Life within a ""hell and heaven, dungeon and sanctuary"" for the mentally ill, here given the fictitious name of Bedloe State Hospital. Bosco (coauthor, Alone with the Devil, 1989) disguises names throughout, not only to protect the privacy of individuals but also to ensure that his story is not seen as simply an exposÃ‰ of a specific institution--for he would have us know that there are a multitude of ""Bedloes"" in the land. A few statistics and trends are cited, but Bosco tells his story largely by getting inside the heads of people. Leading these is Bedloe's medical director, who has recurring dreams of being the first Psychiatrist General of the US with a wonderful program that takes care of everyone--except his own schizophrenic daughter. At work, he struggles with Bedloe's superintendent, a small-minded bureaucrat promoted above his level of competence. The staff includes humane, skilled doctors as well as ones who are a disgrace to their profession, compassionate attendants as well as sadistic ones. At the bottom of the pyramid are the patients themselves, mostly helpless and often hopeless. Neglect and abuse are commonplace, and murder, rape, and suicide are not unusual. Even more shocking--because of its acceptance as policy--is ""treatment by bus ticket,"" i.e., getting rid of patients by declaring them ""stabilized"" and putting them on a bus to another state. Keeping watch on all this horror are only an accreditation committee that permits Bedloe to exist but keeps it on probation, and the patients' families--some of which, driven by the failure of the system, have organized themselves into a force for change. In the ugly world Bosco describes, they are the brightest ray of hope. A grim and gripping report.