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According to his chart at the Massachusetts Mental Health Hospital, Charles Pillsbury was born on September 26, 1961, in Youngstown, Ohio. The second of four children, Charlie, as he was known, experienced no injuries in utero or during or after delivery, and his mother and father had no known medical or social predispositions to mental illness. The Pillsbury family was, according to the chart, unremarkable, as was Charles until, in second grade, he began to act in a way that made his teachers take notice. He talked and sometimes laughed to himself and added words when he read aloud and covered his math problems with unrelated numbers. The older teachers called it hijinks while the newer teachers called it impulsivity or attention deficit until, in ninth grade, he began to hallucinate. A voice that was green told him to kill Linda Thorpe, a classmate, by stabbing her with his bowie knife, an ill-considered gift from his mother's brother. Stab her in the neck, the voice said when Charles passed her in the hall. Turn around, it said when, to avoid her, he took increasingly elaborate routes from class to class. Then the voice told him to kill her in the library, and Charles left a note on her locker. "Go to the library and you'll die!" it warned, and Charles was caught and suspended. Already worried that people were watching him, he returned to school with everyone doing just that, a situation that continued until, in tenth grade, he put his fist through a window in the music room. He was taken to the hospital in Youngstown and, from there, to Hannah Pavilion, part of University Hospital in Cleveland where, in the age of de-institutionalization, he was taught to institutionalize himself, to analyze himself, to think in the third rather than the first person, after which he returned to Youngstown and tried to finish tenth grade with the help of a tutor and then summer school and then by repeating the grade. When he couldn't, he tried for a GED, and, when he couldn't do that, he tried, with the help of his parents, to get and hold an undemanding job that became a series of undemanding jobs until he couldn't hold any job, whatever the demand. Then he added illegal drugs to his other drugs, and his family caught him and kicked him out as did a group home when he started dealing as well as using drugs. Left with no alternative, his parents took him back and, again, kicked him out, as did his siblings when, one after the other, they gave him another chance, after which his family no longer knew, day to day, where he was or whether he was alive.

One day they'd see him standing in front of the public library, and the next day they'd see him walking across the campus of Youngstown State or sitting on a bench in Wick or Crandall Park or camped out along the freeway, and then they wouldn't see or hear from him until, a week or two weeks or two months later, they got a call from an emergency room in Portland, Maine, or Portland, Oregon, or Chicago, or Saint Louis, or Nashville. "We've got a man by the name of Pillsbury here …" the calls said until, one day, there was a call from Boston, after which the calls never came from anywhere else. Whether he'd connected with a provider there or his condition had stabilized or he'd found a ventilation grate that was warm and out of the rain, his family didn't know and didn't ask. Charlie no longer had anything that anyone could call a life, they thought, but, about this, they were wrong.

With each hospitalization, Charles got a new set of medicines that he sometimes took and sometimes pocketed when the nurses weren't looking, after which he'd add them to the pills he got from his outpatient doctors, some of the doctors knowing about the others but some not and none of them...