Mrs. Frumkin: “Since Sonya killed herself, Isadore Finkel hasn’t had another heart attack. The Finkels come to New York to visit every few months. I saw them a while ago, and they looked so gorgeous. It’s no wonder. The cause of all their trouble was removed.”

Sylvia’s response: “Ma, are you trying to tell me something?”

At this moment, Sheehan commented years later, “I wished I could crawl under the table.”

The entire final section of the book is horribly uncomfortable, as the reader can see the whole Frumkin family cracking under the strain of Sylvia’s illness. And as she oscillates between lucidity and madness, you can predict her decline: her violent outbursts, her medication mismanagement, her ultimate return to the hospital. Once she’s back at Creedmoor, she picks up right where she left off. She dabs blue eyeshadow on her lips, ties a white T-shirt around her neck, and sashays through the ward.

“I first met Geraldo Rivera when I was in Elmhurst,” she says. “I think the Cowardly Lion was secretly married to Judy Garland. I’m going to marry Lyle Waggoner, who plays Steve Trevor. I’m going to take Lynda Carter’s place on Wonder Woman when I marry Steve. I want to have my own show, a show called Sylvia’s. I’m my favorite person. I only wish I could get along with everyone as well as I get along with me.”

*****

In some ways, Sheehan’s greatest achievement boils down to the fact that she was able to get this book published at all. My own experience writing about mentally ill people—or prisoners, juvenile delinquents, addicts, and others on the fringes of society—has taught me how hard this can be. Tougher than the challenges of reporting and writing can be the ineffable task of trying to excite an editor enough to get your story into print.

Can you imagine any magazine today publishing the four-part series on Sylvia Frumkin that became this book? Even in 1981, its mere existence was improbable. In her book’s acknowledgements, Sheehan admits as much when she thanks William Shawn, editor of The New Yorker, describing him as “the only editor in the world who would have let a writer try to write about such a sad and difficult subject and who would then have published a hundred thousand words on the subject.”

In 1995, The New Yorker published “The Last Days of Sylvia Frumkin,” an article by Sheehan that doubles as a postscript to her book. Sylvia had died the year before of cardiac arrest inside another state mental hospital, Rockland Psychiatric Center, at age 46. In her article, Sheehan offers a behind-the-scenes look at her relationship with Sylvia: the inevitable tensions between writer and subject, which were compounded by Sylvia’s schizophrenia, and her efforts to maintain a friendship with her subject long after the book was done.

Three years ago, my aunt Holly passed away, too, though she made it to 61. She died at home, alone, in a tiny, dingy apartment in New Hampshire, her marriage long since ended. Like Sylvia, Aunt Holly’s last years were her worst. She became progressively sicker, the illness tightening its grip on her psyche, the voices in her head growing louder and more menacing. Some days they told her that 9/11 was her fault—that somehow she’d caused the Twin Towers to topple—and she’d feel overwhelmed by guilt, no matter how many times you tried to tell her that she had nothing to do with 9/11.

Her death had been unexpected; we don’t know the exact cause, but it, too, may have been cardiac arrest. I wrote her obituary for the local paper and included everything I thought she’d have wanted it to say: that she was an “extraordinary woman” with a “feisty spirit, warm manner, and an artistic soul”; that as a child she’d studied with the legendary Mary Day at the Washington School of Ballet; that she’d been a dance major at Skidmore and gone on to teach dance in Germany.

Jennifer Gonnerman is a contributing writer for New York and Mother Jones. Her book Life on the Outside: The Prison Odyssey of Elaine Bartlett was a finalist for the 2004 National Book Award.