Susanna sits in a therapist’s office. The therapist notes that Susanna has a pimple and has been picking at her face. Susanna nods, admitting that she has been doing so. The therapist asks if Susanna has a boyfriend, and Susanna nods again. The therapist then asks if Susanna is having trouble with her boyfriend but phrases his query as less of a question than a statement. The therapist, having sized Susanna up, informs her that she is in need of a rest. Susanna agrees, though she simply feels tired after a long morning. The therapist walks away into an adjacent room, and Susanna hears him having a conversation on the telephone. Susanna has the impulse to get up and leave the office while the therapist carries on his phone call, but she feels too tired to walk the several blocks to the train.
After a quick meeting, this therapist—whom Susanna has never met before—makes a judgment call and tells her that she needs a “rest.” The exhausted Susanna—who has, in truth, been suffering psychologically—assumes he simply means a break from her day-to-day routine. As the therapist departs the room and gets on the phone, though, Susanna is filled with dread, and is tempted by the thought of fleeing whatever it is the therapist is cooking up for her in the next room. Susanna’s exhaustion is so complete, however, that she cannot motivate herself to leave, and thus she surrenders herself to whatever the therapist has in store for her.
When the therapist reenters the office, he announces that he has found a room for Susanna in a place where she can rest for a couple of weeks. Susanna hears a taxi pulling up outside the office. The therapist takes Susanna by the elbow, pinching her, and steers her outside to the waiting cab. The driver asks Susanna where she is going, and the therapist answers for her: he instructs the cabbie to take her to McLean, and to not let her out until they arrive. Susanna, exhausted, leans back against the seat and closes her eyes, relieved to be taking a taxi instead of having to stand and wait for the train to come.
Susanna finds herself pulled along into a series of events whose outcome she cannot, due to her exhausted and muddled mental state, predict. She is not necessarily being strung along against her will, though, as at the moment she seems to have no real willpower to draw on. Susanna is at the end of her rope and very near—or possibly beyond—the porous barrier between the world of sanity and the “parallel” one which is home to the mentally ill and the insane.
An insert of a scanned document labeled “INQUIRY CONCERNING ADMISSION” to McLean Hospital describes Susanna as “profoundly depressed [and] suicidal; promiscuous; desperate.” A second insert, a memorandum from the therapist who recommended Susanna for admission to the hospital, describes Susanna’s “chaotic unplanned life,” the “progressive decompensation and reversal of [her] sleep cycle,” her “history of suicidal attempts,” and her “immersion in fantasy.”
Scanned inserts from Susanna’s real-life medical files, which crop up repeatedly throughout her memoir as punctuation or foreshadowing, reveal the depths of her misery as perceived by others. In a book that is largely about the strangeness and isolation of individual perception, it is up to the readers to determine whether Susanna’s case files accurately represent her external and internal state, or whether they are simply more tools of manipulation and control employed by those around her, who are frightened by the moods, emotions, and unknowable inner life of a volatile teenage girl.