... the book feels at once crafted, its prose full of calibrated grace, and startlingly unmediated. No brush (with obscurity) is necessary to buff its surface ... Howland seems reluctant to reinscribe the cruelties of these categories: sick and well, normal and abnormal. Suspicious of the ways in which they are delineated, she proceeds according to a simpler binary. Those who suffer are patients. Those who don’t are not ... The choice for Howland thus becomes one between the vulnerability of the inmate and the brusque, fatuous bullying of the keeper ... Her tone, recounting the stampede toward the doors, feels slightly mocking. She’s no longer present in the anguish of the moment, but she isn’t explaining it to us from without, either. Instead, she seems to be ironically reconstructing a flood of feelings that has already subsided, serving them up as a wry, self-conscious simulation: 'We’re being forced, that’s what it is!' There’s the nauseating sense that Howland is veering ever closer to a real, claustrophobic horror—one that even now lunges toward her, out of the past—but, thank God, the doors are sliding shut ... Howland holds her life at arm’s length; recounting a nurse’s rudeness or a fellow-inmate’s aggression, she sounds grateful for the good material ... It all feels like an attempt to overwrite, or perhaps just write away from, the present tense of suffering—which, for Howland, is akin to madness. Similes, any device that transforms a thing into what it is not, become helpmeets: if Howland’s mother suggests a glamorous animal, then the patients appear as beautiful aliens ... When people write about their rendezvous with mental illness, there are often a few false notes scattered among the true ones, places where the meaning of the thing feels not fully absorbed. Howland’s book struck me as remarkably perceptive and wise, but there was one passage, toward the end, that protruded as an exception .. This may not be the smug sentimentality of the memoir’s psychiatrists, who are eager to congratulate Howland for submitting to their expert care. But it does seem to contain the felt truth of someone who parted from her life and then returned. No one is going to rediscover you. You have to rediscover yourself.
This is not a story of mere neglect but of a writer’s collusion with invisibility, with a lifelong ambivalence toward selfhood and its burdens ... The onus of personality, the weight of the past, crop up often in Howland’s work ... As that first paragraph portended, this is a story about her neighbor’s heart, not her own — an anthology of the lives she encounters in the ward known as W-3 ... here’s a refusal to romanticize sickness or health. Her suffering doesn’t make her unique or interesting; instead it folds her into a common experience. Her insistence is on telling the story of a collective with blunt clarity, and sidestepping the genre’s potential for sentimentality or sensationalism. She brings the particularities of the world to life, how hair care was a miserable problem for the women of the ward; everyone just gave up and resorted to wearing towels like turbans ... It’s what hooked me — the temperature of the prose, its cool watchfulness. The narration isn’t distant, but it isn’t intimate either. Howland isn’t interested in redemption or instruction — but something more elusive ... It’s that quality of depiction that Howland seems to pursue — the clarity that allows readers to feel as if we are encountering the ward itself, Zelma herself, and not the narrator’s projections, not her own need.
Howland’s story is not so much the description of her inner experience as it is a kind of group portrait of the ward ... personalities and many others whirl by somewhat quickly, observed by a wry narrator who’s attentive to manner and mood, but doesn’t get to know her fellow patients deeply and dares not take too many liberties imagining their inner lives ... Howland is committed to a kind of first-person plural perspective, stressing the we of the ward rather than her personal experience, as if trying to translate the effective therapeutic process into an aesthetic principle. After the first few chapters, she stops reflecting on her pre-institutional life, no longer dipping back into her past to flesh out the story of her recovery. Nor does she tell us much about her ongoing relationships with people in or out of the hospital ... There is a kind of self-effacing blankness at the center of the book.