Narrated by Francis Xavier Petrel, a man who relies on psychiatric medicine to quiet the voices in his head, this novel exhibits a profound understanding of the dark side of the human psyche. Twenty years have passed since Western State Hospital closed its doors and its remaining patients, including young Francis, were reintegrated into the outside world. Upon re-encountering the grounds of the institution, certain memories emerge from the recesses of Francis's agitated mind: events that led up to the hospital's closing and the unsolved murder of a young nurse whose mutilated body was found in a closet one night after lights out--the murderer was always suspected to be one of her own patients.