Checks, a system of surveillance in which nurses open the doors of patients’ rooms and slip into common areas in five, fifteen, or thirty-minute intervals, “murder” time for Susanna and her fellow patients. They watch their lives pass by five minutes at a time. Susanna was one of the rare patients who was eventually placed on half-hour checks, but her roommate Georgina never made it past fifteen-minute checks, so Susanna’s small privilege made no difference. Because of checks, most patients preferred to sit in the common areas so as to avoid the constant opening and closing of doors. Sometimes, Kaysen writes, nurses would have the “audacity,” while performing checks, to ask one patient where another patient was. At night, checks became a kind of deranged lullaby. During the day, they were the “pulse” of the ward.
In this section of the novel, Susanna is outlining the many strange protocols and procedures which dictate life on the ward. Despite the myriad ways in which patients are subjected to stringent control and total loss of privacy, checks are, according to Susanna, perhaps the most uncanny and dehumanizing aspect of life on the ward. The metronomic, repetitive quality of checks mirrors the circuitous and intrusive thoughts from which Susanna and many of her fellow patients suffer, creating an inescapable loop of control and desire for escape.