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Abe Redden was very surprised when he found Seymour Ratner dead in the seclusion room. It was true that at one point or another almost everyone at Four Elms, a private psychiatric hospital, had expressed a desire to throttle Seymour. He was driving everyone crazier¿even Redden, his psychiatrist. And Seymour was always claiming that someone was out to get him. But it was also true that people are not supposed to die in seclusion rooms¿the "safe" rooms that have absolutely nothing in them; and nobody could have gotten into or out of that particular room, since the keyhole was blocked with wire. Nor could Seymour have killed himself, for there was a guard stationed all night at the door, observing him. Most important, Seymour Ratner was more alive than any other person at that hospital. It was unthinkable that he should die.
Nevertheless, Seymour was dead, found hanging from a strip of cloth in the seclusion room. His final words: THEY HAVE KILLED ME.
Enter Detective William Moore. What he finds are a rash of threatening letters, two more suspected murders, several rapes, and the most bizarre group of suspects imaginable, among them a woman who believes the Mafia is shooting rays at her, a man whose tenuous grasp of reality has reduced him to complete ineptitude, his sidekick, who is incapable of distinguishing people from toilet paper, a man who speaks only in a mysterious tongue, a young man who believes policemen communicate by scratching their behinds, an alcoholic, a rapist, a catatonic minister, and a child abuser. Half of these people are also hospital staff. Moreover, the number-one suspect is a disheveled, morose man who has had brushes with the law before and who just happens to be a very dedicated and very good doctor called Abraham Redden.
What it all adds up to is a fast, furious, riotously funny tale of murder and intrigue, set in a place where the usual standards of sanity don't apply, where nothing is ever normal. More important, it is also a convincing portrait of real people trying to understand their responsibilities to each other, a remarkable evocation of the madness that is the modern-day psychiatric institution.