Unit #4, more or less equidistant from both the hospital parking lot and the steep ravine, is a repository for Alzheimer’s patients with VA pensions. #4’s residents wear jammies 24/7, the diapers underneath giving them a lumpy and toddlerish aspect. The patients are frequently visible at #4’s windows, in jammies, splayed and open-mouthed, sometimes shrieking, sometimes just mutely open-mouthed, splayed against the windows. They give everybody at Ennet House the howling fantods. One ancient retired Air Force nurse does nothing but scream ‘Help!’ for hours at a time from a second-story window. Since the Ennet House residents are drilled in a Boston-AA recovery program that places great emphasis on ‘Asking for Help,’ the retired shrieking Air Force nurse is the object of a certain grim amusement, sometimes. Not six weeks ago, a huge stolen HELP WANTED sign was found attached to #4’s siding right below the retired shrieking nurse’s window, and #4’s director was less than amused, and demanded that Pat Montesian determine and punish the Ennet House residents responsible, and Pat had delegated the investigation to Don Gately, and though Gately had a pretty good idea who the perps were he didn’t have the heart to really press and kick ass over something so much like what he’d done himself, when new and cynical, and so the whole thing pretty much blew over.

…

‘d been a confarmed bowl-splatterer for yars b’yond contin’. ‘d been barred from t’facilities at o’t’ troock stops twixt hair’n Nork for yars. T’wallpaper in de loo a t’ome hoong in t’ese carled sheets froom t’wall, ay till yo. But now woon dey . . . ay’ll remaember’t’always. T’were a wake to t’day ofter ay stewed oop for me ninety-day chip. Ay were tray moents sobber. Ay were thar on t’throne a’t’ome, you new. No’t’put too fain a point’on it, ay prodooced as er uzhal and … and ay war soo amazed as to no’t’belaven’ me yairs. ‘Twas a sone so wonefamiliar at t’first ay tought ay’d droped me wallet in t’loo, do you new. Ay tought ay’d droped me wallet in t’loo as Good is me wetness. So doan ay bend twixt m’knays and’ad a luke in t’dim o’t’loo, and codn’t belave me’yize. So gud paple ay do then ay drope to m’knays by t’loo an’t’ad a rail luke. A loaver’s luke, d’yo new. And friends t’were loavely past me pur poewers t’say. T’were a tard in t’loo. A rail tard. T’were farm an’ teppered an’ aiver so jaintly aitched. T’luked … constroocted instaid’ve sprayed. T’luked as ay fel’t’in me ‘eart Good ‘imsailf maint a tard t’luke. Me friends, this tard’o’mine practically had a poolse. Ay sted doan on m’knays and tanked me Har Par, which ay choose t’call me Har Par Good, an’ ay been tankin me Har Par own m’knays aiver sin, marnin and natetime an in t’loo’s’well, aiver sin.

…

It kind of enrages Lenz to like somebody. There would be no way to say any of this out loud to Green. As it gets past 2200h. and the meatloaf in his pocket’s baggie’s gotten dark and hard from disuse the pressure to exploit the c. 2216 interval for resolution builds to a terrible pitch, but Lenz still can’t yet quite get it up to ask Green to walk back some other way at least once in a while. How does he do it and still have Green know that he thinks he’s OK? But you don’t come right out there and let somebody hear you say you think they’re OK. When it’s a girl you’re just trying to X it’s a different thing, straightforwarder; but like for instance where do you look with your eyes when you tell somebody you like them and mean what you say? You can’t look right at them, because then what if their eyes look at you as your eyes look at them and you lock eyes as you’re saying it, and then there’d be some awful like voltage or energy there, hanging between you. But you can’t look away like you’re nervous, like some nervous kid asking for a date or something. You can’t go around giving that kind of thing of yourself away.

…

And a lot of the people in the different brick houses are damaged or askew and lean hard to one side or are twisted into themselves, through the windows, and he can feel his heart going out into the world through them, which is good for insomnia. A woman’s voice, calling for help without any real urgency — not like the screams that signify the Moms laughing or screaming at night — sounds from a darkened upper window. And across the little street that’s crammed with cars everybody has to move at 0000h. is Ennet’s House, where the Headmistress has a disability and had had a wheelchair ramp installed and has twice invited Mario in during the day for a Caffeine-Free Millennial Fizzy, and Mario likes the place: it’s crowded and noisy and none of the furniture has protective plastic wrap, but nobody notices anybody else or comments on a disability and the Headmistress is kind to the people and the people cry in fron tof each other. The inside of it smells like an ashtray, but Mario’s felt good both times in Ennet’s House because it’s very real; people are crying and making noise and getting less unhappy, and once he heard somebody say God with a straight face and nobody looked at them or looked down or smiled in any sort of way where you could tell they were worried inside.

…

I wish for my death but have not the courage to make actions to cause death. I twice try to roll over the side of a tall Swiss hill but cannot bring myself. I curse myself for cowardice and inutile. I roll about, hoping to be hit by a vehicle of someone else, but at the last minute rolling out of the path of vehicles on Autoroutes, for I am unable to will my death. The more pain in my self, the more I am inside the self and cannot will my death, I think. I feel I am chained in a cage of the self, from the pain. Unable to care or choose anything outside it. Unable to see anything or feel anything outside my pain.

…

Sometimes Gately would come out of a Demerol-nod and look at pale passive Pamela lying there sleeping beautifully and undergo a time-lapse clairvoyant thing where he could almost visibly watch her losing her looks through her twenties and her face starting to slide over off her skull onto the pillow she held like a stuffed toy, becoming a lounge-hag right before his eyes. The vision aroused more compassion than horror, which Gately never even considered might qualify him as a decent person.

…

And when he came back to, he was flat on his back on the beach in the freezing sand, and it was raining out of a low sky, and the tide was way out.