An occasonally gritty but terribly uneven glimpse into the day-to-day chaos of a slum-neighborhood mental health clinic--as presented in alternating chapters by psychiatrist Vince Bellino (clinic director) and social worker Pat Patterson (clinic coordinator), two narrators who, unfortunately, spend more time in longwinded, un-lifelike chatter than in on-the-job action. Vince is an earthy, old-fashioned type; Pat's a one-note feminist who has decided to leave the clinic to pursue her doctorate. So there's lots of marginally amusing battling (with sentiment underneath) between them while an unfocused assortment of cases--ranging uneasily in tone from all-out melodrama to black comedy--are argued about and (too infrequently) acted on. Two patients commit suicide (one is the clinic's ""mascot,"" a beautiful young woman suffering from quasi-retardation). One of the staff shrinks is revealed to be a raving paranoiac. A transsexual gets violent--and the cowardly staff must face its lack of team spirit. A patient nearly dies of a heart attack: the psychiatrists are helpless in the face of a medical crisis. Pat visits a neglectful mother in a hopeless situation. But all the incidents here only momentarily break up the long, often tediously jargon-y shoptalk. . . until the final episode, which, though wildly overextended, is almost worth waiting for: a paranoid patient is at home threatening to shoot her daughter; Pat must go over and control this hair-trigger situation (in the roughest part of the neighborhood), soon followed by Vince; and the ensuing mini-drama is effectively claustrophobic, often brutally funny. Otherwise, however, none of the cases receives enough dramatic attention to become involving. And though some of the eccentric background details are creepily convincing (a clinic nurse who's into astrology and dresses like the Dragon Lady), the supporting staff members are just cartoons; and the two lead characters lose credibility and sympathy with their incessant puerile wordplay: ""The best laid plans of mice and social workers often turn out to be bad lays. . . . You sound like Dorothy Johnson after she got her Masters."" Thoroughly unsuccessful as a novel, then--but there's enough authentically appalling atmosphere (Pietropinto wrote Beyond the Male Myth, Congress is an M.S.W.) and confrontation of mental-health-clinic issues to engage those with a pre-existing interest in the subject.