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N O E S C A P E : T H E E N D L E S S D R E A M S O F E L G I N One morning I was sitting in the dayroom at Kilbourne I, a long-term unit at Elgin Mental Health Center in Elgin,Illinois,when a frail blond girl knelt before me on the terrazzo floor and began praying. Her face was plain and round and pale, like that of a saint in a prayer book. She appeared to be in pain. She wore a faded yellow blouse, slacks of a flimsy dark blue material, and cloth hospital slippers. She knelt about five feet in front of me, clutching her hands together in a beatific attitude . She tilted her head and cast her eyes heavenward. “Holy Mary, mother of God,” she muttered, “pray for us sinners, now and at the hour of our death, amen. Hail Mary, full of grace, the Lord is with thee . . .” The room was hot and close with the smell of bodies. It was an all-female unit with thirty-eight beds. I saw perhaps two-dozen women wandering this way and that or sleeping in chairs or simply standing and staring. I could hear the television set in the next room. Big Valley was playing loudly, as some of the women put on makeup with the help of a staff member. The praying girl stood and approached my chair to look at me. She stood close enough so that I could see the dried saliva at the corners of her mouth. Her lips were cracked and caked with spots of blood. “I’m sorry, Pontius Pilate Jim Wolf,” she said. She bent down and kissed me on the forehead.“I’m sorry.” She bent again and kissed me fullon the mouth.“I hate schizophrenia,” she said. “How do you feel?” I asked. “Tired.And it hurts right here.”She drew her fingernail across her forehead from left to right, as if she would cut the top of her head off to show me what was inside.  A black woman with a moon face stepped forward and said, “I think I’m God but I might be Eve.” She smiled and disappeared. A burly woman with tight blue jeans and a s man’s haircut stood by my chair, leaning in close, staring at me intently. Her face was six inches from mine. She had been in the other room where the makeup was being applied.Her cheeks were painted bright purple,like melanoma, and her lips were the color of wine. She looked apparitional , holy, mannish. She looked angry, as if she were about to challenge me, but she only stared, her brown eyes clear and wet with fluorescent reflections, and we stayed like that until a scream from somewhere broke our contact. I crossed over to Kilbourne II,the men’s side,and sat in the nurses’ station, a glassed-in booth from which we could watch the patients circling like fish in a tank. Most of them were schizophrenic, though some were bipolar, and others were so depressed that they were dangerous .About  percent of the  patients at the Elgin Mental Health Center resdie there involuntarily. It was one of the last of the old nineteenth -century mental institutions, set on acres and acres of rolling land, rich with gothic buildings of stone and brick that nestled among the ancient trees. At : an aide wheeled out a stainless-steel cart with a black plastic garbage bag tied to the side. On the tray were stacks of little paper cups, a white towel, a green plastic pitcher of red fruit punch, and a white plastic cassette of medications. The cassette looked like an oversized ice tray. Each cube contained a small white paper cup with pills in it. The orange ones were Thorazine, the green or white or yellow ones were Haldol, and the funny pastel fuchsia ones were called Big Bombers, two hundred milligrams of Mellaril. Most of the patients lined up to take their medications,rolling the pills like dice from a cup, then washing them down with a paper jigger of punch. It was a chemical crapshoot: if they rolled the right numbers, they got to go home. Even though they were long-term patients, the chronic cases, the program called for rehabilitation through chemistry and behavior modification . The days of warehousing mental patients were, at least theoretically, over. The ward...

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