Norah Vincent's second book sets up a paradox for itself: How can anyone describe what it's really like to live in a mental institution, when the only people admitted are insane? In sheer degree of difficulty, voluntarily checking into psychiatric care is a step up for the woman who, for her first book, Self-Made Man, decided to live as a man for 18 months. But being committed turns out to be a step as false as her male persona.
After completing Self-Made Man, Vincent spiraled into depression and checked herself into a hospital—not her first trip, but one she gave special consideration after her sociological exploits. Curious about the effects different forms of treatment might have on her still-precarious mental health, Vincent decided to sign herself into three different care centers—an urban public hospital, a private clinic in a rural area, and an "alternative" facility she found online—in order to experience patient life as a reporter or observer could never do.
At the start of her experiment, Vincent admits to feeling well as she checks herself into Meriweather, the public hospital which proves the least comfortable, and the hardest for her to exit. But it isn't her status as a patient that jeopardizes her journalistic insight—in many instances, that only deepens her identification with the people around her. The problems stem from her snotty self-assurance that aspects of asylum treatment won't work on her; when she doesn't respond well to them, she congratulates herself for debunking the prevailing wisdom. Particularly at Meriweather, Vincent enters buoyed by this hypothesis, which becomes a self-fulfilling prophecy. She assumes that treatments won't help her, then relishes reporting that they didn't. The fact that the conditions she describes there are dismal is undermined by the pride she takes in rejecting medical advice on the grounds that everyone else around her is overmedicated. Her feigned shock when the doctor at St. Luke's (the private clinic) turns out to be a rational, helpful practitioner only confirms her belief that private-sector medical care is superior.
Vincent's smug self-exceptionalism ultimately interferes with her project and the chronicle of her own recovery: Nowhere does she truly account how this year spent ricocheting between different types of treatment may have helped or hindered her personally. Even as she details the feelings that pushed her into each institution, she's far too self-aware to offer insight to anyone else.