boyfriend. Teddy Kennedy cured me of my ugliness. I’m pregnant with the son of God. I’m going to marry David Berkowitz and get it over with . . .
Sheehan describes Sylvia as a “perpetual-motion machine, marching, pacing, jogging, and trotting all over the ward.” A fellow patient calls her “the greatest show on earth.” But the show can’t go on forever, and for every grandiose and entertaining soliloquy, there was a time when Sylvia stripped off all her clothes and dashed down the hall, insulted the African-American women who were her caretakers, or spent an entire night screaming while locked inside the “seclusion room.”
During earlier stays at Creedmoor, Sylvia had been injected with Thorazine, bound for weeks in a straitjacket, subjected to electroconvulsive therapy, even given “insulin coma therapy,” in which, as Sheehan writes, “she was put to bed and injected with insulin until she went into a hypoglycemic coma.” When she arrived this time, the psychiatrist who evaluated her was foreign-born, like many of the doctors at Creedmoor. When she tells him she knows Mary Poppins and is making a movie with Don Knotts, he has no idea who she’s talking about. As a result, he gives her an incorrect diagnosis—manic depression instead of schizophrenia. Months of medication mistakes follow, causing her to get worse rather than better.
Eventually the reader comes to realize that no matter how crazy Sylvia may be, the world of Creedmoor might be even crazier. The “seclusion rooms” have no pads on the walls, even though some patients have a habit of head-banging; female patients sleep hugging their pocketbooks for lack of a safe place to store them; more than a few employees steal from the job (one year, half the turkeys for the patients’ Thanksgiving dinners disappeared); medical charts teem with errors, including notations that “numerous patients had taken their medication on February 29 and February 30, 1979.”
There is no doubt that Sylvia’s psychiatrist is a terrible doctor—he gets indicted a year later for “selling more than five thousand prescriptions of Valium and Tuinal,” Sheehan writes—but among Sheehan’s most troubling insights into the mental-health system is how haphazard so much of the care is. No psychiatrist bothers to read Sylvia’s chart long enough to become an expert on her case. There’s little logic to her treatment. She’s given medicines that hadn’t worked for her in the past—or medicines that only worked at a much greater dosage than she’s prescribed. She bounces from doctor to doctor, from one facility to another, her fate and her sanity determined by whomever winds up with her chart in their hands.