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“You can have your coffee as you leave. We’re almost done with you,” Dr. Redding said, stretching his long legs under the table. “We can all use a coffee break. This is the last of them, isn’t it?”

“Yes, Doctor,” Patty said, consulting her calendar.

“Co

“But last time I got better and they let me out without any operation!”

“And here you are again. Aren’t you? Your brother … what’s his name?”

“Lewis Camacho,” Patty read. “From Bound Brook, New Jersey.”

“Your brother … er … in New Jersey … Mr. Coman‑chee? … has signed the permission. The procedure will be carried out Monday. In a month you’ll be released. Consider that, Co

The staff leaned back in their chairs and turned to each other as Co

“I don’t know!” She held up her hands. “I don’t understand what they’re doing. You ask them. They keep talking about my brother Luis. I don’t understand what they want me to do.”

“Wait here. Just hold on.” Tony stuck his head into the room, where she saw past him the doctors pushing back their chairs and begi

When Tony came out the water was still pouring down. “Come on, Ramos. They’re done with you. Leave the doctors’ coffee alone, don’t mess up now. You can get a cup on the patients’ side.”

“They don’t want me anymore?” She blinked confusion.

“What do you think, they need all day to make up their minds about you? They’re big‑shot doctors. That Redding, he had his picture in Time.Patty showed me, she keeps a scrap‑book on him. Dr. Argent, he goes up to Washington to testify before Congress to set them straight on things. You don’t think they got all day to waste making up their minds about what to do with you!”

She washed her hands in the bathroom, she washed them again and again. “I just killed six people,” she said to the mirror, but she washed her hands because she was terrified of the poison. “I murdered them dead. Because theyare the violence‑prone. Theirs is the money and the power, theirs the poisons that slow the mind and dull the heart. Theirs are the powers of life and death. I killed them. Because it is war.” Her hands shook like a willow branch used by dowsers in Texas, a willow branch pulled by water deep in the ground. “I’m a dead woman now too. I know it. But I did fight them. I’m not ashamed. I tried.”

She broke the bottle under ru

She thought of Luciente, but she could no longer reach over. She could no longer catch. She had a

For Skip, for Alice, for Tina, for Captain Cream and Orville, for Claud, for you who will be born from my best hopes, to you I dedicate my act of war. At least once I fought and won.

After a while she heard the commotion and they came with stretchers–four. Dr. Morgan was trying to cut down on coffee, and Miss Moynihan was being sick in the staff bathroom. I am not sorry, she thought, her heard pounding terribly, and she sat on her bed, waiting.

TWENTY

Excerpts from the Official History of

Consuelo Camacho Ramos

State of New York–Department of Mental Hygiene

Bellevue Hospital

CLINICAL SUMMARY

IDENTIFICATION: This 35‑year‑old Mexican‑American Catholic woman separated from her husband Edward for the past three years has one child, Angelina, aged 4. The patient has been on Aid to Dependent Children since last May.

PRESENTING PROBLEM: This patient brought her child into emergency at N.Y.U., stating that she had accidentally broken her wrist. The child was bruised. When questioned by caseworker, the patient readily admitted beating her daughter, while drunk or drugged. The patient was incoherent, weeping, and exhibited bizarre behavior.

PAST HISTORY: This socially disorganized individual has been in an increasingly deteriorating state since the breakup of her marriage. Whereabouts of husband unknown. This patient has been in conflict with the law for two years. Convicted of aiding and abetting a pickpocket and given a suspended sentence and a year’s probation last April. The patient refers to an illegal abortion, followed by severe hemorrhaging and complications, for which a hysterectomy was performed at Metropolitan. The patient has recent alcohol and barbiturate problems. Seems hostile and suspicious toward authority. Lack of control and frustration tolerance. The patient has a tendency to act out problems with violent expression and hostile and extrapunitive tendencies.

MENTAL STATUS: This patient is disheveled and appears to be older than her stated age. She readily admits needing help. She is cooperative but confused and occasionally suspicious. Has not demonstrated assaultive behavior on the ward.

STREAM OF MENTAL ACTIVITY: The patient is incoherent. The patient’s thinking is extremely concrete.

EMOTIONAL REACTIONS: The patient’s general mood is anxious and exhibits extreme guilt. The patient’s affect is inappropriate, marked by crying without cause.

CONTENT OF THOUGHTS: Denies suicidal ideation. Denies delusions or hallucinations.

SENSORIUM, MENTAL GRASP AND CAPACITY: Sensorium clear. Oriented times three. Recent and remote memory appear weak. The patient has somewhat slow intelligence and answers questions poorly.

DIAGNOSIS: Schizophrenia, undiff. type 295.90.

State of New York–Department of Mental Hygiene

Rockover State Psychiatric Hospital

DISCHARGE NOTE

Dr. Messinger

HISTORY: This 35‑year‑old Mexican‑American woman, Catholic mother of one daughter, was hospitalized at Bellevue because of child abuse, alcohol problems, confusion, and bizarre behavior, and admitted here February 8.

HOSPITAL COURSE: The pt. responded well to medication, although with pronounced side effects, swollen tongue, etc. Her behavior slowly normalized and the pt. exhibited decreased psychiatric signs and symptoms.