Lem's first novel, written in 1948, and suppressed in Poland--not too surprisingly, given the Eastern bloc's use of psychiatry as an instrument of the state: part autobiography, part mordant commentary, part metaphor. In the Poland of 1939, recently conquered by the Germans, young doctor Stefan, confused by what has happened to his family and his country, accepts a position in a mental hospital at the urging of his friend Staszek. At first the hospital seems a fitting refuge from the madness without, but soon Stefan begins to have doubts. The poet Sekulowski, not mad but another refugee, talks endlessly, provocatively, and sometimes fascinatingly, but never listens to anyone. Staszek falls insanely in love with the beautiful but aloof Dr. Nosilewska. Dr. Marglewski, contemptuous of his patients, is wholly preoccupied with his private study of the psychological quirks of past geniuses. The surgeon, Kauters, diagnoses a brain tumor in one patient but, enthralled by the clinical progress of the disease, delays the necessary operation: finally, assisted by an appalled Stefan, he kills the patient on the operating table. The nurses are negligent and frequently brutal. And partisans haunt the nearby woods, stockpiling weapons. Then the Germans arrive, bearing their own brand of psychiatry: all the patients are to be shot. Director Pajpak, the sole voice of compassion, tries to hide some of the recovered patients, but Sekulowski betrays them and in turn is dragged forth screaming by his executioners. Kauters trumpets his German ancestry and promptly switches sides. Stefan escapes with a suddenly passionate Nosilewska. Terrifying insights. Absorbing, also, to watch Leto outline many of the themes and ideas that he will later develop brilliantly in his science fiction. All in all, not for the fainthearted, even though Lem is not yet at full power here.