IS THERE NO PLACE ON EARTH FOR ME?

Thanks to this monumental piece of reportage, the name ""Sylvia Frumkin"" will probably become part of the psychiatric vocabulary--a short-hand description for the mental patient who spends years moving from home to hospital (and back), from treatment-center to halfway house (and back), from one program to another, from one anti-psychotic drug to another, from one level of illness to another. And, if Sheehan does a solid job of using this case-history to suggest the muddled state of today's public psychiatric care, she does even better when simply, impassively tagging along with Sylvia Frumkin of Queens, N.Y. (not her real name). We first meet Sylvia--""a heavy, ungainly young woman""--in June 1978, on the night when her latest stay in a halfway institution ends in another psychotic episode; we follow her back to Creedmoor Psychiatric Center, where she is admitted for the eighth time; we see her being astonishingly mis-diagnosed--as a manic-depressive--by a Chinese psychiatrist with limited English. (Sylvia is a ""textbook case of schizophrenia."") And, while Sheehan sketches in the Creedmoor scene--its history, its understaffing, its problems--we witness Sylvia's harrowing, violent, ghastly/funny behavior in the wards. . . complete with Joycean monologues built around brand/celebrity names. (A fellow patient calls her ""the greatest show on earth."") Sylvia escapes, returns (she's a voluntary patient), improves after being put on the proper drug at last, graduates to a typing-workshop, wrangles with her difficult parents, moves to a halfway hotel--and, in February 1979, runs off to rejoin born-again-Christian friends who believe that she is ""possessed by demons."" Wisely, then, at this shattering point, Sheehan flashes back: to study Sylvia's childhood (a monstrously rejecting mother); to consider the causes of schizophrenia (at least partly genetic); to follow the 15 years of treatment that started when Sylvia was a teenager--from talk-therapy to shock-treatments, from insulin-coma therapy (even then considered ""outmoded and dangerous"") to Thorazine & Co., from wards to halfway houses to cults. And then, finally, back to 1979--as Sylvia (led by ""voices"") is born-again again, tries living at home again (with painful results), goes back to Creedmoor again (often locked in the seclusion room). . . but, according to an afterword, is now improving remarkably. Admittedly, Sheehan is much better as reporter than she is as medico-sociologist: she crudely, misleadingly oversimplifies the controversy about schizophrenia's causes; she raises questions re the ""depopulation"" policy of mental institutions but fails to follow up on them. And the second half of the book--the recap of Sylvia's pre-1978 treatment--tends to drag. Nonetheless, this is for the most part a model of close-up journalism: totally convincing, unsentimental yet obviously compassionate, rigorously plain--and plainly overwhelming.